1
|
Galsky MD, Daneshmand S, Izadmehr S, Gonzalez-Kozlova E, Chan KG, Lewis S, Achkar BE, Dorff TB, Cetnar JP, Neil BO, D'Souza A, Mamtani R, Kyriakopoulos C, Jun T, Gogerly-Moragoda M, Brody R, Xie H, Nie K, Kelly G, Horowitz A, Kinoshita Y, Ellis E, Nose Y, Ioannou G, Cabal R, Del Valle DM, Haines GK, Wang L, Mouw KW, Samstein RM, Mehrazin R, Bhardwaj N, Yu M, Zhao Q, Kim-Schulze S, Sebra R, Zhu J, Gnjatic S, Sfakianos J, Pal SK. Author Correction: Gemcitabine and cisplatin plus nivolumab as organ-sparing treatment for muscle-invasive bladder cancer: a phase 2 trial. Nat Med 2024; 30:1211. [PMID: 38242983 PMCID: PMC11031387 DOI: 10.1038/s41591-024-02814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Affiliation(s)
- Matthew D Galsky
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Siamak Daneshmand
- Department of Urology, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Sudeh Izadmehr
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edgar Gonzalez-Kozlova
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin G Chan
- Department of Urology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sara Lewis
- Department of Radiology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bassam El Achkar
- Department of Radiology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tanya B Dorff
- Department of Medical Oncology & Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jeremy Paul Cetnar
- Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland, OR, USA
| | - Brock O Neil
- Department of Urology, University of Utah, Salt Lake City, UT, USA
| | - Anishka D'Souza
- Division of Hematology and Medical Oncology, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Ronac Mamtani
- Division of Hematology and Medical Oncology, University of Pennsylvania Abramson Cancer Center, Philadelphia, PA, USA
| | - Christos Kyriakopoulos
- Division of Hematology and Medical Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Tomi Jun
- Genentech, South San Francisco, CA, USA
- Formerly with the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mahalya Gogerly-Moragoda
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Brody
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hui Xie
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kai Nie
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Geoffrey Kelly
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amir Horowitz
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yayoi Kinoshita
- Department of Pathology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ethan Ellis
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yohei Nose
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giorgio Ioannou
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rafael Cabal
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Diane M Del Valle
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - G Kenneth Haines
- Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Li Wang
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Gene Dx, Stamford, CT, USA
| | - Kent W Mouw
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert M Samstein
- Department of Radiation Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Reza Mehrazin
- Department of Urology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nina Bhardwaj
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Seunghee Kim-Schulze
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Sebra
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jun Zhu
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Gene Dx, Stamford, CT, USA
| | - Sacha Gnjatic
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Sfakianos
- Department of Urology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sumanta K Pal
- Department of Medical Oncology & Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| |
Collapse
|
2
|
Kim CG, Hong MH, Kim D, Lee BH, Kim H, Ock CY, Kelly G, Bang YJ, Kim G, Lee JE, Kim C, Kim SH, Hong HJ, Park YM, Sim NS, Park H, Park JW, Lee CG, Kim KH, Park G, Jung I, Han D, Kim JH, Cha J, Lee I, Kang M, Song H, Oum C, Kim S, Kim S, Lim Y, Kim-Schulze S, Merad M, Yoon SO, Kim HJ, Koh YW, Kim HR. A phase II open-label randomized clinical trial of preoperative durvalumab or durvalumab plus tremelimumab in resectable head and neck squamous cell carcinoma. Clin Cancer Res 2024:735107. [PMID: 38457288 DOI: 10.1158/1078-0432.ccr-23-3249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/06/2024] [Accepted: 03/06/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE Clinical implications of neoadjuvant immunotherapy in patients with locally advanced but resectable head and neck squamous cell carcinoma (HNSCC) remain largely unexplored. PATIENTS AND METHODS Patients with resectable HNSCC were randomized to receive a single dose of preoperative durvalumab (D) with or without tremelimumab (T) before resection, followed by postoperative (chemo)radiation based on multidisciplinary discretion and 1-year D treatment. Artificial intelligence (AI)-powered spatial distribution analysis of tumor-infiltrating lymphocytes and high-dimensional profiling of circulating immune cells tracked dynamic intratumoral and systemic immune responses. RESULTS Of the 48 patients enrolled (D: 24 patients, D+T: 24 patients), 45 underwent surgical resection per protocol (D: 21 patients; D+T: 24 patients). D+/-T had a favorable safety profile and did not delay surgery. Distant recurrence-free survival (DRFS) was significantly better in patients treated with D+T than in those treated with D monotherapy. AI-powered whole-slide image analysis demonstrated that D+T significantly reshaped the tumor microenvironment toward immune-inflamed phenotypes, in contrast to D monotherapy or cytotoxic chemotherapy. High-dimensional profiling of circulating immune cells revealed a significant expansion of T cell subsets characterized by proliferation and activation in response to D+T therapy, which was rare following D monotherapy. Importantly, expansion of specific clusters in CD8+ T cells and non-regulatory CD4+ T cells with activation and exhaustion programs was associated with prolonged DRFS in patients treated with D+T. CONCLUSIONS Preoperative D+/-T is feasible and may benefit patients with resectable HNSCC. Distinct changes in the tumor microenvironment and circulating immune cells were induced by each treatment regimen, warranting further investigation.
Collapse
Affiliation(s)
- Chang Gon Kim
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Min Hee Hong
- Yonsei Cancer Center, Seoul, Korea (South), Republic of
| | - Dahee Kim
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Brian Hyohyoung Lee
- Seoul National University Graduate School, Seoul, Korea (South), Republic of
| | - Hyunwook Kim
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | | | - Geoffrey Kelly
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yoon Ji Bang
- Seoul National University College of Medicine, Korea (South), Republic of
| | - Gamin Kim
- Yonsei University College of Medicine, seoul, Korea (South), Republic of
| | - Jung Eun Lee
- Yonsei University College of Medicine, seoul, Korea (South), Republic of
| | - Chaeyeon Kim
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Se-Heon Kim
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Hyun Jun Hong
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Young Min Park
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Nam Suk Sim
- Yonsei University College of Medicine, Severance Hospital, Seoul, Korea (South), Republic of
| | - Heejung Park
- Yonsei University College of Medicine, seoul, Korea (South), Republic of
| | - Jin Woo Park
- Severance Hospital, Seoul, Korea (South), Republic of
| | - Chang Geol Lee
- Yonsei Cancer CTR, Seoul, seodaemun-gu, Korea (South), Republic of
| | - Kyung Hwan Kim
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Goeun Park
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Inkyung Jung
- University of Ulsan College of Medicine, Korea (South), Republic of
| | - Dawoon Han
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Jong Hoon Kim
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Junha Cha
- Yonsei University, Seoul, Korea (South), Republic of
| | - Insuk Lee
- Yonsei University, Seoul, Korea (South), Republic of
| | | | - Heon Song
- Lunit, Seoul, Korea (South), Republic of
| | | | | | - Sukjun Kim
- Lunit, Seoul, Korea (South), Republic of
| | | | | | - Miriam Merad
- Precision Immunology Institute, New York, NY, United States
| | - Sun Och Yoon
- Severance Hospital, Seoul, Korea (South), Republic of
| | - Hyun Je Kim
- Seoul National University College of Medicine, Korea (South), Republic of
| | - Yoon Woo Koh
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| | - Hye Ryun Kim
- Yonsei University College of Medicine, Seoul, Korea (South), Republic of
| |
Collapse
|
3
|
Galsky MD, Daneshmand S, Izadmehr S, Gonzalez-Kozlova E, Chan KG, Lewis S, Achkar BE, Dorff TB, Cetnar JP, Neil BO, D'Souza A, Mamtani R, Kyriakopoulos C, Jun T, Gogerly-Moragoda M, Brody R, Xie H, Nie K, Kelly G, Horowitz A, Kinoshita Y, Ellis E, Nose Y, Ioannou G, Cabal R, Del Valle DM, Haines GK, Wang L, Mouw KW, Samstein RM, Mehrazin R, Bhardwaj N, Yu M, Zhao Q, Kim-Schulze S, Sebra R, Zhu J, Gnjatic S, Sfakianos J, Pal SK. Gemcitabine and cisplatin plus nivolumab as organ-sparing treatment for muscle-invasive bladder cancer: a phase 2 trial. Nat Med 2023; 29:2825-2834. [PMID: 37783966 PMCID: PMC10667093 DOI: 10.1038/s41591-023-02568-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/24/2023] [Indexed: 10/04/2023]
Abstract
Cystectomy is a standard treatment for muscle-invasive bladder cancer (MIBC), but it is life-altering. We initiated a phase 2 study in which patients with MIBC received four cycles of gemcitabine, cisplatin, plus nivolumab followed by clinical restaging. Patients achieving a clinical complete response (cCR) could proceed without cystectomy. The co-primary objectives were to assess the cCR rate and the positive predictive value of cCR for a composite outcome: 2-year metastasis-free survival in patients forgoing immediate cystectomy or
Collapse
Affiliation(s)
- Matthew D Galsky
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Siamak Daneshmand
- Department of Urology, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Sudeh Izadmehr
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edgar Gonzalez-Kozlova
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kevin G Chan
- Department of Urology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Sara Lewis
- Department of Radiology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bassam El Achkar
- Department of Radiology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tanya B Dorff
- Department of Medical Oncology & Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jeremy Paul Cetnar
- Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland, OR, USA
| | - Brock O Neil
- Department of Urology, University of Utah, Salt Lake City, UT, USA
| | - Anishka D'Souza
- Division of Hematology and Medical Oncology, Keck School of Medicine of USC, Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Ronac Mamtani
- Division of Hematology and Medical Oncology, University of Pennsylvania Abramson Cancer Center, Philadelphia, PA, USA
| | - Christos Kyriakopoulos
- Division of Hematology and Medical Oncology, University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Tomi Jun
- Genentech, South San Francisco, CA, USA
- Formerly with the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mahalya Gogerly-Moragoda
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Brody
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hui Xie
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kai Nie
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Geoffrey Kelly
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amir Horowitz
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yayoi Kinoshita
- Department of Pathology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ethan Ellis
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yohei Nose
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giorgio Ioannou
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rafael Cabal
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Diane M Del Valle
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - G Kenneth Haines
- Department of Pathology, Molecular and Cell-based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Li Wang
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Gene Dx, Stamford, CT, USA
| | - Kent W Mouw
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert M Samstein
- Department of Radiation Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Reza Mehrazin
- Department of Urology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nina Bhardwaj
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Seunghee Kim-Schulze
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Sebra
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jun Zhu
- Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Gene Dx, Stamford, CT, USA
| | - Sacha Gnjatic
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Sfakianos
- Department of Urology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sumanta K Pal
- Department of Medical Oncology & Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| |
Collapse
|
4
|
Ruan DF, Fribourg M, Yuki Y, Park YH, Martin M, Kelly G, Lee B, Miguel de Real R, Lee R, Geanon D, Kim-Schulze S, McCarthy M, Chun N, Cravedi P, Carrington M, Heeger PS, Horowitz A. Understanding the heterogeneity of alloreactive natural killer cell function in kidney transplantation. bioRxiv 2023:2023.09.01.555962. [PMID: 37732256 PMCID: PMC10508724 DOI: 10.1101/2023.09.01.555962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Human Natural Killer (NK) cells are heterogeneous lymphocytes regulated by variegated arrays of germline-encoded activating and inhibitory receptors. They acquire the ability to detect polymorphic self-antigen via NKG2A/HLA-E or KIR/HLA-I ligand interactions through an education process. Correlations among HLA/KIR genes, kidney transplantation pathology and outcomes suggest that NK cells participate in allograft injury, but mechanisms linking NK HLA/KIR education to antibody-independent pathological functions remain unclear. We used CyTOF to characterize pre- and post-transplant peripheral blood NK cell phenotypes/functions before and after stimulation with allogeneic donor cells. Unsupervised clustering identified unique NK cell subpopulations present in varying proportions across patients, each of which responded heterogeneously to donor cells based on donor ligand expression patterns. Analyses of pre-transplant blood showed that educated, NKG2A/KIR-expressing NK cells responded greater than non-educated subsets to donor stimulators, and this heightened alloreactivity persisted > 6 months post-transplant despite immunosuppression. In distinct test and validation sets of patients participating in two clinical trials, pre-transplant donor-induced release of NK cell Ksp37, a cytotoxicity mediator, correlated with 2-year and 5-year eGFR. The findings explain previously reported associations between NK cell genotypes and transplant outcomes and suggest that pre-transplant NK cell analysis could function as a risk-assessment biomarker for transplant outcomes.
Collapse
Affiliation(s)
- Dan Fu Ruan
- Department of Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Miguel Fribourg
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Nephrology, Department of Medicine, Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yuko Yuki
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
- Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute Frederick, MD, USA
- Laboratory of Integrative Cancer Immunology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Yeon-Hwa Park
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
- Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute Frederick, MD, USA
- Laboratory of Integrative Cancer Immunology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Maureen Martin
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
- Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute Frederick, MD, USA
- Laboratory of Integrative Cancer Immunology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Geoffrey Kelly
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian Lee
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ronaldo Miguel de Real
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Lee
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniel Geanon
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Seunghee Kim-Schulze
- Department of Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Melissa McCarthy
- Dean’s Flow Cytometry CoRE, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicholas Chun
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Nephrology, Department of Medicine, Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paolo Cravedi
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Nephrology, Department of Medicine, Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mary Carrington
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
- Basic Science Program, Frederick National Laboratory for Cancer Research, National Cancer Institute Frederick, MD, USA
- Laboratory of Integrative Cancer Immunology, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Peter S. Heeger
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
- These authors contributed equally
| | - Amir Horowitz
- Department of Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- These authors contributed equally
| |
Collapse
|
5
|
Allworth MB, Goonan B, Nelson JE, Kelly G, McGrath SR, Woodgate RG. Comparison of the efficacy of macrocyclic lactone anthelmintics, either singly or in combination with other anthelmintic(s), in nine beef herds in southern NSW. Aust Vet J 2023. [PMID: 37158491 DOI: 10.1111/avj.13248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 03/26/2023] [Accepted: 04/09/2023] [Indexed: 05/10/2023]
Abstract
Anthelmintic resistance (AR) is a well-recognized challenge in farmed ruminants. The use of anthelmintics in combination is one of the strategies recommended to slow the rate of AR development. Two studies were undertaken in 2017 and 2019 to assess the efficacy of single-dose macrocyclic lactone (ML) anthelmintic and ML combination drenches. In total, 11 Faecal Egg Count Reduction Trials (FECRTs) were set up in 10 different beef herds, with results available from 10 of those FECRTs (9 herds). AR to a single ML anthelmintic was detected in all 9 herds, with resistance to Cooperia and Haemonchus spp on 9 farms, and resistance to Ostertagia and Trichostrongylus spp on 2 farms. In contrast, for the ML combination anthelmintics, all FECRTs resulted in efficacies of 99%-100%. The results suggest that cattle producers should strongly consider using combination drenches in their herds in preference to single actives.
Collapse
Affiliation(s)
- M B Allworth
- Fred Morley Centre, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
- Gulbali institute, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
| | - B Goonan
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
| | - J E Nelson
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
| | - G Kelly
- Boehringer Ingelheim Animal Health Australia Pty. Ltd., Macquarie Park, New South Wales, Australia
| | - S R McGrath
- Fred Morley Centre, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
- Gulbali institute, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
| | - R G Woodgate
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
- Gulbali institute, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia
| |
Collapse
|
6
|
Ramos SA, Armitage LH, Morton JJ, Alzofon N, Handler D, Kelly G, Homann D, Jimeno A, Russ HA. Generation of functional thymic organoids from human pluripotent stem cells. Stem Cell Reports 2023; 18:829-840. [PMID: 36963390 PMCID: PMC10147832 DOI: 10.1016/j.stemcr.2023.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/25/2023] [Accepted: 02/26/2023] [Indexed: 03/26/2023] Open
Abstract
The thymus is critical for the establishment of a functional and self-tolerant adaptive immune system but involutes with age, resulting in reduced naive T cell output. Generation of a functional human thymus from human pluripotent stem cells (hPSCs) is an attractive regenerative strategy. Direct differentiation of thymic epithelial progenitors (TEPs) from hPSCs has been demonstrated in vitro, but functional thymic epithelial cells (TECs) only form months after transplantation of TEPs in vivo. We show the generation of TECs in vitro in isogenic stem cell-derived thymic organoids (sTOs) consisting of TEPs, hematopoietic progenitor cells, and mesenchymal cells, differentiated from the same hPSC line. sTOs support T cell development, express key markers of negative selection, including the autoimmune regulator (AIRE) protein, and facilitate regulatory T cell development. sTOs provide the basis for functional patient-specific thymic organoid models, allowing for the study of human thymus function, T cell development, and transplant immunity.
Collapse
Affiliation(s)
- Stephan A Ramos
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Lucas H Armitage
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - John J Morton
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Nathaniel Alzofon
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Diana Handler
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Geoffrey Kelly
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Dirk Homann
- Diabetes, Metabolism and Obesity Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Antonio Jimeno
- Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA; Charles C. Gates Center for Regenerative Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Holger A Russ
- Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Charles C. Gates Center for Regenerative Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA; Diabetes Institute, University of Florida, Gainesville, FL 32610, USA; Department of Pathology and Therapeutics, University of Florida, Gainesville, FL 32610, USA.
| |
Collapse
|
7
|
Pintado Silva J, Fenutria R, Bernal-Rubio D, Sanchez-Martin I, Hunziker A, Chebishev E, Veloz J, Kelly G, Kim-Schulze S, Whitehead S, Durbin A, Ramos I, Fernandez-Sesma A. The dengue virus 4 component of NIAID's tetravalent TV003 vaccine drives its innate immune signature. Exp Biol Med (Maywood) 2022; 247:2201-2212. [PMID: 36734144 PMCID: PMC9899989 DOI: 10.1177/15353702231151241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Annually, roughly 2.5 billion people are at risk for dengue virus (DENV) infection, and the incidence of infection has increased 30-fold since its discovery in the 1900s. At present, there are no globally licensed antiviral treatments or vaccines that protect against all four of the DENV serotypes. The NIAID Live Attenuated Tetravalent Vaccine (LATV) dengue vaccine candidate is composed of variants of three DENV serotypes attenuated by a 30 nucleotide (Δ30) deletion in the 3' untranslated region and a fourth component that is a chimeric virus in which the prM and E genes of DENV-2 replace those of DENV-4 on the rDEN4Δ30 backbone. The vaccine candidate encodes the non-structural proteins of DENV-1, DENV-3, and DENV-4, which could be of critical importance in the presentation of DENV-specific epitopes in a manner that facilitates antigen presentation and confers higher protection. Our findings demonstrate that the attenuation mechanism (Δ30) resulted in decreased viral infectivity and replication for each vaccine virus in monocyte-derived dendritic cells but were able to generate a robust innate immune response. When tested as monovalent viruses, DEN-4Δ30 displayed the most immunogenic profile. In addition, we found that the tetravalent DENV formulation induced a significantly greater innate immune response than the trivalent formulation. We demonstrate that the presence of two components with a DENV-4Δ30 backbone is necessary for the induction of RANTES, CD40, IP-10, and Type I IFN by the tetravalent formulation. Finally, we found that the DEN-4Δ30 backbone in the DENV-2 component of the vaccine enhanced its antigenic properties, as evidenced by enhanced ability to induce IP-10 and IFNα2 in monocyte-derived dendritic cells. In sum, our study shows that the Δ30 and Δ30/Δ31 mutations attenuate the DENV vaccine strains in terms of replication and infectivity while still allowing the induction of a robust innate immune response.
Collapse
Affiliation(s)
- Jessica Pintado Silva
- Department of Microbiology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
- Graduate School of Biomedical
Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029,
USA
| | - Rafael Fenutria
- Department of Microbiology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Dabeiba Bernal-Rubio
- Department of Microbiology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Irene Sanchez-Martin
- Department of Microbiology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Annika Hunziker
- Department of Microbiology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Eva Chebishev
- Department of Microbiology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
- Graduate School of Biomedical
Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029,
USA
| | - Jeury Veloz
- Department of Microbiology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
- Graduate School of Biomedical
Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029,
USA
| | - Geoffrey Kelly
- Precision Immunology Institute,
Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Seunghee Kim-Schulze
- Precision Immunology Institute,
Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Steve Whitehead
- Department of Neurology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
- Laboratory of Viral Diseases
(LVD), NIAID, NIH, Rockville, MD 20852, USA
| | - Anna Durbin
- Precision Immunology Institute,
Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Division of Global Disease and
Epidemiology Control, Johns Hopkins Bloomberg School of Public Health,
Rockville, MD 20852, USA
| | - Irene Ramos
- Department of Neurology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
- Precision Immunology Institute,
Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ana Fernandez-Sesma
- Department of Microbiology, Icahn
School of Medicine at Mount Sinai, New York, NY 10029, USA
- Graduate School of Biomedical
Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029,
USA
| |
Collapse
|
8
|
Martin SB, Polubothu S, Bruzos A, Lopez-Balboa P, Bulstrode N, Kelly G, Kinsler V. 260 Mosaic BRAF fusions are a recurrent cause of multiple congenital melanocytic naevi. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.272] [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: 11/19/2022]
|
9
|
Salomé B, Sfakianos JP, Ranti D, Daza J, Bieber C, Charap A, Hammer C, Banchereau R, Farkas AM, Ruan DF, Izadmehr S, Geanon D, Kelly G, de Real RM, Lee B, Beaumont KG, Shroff S, Wang YA, Wang YC, Thin TH, Garcia-Barros M, Hegewisch-Solloa E, Mace EM, Wang L, O'Donnell T, Chowell D, Fernandez-Rodriguez R, Skobe M, Taylor N, Kim-Schulze S, Sebra RP, Palmer D, Clancy-Thompson E, Hammond S, Kamphorst AO, Malmberg KJ, Marcenaro E, Romero P, Brody R, Viard M, Yuki Y, Martin M, Carrington M, Mehrazin R, Wiklund P, Mellman I, Mariathasan S, Zhu J, Galsky MD, Bhardwaj N, Horowitz A. NKG2A and HLA-E define an alternative immune checkpoint axis in bladder cancer. Cancer Cell 2022; 40:1027-1043.e9. [PMID: 36099881 PMCID: PMC9479122 DOI: 10.1016/j.ccell.2022.08.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [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: 12/16/2021] [Revised: 06/24/2022] [Accepted: 08/05/2022] [Indexed: 12/12/2022]
Abstract
Programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1)-blockade immunotherapies have limited efficacy in the treatment of bladder cancer. Here, we show that NKG2A associates with improved survival and responsiveness to PD-L1 blockade immunotherapy in bladder tumors that have high abundance of CD8+ T cells. In bladder tumors, NKG2A is acquired on CD8+ T cells later than PD-1 as well as other well-established immune checkpoints. NKG2A+ PD-1+ CD8+ T cells diverge from classically defined exhausted T cells through their ability to react to human leukocyte antigen (HLA) class I-deficient tumors using T cell receptor (TCR)-independent innate-like mechanisms. HLA-ABC expression by bladder tumors is progressively diminished as disease progresses, framing the importance of targeting TCR-independent anti-tumor functions. Notably, NKG2A+ CD8+ T cells are inhibited when HLA-E is expressed by tumors and partly restored upon NKG2A blockade in an HLA-E-dependent manner. Overall, our study provides a framework for subsequent clinical trials combining NKG2A blockade with other T cell-targeted immunotherapies, where tumors express higher levels of HLA-E.
Collapse
Affiliation(s)
- Bérengère Salomé
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - John P Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Daniel Ranti
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jorge Daza
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Christine Bieber
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Andrew Charap
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Christian Hammer
- Department of Cancer Immunology, Genentech, South San Francisco, CA 94080, USA; Department of Human Genetics, Genentech, South San Francisco, CA 94080, USA
| | - Romain Banchereau
- Department of Oncology Biomarker Development, Genentech, South San Francisco, CA 94080, USA
| | - Adam M Farkas
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Dan Fu Ruan
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sudeh Izadmehr
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Daniel Geanon
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Geoffrey Kelly
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ronaldo M de Real
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Brian Lee
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Kristin G Beaumont
- Center for Advanced Genomics Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sanjana Shroff
- Center for Advanced Genomics Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Yuanshuo A Wang
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ying-Chih Wang
- Center for Advanced Genomics Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Tin Htwe Thin
- Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Monica Garcia-Barros
- Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Everardo Hegewisch-Solloa
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Emily M Mace
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Li Wang
- Center for Advanced Genomics Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Sema4, a Mount Sinai Venture, Stamford, CT 06902, USA
| | - Timothy O'Donnell
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Diego Chowell
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ruben Fernandez-Rodriguez
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mihaela Skobe
- Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nicole Taylor
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Seunghee Kim-Schulze
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Robert P Sebra
- Center for Advanced Genomics Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Sema4, a Mount Sinai Venture, Stamford, CT 06902, USA; Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Doug Palmer
- AstraZeneca, Oncology R & D Unit, Gaithersburg, MD 20878, USA
| | | | - Scott Hammond
- AstraZeneca, Oncology R & D Unit, Gaithersburg, MD 20878, USA
| | - Alice O Kamphorst
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Karl-Johan Malmberg
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | | | - Pedro Romero
- Department of Oncology UNIL CHUV, University of Lausanne, Lausanne, Switzerland
| | - Rachel Brody
- Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mathias Viard
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA
| | - Yuko Yuki
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA
| | - Maureen Martin
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA
| | - Mary Carrington
- Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD 21701, USA; Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, USA
| | - Reza Mehrazin
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Peter Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ira Mellman
- Department of Cancer Immunology, Genentech, South San Francisco, CA 94080, USA
| | - Sanjeev Mariathasan
- Department of Oncology Biomarker Development, Genentech, South San Francisco, CA 94080, USA
| | - Jun Zhu
- Center for Advanced Genomics Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Sema4, a Mount Sinai Venture, Stamford, CT 06902, USA
| | - Matthew D Galsky
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nina Bhardwaj
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Amir Horowitz
- The Marc and Jennifer Lipschultz Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Oncological Sciences, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| |
Collapse
|
10
|
Yao L, Jayasinghe RG, Lee BH, Bhasin SS, Pilcher W, Doxie DB, Gonzalez-Kozlova E, Dasari S, Fiala MA, Pita-Juarez Y, Strausbauch M, Kelly G, Thomas BE, Kumar SK, Cho HJ, Anderson E, Wendl MC, Dawson T, D'Souza D, Oh ST, Cheloni G, Li Y, DiPersio JF, Rahman AH, Dhodapkar KM, Kim-Schulze S, Vij R, Vlachos IS, Mehr S, Hamilton M, Auclair D, Kourelis T, Avigan D, Dhodapkar MV, Gnjatic S, Bhasin MK, Ding L. Comprehensive characterization of the multiple myeloma immune microenvironment using integrated scRNA-seq, CyTOF, and CITE-seq analysis. Cancer Research Communications 2022; 2:1255-1265. [PMID: 36969740 PMCID: PMC10035369 DOI: 10.1158/2767-9764.crc-22-0022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/09/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022]
Abstract
Abstract
As part of the Multiple Myeloma Research Foundation (MMRF) immune atlas pilot project, we compared immune cells of Multiple Myeloma (MM) bone marrow samples from 18 patients assessed by single-cell RNA-seq (scRNA-seq), mass cytometry (CyTOF), and Cellular Indexing of Transcriptomes and Epitopes by Sequencing (CITE-seq) to understand the concordance of measurements among single-cell techniques. Cell type abundances are relatively consistent across the three approaches, while variations are observed in T cells, macrophages, and monocytes. Concordance and correlation analysis of cell type marker gene expression across different modalities highlighted the importance of choosing cell type marker genes best suited to particular modalities. By integrating data from these three assays, we found International Staging System (ISS) stage 3 patients exhibited decreased CD4+ T/ CD8+ T cells ratio. Moreover, we observed upregulation of RAC2 and PSMB9, in NK cells of fast progressors (FP) compared to those of non-progressors (NP), as revealed by both scRNA-seq and CITE-seq RNA measurement. This detailed examination of the immune microenvironment in MM using multiple single cell technologies revealed markers associated with MM rapid progression which will be further characterized by the full-scale immune atlas project.
Collapse
Affiliation(s)
- Lijun Yao
- Washington University, St. Louis University School of Medicine, St. Louis, Mo, United States
| | - Reyka G Jayasinghe
- Washington University in St. Louis School of Medicine, Saint Louis, MO, United States
| | - Brian H. Lee
- Icahn School of Medicine at Mt. Sinai, New York, United States
| | - Swati S. Bhasin
- Emory University School of Medicine, Atlanta, GA, United States
| | | | | | | | | | - Mark A Fiala
- Washington University in St. Louis School of Medicine, St. Louis, United States
| | | | | | - Geoffrey Kelly
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Beena E Thomas
- Emory University School of Medicine, Atlanta, Ga, United States
| | | | - Hearn Jay Cho
- Multiple Myeloma Research Foundation, Norwalk, CT, United States
| | | | - Michael C. Wendl
- Washington University, St. Louis University School of Medicine, St. Louis, Mo, United States
| | - Travis Dawson
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Darwin D'Souza
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stephen T Oh
- Washington University in St. Louis School of Medicine, St. Louis, United States
| | - Giulia Cheloni
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Ying Li
- Mayo Clinic, Rochester, Minnesota, United States
| | | | - Adeeb H. Rahman
- Icahn School of Medicine at Mt. Sinai, New York, United States
| | | | | | - Ravi Vij
- Washington University in St. Louis, Saint Louis, MO, United States
| | | | - Shaadi Mehr
- Multiple Myeloma Research Foundation, Norwalk, CT, United States
| | - Mark Hamilton
- Multiple Myeloma Research Foundation, Norwalk, CT, United States
| | | | | | - David Avigan
- Harvard Medical School, Boston, MA, United States
| | | | - Sacha Gnjatic
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Manoj K. Bhasin
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Li Ding
- Washington University School of Medicine in St. Louis, St Louis, MO, United States
| |
Collapse
|
11
|
Mauger M, Kelly G, Annandale CH, Robertson ID, Waichigo FK, Aleri JW. Anthelmintic resistance of gastrointestinal nematodes in dairy calves within a pasture-based production system of south West Western Australia. Aust Vet J 2022; 100:283-291. [PMID: 35383394 PMCID: PMC9542819 DOI: 10.1111/avj.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 02/15/2022] [Accepted: 03/20/2022] [Indexed: 11/30/2022]
Abstract
The objective of this study was to determine the prevalence of gastrointestinal nematodes among post‐weaned calves aged between 4 and 12 months old within a pasture‐based system of south west Australia and quantify the level of anthelmintic resistance. Pre‐treatment FECs were monitored on 14 dairy farms. Anthelmintic resistance was assessed on 11 of the farms. Control FECs were compared with anthelmintic FECs at 14 days post‐treatment with doramectin (injectable), levamisole (oral), fenbendazole (oral) and a levamisole/abamectin combination (pour‐on). Results demonstrate a strong level of anthelmintic resistance, with at least one class of anthelmintic failing to achieve a 95% reduction in FEC in one or more gastrointestinal nematode species. Doramectin was fully effective against Ostertagia, but C. oncophora displayed resistance in 91% of the farms. Conversely, levamisole was fully effective against C. oncophora, but Ostertagia displayed resistance in 80% of the farms. Fenbendazole resistance was present in both C. onocphora and Ostertagia in 64% and 70% of the farms, respectively. Trichostrongylus showed low resistance, occurring in doramectin (14%) and levamisole/abamectin combination (14%). This study confirms that anthelmintic resistance is common. Regular FEC reduction testing is recommended to monitor and guide decision‐making for appropriate anthelmintic usage.
Collapse
Affiliation(s)
- M Mauger
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - G Kelly
- Boehringer Ingelheim Animal Health Australia Pty. Ltd., North Ryde, New South Wales, Australia
| | - C H Annandale
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - I D Robertson
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia.,College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China
| | - F K Waichigo
- Brunswick Veterinary Services, Brunswick Junction, Western Australia, Australia
| | - J W Aleri
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia.,Centre for Animal Production and Health, Future Foods Institute, Murdoch University, Murdoch, Western Australia, Australia
| |
Collapse
|
12
|
Salomé B, Sfakianos JP, Daza J, Charap A, Farkas AM, Geanon D, Kelly G, De Real RM, Lee B, Beaumont KG, Shroff S, Wang YC, Wang YSA, Wang L, Sebra RP, Kamphorst AO, Malmberg KJ, Marcenaro E, Romero P, Brody R, Yuki Y, Martin M, Carrington M, Mehrazin R, Wiklund P, Zhu J, Galsky MD, Bhardwaj N, Horowitz A. Abstract P046: NKG2A and HLA-E define a novel alternative immune checkpoint axis in bladder cancer. Cancer Immunol Res 2022. [DOI: 10.1158/2326-6074.tumimm21-p046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Bladder cancer is characterized by a poor prognosis, with muscle-invasive cases harboring a 34-76% 10-year recurrence-free survival rate [1]. Neoadjuvant PD-1/PD-L1 blockade strategies have recently been approved by the US Food and Drug Administration for bladder cancer treatment, yet only achieving a complete response rate of 31-37%, thereby suggesting additional mechanisms of resistance [2]. HLA-E is a known inhibitor of NKG2A+ CD8 T cells and NK cell responses. A monoclonal antibody binding to the NKG2A receptor has been developed and proven to restore CD8 T cell and NK cell responses in head and neck cancer, with ongoing clinical trials across multiple tumor indications [3,4]. We evaluated the potential role of the HLA-E/NKG2A inhibitory pathway in modulating T cell immunity in bladder cancer. Methods: CyTOF was performed on CD8+ T cells from fresh bladder tumors (n=6), as well as on expanded CD8+ T cells from bladder-draining lymph nodes (n=11) and tumors (n=8). Flow cytometry (n=25) and single-cell RNA-sequencing (scRNAseq) (n=13) were performed on cells from fresh bladder tumors. Results: Mechanisms of tumor escape from CD8+ T cell recognition include impairment of antigen presentation. Accordingly, we found a significant reduction of HLA class I expression on tumors. However, expression of DNAM-1-activating ligands (e.g. CD112,CD155) on bladder tumors was retained, indicating a possible role for TCR-independent activation pathways traditionally ascribed to natural killer (NK) cells. Using mass cytometry and scRNAseq, we observed that acquisition of NKG2A on tumor-derived PD-1+ CD8+ T cells promotes tissue-resident memory features alongside diminished CD28 expression and significantly weaker sensitivity to CD3/CD28-signaling. However, NKG2A+ CD8 T cells possess a proliferative advantage with enhanced expression of DNAM-1 and cytolytic machinery. Strikingly, we found that NKG2A+PD-1+ CD8 T cells are strongly activated in response to HLA class I-deficient tumors compared to their NKG2A− PD-1+ CD8 T cell counterparts. TCR-independent NK-like function by NKG2A+ CD8 T cell is partly mediated by the DNAM-1 pathway and inhibited by HLA-E. NKG2A+ CD8 T cell functions are restored upon NKG2A blockade, where efficiency positively correlates with HLA-E expression on bladder tumors. Discussion: Collectively, our data indicate that NKG2A+ CD8 T cells display a strong capacity for TCR-independent activation that enables them to circumvent bladder tumor evasion mechanisms. NKG2A+ CD8 T cells lack expression of CD28 suggesting a lower susceptibility to PD-1-mediated inhibition. Our data suggest a need for thorough reappraisal of current protocols that assess CD8 T cell exhaustion and for strategies to restore their antitumor functions. References: 1. Sanli, O. et al., Nat Rev Dis Primers, 2017 2. Rouanne, M. et al., Eur Urol Oncol, 2020 3. André, P. et al., Cell, 2018 4. Van Hall, T. et al., J Immunother Cancer, 2019
Citation Format: Bérengère Salomé, John P. Sfakianos, Jorge Daza, Andrew Charap, Adam M. Farkas, Daniel Geanon, Geoffrey Kelly, Ronaldo M. De Real, Brian Lee, Kristin G. Beaumont, Sanjana Shroff, Ying-Chih Wang, Yuan-Shuo A. Wang, Li Wang, Robert P. Sebra, Alice O. Kamphorst, Karl J. Malmberg, Emanuela Marcenaro, Pedro Romero, Rachel Brody, Yuko Yuki, Maureen Martin, Mary Carrington, Reza Mehrazin, Peter Wiklund, Jun Zhu, Matthew D. Galsky, Nina Bhardwaj, Amir Horowitz. NKG2A and HLA-E define a novel alternative immune checkpoint axis in bladder cancer [abstract]. In: Abstracts: AACR Virtual Special Conference: Tumor Immunology and Immunotherapy; 2021 Oct 5-6. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(1 Suppl):Abstract nr P046.
Collapse
Affiliation(s)
- Bérengère Salomé
- 1Department of Oncological Sciences, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - John P. Sfakianos
- 2Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Jorge Daza
- 2Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Andrew Charap
- 1Department of Oncological Sciences, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Adam M. Farkas
- 3Division of Hematology and Medical Oncology, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Daniel Geanon
- 4Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Geoffrey Kelly
- 4Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Ronaldo M. De Real
- 4Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Brian Lee
- 4Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Kristin G. Beaumont
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Sanjana Shroff
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Ying-Chih Wang
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Yuan-Shuo A. Wang
- 2Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Li Wang
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
- 6Sema4, A Mount Sinai Venture, Stamford, CT,
| | - Robert P. Sebra
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
- 6Sema4, A Mount Sinai Venture, Stamford, CT,
- 7Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Alice O. Kamphorst
- 1Department of Oncological Sciences, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Karl J. Malmberg
- 8Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway,
- 9Institute of Clinical Medicine, University of Oslo, Oslo, Norway,
- 10Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden,
| | - Emanuela Marcenaro
- 11Department of Experimental Medicine, University of Genoa, Genoa, Italy,
| | - Pedro Romero
- 12Department of Oncology UNIL CHUV, University of Lausanne, Lausanne, Switzerland,
| | - Rachel Brody
- 13Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY,Basic Science Program, Frederick National Laboratory for Cancer Research, Frederick, MD,Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA,
| | - Yuko Yuki
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
- 6Sema4, A Mount Sinai Venture, Stamford, CT,
| | - Maureen Martin
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
- 6Sema4, A Mount Sinai Venture, Stamford, CT,
| | - Mary Carrington
- 3Division of Hematology and Medical Oncology, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
- 6Sema4, A Mount Sinai Venture, Stamford, CT,
- *These authors contributed equally
| | - Reza Mehrazin
- 2Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Peter Wiklund
- 2Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Jun Zhu
- 5Icahn Institute for Data Science and Genomics Technology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY,
- 6Sema4, A Mount Sinai Venture, Stamford, CT,
| | - Matthew D. Galsky
- 3Division of Hematology and Medical Oncology, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
| | - Nina Bhardwaj
- 3Division of Hematology and Medical Oncology, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
- *These authors contributed equally
| | - Amir Horowitz
- 1Department of Oncological Sciences, Precision Immunology Institute, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY,
- *These authors contributed equally
| |
Collapse
|
13
|
Salome B, Sfakianos J, Charap A, Farkas A, Geanon D, Kelly G, Real RD, Lee B, Beaumont K, Shroff S, Wang YC, Wang YS, Wang L, Sebra R, Kamphorst A, Malmberg KJ, Marcenaro E, Romero P, Brody R, Yuki Y, Martin M, Carrington M, Mehrazin R, Wiklund P, Zhu J, Galsky M, Bhardwaj N, Horowitz A. 314 NKG2A and HLA-E define a novel alternative immune checkpoint axis in bladder cancer. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BackgroundBladder cancer is characterized by a poor prognosis, with muscle-invasive cases harboring a 34–76% 10-year recurrence-free survival rate.1 Neoadjuvant PD-1/PD-L1 blockade strategies have recently been approved by the US Food and Drug Administration for bladder cancer treatment, yet only achieving a complete response rate of 31–37%, thereby suggesting additional mechanisms of resistance.2 HLA-E is a known inhibitor of NKG2A+ CD8 T cells and NK cell responses. A monoclonal antibody binding to the NKG2A receptor has been developed and proven to restore CD8 T cell and NK cell responses in head and neck cancer, with ongoing clinical trials across multiple tumor indications.3 4 We evaluated the potential role of the HLA-E/NKG2A inhibitory pathway in modulating T cell immunity in bladder cancer.MethodsCyTOF was performed on CD8+ T cells from fresh bladder tumors (n=6), as well as on expanded CD8+ T cells from bladder-draining lymph nodes (n=11) and tumors (n=8). Flow cytometry (n=25) and single-cell RNA-sequencing (scRNAseq) (n=13) were performed on cells from fresh bladder tumors.ResultsMechanisms of tumor escape from CD8+ T cell recognition include impairment of antigen presentation. Accordingly, we found a significant reduction of HLA class I expression on tumors. However, expression of DNAM-1-activating ligands (e.g. CD112,CD155) on bladder tumors was retained, indicating a possible role for TCR-independent activation pathways traditionally ascribed to natural killer (NK) cells. Using mass cytometry and scRNAseq, we observed that acquisition of NKG2A on tumor-derived PD-1+ CD8+ T cells promotes tissue-resident memory features alongside diminished CD28 expression and significantly weaker sensitivity to CD3/CD28-signaling. However, NKG2A+ CD8 T cells possess a proliferative advantage with enhanced expression of DNAM-1 and cytolytic machinery.Strikingly, we found that NKG2A+PD-1+ CD8 T cells are strongly activated in response to HLA class I-deficient tumors compared to their NKG2A- PD-1+ CD8 T cell counterparts. TCR-independent NK-like function by NKG2A+ CD8 T cell is partly mediated by the DNAM-1 pathway and inhibited by HLA-E. NKG2A+ CD8 T cell functions are restored upon NKG2A blockade, where efficiency positively correlates with HLA-E expression on bladder tumors.ConclusionsCollectively, our data indicate that NKG2A+ CD8 T cells display a strong capacity for TCR-independent activation that enables them to circumvent bladder tumor evasion mechanisms. NKG2A+ CD8 T cells lack expression of CD28 suggesting a lower susceptibility to PD-1-mediated inhibiton. Our data suggest a need for thorough reappraisal of current protocols that assess CD8 T cell exhaustion and for strategies to restore their antitumor functions.ReferencesSanli O, Dobruch J, Knowles MA, Burger M, Alemozaffar M, Nielsen ME, Lotan Y. Bladder cancer. Nat Rev Dis Primers 2017 April 13;3:17022. doi: 10.1038/nrdp.2017.22. PMID: 28406148. Rouanne M, Bajorin DF, Hannan R, Galsky MD, Williams SB, Necchi A, Sharma P, Powles T. Rationale and outcomes for neoadjuvant immunotherapy in urothelial carcinoma of the bladder. Eur Urol Oncol 2020 December;3(6):728–738. doi: 10.1016/j.euo.2020.06.009. Epub 2020 Nov 8. PMID: 33177001. André P, Denis C, Soulas C, Bourbon-Caillet C, Lopez J, Arnoux T, Bléry M, Bonnafous C, Gauthier L, Morel A, Rossi B, Remark R, Breso V, Bonnet E, Habif G, Guia S, Lalanne AI, Hoffmann C, Lantz O, Fayette J, Boyer-Chammard A, Zerbib R, Dodion P, Ghadially H, Jure-Kunkel M, Morel Y, Herbst R, Narni-Mancinelli E, Cohen RB, Vivier E. Anti-NKG2A mAb is a checkpoint inhibitor that promotes anti-tumor immunity by unleashing both T and NK Cells. Cell 2018 December 13;175(7):1731–1743.e13. doi: 10.1016/j.cell.2018.10.014. Epub 2018 Nov 29. PMID: 30503213; PMCID: PMC6292840. van Hall T, André P, Horowitz A, Ruan DF, Borst L, Zerbib R, Narni-Mancinelli E, van der Burg SH, Vivier E. Monalizumab: inhibiting the novel immune checkpoint NKG2A. J Immunother Cancer 2019 October 17;7(1):263. doi: 10.1186/s40425-019-0761-3. PMID: 31623687; PMCID: PMC6798508.
Collapse
|
14
|
Horowitz A, Daza J, Alice Wang Y, Ranti D, Salome B, Merritt E, Cavallo-Fleming JA, Hegewisch-Solloa E, Mace E, Farkas A, Shroff S, Tran M, Qi J, Patel M, Geanon D, Kelly G, Real RD, Lee B, Kim-Schulze S, Thin TH, Garcia-Barros M, Beaumont K, Wang YC, Wang L, LaRoche D, Lee Y, Sebra R, Brody R, Mehrazin R, Zhu J, Tocheva A, Hopkins B, Wiklund P, Galsky M, Bhardwaj N, Sfakianos J. 621 NKG2A and HLA-E define a novel mechanism of resistance to immunotherapy with M. bovis BCG in non-muscle-invasive bladder cancer patients. J Immunother Cancer 2021. [DOI: 10.1136/jitc-2021-sitc2021.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background75% of diagnosed bladder tumors are non-muscle-invasive (NMIBC)[1, 2]. Most require intravesical instillation of M.bovis Bacillus Calmette-Guérin (BCG). Recurrence after immunotherapy occurs in ~50% patients. Development of treatments for BCG-resistant disease has lagged partly because few studies have attempted to understand the relationship between timing of tumor recurrence, reasoning for the recurrence, and the state of immune system at the time of recurrence.Immune exhaustion is observed following microbial infections, cancers and chronic inflammation [3–5]. Natural Killer (NK) cells are among the earliest responders[6–8] and undergo a similar program of exhaustion as T cells[9]. HLA-E strongly inhibits NKG2A-expressing NK and CD8+T cells and is commonly upregulated on tumors[10]. We evaluated the potential restorative capacity of NKG2A and PD-L1-blockade for reinvigorating NK and CD8+T cell antitumor functions in in BCG-resistant bladder cancer.Methods mRNA analysis of 2,892 genes was performed on tumor tissue of NMIBC patients before and after BCG therapy (n=35). Immunostaining (serial-IHC,immunofluorescence,imaging-mass cytometry) was performed on consecutive tissue sections. Single-cell-RNA-sequencing (scRNAseq) was performed on fresh bladder tumors (NMIBC,n=4; MIBC,n=9). OLink Proteomics (”Inflammation” panel) was performed longitudinally on plasma/urine from a prospective cohort of NMIBC patients. Patient tumors (n=3) were expanded as organoids and co-cultured with autologous tumor-derived NK and CD8+T cells in presence/absence of anti-PD-L1/NKG2A antibodies.ResultsWe demonstrate a robust local TME and systemic response to BCG that correlates with chronic inflammation and adaptive resistance rather than with preventing tumor recurrence. This resistance is mediated through IFN-γ-production by tumor-infiltrating NKG2A+NK and NKG2A+PD-1+CD8+T cells and results in increased HLA-E and PD-L1 on recurring tumors. Co-culture of treatment-naïve NMIBC tumors with recombinant IFN-gamma directly enhanced expression of PD-L1 and HLA-E. Longitudinal analysis of plasma before and during BCG immunotherapy revealed an inflammatory signature, including but not limited to IFN-gamma, that is maintained throughout treatment.Immunostaining and scRNAseq of NMIBC specimens revealed highly enriched infiltration by NKG2A+NK and NKG2A+CD8+T cells in HLA-EBrightPD-L1+ tumors and were spatially organized relative to tumors in a manner suggesting direct inhibition. Tumor-derived NK and CD8+T cells from BCG-resistant patients were co-cultured with autologous tumor organoids. Preliminary analyses demonstrated an improved anti-tumor response in presence of NKG2A/PD-L1-blockade.ConclusionsOur data support a model of BCG-resistance that points to a novel checkpoint axis that contributes to BCG-resistance: HLA-E/NKG2A. New insights into this axis in NMIBC and how it is altered with repeated BCG exposure will enable us to explore combination therapies (PD-L1/NKG2A-blockade) that may reduce BCG-resistance and provide durable response.ReferencesEidinger D, Morales A: Discussion paper: treatment of superficial bladder cancer in man. Ann N Y Acad Sci 1976, 277:239–240.Morales A, Eidinger D, Bruce AW: Intracavitary Bacillus Calmette-Guerin in the treatment of superficial bladder tumors. J Urol 1976, 116:180–183.Blank CU, Haining WN, Held W, Hogan PG, Kallies A, Lugli E, Lynn RC, Philip M, Rao A, Restifo NP et al: Defining ‘T cell exhaustion’. Nat Rev Immunol 2019, 19:665–674.Hashimoto M, Kamphorst AO, Im SJ, Kissick HT, Pillai RN, Ramalingam SS, Araki K, Ahmed R: CD8 T Cell Exhaustion in Chronic Infection and Cancer: Opportunities for Interventions. Annu Rev Med 2018, 69:301–318.McLane LM, Abdel-Hakeem MS, Wherry EJ: CD8 T Cell Exhaustion During Chronic Viral Infection and Cancer. Annu Rev Immunol 2019, 37:457–495.Lanier LL: NK cell receptors. Annu Rev Immunol 1998, 16:359–393.Biron CA, Gazzinelli RT: Effects of IL-12 on immune responses to microbial infections: a key mediator in regulating disease outcome. Curr Opin Immunol 1995, 7:485–496.Welsh RM, Jr.: Cytotoxic cells induced during lymphocytic choriomeningitis virus infection of mice. I. Characterization of natural killer cell induction. J Exp Med 1978, 148:163–181.da Silva IP, Gallois A, Jimenez-Baranda S, Khan S, Anderson AC, Kuchroo VK, Osman I, Bhardwaj N: Reversal of NK-cell exhaustion in advanced melanoma by Tim-3 blockade. Cancer Immunol Res 2014, 2:410–422.van Hall T, Andre P, Horowitz A, Ruan DF, Borst L, Zerbib R, Narni-Mancinelli E, van der Burg SH, Vivier E: Monalizumab: inhibiting the novel immune checkpoint NKG2A. J Immunother Cancer 2019, 7:263.Ethics ApprovalPrimary urothelial bladder cancer tumor tissue was obtained after obtaining informed consent in the context of an Institutional Review Board (IRB)-approved genitourinary cancer clinical database and specimen collection protocol (IRB #10-1180) at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai (New York, NY).
Collapse
|
15
|
Bosworth K, Mustafa Y, Aukland M, Bhat A, Kelly G. P.77 Skin-to-skin care during caesarean section in two obstetric units. Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
16
|
Geanon D, Lee B, Gonzalez‐Kozlova E, Kelly G, Handler D, Upadhyaya B, Leech J, De Real RM, Herbinet M, Magen A, Del Valle D, Charney A, Kim‐Schulze S, Gnjatic S, Merad M, Rahman AH. A streamlined whole blood CyTOF workflow defines a circulating immune cell signature of COVID-19. Cytometry A 2021; 99:446-461. [PMID: 33496367 PMCID: PMC8013522 DOI: 10.1002/cyto.a.24317] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 10/21/2020] [Revised: 12/10/2020] [Accepted: 01/06/2021] [Indexed: 01/21/2023]
Abstract
Mass cytometry (CyTOF) represents one of the most powerful tools in immune phenotyping, allowing high throughput quantification of over 40 parameters at single-cell resolution. However, wide deployment of CyTOF-based immune phenotyping studies are limited by complex experimental workflows and the need for specialized CyTOF equipment and technical expertise. Furthermore, differences in cell isolation and enrichment protocols, antibody reagent preparation, sample staining, and data acquisition protocols can all introduce technical variation that can confound integrative analyses of large data-sets of samples processed across multiple labs. Here, we present a streamlined whole blood CyTOF workflow which addresses many of these sources of experimental variation and facilitates wider adoption of CyTOF immune monitoring across sites with limited technical expertise or sample-processing resources or equipment. Our workflow utilizes commercially available reagents including the Fluidigm MaxPar Direct Immune Profiling Assay (MDIPA), a dry tube 30-marker immunophenotyping panel, and SmartTube Proteomic Stabilizer, which allows for simple and reliable fixation and cryopreservation of whole blood samples. We validate a workflow that allows for streamlined staining of whole blood samples with minimal processing requirements or expertise at the site of sample collection, followed by shipment to a central CyTOF core facility for batched downstream processing and data acquisition. We apply this workflow to characterize 184 whole blood samples collected longitudinally from a cohort of 72 hospitalized COVID-19 patients and healthy controls, highlighting dynamic disease-associated changes in circulating immune cell frequency and phenotype.
Collapse
Affiliation(s)
- Daniel Geanon
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Brian Lee
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Edgar Gonzalez‐Kozlova
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Geoffrey Kelly
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Diana Handler
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Bhaskar Upadhyaya
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - John Leech
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Ronaldo M. De Real
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Manon Herbinet
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Assaf Magen
- Department of Oncological SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Diane Del Valle
- Department of Oncological SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Alexander Charney
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Seunghee Kim‐Schulze
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Sacha Gnjatic
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of Oncological SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Miriam Merad
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of Oncological SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Adeeb H. Rahman
- Human Immune Monitoring CenterIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| |
Collapse
|
17
|
Collart C, Ciccarelli A, Ivanovitch K, Rosewell I, Kumar S, Kelly G, Edwards A, Smith JC. The migratory pathways of the cells that form the endocardium, dorsal aortae, and head vasculature in the mouse embryo. BMC Dev Biol 2021; 21:8. [PMID: 33752600 PMCID: PMC7986287 DOI: 10.1186/s12861-021-00239-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
Background Vasculogenesis in amniotes is often viewed as two spatially and temporally distinct processes, occurring in the yolk sac and in the embryo. However, the spatial origins of the cells that form the primary intra-embryonic vasculature remain uncertain. In particular, do they obtain their haemato-endothelial cell fate in situ, or do they migrate from elsewhere? Recently developed imaging techniques, together with new Tal1 and existing Flk1 reporter mouse lines, have allowed us to investigate this question directly, by visualising cell trajectories live and in three dimensions. Results We describe the pathways that cells follow to form the primary embryonic circulatory system in the mouse embryo. In particular, we show that Tal1-positive cells migrate from within the yolk sac, at its distal border, to contribute to the endocardium, dorsal aortae and head vasculature. Other Tal1 positive cells, similarly activated within the yolk sac, contribute to the yolk sac vasculature. Using single-cell transcriptomics and our imaging, we identify VEGF and Apela as potential chemo-attractants that may regulate the migration into the embryo. The dorsal aortae and head vasculature are known sites of secondary haematopoiesis; given the common origins that we observe, we investigate whether this is also the case for the endocardium. We discover cells budding from the wall of the endocardium with high Tal1 expression and diminished Flk1 expression, indicative of an endothelial to haematopoietic transition. Conclusions In contrast to the view that the yolk sac and embryonic circulatory systems form by two separate processes, our results indicate that Tal1-positive cells from the yolk sac contribute to both vascular systems. It may be that initial Tal1 activation in these cells is through a common mechanism. Supplementary Information The online version contains supplementary material available at 10.1186/s12861-021-00239-3.
Collapse
Affiliation(s)
- C Collart
- Developmental Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.
| | - A Ciccarelli
- Advanced Light Microscopy Facility, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - K Ivanovitch
- Developmental Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - I Rosewell
- Genetic Modification Service, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - S Kumar
- Advanced Light Microscopy Facility, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK.,Photonics Group, 606 Blackett Laboratory, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - G Kelly
- Bioinformatics and Biostatistics Facility, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - A Edwards
- Advanced Sequencing Facility, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - J C Smith
- Developmental Biology Laboratory, Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| |
Collapse
|
18
|
Magri C, Schramme M, Nottrott K, Schweizer‐Gorgas D, Segard E, Kelly G, Schumacher J. Coronoidectomy as a treatment for mandibular immobility caused by fracture of the coronoid process in three horses. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13396] [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: 11/28/2022]
Affiliation(s)
- C. Magri
- Clinéquine VetAgro Sup Marcy l’Etoile France
| | - M. Schramme
- Clinéquine VetAgro Sup Marcy l’Etoile France
| | - K. Nottrott
- Clinéquine VetAgro Sup Marcy l’Etoile France
| | - D. Schweizer‐Gorgas
- Section of Diagnostic Imaging Vetsuisse Faculty University of Berne Berne Switzerland
| | - E. Segard
- Clinéquine VetAgro Sup Marcy l’Etoile France
| | - G. Kelly
- Fethard Equine Hospital Fethard Tipperary Ireland
| | - J. Schumacher
- Department of Large Animal Clinical Sciences College of Veterinary Medicine University of Tennessee Knoxville Tennessee USA
| |
Collapse
|
19
|
East P, Kelly G, Biswas D, Hancock D, Swanton C, de Carne S, Downward J. Stratification method based on RAS pathway oncogenic activity predicts outcome in lung adenocarcinoma. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31113-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
20
|
Geanon D, Lee B, Kelly G, Handler D, Upadhyaya B, Leech J, Herbinet M, Del Valle D, Gnjatic S, Kim-Schulze S, Merad M, Rahman A. A Streamlined CyTOF Workflow To Facilitate Standardized Multi-Site Immune Profiling of COVID-19 Patients. medRxiv 2020:2020.06.26.20141341. [PMID: 32607524 PMCID: PMC7325190 DOI: 10.1101/2020.06.26.20141341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Mass cytometry (CyTOF) represents one of the most powerful tools in immune phenotyping, allowing high throughput quantification of over 40 single parameters at single-cell resolution. However, wide deployment of CyTOF-based immune phenotyping studies are limited by complex experimental workflows and the need for specialized CyTOF equipment and technical expertise. Furthermore, differences in cell isolation and enrichment protocols, antibody reagent preparation, sample staining and data acquisition protocols can all introduce technical variation that can potentially confound integrative analyses of large data-sets of samples processed across multiple labs. Here, we present a streamlined whole blood CyTOF workflow which addresses many of these sources of experimental variation and facilitates wider adoption of CyTOF immune monitoring across sites with limited technical expertise or sample-processing resources or equipment. Our workflow utilizes commercially available reagents including the Fluidigm MaxPar Direct Immune Profiling Assay (MDIPA), a dry tube 30-marker immunophenotyping panel, and SmartTube Proteomic Stabilizer, which allows for simple and reliable fixation and cryopreservation of whole blood samples. We validate a workflow that allows for streamlined staining of whole blood samples with minimal processing requirements or expertise at the site of sample collection, followed by shipment to a central CyTOF core facility for batched downstream processing and data acquisition. We further demonstrate the application of this workflow to characterize immune responses in a cohort of hospitalized COVID-19 patients, highlighting key disease-associated changes in immune cell frequency and phenotype.
Collapse
|
21
|
Kelly G, Hamilton C, Pool J. Investigating the use of rhythmic auditory stimulation for children with acquired brain injury. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.090] [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: 10/24/2022]
|
22
|
Garrod R, Kelly G, Randall S, Palanivel D. Best practice for serial casting to increase ankle range of movement following botulinum toxin in children with acquired brain Injury. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.306] [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: 11/27/2022]
|
23
|
Lee BH, Kelly G, Bradford S, Davila M, Guo XV, Amir EAD, Thrash EM, Solga MD, Lannigan J, Sellers B, Candia J, Tsang J, Montgomery RR, Tamaki SJ, Sigdel TK, Sarwal MM, Lanier LL, Tian Y, Kim C, Hinz D, Peters B, Sette A, Rahman AH. A Modified Injector and Sample Acquisition Protocol Can Improve Data Quality and Reduce Inter-Instrument Variability of the Helios Mass Cytometer. Cytometry A 2019; 95:1019-1030. [PMID: 31364278 PMCID: PMC6750971 DOI: 10.1002/cyto.a.23866] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 03/25/2019] [Revised: 05/22/2019] [Accepted: 07/02/2019] [Indexed: 01/04/2023]
Abstract
Mass cytometry is a powerful tool for high-dimensional single cell characterization. Since the introduction of the first commercial CyTOF mass cytometer by DVS Sciences in 2009, mass cytometry technology has matured and become more widely utilized, with sequential platform upgrades designed to address specific limitations and to expand the capabilities of the platform. Fluidigm's third-generation Helios mass cytometer introduced a number of upgrades over the previous CyTOF2. One of these new features is a modified narrow bore sample injector that generates smaller ion clouds, which is expected to improve sensitivity and throughput. However, following rigorous testing, we find that the narrow-bore sample injector may have unintended negative consequences on data quality and result in lower median and higher coefficients of variation in many antibody-associated signal intensities. We describe an alternative Helios acquisition protocol using a wider bore injector, which largely mitigates these data quality issues. We directly compare these two protocols in a multisite study of 10 Helios instruments across 7 institutions and show that the modified protocol improves data quality and reduces interinstrument variability. These findings highlight and address an important source of technical variability in mass cytometry experiments that is of particular relevance in the setting of multicenter studies. © 2019 International Society for Advancement of Cytometry.
Collapse
Affiliation(s)
- Brian H. Lee
- Human Immune Monitoring Center, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Geoffrey Kelly
- Human Immune Monitoring Center, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Shermineh Bradford
- Human Immune Monitoring Center, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Melanie Davila
- Human Immune Monitoring Center, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - Xinzheng V. Guo
- Human Immune Monitoring Center, Icahn School of Medicine at Mt. Sinai, New York, New York
| | | | - Emily M. Thrash
- Center for Immuno-Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Michael D. Solga
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, Virginia
| | - Joanne Lannigan
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, Virginia
| | - Brian Sellers
- Trans-NIH Center for Human Immunology, Autoimmunity, and Inflammation, National Institutes of Health, Bethesda, Maryland
| | - Julian Candia
- Trans-NIH Center for Human Immunology, Autoimmunity, and Inflammation, National Institutes of Health, Bethesda, Maryland
| | - John Tsang
- Trans-NIH Center for Human Immunology, Autoimmunity, and Inflammation, National Institutes of Health, Bethesda, Maryland
| | - Ruth R. Montgomery
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut
| | - Stanley J. Tamaki
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Tara K. Sigdel
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Minnie M. Sarwal
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Lewis L. Lanier
- Department of Microbiology and Immunology, University of California San Francisco, San Francisco, California
| | - Yuan Tian
- Division of Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, California
| | - Cheryl Kim
- Flow Cytometry Core Facility, La Jolla Institute for Immunology, La Jolla
| | - Denise Hinz
- Flow Cytometry Core Facility, La Jolla Institute for Immunology, La Jolla
| | - Bjoern Peters
- Division of Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, California
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Alessandro Sette
- Division of Vaccine Discovery, La Jolla Institute for Immunology, La Jolla, California
- Department of Medicine, University of California San Diego, La Jolla, California
| | - Adeeb H. Rahman
- Human Immune Monitoring Center, Icahn School of Medicine at Mt. Sinai, New York, New York
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mt. Sinai, New York, New York
| |
Collapse
|
24
|
Derham AM, O'Leary JM, Connolly SE, Schumacher J, Kelly G. Performance comparison of 159 Thoroughbred racehorses and matched cohorts before and after desmotomy of the interspinous ligament. Vet J 2019; 249:16-23. [PMID: 31239160 DOI: 10.1016/j.tvjl.2019.05.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 11/16/2022]
Abstract
Racehorses may perform poorly because of impinging dorsal spinous processes (DSPs) of the thoracolumbar vertebrae. No study has looked objectively at the long-term outcome of racehorses undergoing desmotomy of the interspinous ligament as a treatment for horses with poor performance caused by impinging DSPs. The aim of this study was to examine objectively, by using pre-operative and post-operative racing records, the effectiveness of desmotomy of the interspinous ligament (DISL) in improving the performance of racehorses with impinging DSPs. Medical records of all horses undergoing desmotomy of one or more interspinous ligaments at a referral equine hospital, between February 2015 and September 2016, were reviewed. The study was confined to Thoroughbred racehorses with sufficient historical information and racetrack data to allow their racing performances be compared to that of matched controls. Matched controls were of the same age, sex, and racing type and were trained at the same time by the same trainer as those undergoing desmotomy. The time to follow-up was at least 12 months. Of the 6545 horses presented for poor performance or lameness during the study period, 236 horses (3.6%) underwent desmotomy of one or more interspinous ligaments, and of these, 159 met the inclusion criteria. Horses undergoing desmotomy had significantly better improvement in racing performance than did matched controls. Eight horses developed unilateral neurogenic atrophy of epaxial musculature. DISL between impinging DSPs can improve the performance of racehorses experiencing from poor performance caused by pain resulting from the impinging processes.
Collapse
Affiliation(s)
- A M Derham
- University College Dublin, University Veterinary Hospital, UCD, Belfield, Dublin 4, Ireland.
| | - J M O'Leary
- University College Dublin, University Veterinary Hospital, UCD, Belfield, Dublin 4, Ireland
| | - S E Connolly
- MRC Biostatistics Unit, University of Cambridge, Cambridge Institute of Public Health, Forvie Site, Robinson Way, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK
| | - J Schumacher
- Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN 37996, USA
| | - G Kelly
- Fethard Equine Hospital, Tipperary, Ireland
| |
Collapse
|
25
|
Macdonald J, Kelly G, McCaffrey D. A CALCANEUS FRACTURE WITH INTERPOSED FLEXOR HALLUCIS LONGUS TENDON; A SURGICAL TIP TO AID TENDON REDUCTION. Ulster Med J 2018; 87:201-202. [PMID: 31061547 PMCID: PMC6500420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- J. Macdonald
- Correspondence to: J Macdonald, Altnagelvin Area Hospital, Northern Ireland, E-mail:
| | | | | |
Collapse
|
26
|
Din W, Liu C, Kelly G. Proposal of a new clinical method for removal of button batteries and other ferrous material from the external auditory ear canal and nasal cavity using a fine magnet probe. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
27
|
Kelly G, Messina M, Minns I. NOX66 plus low dose carboplatin: A phase 1 safety and signalling study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy047.006] [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: 11/13/2022] Open
|
28
|
Borchert G, Casciello F, Kelly G, Baxter E, Gannon F, Lee J. Re-sensitising endocrine resistant ER+ breast cancer by targeting epigenetic modifying enzymes. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy047.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
29
|
Love N, Riely G, Ladanyi M, Paley D, Miller K, Kelly G, Moss J, Ziel K. PS02.17 A Biomarker-Driven Algorithm for Sequencing of Systemic Therapy for Metastatic Non-Small Cell Lung Cancer (mNSCLC): A Survey of 25 Investigators. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Kelly G, Minns I, Messina M. NOX66 plus carboplatin - a phase 1 signalling study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx729.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
31
|
Minns I, Kelly G. Chemosensitization of carboplatin by NOX66: Pharmacokinetics and safety. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx367.052] [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: 11/13/2022] Open
|
32
|
Taylor AW, Kelly G, Dal Grande E, Kelly D, Marin T, Hey N, Burke KJ, Licinio J. Population levels of wellbeing and the association with social capital. BMC Psychol 2017; 5:23. [PMID: 28673334 PMCID: PMC5496434 DOI: 10.1186/s40359-017-0193-0] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/22/2017] [Indexed: 11/23/2022] Open
Abstract
Background This research investigates wellbeing at the population level across demographic, social and health indicators and assesses the association between wellbeing and social capital. Method Data from a South Australian monthly chronic disease/risk factor surveillance system of randomly selected adults (mean age 48.7 years; range 16–99) from 2014/5 (n = 5551) were used. Univariable analyses compared wellbeing/social capital indicators, socio-demographic, risk factors and chronic conditions. Multi-nominal logistic regression modelling, adjusting for multiple covariates was used to simultaneously estimate odds ratios for good wellbeing (reference category) versus neither good nor poor, and good wellbeing versus poor wellbeing. Results 48.6% were male, mean age 48.7 (sd 18.3), 54.3% scored well on all four of the wellbeing indicators, and positive social capital indicators ranged from 93.1% for safety to 50.8% for control over decisions. The higher level of social capital corresponded with the good wellbeing category. Modeling showed higher odds ratios for all social capital variables for the lowest level of wellbeing. These higher odds ratios remained after adjusting for confounders. Conclusions The relationship between wellbeing, resilience and social capital highlights areas for increased policy focus.
Collapse
Affiliation(s)
- A W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
| | - G Kelly
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - E Dal Grande
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - D Kelly
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - T Marin
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - N Hey
- What Works Centre for Wellbeing, London, UK
| | - K J Burke
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.,CQUniversity, Appleton Institute, School of Human, Health & Social Sciences, Wayville, South Australia, Australia
| | - J Licinio
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| |
Collapse
|
33
|
Hughes R, Knudsen E, Kirthi S, Kelly G, Tobin A, Sweeney C, Jemec G, Kirby B. Framingham risk assessment in hidradenitis suppurativa. Br J Dermatol 2017; 176:1404-1406. [DOI: 10.1111/bjd.15365] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- R. Hughes
- Department of Dermatology and the Dermatology Research Group; Education and Research Centre; St Vincent's University Hospital; Elm Park Dublin 4 Ireland
| | - E. Knudsen
- Department of Dermatology; Zealand University Hospital Roskilde; Health Sciences Faculty; University of Copenhagen; Roskilde Denmark
| | - S. Kirthi
- Department of Dermatology; Adelaide, Meath and National Children's Hospital; Tallaght, Dublin 24 Ireland
| | - G. Kelly
- Department of Dermatology and the Dermatology Research Group; Education and Research Centre; St Vincent's University Hospital; Elm Park Dublin 4 Ireland
| | - A.M. Tobin
- Department of Dermatology; Adelaide, Meath and National Children's Hospital; Tallaght, Dublin 24 Ireland
| | - C.M. Sweeney
- Department of Dermatology and the Dermatology Research Group; Education and Research Centre; St Vincent's University Hospital; Elm Park Dublin 4 Ireland
| | - G.B.E. Jemec
- Department of Dermatology; Zealand University Hospital Roskilde; Health Sciences Faculty; University of Copenhagen; Roskilde Denmark
| | - B. Kirby
- Department of Dermatology and the Dermatology Research Group; Education and Research Centre; St Vincent's University Hospital; Elm Park Dublin 4 Ireland
| |
Collapse
|
34
|
Sette M, D'Addabbo P, Kelly G, Cicconi A, Micheli E, Cacchione S, Poma A, Gargioli C, Giambra V, Frezza D. Evidence for a quadruplex structure in the polymorphic hs1.2 enhancer of the immunoglobulin heavy chain 3' regulatory regions and its conservation in mammals. Biopolymers 2017; 105:768-78. [PMID: 27287611 PMCID: PMC5516150 DOI: 10.1002/bip.22891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 04/10/2016] [Accepted: 06/01/2016] [Indexed: 11/09/2022]
Abstract
Regulatory regions in the genome can act through a variety of mechanisms that range from the occurrence of histone modifications to the presence of protein-binding loci for self-annealing sequences. The final result is often the induction of a conformational change of the DNA double helix, which alters the accessibility of a region to transcription factors and consequently gene expression. A ∼300 kb regulatory region on chromosome 14 at the 3' end (3'RR) of immunoglobulin (Ig) heavy-chain genes shows very peculiar features, conserved in mammals, including enhancers and transcription factor binding sites. In primates, the 3'RR is present in two copies, both having a central enhancer named hs1.2. We previously demonstrated the association between different hs1.2 alleles and Ig plasma levels in immunopathology. Here, we present the analysis of a putative G-quadruplex structure (tetraplex) consensus site embedded in a variable number tandem repeat (one to four copies) of hs1.2 that is a distinctive element among the enhancer alleles, and an investigation of its three-dimensional structure using bioinformatics and spectroscopic approaches. We suggest that both the role of the enhancer and the alternative effect of the hs1.2 alleles may be achieved through their peculiar three-dimensional-conformational rearrangement. © 2016 Wiley Periodicals, Inc. Biopolymers 105: 768-778, 2016.
Collapse
Affiliation(s)
- Marco Sette
- Department of Chemical Sciences and Technology, University of Roma "Tor Vergata,", Roma, Italy
| | - Pietro D'Addabbo
- Department of Biology, University of Bari "Aldo Moro", Bari, Italy
| | - Geoffrey Kelly
- MRC Biomedical NMR Centre, The Francis Crick Institute, Mill Hill Laboratory, London, UK
| | - Alessandro Cicconi
- Department of Biology and Biotechnology, Sapienza University, Roma, Italy.,Institute Pasteur-Fondazione Cenci-Bolognetti, Roma, Italy
| | - Emanuela Micheli
- Department of Biology and Biotechnology, Sapienza University, Roma, Italy.,Institute Pasteur-Fondazione Cenci-Bolognetti, Roma, Italy
| | - Stefano Cacchione
- Department of Biology and Biotechnology, Sapienza University, Roma, Italy.,Institute Pasteur-Fondazione Cenci-Bolognetti, Roma, Italy
| | - Anna Poma
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Cesare Gargioli
- Department of Biology, University of Roma "Tor Vergata,", Roma, Italy
| | | | - Domenico Frezza
- Department of Biology, University of Roma "Tor Vergata,", Roma, Italy
| |
Collapse
|
35
|
Abstract
Within the last few years, more and more occupational therapists practising in Great Britain have been using standardised assessments in their work. Mostly they rely on popular tests which have gained respectability and acceptance in psychology and related professions. However, it is of utmost importance that occupational therapists are fully aware of how the tests they are using are thought of by a wide variety of people. The purpose of this article was to search the literature and discover what had been said about the Marianne Frostig Developmental Test of Visual Perception. The Frostig Programme for Individual Training and Remediation in Visual Perception is also examined briefly. It is hoped that this review will be of use in helping occupational therapists who are either using the test or thinking about using it to decide whether it is appropriate for their purpose.
Collapse
Affiliation(s)
- G Kelly
- Senior Occupational Therapist, Cherryville Clinic, Belfast
| |
Collapse
|
36
|
Kelly G, Shinners A, Finn G, McMahon V, Gordon H, Grant A. A comparison of physical activity levels in commonly encountered paediatric disability populations. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.326] [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: 11/29/2022]
|
37
|
Abstract
Hidradenitis suppurativa (HS) is a chronic relapsing disease of follicular occlusion that causes immense clinical and psychosocial morbidity when refractory to treatment. HS is no longer considered a disease of primary infectious etiology, although bacteria play a role. There is increasing evidence that HS is associated with immune dysregulation, based on its clinical association with other immune-mediated disorders, by its response to biologic therapy in the clinical arena, and from molecular research. This article summarizes what is known in relation to the inflammatory pathways in HS.
Collapse
Affiliation(s)
- G Kelly
- Department of Dermatology, St. Vincent's University Hospital, Dublin 4, Ireland.
| | - Errol P Prens
- Department of Dermatology, Erasmus University Medical Centre Rotterdam, s-Gravendijkwal 230, 3015 CE Rotterdam, Netherlands
| |
Collapse
|
38
|
Witte S, Dedman C, Harriss F, Kelly G, Chang YM, Witte TH. Comparison of treatment outcomes for superficial digital flexor tendonitis in National Hunt racehorses. Vet J 2016; 216:157-63. [PMID: 27687944 DOI: 10.1016/j.tvjl.2016.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 04/10/2015] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 11/28/2022]
Abstract
Superficial digital flexor (SDF) tendonitis is a common injury in Thoroughbred racehorses. Injuries require prolonged rehabilitation, with unpredictable outcomes and a high incidence of re-injury. This observational case-control study aimed to compare race outcomes after commonly advocated treatments for tendon healing. Clinical and racing records were evaluated for 127 National Hunt racehorses treated between 2007 and 2011 for an SDF tendon injury. Two age- and sex-matched control horses were selected for each case horse to analyse the effect on post-injury racing outcomes of pre-injury data, lesion severity and treatment group [controlled exercise alone, bar firing, intralesional platelet-rich plasma (PRP), tendon splitting, tendon splitting combined with bar firing]. Control horses raced more often than case horses, with higher maximum racing post rating (RPRmax) and longer racing distances. Pre-injury racing performance was not associated with treatment group. Rate of return to racing was not associated with lesion severity or treatment group. Number of races, total distance raced post-injury and RPRmax were not associated with lesion severity or treatment group. Controlled exercise alone offered similar post-injury racing outcomes in National Hunt racehorses with SDF tendonitis to the other treatment options examined. Bar firing, either alone or in conjunction with tendon splitting, provided no additional benefit in rate of return to racing and race performance.
Collapse
Affiliation(s)
| | - C Dedman
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
| | - F Harriss
- Fethard Equine Hospital, Fethard, Kilnockin, Tipperary, Ireland
| | - G Kelly
- Fethard Equine Hospital, Fethard, Kilnockin, Tipperary, Ireland
| | - Y-M Chang
- Research Support Office, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom
| | - T H Witte
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom.
| |
Collapse
|
39
|
Godin-Heymann N, Brabetz S, Murillo MM, Saponaro M, Santos CR, Lobley A, East P, Chakravarty P, Matthews N, Kelly G, Jordan S, Castellano E, Downward J. Tumour-suppression function of KLF12 through regulation of anoikis. Oncogene 2016; 35:3324-34. [PMID: 26455320 PMCID: PMC4929484 DOI: 10.1038/onc.2015.394] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 08/11/2015] [Accepted: 09/05/2015] [Indexed: 12/14/2022]
Abstract
Suppression of detachment-induced cell death, known as anoikis, is an essential step for cancer metastasis to occur. We report here that expression of KLF12, a member of the Kruppel-like family of transcription factors, is downregulated in lung cancer cell lines that have been selected to grow in the absence of cell adhesion. Knockdown of KLF12 in parental cells results in decreased apoptosis following cell detachment from matrix. KLF12 regulates anoikis by promoting the cell cycle transition through S phase and therefore cell proliferation. Reduced expression levels of KLF12 results in increased ability of lung cancer cells to form tumours in vivo and is associated with poorer survival in lung cancer patients. We therefore identify KLF12 as a novel metastasis-suppressor gene whose loss of function is associated with anoikis resistance through control of the cell cycle.
Collapse
Affiliation(s)
- N Godin-Heymann
- Signal Transduction, Cancer Research UK London Research Institute, London, UK
| | - S Brabetz
- Signal Transduction, Cancer Research UK London Research Institute, London, UK
| | - M M Murillo
- Signal Transduction, Cancer Research UK London Research Institute, London, UK
- The Institute of Cancer Research, London, UK
| | - M Saponaro
- Mechanisms of Gene Transcription Laboratory, Cancer Research UK London Research Institute, Clare Hall Laboratories, Hertfordshire, UK
| | - C R Santos
- Translational Cancer Therapeutics, Cancer Research UK London Research Institute, London, UK
| | - A Lobley
- Bioinformatics and Biostatistics Laboratories, Cancer Research UK London Research Institute, London, UK
| | - P East
- Bioinformatics and Biostatistics Laboratories, Cancer Research UK London Research Institute, London, UK
| | - P Chakravarty
- Bioinformatics and Biostatistics Laboratories, Cancer Research UK London Research Institute, London, UK
| | - N Matthews
- Advanced Sequencing Facility, Cancer Research UK London Research Institute, London, UK
| | - G Kelly
- Bioinformatics and Biostatistics Laboratories, Cancer Research UK London Research Institute, London, UK
| | - S Jordan
- Signal Transduction, Cancer Research UK London Research Institute, London, UK
| | - E Castellano
- Signal Transduction, Cancer Research UK London Research Institute, London, UK
| | - J Downward
- Signal Transduction, Cancer Research UK London Research Institute, London, UK
- The Institute of Cancer Research, London, UK
| |
Collapse
|
40
|
Abstract
To the editor The election debrief published in the July issue of Nursing Management ( Aziz 2001 )stated that a report into public private partnerships carried out by the Institute for Public Policy Research was 'likely to recommend that the government pushed ahead with privatisation'. The clear implication of this article was that IPPR's conclusions were inevitable, given the financial support that the project received from private sector companies.
Collapse
Affiliation(s)
- G Kelly
- Institute For Public Policy Research
| |
Collapse
|
41
|
Kelly G, Hughes R, McGarry T, van den Born M, Adamzik K, Fitzgerald R, Lawlor C, Tobin AM, Sweeney CM, Kirby B. Dysregulated cytokine expression in lesional and nonlesional skin in hidradenitis suppurativa. Br J Dermatol 2015; 173:1431-9. [PMID: 26282467 DOI: 10.1111/bjd.14075] [Citation(s) in RCA: 178] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is a dearth of information on the precise pathogenesis of hidradenitis suppurativa (HS), but immune dysregulation is implicated. OBJECTIVES To determine the nature of the immune response in HS. METHODS Skin biopsies - lesional, perilesional (2 cm away) and uninvolved (10 cm away) - were obtained from patients with HS and healthy controls. The expression of various cytokines was determined by enzyme-linked immunosorbent assay, flow cytometry and real-time polymerase chain reaction. RESULTS The expression of the inflammatory cytokines interleukin (IL)-17, IL-1β and tumour necrosis factor-α was enhanced in lesional skin of patients with HS. In addition, IL17A and IL1B mRNA were enhanced in clinically normal perilesional skin. CD4(+) T cells produced IL-17 in HS, while CD11c(+) CD1a(-) CD14(+) cells were sources of IL-1β. Activated caspase-1 was detected in HS skin and was associated with enhanced expression of NLRP3 and IL18. Inhibition of caspase-1 decreased IL-1β and IL-18 production, suggesting that the caspase-1 pathway participates in IL-1β and IL-18 expression in HS. Abnormal cytokine expression was detected in perilesional and uninvolved skin, which may suggest that subclinical inflammation is present in HS skin prior to the formation of an active lesion. CONCLUSIONS This study demonstrates that CD4(+) T cells produce IL-17 in HS and that the IL-17 pathway may be important in HS pathogenesis. CD11c(+) CD1a(-) CD14(+) cells are a source of IL-1β in HS, the production of which was shown to be mediated, in part, via a caspase-1-dependent pathway. These results suggest that IL-17 and the caspase-1-associated cytokines IL-1β and IL-18 may play a role in the pathogenesis of HS.
Collapse
Affiliation(s)
- G Kelly
- Dermatology Research, Education and Research Centre, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
| | - R Hughes
- Dermatology Research, Education and Research Centre, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
| | - T McGarry
- Department of Rheumatology, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland.,The Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland
| | - M van den Born
- Dermatology Research, Education and Research Centre, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
| | - K Adamzik
- Department of Dermatology, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
| | - R Fitzgerald
- Department of Dermatology, Adelaide and Meath Hospital, Tallaght, Dublin, Ireland
| | - C Lawlor
- Department of Plastic Surgery, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
| | - A M Tobin
- Department of Dermatology, Adelaide and Meath Hospital, Tallaght, Dublin, Ireland
| | - C M Sweeney
- Dermatology Research, Education and Research Centre, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
| | - B Kirby
- Department of Dermatology, St Vincent's University Hospital, University College Dublin, Dublin 4, Ireland
| |
Collapse
|
42
|
Saunte D, Boer J, Stratigos A, Szepietowski J, Hamzavi I, Kim K, Zarchi K, Antoniou C, Matusiak L, Lim H, Williams M, Kwon H, Gürer M, Mammadova F, Kaminsky A, Prens E, van der Zee H, Bettoli V, Zauli S, Hafner J, Lauchli S, French L, Riad H, El-Domyati M, Abdel-Wahab H, Kirby B, Kelly G, Calderon P, del Marmol V, Benhadou F, Revuz J, Zouboulis C, Karagiannidis I, Sartorius K, Hagströmer L, McMeniman E, Ong N, Dolenc-Voljc M, Mokos Z, Borradori L, Hunger R, Sladden C, Scheinfeld N, Moftah N, Emtestam L, Lapins J, Doss N, Kurokawa I, Jemec G. Diagnostic delay in hidradenitis suppurativa is a global problem. Br J Dermatol 2015. [DOI: 10.1111/bjd.14038] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
43
|
Assadi R, Rosati L, Moningi S, Hacker-Prietz A, Laheru D, Zheng L, De Jesus-Acosta A, Le D, Kelly G, Moore J, Jackson J, Fishman E, Raman S, McNutt T, Pawlik T, Hirose K, Eckhauser F, Weiss M, Herman J. A Prospective Study Evaluating Stereotactic Body Radiation Therapy in Unresectable Recurrent or Residual Pancreatic Adenocarcinoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
44
|
Cherry AL, Nott TJ, Kelly G, Rulten SL, Caldecott KW, Smerdon SJ. Versatility in phospho-dependent molecular recognition of the XRCC1 and XRCC4 DNA-damage scaffolds by aprataxin-family FHA domains. DNA Repair (Amst) 2015; 35:116-25. [PMID: 26519825 PMCID: PMC4655838 DOI: 10.1016/j.dnarep.2015.10.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/05/2015] [Accepted: 10/05/2015] [Indexed: 11/11/2022]
Abstract
Aprataxin, aprataxin and PNKP-like factor (APLF) and polynucleotide kinase phosphatase (PNKP) are key DNA-repair proteins with diverse functions but which all contain a homologous forkhead-associated (FHA) domain. Their primary binding targets are casein kinase 2-phosphorylated forms of the XRCC1 and XRCC4 scaffold molecules which respectively coordinate single-stranded and double-stranded DNA break repair pathways. Here, we present the high-resolution X-ray structure of a complex of phosphorylated XRCC4 with APLF, the most divergent of the three FHA domain family members. This, combined with NMR and biochemical analysis of aprataxin and APLF binding to singly and multiply-phosphorylated forms of XRCC1 and XRCC4, and comparison with PNKP reveals a pattern of distinct but overlapping binding specificities that are differentially modulated by multi-site phosphorylation. Together, our data illuminate important differences between activities of the three phospho-binding domains, in spite of a close evolutionary relationship between them.
Collapse
Affiliation(s)
- Amy L Cherry
- Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, Mill Hill, London NW7 1AA, UK
| | - Timothy J Nott
- Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, Mill Hill, London NW7 1AA, UK
| | - Geoffrey Kelly
- MRC Genome Damage and Stability Centre, University of Sussex, Brighton BN1 9RQ, UK
| | - Stuart L Rulten
- MRC Genome Damage and Stability Centre, University of Sussex, Brighton BN1 9RQ, UK
| | - Keith W Caldecott
- MRC Genome Damage and Stability Centre, University of Sussex, Brighton BN1 9RQ, UK
| | - Stephen J Smerdon
- Francis Crick Institute, Mill Hill Laboratory, The Ridgeway, Mill Hill, London NW7 1AA, UK.
| |
Collapse
|
45
|
Field EJ, Kelly G, Pleuvry D, Demetriou J, Baines SJ. Indications, outcome and complications with axial pattern skin flaps in dogs and cats: 73 cases. J Small Anim Pract 2015; 56:698-706. [DOI: 10.1111/jsap.12400] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 07/15/2015] [Accepted: 07/24/2015] [Indexed: 11/26/2022]
Affiliation(s)
- E. J. Field
- Langford Veterinary Services; University of Bristol; Langford BS405DU
| | | | - D. Pleuvry
- Boundary Veterinary Clinic; Abingdon OX14 2AA
| | - J. Demetriou
- Dick White Referrals Station Farm; Six Mile Bottom CB8 0UH
| | - S. J. Baines
- Willlows Veterinary Centre & Referral Service; Shirley Solihull B90 4NH
| |
Collapse
|
46
|
Dunphy SE, Sweeney CM, Kelly G, Tobin AM, Kirby B, Gardiner CM. Natural killer cells from psoriasis vulgaris patients have reduced levels of cytotoxicity associated degranulation and cytokine production. Clin Immunol 2015; 177:43-49. [PMID: 26477484 DOI: 10.1016/j.clim.2015.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/08/2015] [Accepted: 10/15/2015] [Indexed: 12/28/2022]
Abstract
Psoriasis vulgaris is a chronic inflammatory disease of the skin with a strong genetic component and immune system involvement. Although some evidence suggests that Natural Killer (NK) cells may play a part in psoriasis, their role is relatively unstudied and results are controversial. In this current study, NK cells from psoriasis patients exhibited reduced degranulation and produced lower levels of the pro-inflammatory cytokines IFN-γ and TNF-α. Further investigation found that NK cells from psoriasis patients and healthy controls expressed similar levels of activation markers, NK cell receptors and apoptosis-inducing molecules. In addition, comparable levels of several cytokines important in NK cell biology were found in the serum of psoriasis patients and healthy controls. Genotyping analysis revealed that HLA-C2, which provides a ligand for killer-cell immunoglobulin-like receptors (KIR) expressed by NK cells, was strongly associated with psoriasis susceptibility. However, no link between the KIR genes themselves and disease was found.
Collapse
Affiliation(s)
- S E Dunphy
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, 152-160 Pearse Street, Trinity College, Dublin 2, Ireland
| | - C M Sweeney
- Department of Dermatology, St Vincent's University Hospital, Dublin 4, Ireland
| | - G Kelly
- Department of Dermatology, St Vincent's University Hospital, Dublin 4, Ireland
| | - A M Tobin
- Department of Dermatology, Tallaght Hospital, Dublin 24, Ireland
| | - B Kirby
- Department of Dermatology, St Vincent's University Hospital, Dublin 4, Ireland
| | - C M Gardiner
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, 152-160 Pearse Street, Trinity College, Dublin 2, Ireland.
| |
Collapse
|
47
|
Chen RJ, Kelly G, Sengupta A, Heydendael W, Nicholas B, Beltrami S, Luz S, Peixoto L, Abel T, Bhatnagar S. MicroRNAs as biomarkers of resilience or vulnerability to stress. Neuroscience 2015. [PMID: 26208845 DOI: 10.1016/j.neuroscience.2015.07.045] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [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: 12/31/2022]
Abstract
Identifying novel biomarkers of resilience or vulnerability to stress could provide valuable information for the prevention and treatment of stress-related psychiatric disorders. To investigate the utility of blood microRNAs as biomarkers of resilience or vulnerability to stress, microRNAs were assessed before and after 7days of chronic social defeat in rats. Additionally, microRNA profiles of two important stress-regulatory brain regions, the medial prefrontal cortex (mPFC) and basolateral amygdala (BLA), were assessed. Rats that displayed vulnerability to subsequent chronic stress exhibited reductions in circulating miR-24-2-5p, miR-27a-3p, miR-30e-5p, miR-3590-3p, miR-362-3p, and miR-532-5p levels. In contrast, rats that became resilient to stress displayed reduced levels of miR-139-5p, miR-28-3p, miR-326-3p, and miR-99b-5p compared to controls. In the mPFC, miR-126a-3p and miR-708-5p levels were higher in vulnerability compared to resilient rats. In the BLA, 77 microRNAs were significantly altered by stress but none were significantly different between resilient and vulnerable animals. These results provide proof-of-principle that assessment of circulating microRNAs is useful in identifying individuals who are vulnerable to the effects of future stress or individuals who have become resilient to the effects of stress. Furthermore, these data suggest that microRNAs in the mPFC but not in the BLA are regulators of resilience/vulnerability to stress.
Collapse
Affiliation(s)
- R J Chen
- Department of Anesthesiology, Children's Hospital of Philadelphia, United States
| | - G Kelly
- Department of Anesthesiology, Children's Hospital of Philadelphia, United States
| | - A Sengupta
- Department of Anesthesiology, Children's Hospital of Philadelphia, United States
| | - W Heydendael
- Department of Anesthesiology, Children's Hospital of Philadelphia, United States
| | - B Nicholas
- Department of Anesthesiology, Children's Hospital of Philadelphia, United States
| | - S Beltrami
- Department of Anesthesiology, Children's Hospital of Philadelphia, United States
| | - S Luz
- Department of Anesthesiology, Children's Hospital of Philadelphia, United States
| | - L Peixoto
- Department of Biology, University of Pennsylvania, United States
| | - T Abel
- Department of Biology, University of Pennsylvania, United States
| | - S Bhatnagar
- Department of Anesthesiology, Children's Hospital of Philadelphia, United States; Department of Anesthesiology, University of Pennsylvania, Perelman School of Medicine, United States.
| |
Collapse
|
48
|
Jamal-Hanjani M, A'Hern R, Birkbak NJ, Gorman P, Grönroos E, Ngang S, Nicola P, Rahman L, Thanopoulou E, Kelly G, Ellis P, Barrett-Lee P, Johnston SRD, Bliss J, Roylance R, Swanton C. Extreme chromosomal instability forecasts improved outcome in ER-negative breast cancer: a prospective validation cohort study from the TACT trial. Ann Oncol 2015; 26:1340-6. [PMID: 26003169 DOI: 10.1093/annonc/mdv178] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [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: 02/23/2015] [Accepted: 03/28/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Chromosomal instability (CIN) has been shown to be associated with drug resistance and poor clinical outcome in several cancer types. However, in oestrogen receptor (ER)-negative breast cancer we have previously demonstrated that extreme CIN is associated with improved clinical outcome, consistent with a negative impact of CIN on tumour fitness and growth. The aim of this current study was to validate this finding using previously defined CIN thresholds in a much larger prospective cohort from a randomised, controlled, clinical trial. PATIENTS AND METHODS As a surrogate measurement of CIN, dual centromeric fluorescence in situ hybridisation was performed for both chromosomes 2 and 15 on 1173 tumours from the breast cancer TACT trial (CRUK01/001). Each tumour was scored manually and the mean percentage of cells deviating from the modal centromere number was used to define four CIN groups (MCD1-4), where tumours in the MCD4 group were defined as having extreme CIN. RESULTS In a multivariate analysis of disease-free survival, with a median follow-up of 91 months, increasing CIN was associated with improved outcome in patients with ER-negative cancer (P trend = 0.03). A similar pattern was seen in ER-negative/HER2-negative cancers (Ptrend = 0.007). CONCLUSIONS This prospective validation cohort study further substantiated the association between extreme CIN and improved outcome in ER-negative breast cancers. Identifying such patients with extreme CIN may help distinguish good from poor prognostic groups, and therefore support treatment and risk stratification in this aggressive breast cancer subtype.
Collapse
Affiliation(s)
- M Jamal-Hanjani
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London
| | - R A'Hern
- ICR-CTSU, Division of Clinical Studies, The Institute of Cancer Research, London
| | - N J Birkbak
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London The Francis Crick Institute, 44 Lincoln's Inn Fields, London
| | - P Gorman
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London
| | - E Grönroos
- The Francis Crick Institute, 44 Lincoln's Inn Fields, London
| | - S Ngang
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London
| | - P Nicola
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London
| | - L Rahman
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London
| | - E Thanopoulou
- The Francis Crick Institute, 44 Lincoln's Inn Fields, London
| | - G Kelly
- The Francis Crick Institute, 44 Lincoln's Inn Fields, London
| | - P Ellis
- Guy's and St Thomas' NHS Trust, London
| | | | | | - J Bliss
- ICR-CTSU, Division of Clinical Studies, The Institute of Cancer Research, London
| | - R Roylance
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - C Swanton
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London The Francis Crick Institute, 44 Lincoln's Inn Fields, London
| |
Collapse
|
49
|
O’Neill K, Lyons A, Larkin L, Kelly G. Muscle thickness and pennation angle of the medial gastrocnemius and tibialis anterior in spastic diplegia versus typically developing children. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3602] [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: 10/23/2022]
|
50
|
Marley WD, Kelly G, Thompson NW. Alcohol-Related Fracture Admissions: A Retrospective Observational Study. Ulster Med J 2015; 84:94-7. [PMID: 26170483 PMCID: PMC4488914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/29/2015] [Indexed: 12/02/2022]
Abstract
INTRODUCTION In April 2011 the NI public health agency estimated that alcohol misuse generates overall annual healthcare costs of £122.2m. There is currently a paucity of data regarding the burden of alcohol-related fractures on the provinces Trauma and Orthopaedic service. PATIENTS AND METHODS A retrospective review of 104 patients over a 12 month period was performed. Data collected using the Fractures Outcomes and Research Database included: age, gender, smoking status, weekly alcohol intake, mechanism of injury and subsequent treatment. RESULTS Alcohol related fractures accounted for 6.1% of all acute fractures admissions in the 12 month period. 73% were male, with a bimodal age distribution. The majority of patients were classed as social drinkers; however a significant proportion (23.1%) were alcohol dependent. 62.5% of patients were smokers at the time of admission. 95% of patients suffered a single injury which was commonly secondary to a simple mechanical fall (53.8%). The majority of patients sustained lower limb injuries, with 30.8% of these being ankle fractures. CONCLUSION In conclusion, our study has identified that alcohol-related trauma creates a significant financial burden on the NHS. It is likely that the incidence of alcohol related fracture is higher than documented in this study. We advocate the assessment of patients using the AUDIT-C score to assess for at risk drinking behaviour in those presenting with an alcohol related fracture.
Collapse
|