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Tseng SH, Cheng MA, Farmer E, Ferrall L, Kung YJ, Lam B, Lim L, Wu TC, Hung CF. Albumin and interferon-β fusion protein serves as an effective vaccine adjuvant to enhance antigen-specific CD8+ T cell-mediated antitumor immunity. J Immunother Cancer 2022; 10:e004342. [PMID: 35459734 PMCID: PMC9036441 DOI: 10.1136/jitc-2021-004342] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Type I interferons (IFN) promote dendritic cells maturation and subsequently enhance generation of antigen-specific CD8 +T cell for the control of tumor. Using type I interferons as an adjuvant to vaccination could prove to be a potent strategy. However, type I interferons have a short half-life. Albumin linked to a protein will prolong the half-life of the linked protein. METHODS In this study, we explored the fusion of albumin to IFNβ (Alb-IFNβ) for its functional activity both in vitro and in vivo. We determined the half-life of Alb-IFNβ following treatment in the serum, tumor, and tumor draining lymph nodes in both wild type and FcRn knockout mice. We characterized the ability of Alb-IFNβ to enhance antigen-specific CD8+ T cells using ovalbumin (OVA) or human papillomavirus (HPV) E7 long peptides. Next, we evaluated the therapeutic antitumor effect of coadministration of AlbIFNβ with antigenic peptides against HPVE7 expressing tumor and the treatment's ability to generate HPVE7 antigen specific CD8+ T cells. The contribution of the antitumor effect by lymphocytes was also examined by an antibody depletion experiment. The ability of Alb-IFNβ to serve as an adjuvant was tested using clinical grade therapeutic protein-based HPV vaccine, TACIN. RESULTS Alb-IFNβ retains biological function and does not alter the biological activity of IFNβ. In addition, Alb-IFNβ extends half-life of IFNβ in serum, lymph nodes and tumor. The coadministration of Alb-IFNβ with OVA or HPVE7 antigenic peptides enhances antigen-specific CD8 +T cell immunity, and in a TC-1 tumor model results in a significant therapeutic antitumor effect. We found that CD8 +T cells and dendritic cells, but not CD4 +T cells, are important for the observed antitumor therapeutic effect mediated by Alb-IFNβ. Finally, Alb-IFNβ served as a potent adjuvant for TA-CIN for the treatment of HPV antigen expressing tumors. CONCLUSIONS Overall, Alb-IFNβ serves as a potent adjuvant for enhancement of strong antigen-specific CD8 +T cell antitumor immunity, reduction of tumor burden, and increase in overall survival. Alb-IFNβ potentially can serve as an innovative adjuvant for the development of vaccines for the control of infectious disease and cancer.
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Affiliation(s)
- Ssu-Hsueh Tseng
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Max A Cheng
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily Farmer
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Louise Ferrall
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yu Jui Kung
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Brandon Lam
- Stanford Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Ling Lim
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - T-C Wu
- Pathology, Oncology, Obstetrics and Gynecology, Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chien-Fu Hung
- Pathology, Johns Hopkins Univ, Baltimore, Maryland, USA
- Oncology, Johns Hopkins University, Baltimore, MD, USA
- Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD, USA
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2
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Farmer E, Cheng MA, Hung CF, Wu TC. Vaccination Strategies for the Control and Treatment of HPV Infection and HPV-Associated Cancer. Recent Results Cancer Res 2021; 217:157-195. [PMID: 33200366 DOI: 10.1007/978-3-030-57362-1_8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection, currently affecting close to 80 million Americans. Importantly, HPV infection is recognized as the etiologic factor for numerous cancers, including cervical, vulval, vaginal, penile, anal, and a subset of oropharyngeal cancers. The prevalence of HPV infection and its associated diseases are a significant problem, affecting millions of individuals worldwide. Likewise, the incidence of HPV infection poses a significant burden on individuals and the broader healthcare system. Between 2011 and 2015, there were an estimated 42,700 new cases of HPV-associated cancers each year in the United States alone. Similarly, the global burden of HPV is high, with around 630,000 new cases of HPV-associated cancer occurring each year. In the last decade, a total of three preventive major capsid protein (L1) virus-like particle-based HPV vaccines have been licensed and brought to market as a means to prevent the spread of HPV infection. These prophylactic vaccines have been demonstrated to be safe and efficacious in preventing HPV infection. The most recent iteration of the preventive HPV vaccine, a nanovalent, L1-VLP vaccine, protects against a total of nine HPV types (seven high-risk and two low-risk HPV types), including the high-risk types HPV16 and HPV18, which are responsible for causing the majority of HPV-associated cancers. Although current prophylactic HPV vaccines have demonstrated huge success in preventing infection, existing barriers to vaccine acquisition have limited their widespread use, especially in low- and middle-income countries, where the burden of HPV-associated diseases is highest. Prophylactic vaccines are unable to provide protection to individuals with existing HPV infections or HPV-associated diseases. Instead, therapeutic HPV vaccines capable of generating T cell-mediated immunity against HPV infection and associated diseases are needed to ameliorate the burden of disease in individuals with existing HPV infection. To generate a cell-mediated immune response against HPV, most therapeutic vaccines target HPV oncoproteins E6 and E7. Several types of therapeutic HPV vaccine candidates have been developed including live-vector, protein, peptide, dendritic cell, and DNA-based vaccines. This chapter will review the commercially available prophylactic HPV vaccines and discuss the recent progress in the development of therapeutic HPV vaccines.
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Affiliation(s)
- Emily Farmer
- Department of Pathology, The Johns Hopkins School of Medicine, Cancer Research Building II, 1550 Orleans Street, Baltimore, MD, 21287, USA
| | - Max A Cheng
- Department of Pathology, The Johns Hopkins School of Medicine, Cancer Research Building II, 1550 Orleans Street, Baltimore, MD, 21287, USA
| | - Chien-Fu Hung
- Department of Pathology, The Johns Hopkins School of Medicine, Cancer Research Building II, 1550 Orleans Street, Baltimore, MD, 21287, USA.,Department of Oncology, The Johns Hopkins School of Medicine, Cancer Research Building II, 1550 Orleans Street, Baltimore, MD, 21287, USA
| | - T-C Wu
- Department of Pathology, The Johns Hopkins School of Medicine, Cancer Research Building II, 1550 Orleans Street, Baltimore, MD, 21287, USA. .,Department of Oncology, The Johns Hopkins School of Medicine, Cancer Research Building II, 1550 Orleans Street, Baltimore, MD, 21287, USA. .,Department of Obstetrics and Gynecology, The Johns Hopkins School of Medicine, Cancer Research Building II, 1550 Orleans Street, Baltimore, MD, 21287, USA. .,Department of Pathology, Oncology, Obstetrics and Gynecology, and Molecular Microbiology and Immunology, The Johns Hopkins Medical Institutions, Cancer Research Building II, Room 309, 1550 Orleans Street, Baltimore, MD, 21287, USA.
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3
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Li X, Farmer E, Kung R, Li A, Bodley J, Carr L, Gagnon L, Herschorn S, Lee P. Stress Urinary Incontinence Surgery Outcomes: A 6-Year Review. J Minim Invasive Gynecol 2020. [DOI: 10.1016/j.jmig.2020.08.185] [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: 11/25/2022]
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4
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Tseng SH, Park ST, Lam B, Tsai YC, Cheng MA, Farmer E, Xing D, Hung CF. Novel, genetically induced mouse model that recapitulates the histological morphology and immunosuppressive tumor microenvironment of metastatic peritoneal carcinomatosis. J Immunother Cancer 2020; 8:e000480. [PMID: 32111730 PMCID: PMC7057437 DOI: 10.1136/jitc-2019-000480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Accepted: 01/22/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Peritoneal carcinomatosis is a hallmark of advanced peritoneal tumor progression, particularly for tubal/ovarian high-grade serous carcinomas (HGSCs). Patients with peritoneal carcinomatosis have poor survival rates and are difficult to treat clinically due to widespread tumor dissemination in the peritoneal cavity. METHODS We developed a clinically relevant, genetically induced, peritoneal carcinomatosis model that recapitulates the histological morphology and immunosuppressive state of the tumor microenvironment of metastatic peritoneal HGSCs by intraperitoneally injecting shp53, AKT, c-Myc, luciferase and sleeping beauty transposase, followed by electroporation (EP) in the peritoneal cavity of immunocompetent mice (intraperitoneal (IP)/EP mice). RESULTS Similar to the spread of human ovarian cancers, IP/EP mice displayed multiple tumor nodules attached to the surface of the abdomen. Histopathological analysis indicated that these tumors were epithelial in origin. These IP/EP mice also displayed a loss of CD3+ T cell infiltration in tumors, highly expressed inhibitory checkpoint molecules in tumor-infiltrating and global CD4+ and CD8+ T cells, and increased levels of transforming growth factor-β in the ascites, all of which contribute to the promotion of tumor growth. CONCLUSIONS Overall, our tumor model recapitulates clinical peritoneal HGSC metastasis, which makes it ideal for preclinical drug screening, testing of immunotherapy-based therapeutics and studying of the tumor biology of peritoneal carcinomatosis.
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Affiliation(s)
- Ssu-Hsueh Tseng
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sung-Taek Park
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Brandon Lam
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ya-Chea Tsai
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Max A Cheng
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Emily Farmer
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Deyin Xing
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chien-Fu Hung
- Pathology, Johns Hopkins University, Baltimore, Maryland, USA
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5
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Kang TH, Mao CP, Kim YS, Kim TW, Yang A, Lam B, Tseng SH, Farmer E, Park YM, Hung CF. TLR9 acts as a sensor for tumor-released DNA to modulate anti-tumor immunity after chemotherapy. J Immunother Cancer 2019; 7:260. [PMID: 31619293 PMCID: PMC6794732 DOI: 10.1186/s40425-019-0738-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 07/12/2019] [Accepted: 09/11/2019] [Indexed: 12/19/2022] Open
Abstract
The tumor microenvironment exists in a state of dynamic equilibrium, in which a balance of agonist and antagonist signals govern the anti-tumor immune responses. Previous studies have shown that chemotherapy could shift this balance in favor of agonistic signals for the anti-tumor immune responses mounted by CD8+ cytotoxic T lymphocytes (CTL), providing sufficiently high antigen density within the tumor. We undertook the current study to characterize the anti-tumor immune response following chemotherapy and its underlying mechanisms. We show that this 'adjuvant effect' of chemotherapy is, at least partially, mediated by the release of tumor DNA and acts through the Toll-like receptor 9 (TLR9) pathway. We found that tumor-released DNA causes accumulation, antigen uptake, and maturation of dendritic cells (DCs) in the tumor in a TLR9-dependent manner. These DCs subsequently migrate into the draining lymph nodes and prime tumor-specific CTLs. Our study provides novel insights to the molecular and cellular mechanisms by which chemotherapy converts the tumor microenvironment into a site permissive for the activation of a potent tumor-specific adaptive immune response.
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Affiliation(s)
- Tae Heung Kang
- Department of Immunology, College of Medicine, Konkuk University, 268, Chungju, South Korea
| | - Chih-Ping Mao
- MD-PhD Program, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
- Graduate Program in Immunology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Young Seob Kim
- Department of Immunology, College of Medicine, Konkuk University, 268, Chungju, South Korea
| | - Tae Woo Kim
- Division of Infection and Immunology, Graduate School of Medicine, Korea University, Seoul, South Korea
| | - Andrew Yang
- Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
- MD-PhD Program, Baylor College of Medicine, Houston, TX, USA
| | - Brandon Lam
- Graduate Program in Immunology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
- Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Ssu-Hsueh Tseng
- Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Emily Farmer
- Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Yeong-Min Park
- Department of Immunology, College of Medicine, Konkuk University, 268, Chungju, South Korea.
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
- Department of Oncology, Johns Hopkins University, Baltimore, MD, USA.
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6
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Xing D, Liu Y, Park HJ, Baek I, Tran H, Cheang G, Novo J, Dillon J, Matoso A, Farmer E, Cheng MA, Tsai YC, Lombardo K, Conner MG, Vang R, Hung CF, Wu TC, Song W. Recurrent genetic alterations and biomarker expression in primary and metastatic squamous cell carcinomas of the vulva. Hum Pathol 2019; 92:67-80. [PMID: 31437519 DOI: 10.1016/j.humpath.2019.08.003] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/30/2019] [Accepted: 08/07/2019] [Indexed: 12/26/2022]
Abstract
Using a comprehensive next-generation sequencing pipeline (143 genes), Oncomine Comprehensive v.2, we analyzed genetic alterations on a set of vulvar squamous cell carcinomas (SCCs) with emphasis on the primary and metastatic samples from the same patient, to identify amenable therapeutic targets. Clinicopathologic features were reported and genomic DNA was extracted from 42 paraffin-embedded tumor tissues of 32 cases. PD-L1 expression was evaluated in 20 tumor tissues (10 cases with paired primary and metastatic tumors). Fifteen (88%) of 17 successfully analyzed HPV-unrelated SCCs harbored TP53 mutations. 2 different TP53 mutations had been detected in the same tumor in 4 of 15 cases. Other recurrent genetic alterations in this group of tumors included CDKN2a mutations (41%), HRAS mutations (12%), NOTCH1 mutations (12%) and BIRC3 (11q22.1-22.2) amplification (12%). Six HPV-related tumors harbored PIK3CA, BAP1, PTEN, KDR, CTNNB1, and BRCA2 mutations, of which, one case also contained TP53 mutation. Six cases showed identical mutations in paired primary site and distant metastatic location and four cases displayed different mutational profiles. PD-L1 expression was seen in 6 of 10 primary tumors and all 6 paired cases showed discordant PD-L1 expression in the primary and metastatic sites. Our results further confirmed the genetic alterations that are amenable to targeted therapy, offering the potential for individualized management strategies for the treatment of these aggressive tumors with different etiology. Discordant PD-L1 expression in the primary and metastatic vulvar SCCs highlights the importance of evaluation of PD-L1 expression in different locations to avoid false negative information provided for immunotherapy.
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Affiliation(s)
- Deyin Xing
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD; Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD.
| | - Yuehua Liu
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Hyeon Jin Park
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York 10065, NY
| | - Inji Baek
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York 10065, NY
| | - Hung Tran
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York 10065, NY
| | - Gloria Cheang
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York 10065, NY
| | - Jorge Novo
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Jessica Dillon
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Andres Matoso
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Emily Farmer
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Max A Cheng
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Ya-Chea Tsai
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Kara Lombardo
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Michael G Conner
- Department of Pathology, The University of Alabama at Birmingham, Birmingham 35233, AL
| | - Russell Vang
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD; Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Chien-Fu Hung
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD; Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Tzyy-Choou Wu
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD; Department of Oncology, The Johns Hopkins Medical Institutions, Baltimore 21231, MD; Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore 21231, MD
| | - Wei Song
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York 10065, NY.
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7
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Lee SY, Oh JY, Kang TH, Shin HS, Cheng MA, Farmer E, Wu TC, Hung CF. Endoplasmic reticulum stress enhances the antigen-specific T cell immune responses and therapeutic antitumor effects generated by therapeutic HPV vaccines. J Biomed Sci 2019; 26:41. [PMID: 31133013 PMCID: PMC6535840 DOI: 10.1186/s12929-019-0536-7] [Citation(s) in RCA: 5] [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: 11/02/2018] [Accepted: 05/07/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Endoplasmic reticulum stress has a profound effect on cancer cell proliferation and survival, and also has the capacity to activate cells of the adaptive immune system. Multimodal treatment methods that utilize and combine conventional cancer therapies with antigen-specific immunotherapies have emerged as promising approaches for the treatment and control of cancer. However, it is not well known whether endoplasmic reticulum stress-inducing agents can influence the efficacy of tumor antigen-targeting vaccines. METHODS In the past, we developed a therapeutic human papillomavirus (HPV) DNA vaccine that encodes for calreticulin (CRT) linked to the HPV16 E7 antigen (CRT/E7). In this study, we utilize the CRT/E7 and further encode for an endoplasmic reticulum (ER) stress-inducing agent, 3-bromopyruvate (3-BrPA), in a preclinical model, by harnessing its potential to enhance HPV16 E7-specific CD8+ T cell immune responses as well as antitumor effects against E7-expressing tumors (TC-1 cells). E7-specific CD8+ T cells were added to evaluate the cytotoxicity of luciferase-expressing TC-1 tumor cells treated with 3-BrPA in vitro, as measured with an IVIS Luminescence Imaging System. We also determined the levels of ER stress markers in 3-BrPA-treated TC-1 cells. TC-1 tumor-bearing mice were treated with either 3-BrPA (10 mg/kg, intraperitoneal injection) and/or CRT/E7 DNA vaccine (30 μg/mouse). RESULTS Treatment of E7-expressing TC-1 tumor cells with 3-BrPA induced significantly higher in vitro cytotoxicity and resulted in upregulation of endoplasmic reticulum stress markers (CHOP and GRP78). More importantly, combination treatment of 3-BrPA and the CRT/E7 DNA vaccine led to improved antigen-specific CD8+ T cell immune responses as well as therapeutic antitumor effects in TC-1 tumor-bearing mice. CONCLUSIONS Our data indicate that 3-BrPA can enhance therapeutic HPV vaccine potency in generating improved antigen-specific immune responses and antitumor effects. These findings have important implications for future clinical translation and provide novel strategies for the treatment of HPV-associated diseases.
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Affiliation(s)
- Sung Yong Lee
- Department of Respiratory & Critical Care Medicine, Korea University Medical Center, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Jee Youn Oh
- Department of Respiratory & Critical Care Medicine, Korea University Medical Center, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Tae Heung Kang
- Department of Immunology, Konkuk University Medical Center, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, South Korea
| | - Hyun Seock Shin
- Department of Pathology, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Max A Cheng
- Department of Pathology, Johns Hopkins Medical Institutes, 1550 Orleans Street, Cancer Research Building II, Baltimore, MD, 21287, USA.,Department of Obstetrics & Gynecology, Johns Hopkins Medical Institutes, 1550 Orleans Street, Cancer Research Building II, Baltimore, MD, 21287, USA
| | - Emily Farmer
- Department of Pathology, Johns Hopkins Medical Institutes, 1550 Orleans Street, Cancer Research Building II, Baltimore, MD, 21287, USA.,Department of Obstetrics & Gynecology, Johns Hopkins Medical Institutes, 1550 Orleans Street, Cancer Research Building II, Baltimore, MD, 21287, USA
| | - T-C Wu
- Department of Pathology, Johns Hopkins Medical Institutes, 1550 Orleans Street, Cancer Research Building II, Baltimore, MD, 21287, USA.,Department of Obstetrics & Gynecology, Johns Hopkins Medical Institutes, 1550 Orleans Street, Cancer Research Building II, Baltimore, MD, 21287, USA.,Department of Molecular Microbiology & Immunology, Johns Hopkins Medical Institutes, 1550 Orleans Street, Cancer Research Building II, Baltimore, MD, 21287, USA.,Department of Oncology, Johns Hopkins University School of Medicine, CRB II Room 307, 1550 Orleans Street, Baltimore, MD, 21287, USA
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins Medical Institutes, 1550 Orleans Street, Cancer Research Building II, Baltimore, MD, 21287, USA. .,Department of Oncology, Johns Hopkins University School of Medicine, CRB II Room 307, 1550 Orleans Street, Baltimore, MD, 21287, USA.
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8
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Lee SM, Bond N, Callaway C, Clark B, Farmer E, Mallard M, Jang SS. Dissipative particle dynamics simulation of multicompartment micelle nanoreactor with channel for reactants. RSC Adv 2018; 8:37866-37871. [PMID: 35558591 PMCID: PMC9089328 DOI: 10.1039/c8ra07023g] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 08/22/2018] [Accepted: 11/06/2018] [Indexed: 11/21/2022] Open
Abstract
The structural variation of multicompartment micelles is investigated using a dissipative particle dynamics simulation method for nano-reactor application. It turns out that well-defined multicompartment micelles with channel structures can be generated through the self-assembly of triblock copolymers consisting of a hydrophilic (A), a lipophilic (B), and a fluorophobic (C) block arranged in a B–A–C sequence: The corona and core are formed by the hydrophilic A block and the fluorophilic C block, respectively while the channel between the aqueous phase and core is formed by the lipophilic B block and the core. By performing a set of simulations, it is confirmed that channel size can be controlled as a function of the block length ratios between blocks A and B. Furthermore, it is also confirmed that the reactants pass through such channels to reach the micelle core by analyzing the pair correlation functions. By monitoring the change of the number of reactants in the multicompartment micelle, it is revealed that the diffusion of reactants into the core is slowed down as the concentration gradient is decreased. This work provides mesoscopic insight for the formation of multicompartment micelles and transport of reactants for use in the design of micelles as nanoreactors. The structural variation of multicompartment micelles is investigated using a dissipative particle dynamics simulation method for nano-reactor application.![]()
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Affiliation(s)
- Seung Min Lee
- Computational NanoBio Technology Laboratory, School of Materials Science and Engineering, Georgia Institute of Technology 771 Ferst Drive NW Atlanta GA 30332-0245 USA
| | - Nicholas Bond
- Computational NanoBio Technology Laboratory, School of Materials Science and Engineering, Georgia Institute of Technology 771 Ferst Drive NW Atlanta GA 30332-0245 USA
| | - Connor Callaway
- Computational NanoBio Technology Laboratory, School of Materials Science and Engineering, Georgia Institute of Technology 771 Ferst Drive NW Atlanta GA 30332-0245 USA
| | - Benjamin Clark
- Computational NanoBio Technology Laboratory, School of Materials Science and Engineering, Georgia Institute of Technology 771 Ferst Drive NW Atlanta GA 30332-0245 USA
| | - Emily Farmer
- Computational NanoBio Technology Laboratory, School of Materials Science and Engineering, Georgia Institute of Technology 771 Ferst Drive NW Atlanta GA 30332-0245 USA
| | - MacKensie Mallard
- Computational NanoBio Technology Laboratory, School of Materials Science and Engineering, Georgia Institute of Technology 771 Ferst Drive NW Atlanta GA 30332-0245 USA
| | - Seung Soon Jang
- Computational NanoBio Technology Laboratory, School of Materials Science and Engineering, Georgia Institute of Technology 771 Ferst Drive NW Atlanta GA 30332-0245 USA .,Institute for Electronics and Nanotechnology, Georgia Institute of Technology Atlanta GA USA.,Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology Atlanta GA USA.,Strategic Energy Institute, Georgia Institute of Technology Atlanta GA 30332 USA
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9
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Qiu J, Peng S, Ma Y, Yang A, Farmer E, Cheng MA, Roden RBS, Wu TC, Chang YN, Hung CF. Epithelial boost enhances antigen expression by vaccinia virus for the generation of potent CD8+ T cell-mediated antitumor immunity following DNA priming vaccination. Virology 2018; 525:205-215. [PMID: 30296681 DOI: 10.1016/j.virol.2018.09.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 05/10/2018] [Revised: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 11/19/2022]
Abstract
While both pNGVL4a-Sig/E7(detox)/HSP70 DNA vaccine and TA-HPV recombinant vaccinia viral vector-based vaccines have elicited HPV-specific CD8+ T cell responses in HPV16/E7-expressing tumor models, and been used as prime-boost regimen to enhance HPV-specific immune responses in humans (NCT00788164), the optimal route of administration for TA-HPV remains unclear. In a preclinical model, we examined the immunogenicity of priming with intramuscular pNGVL4a-Sig/E7(detox)/HSP70 followed by TA-HPV boost through different administration routes. We observed that priming twice with a pNGVL4a-Sig/E7(detox)/HSP70 followed by a single TA-HPV immunization boost through skin scarification generated the strongest antigen-specific CD8+ T cell response in C57BL/6 mice. These data translate to tumor control and prolonged survival of treated mice. Our results provide rationale for future clinical testing of intramuscular pNGVL4a-Sig/E7(detox)/HSP70 DNA vaccine prime, TA-HPV vaccine skin scarification boost immunization regimen for the control of HPV-associated diseases.
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Affiliation(s)
- Jin Qiu
- Department of Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Shiwen Peng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Ying Ma
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States; Department of Gynecology and Obstetrics, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong province, China
| | - Andrew Yang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Emily Farmer
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Max A Cheng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Richard B S Roden
- Department of Pathology, Department of Gynecology and Obstetrics, and Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - T-C Wu
- Departments of Pathology, Department of Obstetrics and Gynecology, Department of Molecular Microbiology and Immunology, and Department of Oncology. Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Yung-Nien Chang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States; Papivax Biotech Inc., Taipei, Taiwan, ROC
| | - Chien-Fu Hung
- Department of Pathology and Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
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10
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Kim YS, Park HJ, Park JH, Hong EJ, Jang GY, Jung ID, Han HD, Lee SH, Vo MC, Lee JJ, Yang A, Farmer E, Wu TC, Kang TH, Park YM. A novel function of API5 (apoptosis inhibitor 5), TLR4-dependent activation of antigen presenting cells. Oncoimmunology 2018; 7:e1472187. [PMID: 30288341 DOI: 10.1080/2162402x.2018.1472187] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 10/06/2017] [Revised: 04/10/2018] [Accepted: 04/30/2018] [Indexed: 12/20/2022] Open
Abstract
Dendritic cell (DC)-based vaccines are recognized as a promising immunotherapeutic strategy against cancer. Various adjuvants are often incorporated to enhance the modest immunogenicity of DC vaccines. More specifically, many of the commonly used adjuvants are derived from bacteria. In the current study, we evaluate the use of apoptosis inhibitor 5 (API5), a damage-associated molecular pattern expressed by many human cancer cells, as a novel DC vaccine adjuvant. We showed that API5 can prompt activation and maturation of DCs and activate NFkB by stimulating the Toll-like receptor signaling pathway. We also demonstrated that vaccination with API5-treated DCs pulsed with OVA, E7, or AH1-A5 peptides led to the generation of OVA, E7, or AH1-A5-specific CD8 + T cells and memory T cells, which is associated with long term tumor protection and antitumor effects in mice, against EG.7, TC-1, and CT26 tumors. Additionally, we determined that API5-mediated DC activation and immune stimulation are dependent on TLR4. Lastly, we showed that the API5 protein sequence fragment that is proximal to its leucine zipper motif is responsible for the adjuvant effects exerted by API5. Our data provide evidence that support the use of API5 as a promising adjuvant for DC-based therapies, which can be applied in combination with other cancer therapies. Most notably, our results further support the continued investigation of human-based adjuvants.
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Affiliation(s)
- Young Seob Kim
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - Hyun Jin Park
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - Jung Hwa Park
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - Eun Ji Hong
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - Gun-Young Jang
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - In Duk Jung
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - Hee Dong Han
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - Seung-Hyun Lee
- Department of Microbiology, KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - Manh-Cuong Vo
- Hematology-Oncology, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea
| | - Je-Jung Lee
- Hematology-Oncology, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea
| | - Andrew Yang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Emily Farmer
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - T-C Wu
- Department of Pathology, Department of Obstetrics and Gynecology, Department of Molecular Microbiology and Immunology, and Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Tae Heung Kang
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
| | - Yeong-Min Park
- Department of Immunology KU Open Innovation Center, School of Medicine, Konkuk University, Chungju, South Korea
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11
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Qiu J, Peng S, Yang A, Ma Y, Han L, Cheng MA, Farmer E, Hung CF, Wu TC. Intramuscular vaccination targeting mucosal tumor draining lymph node enhances integrins-mediated CD8+ T cell infiltration to control mucosal tumor growth. Oncoimmunology 2018; 7:e1463946. [PMID: 30221059 PMCID: PMC6136882 DOI: 10.1080/2162402x.2018.1463946] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 10/16/2022] Open
Abstract
Purpose: Mucosal immunization is suggested to be crucial for controlling tumors in the mucosal region; however, therapeutic DNA vaccination with electroporation in various mucosal sites has yet to become clinically adaptable. Since tumor-draining lymph nodes (tdLNs) have been suggested as immune-educated sites that can be utilized to mount a potent antitumor immune response, we examined whether intramuscular DNA vaccination with electroporation at sites that target the mucosal tdLNs could elicit mucosal immune response to restrict tumor growth. Experimental Design: The efficacy and mechanism of intramuscular administration of a therapeutic DNA vaccine with electroporation at different sites was examined by lymphocyte analysis, tumor growth, mouse survival, as well as integrin expression, in mice bearing orthotopic HPV16 E6/E7+ syngeneic TC-1 tumors in various mucosal areas. Results: While provoking comparable systemic CD8+ T cell responses, intramuscular hind leg vaccination generated stronger responses in cervicovaginal-draining LNs to control cervicovaginal tumors, whereas intramuscular front leg vaccination generated stronger responses in oral-draining LNs to control buccal tumors. Surgical removal of tdLNs abolished the antitumor effects of therapeutic vaccination. Mucosal-tdLN-targeted intramuscular vaccination induced the expression of mucosal-homing integrins LPAM-1 and CD49a by tumor-specific CD8+ T cells in the tdLNs. Inhibition of these integrins abolished the therapeutic effects of vaccination and the infiltration of tumor-specific CD8+ T cells into mucosal tumors. Conclusions: Our findings demonstrate that tumor draining lymph nodes targeted intramuscular immunization can effectively control mucosal tumors, which represents a readily adaptable strategy for treating mucosal cancers in humans.
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Affiliation(s)
- Jin Qiu
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Shiwen Peng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Andrew Yang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Ying Ma
- Department of Gynecology and Obstetrics, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong province, China; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Liping Han
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Max A. Cheng
- Department of Pathology; Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Emily Farmer
- Department of Pathology; Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Chien-Fu Hung
- Department of Pathology and Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - T.-C. Wu
- Departments of Pathology, Department of Obstetrics and Gynecology, Department of Molecular Microbiology and Immunology, and Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, UnitedStates
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12
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Abstract
Human papillomavirus (HPV) has long been recognized as the causative agent of cervical cancer. High-risk HPV types 16 and 18 alone are responsible for over 70% of all cases of cervical cancers. More recently, HPV has been identified as an etiological factor for several other forms of cancers, including oropharyngeal, anogenital, and skin. Thus, the association of HPV with these malignancies creates an opportunity to control these HPV lesions and HPV-associated malignancies through immunization. Strategies to prevent or to therapeutically treat HPV infections have been developed and are still pushing innovative boundaries. Currently, commercial prophylactic HPV vaccines are widely available, but they are not able to control established infections or lesions. As a result, there is an urgent need for the development of therapeutic HPV vaccines, to treat existing infections, and to prevent the development of HPV-associated cancers. In particular, DNA vaccination has emerged as a promising form of therapeutic HPV vaccine. DNA vaccines have great potential for the treatment of HPV infections and HPV-associated cancers due to their safety, stability, simplicity of manufacturability, and ability to induce antigen-specific immunity. This review focuses on the current state of therapeutic HPV DNA vaccines, including results from recent and ongoing clinical trials, and outlines different strategies that have been employed to improve their potencies. The continued progress and improvements made in therapeutic HPV DNA vaccine development holds great potential for innovative ways to effectively treat HPV infections and HPV-associated diseases.
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Affiliation(s)
- Max A Cheng
- 1 Department of Pathology, Johns Hopkins Medical Institutions , Baltimore, Maryland
| | - Emily Farmer
- 1 Department of Pathology, Johns Hopkins Medical Institutions , Baltimore, Maryland
| | - Claire Huang
- 1 Department of Pathology, Johns Hopkins Medical Institutions , Baltimore, Maryland
| | - John Lin
- 1 Department of Pathology, Johns Hopkins Medical Institutions , Baltimore, Maryland
| | - Chien-Fu Hung
- 1 Department of Pathology, Johns Hopkins Medical Institutions , Baltimore, Maryland.,2 Department of Oncology, Johns Hopkins Medical Institutions , Baltimore, Maryland
| | - T-C Wu
- 1 Department of Pathology, Johns Hopkins Medical Institutions , Baltimore, Maryland.,2 Department of Oncology, Johns Hopkins Medical Institutions , Baltimore, Maryland.,3 Department of Obstetrics and Gynecology, Johns Hopkins Medical Institutions , Baltimore, Maryland.,4 Department of Molecular Microbiology and Immunology, Johns Hopkins Medical Institutions , Baltimore, Maryland
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13
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Campbell N, Milligan W, Iliopoulos J, Farmer E. Keep off the grass: Cannabis abuse and vasculitis in a teenager. Sonography 2018. [DOI: 10.1002/sono.12134] [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: 11/10/2022]
Affiliation(s)
- N. Campbell
- Liverpool Vascular Laboratory; NSW Australia
| | - W. Milligan
- Liverpool Vascular Laboratory; NSW Australia
| | | | - E. Farmer
- Liverpool Vascular Laboratory; NSW Australia
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14
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Lin YH, Yang MC, Tseng SH, Jiang R, Yang A, Farmer E, Peng S, Henkle T, Chang YN, Hung CF, Wu TC. Integration of Oncogenes via Sleeping Beauty as a Mouse Model of HPV16 + Oral Tumors and Immunologic Control. Cancer Immunol Res 2018; 6:305-319. [PMID: 29362220 DOI: 10.1158/2326-6066.cir-16-0358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 08/24/2017] [Accepted: 01/16/2018] [Indexed: 12/19/2022]
Abstract
Human papillomavirus type 16 (HPV16) is the etiologic factor for cervical cancer and a subset of oropharyngeal cancers. Although several prophylactic HPV vaccines are available, no effective therapeutic strategies to control active HPV diseases exist. Tumor implantation models are traditionally used to study HPV-associated buccal tumors. However, they fail to address precancerous phases of disease progression and display tumor microenvironments distinct from those observed in patients. Previously, K14-E6/E7 transgenic mouse models have been used to generate spontaneous tumors. However, the rate of tumor formation is inconsistent, and the host often develops immune tolerance to the viral oncoproteins. We developed a preclinical, spontaneous, HPV16+ buccal tumor model using submucosal injection of oncogenic plasmids expressing HPV16-E6/E7, NRas G12V , luciferase, and sleeping beauty (SB) transposase, followed by electroporation in the buccal mucosa. We evaluated responses to immunization with a pNGVL4a-CRT/E7(detox) therapeutic HPV DNA vaccine and tumor cell migration to distant locations. Mice transfected with plasmids encoding HPV16-E6/E7, NRas G12V , luciferase, and SB transposase developed tumors within 3 weeks. We also found transient anti-CD3 administration is required to generate tumors in immunocompetent mice. Bioluminescence signals from luciferase correlated strongly with tumor growth, and tumors expressed HPV16-associated markers. We showed that pNGVL4a-CRT/E7(detox) administration resulted in antitumor immunity in tumor-bearing mice. Lastly, we demonstrated that the generated tumor could migrate to tumor-draining lymph nodes. Our model provides an efficient method to induce spontaneous HPV+ tumor formation, which can be used to identify effective therapeutic interventions, analyze tumor migration, and conduct tumor biology research. Cancer Immunol Res; 6(3); 305-19. ©2018 AACR.
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Affiliation(s)
- Yi-Hsin Lin
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Department of Obstetrics and Gynecology, Tri-Service General Hospital, Taipei City, Taiwan.,Department of Obstetrics and Gynecology, Tri-Service General Hospital, Penghu Branch, Taiwan
| | - Ming-Chieh Yang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung. Taiwan
| | - Ssu-Hsueh Tseng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Rosie Jiang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Andrew Yang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Emily Farmer
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Shiwen Peng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Talia Henkle
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Yung-Nien Chang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland. .,Departments of Oncology, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - T-C Wu
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland. .,Departments of Oncology, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, Maryland.,Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, Maryland
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15
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Yang A, Peng S, Farmer E, Zeng Q, Cheng MA, Pang X, Wu TC, Hung CF. Enhancing antitumor immunogenicity of HPV16-E7 DNA vaccine by fusing DNA encoding E7-antigenic peptide to DNA encoding capsid protein L1 of Bovine papillomavirus. Cell Biosci 2017; 7:46. [PMID: 28852471 PMCID: PMC5569540 DOI: 10.1186/s13578-017-0171-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 06/21/2017] [Accepted: 08/12/2017] [Indexed: 01/10/2023] Open
Abstract
Background Human papillomavirus (HPV) has been identified as the primary etiologic factor of cervical cancer, the fourth leading cause of cancer death in females worldwide. We have previously shown that coadministration of DNA encoding L1 capsid protein of Bovine papillomavirus (BPV) can enhance the antigen-specific immune response elicited by a therapeutic HPV16-E7 DNA vaccination. In this study, we sought to generate and evaluate the immunogenicity of a therapeutic HPV16-E7 DNA vaccine that encodes the fusion construct of HPV16-E7 and BPV-L1. Results We generated a therapeutic HPV16-E7 DNA vaccine construct, pcDNA3-BPVL1-E7(49-57), encoding the fusion sequence of full-length BPVL1 protein and a murine E7 antigenic epitope, aa49-57. Transfecting 293-Db cells with pcDNA3-BPVL1-E7(49-57) demonstrated that this DNA construct can effectively lead to the presentation of E7 epitope for the activation of E7-specific CD8+ T cells in vitro. Intramuscular vaccination of pcDNA3-BPVL1-E7(49-57) with electroporation generated a stronger E7-specific CD8+ T cell-mediated immune response than coadministration of pcDNA3-BPVL1 and pcDNA3-E7(49-57) in C57BL/6 mice. Furthermore, we observed that the strong E7-specific CD8+ T cell response elicited by pcDNA3-BPVL1-E7(49-57) vaccination translated into potent protective and therapeutic antitumor effects in C57BL/6 mice against HPV16-E7 expressing TC-1 tumor cells. Finally, using antibody depletion experiment, we showed that the antitumor immune response generated by pcDNA3-BPVL1-E7(49-57) is CD8+ T cell dependent, and CD4+ T cell and NK cell independent. Conclusion Treatment with fusion construct of BPV-L1 and HPV16-E7 epitope can elicit effective E7-specific antitumor immune response in mice. Due to the potential ability of the fusion DNA construct to also trigger immune responses specific to the L1 protein, the current study serves to support future design of HPV DNA vaccines encoding fusion HPVL1-E6/E7 constructs for the generation of both T cell and B cell mediated immune responses against HPV infections and associated diseases.
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Affiliation(s)
- Andrew Yang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Shiwen Peng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Emily Farmer
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Qi Zeng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Max A Cheng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Xiaowu Pang
- Department of Oral Pathology, Howard University College of Dentistry, Washington, DC USA
| | - T-C Wu
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA.,Department of Obstetrics and Gynecology, Johns Hopkins Medical Institutions, Baltimore, MD USA.,Department of Molecular Microbiology and Immunology, Johns Hopkins Medical Institutions, Baltimore, MD USA.,Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD USA.,The Johns Hopkins University School of Medicine, CRB II Room 309, 1550 Orleans Street, Baltimore, MD 21231 USA
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA.,Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD USA.,The Johns Hopkins University School of Medicine, CRB II Room 307, 1550 Orleans Street, Baltimore, MD 21231 USA
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16
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Ma Y, Yang A, Peng S, Qiu J, Farmer E, Hung CF, Wu TC. Characterization of HPV18 E6-specific T cell responses and establishment of HPV18 E6-expressing tumor model. Vaccine 2017; 35:3850-3858. [PMID: 28599791 DOI: 10.1016/j.vaccine.2017.05.081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 03/22/2017] [Revised: 05/02/2017] [Accepted: 05/26/2017] [Indexed: 02/02/2023]
Abstract
Human papillomavirus (HPV) has been identified as the primary etiologic factor of cervical cancer, and subsets of anogenital and oropharyngeal cancers. HPV18 is the second most prevalent high-risk HPV type after HPV16. Furthermore, HPV18 is responsible for approximately 12% of cervical squamous cell carcinoma and 37% of cervical adenocarcinoma cases worldwide. In this study, we aimed to characterize the HPV18-E6-specific epitope and establish an HPV18 animal tumor model to evaluate the E6-specific immune response induced by our DNA vaccine. We vaccinated naïve C57BL/6 mice with a prototype DNA vaccine, pcDNA3-HPV18-E6, via intramuscular injection followed by electroporation, and analyzed the E6-specific CD8+ T cell responses by flow cytometry using a reported T cell epitope. We then characterized the MHC restriction element for the characterized HPV18-E6 epitope. Additionally, we generated an HPV18-E6-expressing tumor cell line to study the antitumor effect mediated by E6-specific immunity. We observed a robust HPV18-E6aa67-75 peptide-specific CD8+ T cell response after vaccination with pcDNA3-HPV18-E6. Further characterization demonstrated that this epitope was mainly restricted by H-2Kb, but was also weakly presented by HLA-A∗0201, as previously reported. We observed that vaccination with pcDNA3-HPV18-E6 significantly inhibited the growth of HPV18-E6-expressing tumor cells, TC-1/HPV18-E6, in mice. An antibody depletion study demonstrated that both CD4+ and CD8+ T cells are necessary for the observed antitumor immunity. The characterization of HPV18-E6-specific T cell responses and the establishment of HPV18-E6-expressing tumor cell line provide infrastructures for further development of HPV18-E6 targeted immunotherapy.
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Affiliation(s)
- Ying Ma
- Department of Gynecology and Obstetrics, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong Province, China; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Andrew Yang
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Shiwen Peng
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Jin Qiu
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Emily Farmer
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States; Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
| | - T-C Wu
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, United States; Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, United States; Department of Obstetrics and Gynecology, Johns Hopkins Medical Institutions, Baltimore, MD, United States; Department of Molecular Microbiology and Immunology, Johns Hopkins Medical Institutions, Baltimore, MD, United States.
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17
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Yang A, Farmer E, Lin J, Wu TC, Hung CF. The current state of therapeutic and T cell-based vaccines against human papillomaviruses. Virus Res 2016; 231:148-165. [PMID: 27932207 DOI: 10.1016/j.virusres.2016.12.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 08/31/2016] [Revised: 12/01/2016] [Accepted: 12/02/2016] [Indexed: 12/12/2022]
Abstract
Human papillomavirus (HPV) is known to be a necessary factor for many gynecologic malignancies and is also associated with a subset of head and neck malignancies. This knowledge has created the opportunity to control these HPV-associated cancers through vaccination. However, despite the availability of prophylactic HPV vaccines, HPV infections remain extremely common worldwide. In addition, while prophylactic HPV vaccines have been effective in preventing infection, they are ineffective at clearing pre-existing HPV infections. Thus, there is an urgent need for therapeutic and T cell-based vaccines to treat existing HPV infections and HPV-associated lesions and cancers. Unlike prophylactic vaccines, which generate neutralizing antibodies, therapeutic, and T cell-based vaccines enhance cell-mediated immunity against HPV antigens. Our review will cover various therapeutic and T cell-based vaccines in development for the treatment of HPV-associated diseases. Furthermore, we review the strategies to enhance the efficacy of therapeutic vaccines and the latest clinical trials on therapeutic and T cell-based HPV vaccines.
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Affiliation(s)
- Andrew Yang
- Department of Pathology, Johns Hopkins University, Baltimore, MD USA
| | - Emily Farmer
- Department of Pathology, Johns Hopkins University, Baltimore, MD USA
| | - John Lin
- Department of Pathology, Johns Hopkins University, Baltimore, MD USA
| | - T-C Wu
- Department of Pathology, Johns Hopkins University, Baltimore, MD USA; Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD USA; Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD USA; Department of Oncology, Johns Hopkins University, Baltimore, MD USA
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins University, Baltimore, MD USA; Department of Oncology, Johns Hopkins University, Baltimore, MD USA.
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18
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Abstract
Background Human papillomavirus (HPV) infections and associated diseases remain a serious burden worldwide. It is now clear that HPV serves as the etiological factor and biologic carcinogen for HPV-associated lesions and cancers. Although preventative HPV vaccines are available, these vaccines do not induce strong therapeutic effects against established HPV infections and lesions. These concerns create a critical need for the development of therapeutic strategies, such as vaccines, to treat these existing infections and diseases. Main Body Unlike preventative vaccines, therapeutic vaccines aim to generate cell-mediated immunity. HPV oncoproteins E6 and E7 are responsible for the malignant progression of HPV-associated diseases and are consistently expressed in HPV-associated diseases and cancer lesions; therefore, they serve as ideal targets for the development of therapeutic HPV vaccines. In this review we revisit therapeutic HPV vaccines that utilize this knowledge to treat HPV-associated lesions and cancers, with a focus on the findings of recent therapeutic HPV vaccine clinical trials. Conclusion Great progress has been made to develop and improve novel therapeutic HPV vaccines to treat existing HPV infections and diseases; however, there is still much work to be done. We believe that therapeutic HPV vaccines have the potential to become a widely available and successful therapy to treat HPV and HPV-associated diseases in the near future.
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Affiliation(s)
- Andrew Yang
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Emily Farmer
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - T C Wu
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.,Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD, USA.,Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA.,Department of Oncology, Johns Hopkins University, Baltimore, MD, USA
| | - Chien-Fu Hung
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA. .,Department of Oncology, Johns Hopkins University, Baltimore, MD, USA. .,The Johns Hopkins University School of Medicine, CRB II Room 307, 1550 Orleans Street, Baltimore, MD, 21231, USA.
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19
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Farmer E, Chase-Topping M, Lawson H, Clutton RE. Factors affecting the perception of recovery quality in horses after anaesthesia. Equine Vet J 2013; 46:328-32. [PMID: 23819890 DOI: 10.1111/evj.12133] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 11/13/2012] [Accepted: 06/24/2013] [Indexed: 12/01/2022]
Abstract
REASONS FOR PERFORMING STUDY A significant effect of gender, experience and background, i.e. an evaluator's relationship with horses as equine anaesthetists, orthopaedic surgeons, practitioners or owners, on perceptions of recovery quality after anaesthesia would reduce the validity of recovery quality scoring systems. OBJECTIVES To determine the effects of evaluator background, experience and gender on their perceptions of recovery quality; and questionnaire response rate as a function of background. STUDY DESIGN Cross-sectional survey. METHODS A total of 440 potential evaluators were invited to evaluate the video-recorded recoveries of 24 horses using a visual analogue scale (VAS) in which 0 = worst, 100 = best possible recovery. A mean score was generated for each of the 1-24 recoveries within each background group. These were compared using Spearman's rank correlation. The effect of gender and experience on VAS scores were analysed using an ordinal logistic regression after scores were categorised into 'intermediate, 'worst' and 'best' recovery categories based on median, 25th and 75th percentile VAS scores, respectively. RESULTS The overall response rate was 35%. The greatest was from the anaesthetists (78%) followed by surgeons (43%). The response rate among owners and practitioners was 26%. Correlation among VAS scores across all background groups was high (Spearman rank > 0.90; P < 0.001). Among the combined veterinarians, there was no significant gender (P = 0.551) or experience (P = 0.103) effect. Among horse owners, the effect of experience was not significant (P = 0.116) although gender was (P = 0.027). Male horse owners awarded significantly greater scores than females. CONCLUSIONS When VAS are used to grade recovery quality, neither the background nor the gender of veterinary evaluators affects quality perception. Male owners awarded greater scores than female owners, implying that they are less critical of recovery quality and a gender effect among horse owners must be considered when VAS are used to score recovery quality.
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Affiliation(s)
- E Farmer
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, UK
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20
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Whalley MG, Farmer E, Brewin CR. Pain flashbacks following the July 7th 2005 London bombings. Pain 2007; 132:332-336. [PMID: 17910905 DOI: 10.1016/j.pain.2007.08.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Revised: 08/07/2007] [Accepted: 08/10/2007] [Indexed: 10/22/2022]
Abstract
Flashbacks in posttraumatic stress disorder (PTSD) are commonly experienced as visual, auditory, olfactory or tactile re-livings of a previously experienced traumatic event. We present the case report of one survivor of the July 7th 2005 London underground bombings who was diagnosed with PTSD and who experienced painful flashbacks. We present retrospective multidimensional measures of his pain using standardised instruments. The case provides further evidence that somatosensory re-experiencing of pain memories is possible. Findings are discussed with regards to memory for pain.
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Affiliation(s)
- M G Whalley
- Sub-Department of Clinical Health Psychology, University College London, Gower Street, London WC1E 6BT, UK Hillingdon Drugs & Alcohol Service, Old Bank House, 64 High Street, Uxbridge, Middlesex UB8 1JP, UK
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21
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Wolff D, Anders V, Corio R, Horn T, Morison WL, Farmer E, Vogelsang GB. Oral PUVA and topical steroids for treatment of oral manifestations of chronic graft-vs.-host disease. Photoderm Photoimm Photomed 2004; 20:184-90. [PMID: 15238096 DOI: 10.1111/j.1600-0781.2004.00102.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral manifestations of chronic graft-vs.-host disease (cGVHD) can significantly affect the quality of life and severity often does not correlate with systemic manifestations. We evaluated the use of topical corticosteroids and the intraoral application of psoralen-UVA (PUVA) for treatment of oral manifestations of cGVHD. METHODS Overall, 18 patients with oral manifestations of cGVHD were treated with either intraoral PUVA (n=7) or with topical corticosteroids (n=16). Four patients received intraoral PUVA after failure of topical steroids and one patient was treated with topical corticosteroids after failing treatment with intraoral PUVA. A glass fiber extension of an UVA source was used for manual intraoral application. Treatment with topical corticosteroids consisted of 0.1 mg/ml dexamethasone mouth wash four times a day in combination with antifungal prophylaxis. RESULTS Four patients showed complete local response (CR) due to intraoral PUVA, two improved and one did not respond. Topical corticosteroids resulted in nine patients in CR, two improved and five did not respond. CONCLUSION Intraoral PUVA as well as topical corticosteroids are effective in treatment of oral manifestations of oral GVHD with few side-effects and improve quality of life in patients with cGVHD.
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Affiliation(s)
- D Wolff
- Division of Haematology and Oncology, Department of Medicine, University of Rostock, E. Heydemann Strasse 6, 18057 Rostock, Germany.
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22
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Abstract
PURPOSE Incisions in radial keratotomy (RK) patients were examined histopathologically to explore the cause of delayed infections occurring following this procedure. METHODS Four corneas from two successful RK patients were obtained postmortem and 1 cornea from an unsuccessful RK was collected following lamellar keratoplasty. The tissue was prepared for light and transmission electron microscopy. RESULTS All incisions examined contained an epithelial plug. The average depth of the plugs for left and right corneas in the 2 successful cases were 142.58 microm (range: 36.46-183.04 microm) and 58.44 microm (range: 29.27-115.66 microm), whereas the unsuccessful case these measurements were 121.06 microm (range: 70.03-172.01 microm). In the successful cases, the plugs were on average 4.2 cells deep (range: 2-5) in one case and for the other the plugs were 8.78 cells deep (range: 1.5-11.5) and 2.72 cells wide (range: 2-4). In the unsuccessful case the plugs were on average 6.89 cells deep (range: 5-11) and 8.56 cells wide (range: 4-13). The average epithelial thickness, measured 200 microm on either side away from the plug, was 47.11 microm and 55.09 microm for the successful cases, and 27.52 microm for the unsuccessful case. Degenerate cells were often observed within the plug and along the overlying surface. Lamellae cut during surgery remained severed in all corneas observed. The stroma adjacent to the incision contained an elevated number of stromal cells (8%-78%). CONCLUSIONS Healing did not include repair of anterior limiting lamina or stromal lamellae, which all remained severed in all incisions observed. Epithelial plugs were invariably present in all incisions regardless of clinical outcome, thus, increasing the distance a basal cell travels to reach the epithelial surface by 2 to 4 times. Since the epithelial cell has a limited life, it is hypothesized that cells originating in the plug may die before reaching the surface, thus, leading to intermittent loss of surface integrity. The loss of the epithelial barrier allows invasion of microorganisms and the delayed onset of keratitis. The larger the plug the greater the possibility of surface defects and resultant infection.
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Affiliation(s)
- J Bergmanson
- Texas Eye Research and Technology Center, University of Houston, Houston, Texas, USA.
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23
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McCord L, Farmer E. Student experiences in nursing homes. A response. Nurs Older People 2001; 12:33. [PMID: 12008367] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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24
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25
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Abstract
Should the nursing, midwifery and health visiting professions welcome the newly formed Council of Deans and Heads of UK University Faculties of Nursing, Midwifery and Health Visiting (Council of Deans, 1998) as the selfappointed ‘authoritative voice’ on all matters concerning education and research? Or should we prepare for another round of power struggles on the journey to integrated professions?
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Affiliation(s)
- E Farmer
- Department of Nursing, University of Stirling, Inverness
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26
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Farmer E. AIDS and the community. P N G Med J 1996; 39:214-7. [PMID: 9795566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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27
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Vogelsang GB, Wolff D, Altomonte V, Farmer E, Morison WL, Corio R, Horn T. Treatment of chronic graft-versus-host disease with ultraviolet irradiation and psoralen (PUVA). Bone Marrow Transplant 1996; 17:1061-7. [PMID: 8807115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Chronic graft-versus-host disease (GVHD) remains a difficult clinical problem to treat and manage. We have reviewed our treatment of 40 patients treated at a single institution with PUVA (ultraviolet irradiation and psoralen) over a 14 year period. Thirty-five patients were treated for refractory chronic GVHD and five patients were treated at presentation of high-risk chronic GVHD. Overall, 31 of 40 patients improved on PUVA treatment. Sixteen patients achieved a complete response to PUVA added to their GVHD regimen. Four of the 15 partial responders had complete resolution of cutaneous GVHD but persistence of other systemic manifestations. The remaining partial responders had at least a 50% improvement in GVHD. We have also used PUVA with a glass fiber extension to treat intra-oral GVHD. PUVA is well tolerated with a high rate of response in the skin and mild side effects except for three patients who had therapy discontinued after phototoxicity (burn).
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Affiliation(s)
- G B Vogelsang
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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28
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Farmer E, Chipperfield C. One-to-one midwifery. Mod Midwife 1996; 6:19-21. [PMID: 8788902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Key elements: Problems of One-to-One midwifery developing a caseload relationships with other staff--perceived 'elitism' boundaries of care for high-risk mothers long hours isolation women's unrealistic expectations of midwife, including overdependence Solutions maintain dialogue with other professionals hospital midwives invited to join OTO midwives on community visits clarify roles and responsibilities direct referral to on-call registrar partnerships with teams peer support weekly group meeting empowering women, reducing overdependence
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Affiliation(s)
- E Farmer
- Centre for Midwifery Practice, Hammersmith Hospitals NHS Trust
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29
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Lalak NJ, Farmer E. Traumatic pseudoaneurysm of the superficial temporal artery associated with facial nerve palsy. J Cardiovasc Surg (Torino) 1996; 37:119-23. [PMID: 8675516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Aneurysms of the superficial temporal artery as a result of trauma occur rarely. These pseudoaneurysms tend to present 2 to 6 weeks following initial injury with a painless swelling which may be associated with a headache, ear discomfort or other vague symptoms. Neurological complications are very rare. A thorough history and physical examination are essential. Investigations such as duplex scanning, angiography or CT scanning may be helpful in difficult cases. The most common treatment is surgical. Embolization may prove to be an alternative to surgery in some cases. We review a rare case of superficial temporal artery aneurysm associated with a facial nerve palsy which was treated surgically. A thorough review of the literature is presented.
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Affiliation(s)
- N J Lalak
- Liverpool Hospital, Liverpool, Sydney, Australia
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30
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31
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Abstract
Trichobezoars are a rare cause of upper gastrointestinal symptoms and most commonly occur in young females with trichophagia. A case, occurring in a 19 year old woman, complicated by transient pancreatitis and jejunal perforation, is presented.
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Affiliation(s)
- A Mekisic
- Department of Surgery, Liverpool Hospital, New South Wales, Australia
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32
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van der Riet P, Karp D, Farmer E, Wei Q, Grossman L, Tokino K, Ruppert JM, Sidransky D. Progression of basal cell carcinoma through loss of chromosome 9q and inactivation of a single p53 allele. Cancer Res 1994; 54:25-7. [PMID: 8261448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Basal cell carcinoma (BCC) of the skin represents a unique group of tumors strongly associated with exposure to UV light. Unlike squamous carcinoma of the skin, BCC is generally indolent, noninvasive, and rarely metastatic. To study the involvement of tumor suppressor genes in these neoplasms, we analyzed 36 BCCs for p53 mutations and a subset of these tumors for loss of chromosomes 17p and 9q. Sixty-nine % of sporadic BCCs had lost a 9q allele, with the common area of loss surrounding the putative gene for nevoid BCC or Gorlin's syndrome. Forty-four % (16 of 36) of BCCs had a mutated p53 allele, usually opposite pyrimidine tracts, which is consistent with UV-induced mutations. Surprisingly, only one tumor had lost a 17p allele, and in all BCCs only one p53 allele was inactivated. This is in direct contrast to other epithelial tumors, which usually progress by the inactivation of both p53 alleles.
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Affiliation(s)
- P van der Riet
- Department of Otolaryngology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland 21205
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33
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Farmer E. Anger rises over fallen Prophit. Br J Nurs 1993; 2:159-60. [PMID: 8457746 DOI: 10.12968/bjon.1993.2.3.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This is make or break year for nursing and, so far, all the indicators point to the latter. Recent publicity in the popular press has demonstrated once again how the selfish and evil pursuit of personal goals so often takes precedence over the common good.
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34
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Abstract
In his editorial Nursing models redundant in practice (Vol 1(5): 219), Francis Biley drew attention to the exploration of the ‘real essence of nursing’. Indicators of this new development are the recognition of nursing narrative as a source of knowledge, new value being attached to feminist perspectives, and the exploration of concepts such as caring.
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35
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O'Connell K, Landman G, Farmer E, Edidin M. Endothelial cells transformed by SV40 T antigen cause Kaposi's sarcomalike tumors in nude mice. Am J Pathol 1991; 139:743-9. [PMID: 1928299 PMCID: PMC1886298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Injection into nude mice of a well-differentiated SV40 T-antigen-transformed murine endothelial cell (EC) line results in widespread invasive tumors confined to connective tissues. The tumors, which do not metastasize, consist of both host-derived cells and transformed EC, displaying histologic features typical of Kaposi's sarcoma (KS). Although the EC is believed to be the cell of origin in KS, this has not been proven and is the subject of debate. The unusual tumorigenicity of this transformed cell suggests that EC-specific gene products induced by SV40 T antigen may contribute to tumorigenesis by autocrine growth stimulation and recruitment of host cells. KS-like tumors may be the result of EC alteration by any virus that induces relevant EC-derived cytokines.
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MESH Headings
- Animals
- Antigens, Polyomavirus Transforming/immunology
- Antigens, Polyomavirus Transforming/physiology
- Cell Line, Transformed
- Cell Transformation, Neoplastic/drug effects
- Cell Transformation, Neoplastic/immunology
- Cell Transformation, Neoplastic/pathology
- Endothelium/cytology
- Endothelium/drug effects
- Immunohistochemistry
- Male
- Mice
- Mice, Nude/physiology
- Sarcoma, Kaposi/etiology
- Sarcoma, Kaposi/immunology
- Sarcoma, Kaposi/pathology
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Affiliation(s)
- K O'Connell
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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36
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Thomas RK, Farmer E, Wallace B. The importance of internal marketing: the case of geriatric services. J Health Care Mark 1991; 11:55-8. [PMID: 10110084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Hospitals seeking to become more aggressive often are tempted to introduce programs prematurely. Using the example of a geriatric services program at a large hospital, the authors illustrate the dangers of neglecting internal marketing and offer recommendations for ensuring internal coordination prior to introduction of a product externally.
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37
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Rader J, Rest E, Farmer E, Rosenshein N. A comparison of wound healing after epithelial resection produced by the ultrasonic surgical aspirator an ablation by carbon dioxide laser. Gynecol Oncol 1991. [DOI: 10.1016/0090-8258(91)90154-w] [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: 10/26/2022]
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38
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Farmer E, Taylor S. Assessment of teaching by Family Medicine Programme vocational trainees. Aust Fam Physician 1990; 19:549-50, 553, 555-7. [PMID: 2363660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Family Medicine Programme vocational trainees are requested to assess by means of a detailed questionnaire the teaching they have received in their general practice training attachments. This paper describes the methods and presents the results of a survey of South Australian and Northern Territory trainees over a three year period. The results show that a survey by questionnaires is an effective method of measuring perceived standards of teaching in training practices.
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Affiliation(s)
- E Farmer
- Family Medicine Programme, South Australia
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39
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Farmer E. Continuing care--collective security. Geriatr Nurs Home Care 1989; 9:24-5. [PMID: 2707600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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40
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41
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Petri M, Barr E, Cho K, Farmer E. Overlap of granulomatous vasculitis and sarcoidosis: presentation with uveitis, eosinophilia, leg ulcers, sinusitis, and past foot drop. J Rheumatol Suppl 1988; 15:1171-3. [PMID: 3172119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A 24-year-old black woman with a history of pulmonary and hepatic sarcoidosis followed by foot drop presented with uveitis, eosinophilia, leg ulcers, and sinus opacification. Biopsy of the leg ulcer and review of the past lung biopsy revealed numerous epithelioid noncaseating granulomas and granulomatous vasculitis. Although her clinical presentation raised the possibility of Wegener's granulomatosis, the many discrete granulomas and lack of necrosis on her biopsies were more in favor of sarcoidosis. Although granulomatous vasculitis has been reported as part of necrotizing sarcoid granulomatosis, our patient was unique in the extent and type of her extrapulmonary symptomatology.
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Affiliation(s)
- M Petri
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205
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42
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Abstract
The value of specimen radiology in the surgical management of palpable breast lesions was assessed in 100 consecutive patients undergoing excision of a palpable breast lump. Only 41 per cent of palpable breast lesions were demonstrable as a radiological abnormality on the excised specimen. The greatest sensitivity was found for lesions which proved to be malignant. Only 27 of 88 benign palpable breast lesions were radiologically visible in the specimen. Surprisingly, only 8 of 13 fibroadenomas were identified as discrete opacities. No residual breast lump was detected on clinical examination in patients reviewed postoperatively, including those patients who had a demonstrable preoperative mammographic abnormality and a negative specimen radiograph. We conclude that specimen radiology does not contribute to the surgical management of palpable breast lesions.
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43
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Farmer E, Ashworth P. Nursing abroad. WHO does what in Europe? Nurs Mirror 1981; 152:37-38. [PMID: 6906825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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44
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Abstract
The current practice in ordering blood for common elective general surgical operations in the Prince of Wales Hospital has been studied. The numbers of patients having serum grouped and held and those having cross-matched were determined, together with the number of units cross-matched. The percentage of patients transfused and the number of units of blood given were then assessed for each procedure. The results demonstrated that blood was often ordered for patients who were most unlikely to require it. In addition, the amounts of blood ordered were frequently excessive, so that the cross-match-to-transfusion ratio (C/T ratio) for some procedures was high. We suggest that relatively simple changes in the current practice of ordering blood for operations should result in savings in costs, and most importantly, in a reduction in the wastage of blood.
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45
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46
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Farmer E. AN ACCOUNT OF AN EXPERIMENT ON VISUAL AFTER-SENSATION IN REFERENCE TO ILLUMINATION IN COAL MINES CARRIED OUT BY THE NATIONAL INSTITUTE OF INDUSTRIAL PSYCHOLOGY. Br J Ophthalmol 1923; 7:328-9. [DOI: 10.1136/bjo.7.7.328] [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: 11/04/2022]
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