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Xu Q, Hu YY, Wen Y, Liu GY, Yang ZP, Zhang CC, Ding MH, Bi HS. [Effect of corneal e-value on myopia control in children and adolescents with orthokeratology]. Zhonghua Yan Ke Za Zhi 2024; 60:330-336. [PMID: 38583056 DOI: 10.3760/cma.j.cn112142-20231122-00245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
Objective: To investigate the influence of corneal e-value on the effectiveness of orthokeratology in controlling myopia in children and adolescents. Methods: A retrospective cohort study was conducted, involving the data from 1 563 myopic patients (1 563 eyes) who underwent orthokeratology at the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from June 2015 to August 2021 and adhered to lens wear for at least 2 years. The cohort consisted of 737 males and 826 females with an average age of (10.84±2.13) years. Based on corneal e-value parameters obtained from corneal topography, patients were categorized into a low e-value group (n=425) and a high e-value group (n=1 138). Data on gender, age, parental myopia history, and baseline measures such as spherical equivalent (SE), axial length, and corneal e-value were collected. Differences in axial length change and corneal fluorescein staining rates were compared between the two groups at 1 and 2 years after the start of lens wear. A generalized linear mixed model was established with axial length change as the dependent variable to analyze the correlation between axial length change and baseline corneal e-value. Results: The initial age of the 1 563 myopic patients was (10.84±2.13) years, with a baseline SE of (-3.05±1.30) D. After 1 year of lens wear, the axial length change was (0.20±0.19) mm in the low e-value group and (0.24±0.20) mm in the high e-value group. After 2 years, the changes were (0.38±0.25) mm and (0.43±0.27) mm, respectively, with statistically significant differences (all P<0.05). The incidence of corneal staining after 1 year of lens wear was 9.2% (39/425) in the low e-value group and 14.1% (160/1 138) in the high e-value group. After 2 years, the rates were 15.8% (67/425) and 21.8% (248/1 138), respectively, with statistically significant differences (all P<0.05). After adjusting for parental myopia history, age, SE, and baseline axial length, the baseline corneal e-value was positively correlated with axial length change at 1 and 2 years after lens wear (all P<0.05). Conclusions: Corneal e-value is an independent factor influencing the effectiveness of orthokeratology in controlling myopia. A smaller corneal e-value is associated with slower axial length growth after orthokeratology, indicating better control of myopia in treated eyes.
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Affiliation(s)
- Q Xu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Provincial Key Laboratory of Integrative Medicine for Prevention and Therapy of Ocular Disease, Jinan 250002, China
| | - Y Y Hu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Provincial Key Laboratory of Integrative Medicine for Prevention and Therapy of Ocular Disease, Jinan 250002, China
| | - Y Wen
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Provincial Key Laboratory of Integrative Medicine for Prevention and Therapy of Ocular Disease, Jinan 250002, China
| | - G Y Liu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Provincial Key Laboratory of Integrative Medicine for Prevention and Therapy of Ocular Disease, Jinan 250002, China
| | - Z P Yang
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Provincial Key Laboratory of Integrative Medicine for Prevention and Therapy of Ocular Disease, Jinan 250002, China
| | - C C Zhang
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Provincial Key Laboratory of Integrative Medicine for Prevention and Therapy of Ocular Disease, Jinan 250002, China
| | - M H Ding
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Provincial Key Laboratory of Integrative Medicine for Prevention and Therapy of Ocular Disease, Jinan 250002, China
| | - H S Bi
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Provincial Key Laboratory of Integrative Medicine for Prevention and Therapy of Ocular Disease, Jinan 250002, China
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Caldera JR, Tsai CM, Trieu D, Gonzalez C, Hajam IA, Du X, Lin B, Liu GY. The characteristics of pre-existing humoral imprint determine efficacy of S. aureus vaccines and support alternative vaccine approaches. Cell Rep Med 2024; 5:101360. [PMID: 38232694 PMCID: PMC10829788 DOI: 10.1016/j.xcrm.2023.101360] [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] [Received: 01/15/2023] [Revised: 08/15/2023] [Accepted: 12/10/2023] [Indexed: 01/19/2024]
Abstract
The failure of the Staphylococcus aureus (SA) IsdB vaccine trial can be explained by the recall of non-protective immune imprints from prior SA exposure. Here, we investigate natural human SA humoral imprints to understand their broader impact on SA immunizations. We show that antibody responses against SA cell-wall-associated antigens (CWAs) are non-opsonic, while antibodies against SA toxins are neutralizing. Importantly, the protective characteristics of the antibody imprints accurately predict the failure of corresponding vaccines against CWAs and support vaccination against toxins. In passive immunization platforms, natural anti-SA human antibodies reduce the efficacy of the human monoclonal antibodies suvratoxumab and tefibazumab, consistent with the results of their respective clinical trials. Strikingly, in the absence of specific humoral memory responses, active immunizations are efficacious in both naive and SA-experienced mice. Overall, our study points to a practical and predictive approach to evaluate and develop SA vaccines based on pre-existing humoral imprint characteristics.
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Affiliation(s)
- J R Caldera
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Chih-Ming Tsai
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Desmond Trieu
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Cesia Gonzalez
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Irshad A Hajam
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Xin Du
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Brian Lin
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - George Y Liu
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA; Division of Infectious Diseases, Rady Children's Hospital, San Diego, CA 92123, USA.
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Gonzalez JJI, Hossain MF, Neef J, Zwack EE, Tsai CM, Raafat D, Fechtner K, Herzog L, Kohler TP, Schlüter R, Reder A, Holtfreter S, Liu GY, Hammerschmidt S, Völker U, Torres VJ, van Dijl JM, Lillig CH, Bröker BM, Darisipudi MN. TLR4 sensing of IsdB of Staphylococcus aureus induces a proinflammatory cytokine response via the NLRP3-caspase-1 inflammasome cascade. mBio 2024; 15:e0022523. [PMID: 38112465 PMCID: PMC10790753 DOI: 10.1128/mbio.00225-23] [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] [Received: 01/27/2023] [Accepted: 11/07/2023] [Indexed: 12/21/2023] Open
Abstract
IMPORTANCE The prevalence of multidrug-resistant Staphylococcus aureus is of global concern, and vaccines are urgently needed. The iron-regulated surface determinant protein B (IsdB) of S. aureus was investigated as a vaccine candidate because of its essential role in bacterial iron acquisition but failed in clinical trials despite strong immunogenicity. Here, we reveal an unexpected second function for IsdB in pathogen-host interaction: the bacterial fitness factor IsdB triggers a strong inflammatory response in innate immune cells via Toll-like receptor 4 and the inflammasome, thus acting as a novel pathogen-associated molecular pattern of S. aureus. Our discovery contributes to a better understanding of how S. aureus modulates the immune response, which is necessary for vaccine development against the sophisticated pathogen.
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Affiliation(s)
| | - Md Faruq Hossain
- Institute for Medical Biochemistry and Molecular Biology, University Medicine Greifswald, Greifswald, Germany
| | - Jolanda Neef
- Department of Medical Microbiology, University of Groningen, University Medical Center, Groningen, the Netherlands
| | - Erin E. Zwack
- Department of Microbiology, New York University Grossman School of Medicine, New York, USA
| | - Chih-Ming Tsai
- Department of Pediatrics, Division of Infectious Diseases, University of California San Diego, La Jolla, California, USA
| | - Dina Raafat
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
- Department of Microbiology and Immunology, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Kevin Fechtner
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Luise Herzog
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Thomas P. Kohler
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Rabea Schlüter
- Imaging Center of the Department of Biology, University of Greifswald, Greifswald, Germany
| | - Alexander Reder
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Silva Holtfreter
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - George Y. Liu
- Department of Pediatrics, Division of Infectious Diseases, University of California San Diego, La Jolla, California, USA
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Uwe Völker
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, Center for Functional Genomics of Microbes, University of Greifswald, Greifswald, Germany
| | - Victor J. Torres
- Department of Microbiology, New York University Grossman School of Medicine, New York, USA
| | - Jan Maarten van Dijl
- Department of Medical Microbiology, University of Groningen, University Medical Center, Groningen, the Netherlands
| | - Christopher H. Lillig
- Institute for Medical Biochemistry and Molecular Biology, University Medicine Greifswald, Greifswald, Germany
| | - Barbara M. Bröker
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Murty N. Darisipudi
- Institute of Immunology, University Medicine Greifswald, Greifswald, Germany
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Hajam IA, Katiki M, McNally R, Lázaro-Díez M, Kolar S, Chatterjee A, Gonzalez C, Paulchakrabarti M, Choudhury B, Caldera JR, Desmond T, Tsai CM, Du X, Li H, Murali R, Liu GY. Functional divergence of a bacterial enzyme promotes healthy or acneic skin. Nat Commun 2023; 14:8061. [PMID: 38052825 PMCID: PMC10697930 DOI: 10.1038/s41467-023-43833-8] [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] [Received: 04/06/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023] Open
Abstract
Acne is a dermatologic disease with a strong pathologic association with human commensal Cutibacterium acnes. Conspicuously, certain C. acnes phylotypes are associated with acne, whereas others are associated with healthy skin. Here we investigate if the evolution of a C. acnes enzyme contributes to health or acne. Two hyaluronidase variants exclusively expressed by C. acnes strains, HylA and HylB, demonstrate remarkable clinical correlation with acne or health. We show that HylA is strongly pro-inflammatory, and HylB is modestly anti-inflammatory in a murine (female) acne model. Structural and phylogenic studies suggest that the enzymes evolved from a common hyaluronidase that acquired distinct enzymatic activity. Health-associated HylB degrades hyaluronic acid (HA) exclusively to HA disaccharides leading to reduced inflammation, whereas HylA generates large-sized HA fragments that drive robust TLR2-dependent pathology. Replacing an amino acid, Serine to Glycine near the HylA catalytic site enhances the enzymatic activity of HylA and produces an HA degradation pattern intermediate to HylA and HylB. Selective targeting of HylA using peptide vaccine or inhibitors alleviates acne pathology. We suggest that the functional divergence of HylA and HylB is a major driving force behind C. acnes health- and acne- phenotype and propose targeting of HylA as an approach for acne therapy.
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Affiliation(s)
- Irshad A Hajam
- Department of Pediatrics, University of California San Diego, San Diego, CA, 92093, USA
| | - Madhusudhanarao Katiki
- Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Randall McNally
- Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Vault Pharma Inc., 570 Westwood Plaza, Los Angeles, CA, 90025, USA
| | - María Lázaro-Díez
- Department of Pediatrics, University of California San Diego, San Diego, CA, 92093, USA
- AIDS Research Institute (IrsiCaixa). VIRus Immune Escape and VACcine Design (VIRIEVAC) Universitary Hospital German Trias i Pujol Crta Canyet s/n 08916, Badalona, Barcelona, Spain
| | - Stacey Kolar
- Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Pharmacology at Armata Pharmaceuticals, Inc., Marina del Rey, CA, 90292, USA
| | - Avradip Chatterjee
- Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Cesia Gonzalez
- Department of Pediatrics, University of California San Diego, San Diego, CA, 92093, USA
| | | | - Biswa Choudhury
- GlycoAnalytics Core, University of California San Diego, San Diego, CA, 92093, USA
| | - J R Caldera
- Department of Pediatrics, University of California San Diego, San Diego, CA, 92093, USA
- Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
- Department of Pathology & Laboratory Medicine, UCLA Health & David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Trieu Desmond
- Department of Pediatrics, University of California San Diego, San Diego, CA, 92093, USA
- School of Pharmacy, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Chih-Ming Tsai
- Department of Pediatrics, University of California San Diego, San Diego, CA, 92093, USA
| | - Xin Du
- Department of Pediatrics, University of California San Diego, San Diego, CA, 92093, USA
| | - Huiying Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA
| | - Ramachandran Murali
- Department of Biomedical Sciences, Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
| | - George Y Liu
- Department of Pediatrics, University of California San Diego, San Diego, CA, 92093, USA.
- Division of Infectious Diseases, Rady Children's Hospital, San Diego, CA, 92123, USA.
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Li L, Hajam I, McGee JS, Tang Z, Zhang Y, Badey N, Mintzer E, Zhang Z, Liu GY, Church GM, Wang Y. Comparative Transcriptome Analysis of Acne vulgaris, Rosacea, and Hidradenitis Suppurativa Supports High Dose Dietary Zinc as a Therapeutic Agent. medRxiv 2023:2023.11.28.23299152. [PMID: 38076983 PMCID: PMC10705630 DOI: 10.1101/2023.11.28.23299152] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Acne vulgaris, rosacea, and hidradenitis suppurativa are enduring inflammatory skin conditions that frequently manifest with akin clinical attributes, posing a considerable challenge for their distinctive diagnosis. While these conditions do exhibit certain resemblances, they also demonstrate distinct underlying pathophysiological mechanisms and treatment modalities. Delving into both the molecular parallels and disparities among these three disorders can yield invaluable insights for refined diagnostics, effective management, and targeted therapeutic interventions. In this report, we present a comparative analysis of transcriptomic data across these three diseases, elucidating differentially expressed genes and enriched pathways specific to each ailment, as well as those shared among them. We also identified high dose dietary zinc as a potential therapeutic agent and validated its efficacy in an acne mouse model.
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Affiliation(s)
- Li Li
- Department of Genetics, Harvard Medical School, Boston, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, USA
| | - Irshad Hajam
- Department of Pediatrics, School of Medicine, UC San Diego, San Diego, USA
| | - Jean S. McGee
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, USA
| | - Zhengkuan Tang
- Department of Genetics, Harvard Medical School, Boston, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, USA
| | - Ye Zhang
- School of Public Health, Harvard University, Boston, USA
| | - Nikil Badey
- Department of Genetics, Harvard Medical School, Boston, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, USA
| | - Esther Mintzer
- Department of Genetics, Harvard Medical School, Boston, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, USA
| | - Zhenrui Zhang
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Cambridge, MA, USA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - George Y. Liu
- Department of Pediatrics, School of Medicine, UC San Diego, San Diego, USA
| | - George M. Church
- Department of Genetics, Harvard Medical School, Boston, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, USA
- Lead contact
| | - Yu Wang
- Department of Genetics, Harvard Medical School, Boston, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, USA
- Key Laboratory of Quantitative Synthetic Biology, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, China
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Shen L, Li YT, Xu MY, Liu GY, Zhang XW, Cheng Y, Zhu GQ, Zhang M, Wang L, Zhang XF, Zuo LG, Geng ZJ, Li J, Wang YY, Song X. [The application of the non-woven fabric and filter paper "sandwich" fixation method in preventing the separation of the mucosal layer and muscular layer in mouse colon histopathological sections]. Zhonghua Bing Li Xue Za Zhi 2023; 52:1040-1043. [PMID: 37805399 DOI: 10.3760/cma.j.cn112151-20230228-00158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Affiliation(s)
- L Shen
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Bengbu Medical College, Bengbu 233000, China
| | - Y T Li
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Bengbu Medical College, Bengbu 233000, China
| | - M Y Xu
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Bengbu Medical College, Bengbu 233000, China
| | - G Y Liu
- Bengbu Medical College, Bengbu 233000, China
| | - X W Zhang
- Bengbu Medical College, Bengbu 233000, China
| | - Y Cheng
- Bengbu Medical College, Bengbu 233000, China
| | - G Q Zhu
- Bengbu Medical College, Bengbu 233000, China
| | - M Zhang
- Bengbu Medical College, Bengbu 233000, China
| | - L Wang
- Bengbu Medical College, Bengbu 233000, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - X F Zhang
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - L G Zuo
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - Z J Geng
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - J Li
- Department of Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - Y Y Wang
- Department of Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - X Song
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
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Chen ZZ, Ding ZJ, Wang ZF, Xu SZ, Zhang SF, Yuan SS, Yan F, Liu GY, Qiu XF, Cai JC. [Comparison between laparoscopic-assisted natural orifice specimen extraction surgery and conventional laparoscopic surgery for left colorectal cancer: 5-year follow-up results of a randomized controlled study]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:768-772. [PMID: 37574293 DOI: 10.3760/cma.j.cn441530-20230406-00103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Objective: To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer. Methods: This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results: Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7-83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively (P=0.455); disease free survival was 90.0% and 83.3%, respectively (P=0.455); overall recurrence rate 6.6% and 10.0%, respectively (P=0.625); and local recurrence rate both were 3.3% (P=0.990), respectively. None of these differences was statistically significant. Conclusions: NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.
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Affiliation(s)
- Z Z Chen
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - Z J Ding
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - Z F Wang
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - S Z Xu
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - S F Zhang
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - S S Yuan
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - F Yan
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - G Y Liu
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - X F Qiu
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
| | - J C Cai
- Department of Gastrointestinal Surgery, Zhongshan Hospital, Xiamen University; Institute of Gastrointestinal Oncology, Medical College of Xiamen University; Xiamen Municipal Key Laboratory of Gastrointestinal Oncology, Xiamen 361004, China
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Askarian F, Tsai CM, Cordara G, Zurich RH, Bjånes E, Golten O, Vinther Sørensen H, Kousha A, Meier A, Chikwati E, Bruun JA, Ludviksen JA, Choudhury B, Trieu D, Davis S, Edvardsen PKT, Mollnes TE, Liu GY, Krengel U, Conrad DJ, Vaaje-Kolstad G, Nizet V. Immunization with lytic polysaccharide monooxygenase CbpD induces protective immunity against Pseudomonas aeruginosa pneumonia. Proc Natl Acad Sci U S A 2023; 120:e2301538120. [PMID: 37459522 PMCID: PMC10372616 DOI: 10.1073/pnas.2301538120] [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] [Received: 01/27/2023] [Accepted: 05/30/2023] [Indexed: 07/20/2023] Open
Abstract
Pseudomonas aeruginosa (PA) CbpD belongs to the lytic polysaccharide monooxygenases (LPMOs), a family of enzymes that cleave chitin or related polysaccharides. Here, we demonstrate a virulence role of CbpD in PA pneumonia linked to impairment of host complement function and opsonophagocytic clearance. Following intratracheal challenge, a PA ΔCbpD mutant was more easily cleared and produced less mortality than the wild-type parent strain. The x-ray crystal structure of the CbpD LPMO domain was solved to subatomic resolution (0.75Å) and its two additional domains modeled by small-angle X-ray scattering and Alphafold2 machine-learning algorithms, allowing structure-based immune epitope mapping. Immunization of naive mice with recombinant CbpD generated high IgG antibody titers that promoted human neutrophil opsonophagocytic killing, neutralized enzymatic activity, and protected against lethal PA pneumonia and sepsis. IgG antibodies generated against full-length CbpD or its noncatalytic M2+CBM73 domains were opsonic and protective, even in previously PA-exposed mice, while antibodies targeting the AA10 domain were not. Preexisting antibodies in PA-colonized cystic fibrosis patients primarily target the CbpD AA10 catalytic domain. Further exploration of LPMO family proteins, present across many clinically important and antibiotic-resistant human pathogens, may yield novel and effective vaccine antigens.
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Affiliation(s)
- Fatemeh Askarian
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
| | - Chih-Ming Tsai
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
| | - Gabriele Cordara
- Department of Chemistry, University of Oslo, N-0315 Oslo, Norway
| | - Raymond H Zurich
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
| | - Elisabet Bjånes
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
| | - Ole Golten
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, N-1432 Ås, Norway
| | | | - Armin Kousha
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
| | - Angela Meier
- Division of Critical Care, Department of Anesthesiology, University of California San Diego, La Jolla, CA 92037
| | - Elvis Chikwati
- Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, N-1432 Ås, Norway
| | - Jack-Ansgar Bruun
- Proteomics and Metabolomics Core Facility, Department of Medical Biology, The Arctic University of Norway, N-9037 Tromsø, Norway
| | | | - Biswa Choudhury
- Glycobiology Research and Training Center, University of California San Diego, La Jolla, CA 92093
| | - Desmond Trieu
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
- School of Pharmacy, University of California San Francisco, San Francisco, CA 94143
| | - Stanley Davis
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
| | | | - Tom Eirik Mollnes
- Research Laboratory, Nordland Hospital, N-8005 Bodø, Norway
- Department of Immunology, University of Oslo Hospital, N-0424 Oslo, Norway
- Center of Molecular Inflammation Research, Norwegian University of Science and Technology, N-7491 Trondheim, Norway
| | - George Y Liu
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
| | - Ute Krengel
- Department of Chemistry, University of Oslo, N-0315 Oslo, Norway
| | - Douglas J Conrad
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla, CA 92037
| | - Gustav Vaaje-Kolstad
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, N-1432 Ås, Norway
| | - Victor Nizet
- Division of Host-Microbe Systems & Therapeutics, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
- Glycobiology Research and Training Center, University of California San Diego, La Jolla, CA 92093
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093
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9
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Wang C, Zhou X, Liu GY, Qu CY, Yuan CY, Zhang YX. [Analysis of different protein expression levels in peripheral blood circulating tumor cells from patients with diffuse large B-cell lymphoma and their predictive efficiency for recurrence]. Zhonghua Yi Xue Za Zhi 2023; 103:1328-1333. [PMID: 37150683 DOI: 10.3760/cma.j.cn112137-20220817-01753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Objective: To analyze the expression levels of differentiation cluster 47 (CD47), signal regulatory protein α (SIRP-α), proto-oncogene (MYC) and proliferating cell associated antigen (Ki67) proteins in peripheral blood circulating tumor cells (CTC) from patients with diffuse large B-cell lymphoma and their predictive efficiency for tumor recurrence. Methods: The data of 82 patients with diffuse large B-cell lymphoma who were confirmed by histopathology and were in remission after chemotherapy in the Hematology Department of Linyi People's Hospital from January 2018 to January 2021 were retrospectively analyzed. There were 44 males and 38 females, and aged from 50 to 75 (63.8±4.6) years. The patients were divided into recurrent group (n=36) and non-recurrent group (n=46) according to their recurrence within 1 year after remission. The fasting peripheral venous blood samples (4 ml) from patients in the morning were collected, and the CTC were isolated. The expression levels of CD47, SIRP-α, MYC and Ki67 proteins in CTC were detected by Western blotting. The correlations between CD47 expression level and SIRP-α, MYC and Ki67 expression levels were analyzed by Pearson correlation analysis. The predictive efficiency of CD47, SIRP-α, MYC and Ki67 expression levels on tumor recurrence was evaluated by receiver operating characteristic (ROC) curves, and the areas under the curve (AUC) were calculated. Results: The expression levels of CD47, SIRP-α, MYC and Ki67 in recurrent group were 2.24±0.23, 1.17±0.12, 1.98±0.20 and 2.63±0.27, while those in non-recurrent group were 2.04±0.21, 1.31±0.13, 1.53±0.16 and 2.24±0.25. The expression levels of CD47, MYC and Ki67 in the recurrent group were higher than those in the non-recurrent group, while the expression levels of SIRP-α were lower than those in the non-recurrent group (all P<0.001). In 82 patients, the expression levels of CD47, SIRP-α, MYC and Ki67 were 2.13±0.22, 1.25±0.13, 1.73±0.18 and 2.41±0.26, respectively. The expression level of CD47 was negatively correlated with the expression level of SIRP-α (r=-0.308, P=0.005), but positively correlated with the expression level of MYC and Ki67 (r=0.484 and 0.332, P=0.012 and 0.003). The sensitivity of CD47, SIRP-α, MYC and Ki67 expression levels in predicting recurrence of diffuse large B-cell lymphoma was 66.7%, 72.2%, 72.2% and 66.7%, with the specificity of 67.4%, 71.7%, 67.4% and 71.7%, and AUC (95%CI) of 0.694 (0.582-0.791), 0.693 (0582-0.790), 0.714 (0.603-0.808) and 0.709 (0.598-0.804), respectively. The sensitivity of the combined detection of the above four indicators was 83.3%, with the specificity of 78.3% and the AUC (95%CI) of 0.864 (0.771-0.930), which was higher than those of the individual detection of each indicator (all P<0.05). Conclusions: The expression level of CD47 was negatively correlated with the expression level of SIRP-α, but positively correlated with the expression level of MYC and Ki67. The expression levels of CD47, SIRP-α, MYC and Ki67 have certain predictive value for tumor recurrence in patients with diffuse large B-cell lymphoma, and the predictive efficiency of combined detection is higher than single indicator detection.
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Affiliation(s)
- C Wang
- Department of Hematology, Linyi People's Hospital of Shandong Province, Linyi 276000, China
| | - X Zhou
- Department of Oncology, Linyi People's Hospital of Shandong Province, Linyi 276000, China
| | - G Y Liu
- Department of Orthopedics, Linyi People's Hospital of Shandong Province, Linyi 276000, China
| | - C Y Qu
- Department of Hematology and Oncology, Longkou People's Hospital of Shandong Province, Longkou 265711, China
| | - C Y Yuan
- Department of Hematology, Dezhou People's Hospital of Shandong Province, Dezhou 253000, China
| | - Y X Zhang
- Department of Hematology, Linyi People's Hospital of Shandong Province, Linyi 276000, China
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10
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Thomas SP, Denizer E, Zuffa S, Best BM, Bode L, Chambers CD, Dorrestein PC, Liu GY, Momper JD, Nizet V, Tsunoda SM, Tremoulet AH. Transfer of antibiotics and their metabolites in human milk: Implications for infant health and microbiota. Pharmacotherapy 2023; 43:442-451. [PMID: 36181712 PMCID: PMC10763576 DOI: 10.1002/phar.2732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 05/17/2023]
Abstract
Antibiotics are an essential tool for perinatal care. While antibiotics can play a life-saving role for both parents and infants, they also cause collateral damage to the beneficial bacteria that make up the host gut microbiota. This is especially true for infants, whose developing gut microbiota is uniquely sensitive to antibiotic perturbation. Emerging evidence suggests that disruption of these bacterial populations during this crucial developmental window can have long-term effects on infant health and development. Although most current studies have focused on microbial disruptions caused by direct antibiotic administration to infants or prenatal exposure to antibiotics administered to the mother, little is known about whether antibiotics in human milk may pose similar risks to the infant. This review surveys current data on antibiotic transfer during lactation and highlights new methodologies to assess drug transfer in human milk. Finally, we provide recommendations for future work to ensure antibiotic use in lactating parents is safe and effective for both parents and infants.
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Affiliation(s)
- Sydney P. Thomas
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
- Collaborative Mass Spectrometry Innovation Center, UC San Diego, La Jolla, California, USA
| | - Erce Denizer
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
- Collaborative Mass Spectrometry Innovation Center, UC San Diego, La Jolla, California, USA
| | - Simone Zuffa
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
- Collaborative Mass Spectrometry Innovation Center, UC San Diego, La Jolla, California, USA
| | - Brookie M. Best
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
- Pediatrics Department-Rady Children's Hospital San Diego, UC San Diego School of Medicine, La Jolla, California, USA
| | - Lars Bode
- Pediatrics Department-Rady Children's Hospital San Diego, UC San Diego School of Medicine, La Jolla, California, USA
- Mother-Milk-Infant Center of Research Excellence (MOMI CORE), UC San Diego, La Jolla, California, USA
| | - Christina D. Chambers
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
- Pediatrics Department-Rady Children's Hospital San Diego, UC San Diego School of Medicine, La Jolla, California, USA
- Hebert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, California, USA
| | - Pieter C. Dorrestein
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
- Collaborative Mass Spectrometry Innovation Center, UC San Diego, La Jolla, California, USA
| | - George Y. Liu
- Pediatrics Department-Rady Children's Hospital San Diego, UC San Diego School of Medicine, La Jolla, California, USA
| | - Jeremiah D. Momper
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
| | - Victor Nizet
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
- Pediatrics Department-Rady Children's Hospital San Diego, UC San Diego School of Medicine, La Jolla, California, USA
| | - Shirley M. Tsunoda
- Skaggs School of Pharmacy and Pharmaceutical Sciences, UC San Diego, La Jolla, California, USA
| | - Adriana H. Tremoulet
- Pediatrics Department-Rady Children's Hospital San Diego, UC San Diego School of Medicine, La Jolla, California, USA
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11
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Tsai CM, Caldera J, Hajam IA, Liu GY. Toward an effective Staphylococcus vaccine: why have candidates failed and what is the next step? Expert Rev Vaccines 2023; 22:207-209. [PMID: 36765453 PMCID: PMC9972957 DOI: 10.1080/14760584.2023.2179486] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Affiliation(s)
- Chih-Ming Tsai
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
| | - Jr Caldera
- Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Irshad A Hajam
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
| | - George Y Liu
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA
- Division of Infectious Diseases, Rady Children's Hospital, San Diego, CA, USA
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12
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Liu GY, Jing LL, Li J, Du XL. [Evaluation of two biomechanical stiffness indexes in the diagnosis of eratoconus and their changes after corneal collagen cross-linking surgery]. Zhonghua Yan Ke Za Zhi 2022; 58:584-591. [PMID: 35959602 DOI: 10.3760/cma.j.cn112142-20211027-00507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To evaluate the diagnostic efficacy of stress-strain index (SSI) for different stages or degrees of keratoconus and changes of SSI and stiffness parameter A1 (SPA1) after corneal collagen cross-linking (CXL) surgery. Methods: Cross-sectional study and retrospective case series study. Ninety-four patients (113 eyes) diagnosed as clinical keratoconus (CKC) in Qingdao Eye Hospital from July 2019 to August 2021 were enrolled in the CKC group, including 69 males and 25 females, aged (20.82±4.53) years, and further divided into subgroups of mild (35 patients, 36 eyes), moderate (36 patients, 40 eyes) and severe (33 patients, 37 eyes) CKC. Fifty-six unaffected eyes of monocular keratoconus patients were enrolled in the subclinical keratoconus (SKC) group. Ninety-one healthy subjects (91 eyes) were recruited as the control group. All subjects were examined by Pentacam topography and Corvis ST measurements to obtain mean keratometry, maximal keratometry, deformation amplitude (DA) ratio at 2 mm, integrated radius (IR), Ambrósio's relational thickness to the horizontal profile, corneal central thickness, SPA1 and SSI for comparison. Forty-eight CKC patients (65 eyes) underwent CXL surgery, and the above parameters were recorded before and 3, 6 and 12 months after operation. Data were analyzed by the ANOVA test, Kruskal-Wallis H test, paired sample test, receiver operating characteristic curves and Pearson correlation. Results: The value of SPA1 in the SKC group accounted for 85.53% (87.92±12.38 vs. 102.79±11.74; t=-6.614, P<0.001) compared with the control group, but the value of SSI had no difference in the two groups (t=0.105, P=0.916). The value of SPA1 in the CKC group accounted for 52.87% (54.35±14.70 vs. 102.79±11.74; t=25.985, P<0.001) compared with the control group. The value of SSI in the CKC group accounted for 67.96% (0.70±0.14 vs. 1.03±0.14; t=-15.305, P<0.001) compared with the control group. The more severe the disease was, the smaller the SPA1 and SSI values were 64.27±12.12, 55.22±12.23, 43.75±12.33; 0.78±0.14, 0.71±0.11, 0.61±0.09, and there were significant statistical differences among groups (mild vs. moderate, mild vs. severe, moderate vs. severe; SPA1: t=3.257, -7.249, -4.159; all P<0.001. SSI: t=2.383, 5.065, 2.798; P=0.018,<0.001,=0.006). Receiver operating characteristic analysis showed that SPA1 had good diagnostic efficiency for subclinical patients [area under curve (AUC)=0.802], while the SSI had no diagnostic value (P=0.802). SPA1 had better diagnostic efficiency than the SSI for keratoconus in different stages, especially in the mild CKC and SKC groups (AUC: 0.914 vs. 0.847). The SSI had a significant positive correlation with SPA1 and a significant negative correlation with DA ratio and IR in the control, SKC and CKC groups (r=0.278, 0.368, 0.550; r=-0.346, -0.462, -0.547; r=-0.612, -0.591, -0.718; P<0.01). For patients who received CXL, maximal keratometry decreased significantly at 6 and 12 months postoperatively (t=4.029, 3.633; all P<0.001), whereas SPA1 increased significantly (t=-3.960, -4.500; all P<0.001). However, the SSI only increased significantly at 3 months (t=-2.577, P=0.012) and returned to the preoperative level at 6 and 12 months postoperatively, with no statistical difference compared with the preoperative level (t=-0.544, -0.257; P=0.589, 0.798). Conclusions: While there was no significant change in the SSI of SKC, the SSI of CKC decreased, and the more severe the disease was, the smaller the value was. The SSI was significantly and consistently correlated with DA ratio, IR and SPA1. The SSI compared with SPA1 had a lower degree of identification in different stages and degrees of keratoconus. The consistency of SPA1 with clinical effects after CXL surgery was higher than that of the SSI parameter.
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Affiliation(s)
- G Y Liu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - L L Jing
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - J Li
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
| | - X L Du
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
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13
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Tsai CM, Caldera JR, Hajam IA, Chiang AWT, Tsai CH, Li H, Díez ML, Gonzalez C, Trieu D, Martins GA, Underhill DM, Arditi M, Lewis NE, Liu GY. Non-protective immune imprint underlies failure of Staphylococcus aureus IsdB vaccine. Cell Host Microbe 2022; 30:1163-1172.e6. [PMID: 35803276 PMCID: PMC9378590 DOI: 10.1016/j.chom.2022.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/10/2022] [Accepted: 06/09/2022] [Indexed: 12/25/2022]
Abstract
Humans frequently encounter Staphylococcus aureus (SA) throughout life. Animal studies have yielded SA candidate vaccines, yet all human SA vaccine trials have failed. One notable vaccine "failure" targeted IsdB, critical for host iron acquisition. We explored a fundamental difference between humans and laboratory animals-natural SA exposure. Recapitulating the failed phase III IsdB vaccine trial, mice previously infected with SA do not mount protective antibody responses to vaccination, unlike naive animals. Non-protective antibodies exhibit increased α2,3 sialylation that blunts opsonophagocytosis and preferentially targets a non-protective IsdB domain. IsdB vaccination of SA-infected mice recalls non-neutralizing humoral responses, further reducing vaccine efficacy through direct antibody competition. IsdB vaccine interference was overcome by immunization against the IsdB heme-binding domain. Purified human IsdB-specific antibodies also blunt IsdB passive immunization, and additional SA vaccines are susceptible to SA pre-exposure. Thus, failed anti-SA immunization trials could be explained by non-protective imprint from prior host-SA interaction.
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Affiliation(s)
- Chih-Ming Tsai
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA
| | - J R Caldera
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Irshad A Hajam
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA
| | - Austin W T Chiang
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA
| | - Chih-Hsiung Tsai
- Department of Life Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Haining Li
- Department of Bioengineering, University of California, San Diego, San Diego, CA 92093, USA
| | - María Lázaro Díez
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA
| | - Cesia Gonzalez
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA
| | - Desmond Trieu
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA
| | - Gislâine A Martins
- Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - David M Underhill
- Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Moshe Arditi
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Nathan E Lewis
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA; Department of Bioengineering, University of California, San Diego, San Diego, CA 92093, USA
| | - George Y Liu
- Department of Pediatrics, University of California, San Diego, San Diego, CA 92093, USA; Division of Infectious Diseases, Rady Children's Hospital, San Diego, CA 92123, USA.
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14
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Chen ZZ, Xu SZ, Ding ZJ, Zhang SF, Yuan SS, Yan F, Wang ZF, Liu GY, Qiu XF, Cai JC. [Comparison between laparoscopic-assisted natural orifice specimen extraction surgery and conventional laparoscopic surgery for left colorectal cancer: a randomized controlled study with 3-year follow-up results]. Zhonghua Wei Chang Wai Ke Za Zhi 2022; 25:604-611. [PMID: 35844123 DOI: 10.3760/cma.j.cn441530-20220129-00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To evaluate the mid-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using the Cai tube in the treatment of left colorectal cancer. Methods: A prospective randomized control trial (China Clinical Trials Registration Number: ChiCTR-OOR-15007060) was performed. Sixty patients with left colorectal cancer at Department of Gastrointestinal Surgery of Zhongshan Hospital from September 2015 to August 2017 were prospectively enrolled. Case inclusion criteria: (1) left colorectal adenocarcinoma (rectal cancer with distance ≥ 8 cm from tumor low margin to anal edge, sigmoid colon cancer, descending colon cancer and left transverse colon cancer) confirmed by preoperative pathology; (2) satisfactory conditions of conventional laparoscopic surgery; (3) maximum diameter of the tumor < 4.5 cm confirmed by preoperative abdominal and pelvic CT or MRI; (4) BMI < 30 kg/m2. Case exclusion criteria: (1) benign lesions, mucinous adenocarcinoma, signet-ring cell carcinoma and other special pathological types of tumors confirmed by preoperative pathological examination; (2) multiple or recurrent cancers; (3) with a history of neoadjuvant chemoradiotherapy; (4) obvious regional infiltration or distant metastasis indicated by preoperative imaging examination; (5) intestinal obstruction, intestinal perforation, etc. Participants were randomly assigned to NOSES group (using the Cai tube) and conventional laparoscopy (CL) group by random number table method. Clinical data between two groups were compared and analyzed, including perioperative conditions, tumor exfoliation cell detection and bacterial culture results of intraperitoneal lavage fluid, postoperative complications (Clavien-Dindo grading), postoperative pain [visual simulation scoring (VAS) assessment], anal function (Kirwan anal function grading assessment), and postoperative 3-year disease-free survival (DFS), overall survival (OS), overall recurrence rate, and local recurrence rate. Results: A total of 60 patients were enrolled, with 30 in the NOSES group and 30 in the CL group. All the patients in the NOSES group successfully completed operation with Cai tube. Baseline data between the two groups were not significantly different (all P>0.05). There were no statistically significant differences between two groups in conversion rate to open surgery, number of lymph node harivested, proximal and distal resection margin of tumor, negative rate of circumferential margin, operation time, blood loss, inflammatory indexes, postoperative anal function, postoperative hospital stay, hospitalization cost, morbidity of postoperative complications (Clavien-Dindo grade II or above) (all P>0.05). Compared to the CL group, the NOSES group had lower maximum postoperative VAS score (2.5±0.3 vs. 5.1±0.4, t=3.187, P<0.01), and fewer use of additional postoperative analgesia [6.7% (2/30) vs. 33.3% (10/30),χ2=6.670, P=0.02]. The postoperative time to gas passage was shorter in the NOSES group [(2.2±1.4) days vs. (3.1±1.2) days,P=0.026]. No tumor cells and bacterial contamination were found in abdominal lavage fluid before and after operation in either group. The anal function at postoperative 3-month of all the patients in the NOSES group was Kirwan grade I to II, while in the CL group, anal function of 2 cases (6.7%) was Kirwan grade III, and of 28 cases was also Kirwan grade I to II, whose difference was not statistically significant (P>0.05). In the NOSES group and the CL group, 3-year DFS was 96.7% and 83.3% (P=0.090), OS was 100% and 90% (P=0.096), overall recurrence rate was 3.3% and 10.0% (P=0.166), and local recurrence rate was 3.3% and 3.3% (P=0.999), respectively, whose differences were not statistically significant (all P>0.05). Conclusions: In the treatment of left colorectal cancer, compared with conventional laparoscopic colectomy, NOSES colectomy using Cai tube exhibits less scar, less postoperative pain, shorter recovery of gastrointestinal function, and similar mid-term outcomes. Given proper surgical indications, the surgical procedure is safe and feasible.
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Affiliation(s)
- Z Z Chen
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - S Z Xu
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - Z J Ding
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - S F Zhang
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - S S Yuan
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - F Yan
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - Z F Wang
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - G Y Liu
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - X F Qiu
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
| | - J C Cai
- Department of Gastrointestinal Surgery, Gastrointestinal Tumor Institute of Xiamen University School of Medicine, Xiamen Key Laboratory of Gastrointestinal Tumor, Zhongshan Hospital, Xiamen University, Fujian Xiamen 361004, China
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15
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Tsai CM, Hajam IA, Caldera JR, Liu GY. Integrating complex host-pathogen immune environments into S. aureus vaccine studies. Cell Chem Biol 2022; 29:730-740. [PMID: 35594849 DOI: 10.1016/j.chembiol.2022.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/08/2021] [Revised: 02/16/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022]
Abstract
Staphylococcus aureus (SA) is a leading cause of bacterial infection and antibiotic resistance globally. Therefore, development of an effective vaccine has been a major goal of the SA field for the past decades. With the wealth of understanding of pathogenesis, the failure of all SA vaccine trials has been a surprise. We argue that experimental SA vaccines have not worked because vaccines have been studied in naive laboratory animals, whereas clinical vaccine efficacy is tested in immune environments reprogrammed by SA. Here, we review the failed SA vaccines that have seemingly defied all principles of vaccinology. We describe major SA evasion strategies and suggest that they reshape the immune environment in a way that makes vaccines prone to failures. We propose that appropriate integration of concepts of host-pathogen interaction into vaccine study designs could lead to insight critical for the development of an effective SA vaccine.
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Affiliation(s)
- Chih-Ming Tsai
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA
| | - Irshad A Hajam
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA
| | - J R Caldera
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - George Y Liu
- Division of Infectious Diseases, Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA; Division of Infectious Diseases, Rady Children's Hospital, San Diego, CA 92123, USA.
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16
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Dong PT, Jusuf S, Hui J, Zhan Y, Zhu Y, Liu GY, Cheng JX. Photoinactivation of catalase sensitizes wide-ranging bacteria to ROS-producing agents and immune cells. JCI Insight 2022; 7:153079. [PMID: 35446788 PMCID: PMC9220836 DOI: 10.1172/jci.insight.153079] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 04/20/2022] [Indexed: 11/17/2022] Open
Abstract
Bacteria have evolved to cope with the detrimental effects of ROS using their essential molecular components. Catalase, a heme-containing tetramer protein expressed universally in most aerobic bacteria, plays an indispensable role in scavenging excess hydrogen peroxide (H2O2). Here, through use of wild-type and catalase-deficient mutants, we identified catalase as an endogenous therapeutic target of 400–420 nm blue light. Catalase residing inside bacteria could be effectively inactivated by blue light, subsequently rendering the pathogens extremely vulnerable to H2O2 and H2O2-producing agents. As a result, photoinactivation of catalase and H2O2 synergistically eliminated a wide range of catalase-positive planktonic bacteria and P. aeruginosa inside biofilms. In addition, photoinactivation of catalase was shown to facilitate macrophage defense against intracellular pathogens. The antimicrobial efficacy of catalase photoinactivation was validated using a Pseudomonas aeruginosa–induced mouse abrasion model. Taken together, our findings offer a catalase-targeting phototherapy approach against multidrug-resistant bacterial infections.
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Affiliation(s)
- Pu-Ting Dong
- Department of Biomedical Engineering, Boston University, Boston, United States of America
| | - Sebastian Jusuf
- Department of Biomedical Engineering, Boston University, Boston, United States of America
| | - Jie Hui
- Department of Biomedical Engineering, Boston University, Boston, United States of America
| | - Yuewei Zhan
- Department of Biomedical Engineering, Boston University, Boston, United States of America
| | - Yifan Zhu
- Department of Chemistry, Boston University, Boston, United States of America
| | - George Y Liu
- Department of Pediatrics, University of California, San Diego, San Diego, United States of America
| | - Ji-Xin Cheng
- Boston University, Boston, United States of America
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17
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Zhang YY, Yu XL, Cao AY, Hu Z, Liu GY, Shen ZZ, Shao ZM, Wu J. [The effect of adjuvant radiotherapy on postoperative complications of immediate deep inferior epigastric artery perforator flap breast reconstruction]. Zhonghua Wai Ke Za Zhi 2021; 59:780-784. [PMID: 34404177 DOI: 10.3760/cma.j.cn112139-20201103-00781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To examine the effect of adjuvant radiotherapy on postoperative complications of immediate deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. Methods: Data was collected from 185 patients underwent immediate DIEP reconstruction during November 2006 to March 2020 Department of Breast surgery, Fudan University shanghai Cancer Center. All the patients were female, aging (43.0±7.8) years (range: 29 to 61 years). The series included with a total of 187 flaps (2 bilateral, 183 unilateral). Included patients were divided into 2 groups: immediate DIEP reconstruction requring or not requring post-mastectomy radiation therapy (71 cases (71 flaps) in PMRT group, 114 cases (116 flaps) in control group). The aesthetic outcome were measured by Kroll score system and compared between the groups by t test. The complications included partial flap loss, minor necrosis were analyzed between the groups by χ2 test, while the influence of the other correlation factors on complication occurrence was analyzed by Logistic analysis. Results: The controll groups showed higher aesthetic results (2.21±0.55 vs. 2.47±0.82, t=-2.593, P=0.010). Complication rate in PMRT group was higher than that in control group (19.7% (15/71) vs. 4.2% (4/116), χ²=15.079,P<0.01). The complication rate was not correlated with age, body mass index, perforator number, neoadjuvant chemotherapy and adjuvant chemotherapy. Conclusions: Correlation was observed between adiuvant radiotherapy and post-operative complication of the DIEP flap. However, the complication occurrence and aesthetic results remain in the acceptable range. The other factors such as age, body mass index, perforator number, neoadjuvant chemotherapy and adjuvant chemotherapy should not be considered as prognosis factor of post-operative complication of the DIEP flap.
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Affiliation(s)
- Y Y Zhang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of oncology, Shanghai Medical College, Fuban University, Shanghai 200032, China
| | - X L Yu
- Department of Radiology, Fudan University Shanghai Cancer Center, Department of oncology, Shanghai Medical College, Fuban University, Shanghai 200032, China
| | - A Y Cao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of oncology, Shanghai Medical College, Fuban University, Shanghai 200032, China
| | - Z Hu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of oncology, Shanghai Medical College, Fuban University, Shanghai 200032, China
| | - G Y Liu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of oncology, Shanghai Medical College, Fuban University, Shanghai 200032, China
| | - Z Z Shen
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of oncology, Shanghai Medical College, Fuban University, Shanghai 200032, China
| | - Z M Shao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of oncology, Shanghai Medical College, Fuban University, Shanghai 200032, China
| | - J Wu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of oncology, Shanghai Medical College, Fuban University, Shanghai 200032, China
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18
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Bai GQ, Chen WL, Huang XH, Zhao SJ, Zhao SP, Chen XJ, Chen SW, Yang H, Lu X, Liu GY, Chen QH, Zhang LA, Jin L. [Evaluation of the diagnosis and treatment of cesarean scar pregnancy induced in the second trimester: a national multicenter retrospective study]. Zhonghua Fu Chan Ke Za Zhi 2021; 56:545-553. [PMID: 34420286 DOI: 10.3760/cma.j.cn112141-20210331-00167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the risk factors of adverse pregnancy outcomes for induced abortion of cesarean scar pregnancy in midtrimester. Methods: A national multicenter retrospective study was conducted. A total of 154 singletons pregnant women with cesarean scar pregnancy during the second trimester induced abortion by various reasons in 12 tertiary A hospitals were selected, their pregnant outcomes were observed and the risk factors of serious adverse outcomes were analyzed with univariate and multivariate logstic regression; the role of ultrasound and MRI in predicting placenta accreta and severe adverse outcomes was evaluated, the effectiveness of uterine artery embolization (UAE) in preventing hemorrhage in pregnant women with and without placenta accreta was compared. Results: Among 154 subjects, the rate of placenta accreta was 42.2% (65/154), the rate of postpartum hemorrhage≥1 000 ml was 39.0% (60/154), the rate of hysterectomy was 14.9% (23/154), the rate of uterine rupture was 0.6% (1/154). The risk factor of postpartum hemorrhage≥1 000 ml and hysterectomy was placenta accreta (P<0.01). For each increase in the number of parity, the risk of placenta accreta increased 2.385 times (95%CI: 1.046-5.439; P=0.039); and the risk of placenta accreta decreased with increasing ultrasound measurement of scar myometrium thickness (OR=0.033, 95%CI: 0.001-0.762; P=0.033). The amount of postpartum hemorrhage and hysterectomy rate in the group with placenta accreta diagnosed by ultrasound combined with MRI were not significantly different from those in the group with placenta accreta diagnosed by ultrasound only or MRI only (all P>0.05). For pregnant women with placenta accreta, there were no significant difference in the amount of bleeding and hysterectomy rate between the UAE group [median: 1 300 ml; 34% (16/47)] and the non-embolization group (all P>0.05); in pregnant women without placenta accreta, the amount of bleeding in the UAE group was lower than that in the non-embolization group (median: 100 vs 600 ml; P<0.01), but there was no significant difference in hysterectomy rate [2% (1/56) vs 9% (3/33); P>0.05]. Conclusions: (1) Placenta accreta is the only risk factor of postpartum hemorrhage≥1 000 ml with hysterectomy for induced abortion of cesarean scar pregnancy in midtrimester; multi-parity and ultrasound measurement of scar myometrium thickness are risk factors for placenta accreta. (2) The technique of using ultrasound and MRI in predicting placenta accreta of cesarean scar pregnancy needs to be improved. (3) It is necessary to discuss of UAE in preventing postpartum hemorrhage for induced abortion of cesarean scar pregnancy in midtrimester.
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Affiliation(s)
- G Q Bai
- Department of Obstetrics and Gynecology, the First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China
| | - W L Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - X H Huang
- Department of Obstetrics and Gynecology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - S J Zhao
- Department of Gynecology, Wuxi Maternal and Child Health Hospital, Nanjing Medical University, Wuxi 214001, China
| | - S P Zhao
- Department of Gynecology, Qingdao Women and Children's Hospital, Qingdao University,Qingdao 266034, China
| | - X J Chen
- Department of Gynecology, Fujian Provincial Maternity and Children's Hospital, Fuzhou 350000, China
| | - S W Chen
- Department of Family Planning, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - H Yang
- Department of Family Planning, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300052, China
| | - X Lu
- Department of Obstetrics and Gynecology, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, China
| | - G Y Liu
- Department of Obstetrics and Gynecology, Bejing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Q H Chen
- Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xiamen University, Xiamen 361003, Chian
| | - L A Zhang
- Department of Family Planning, Children's Hospital of Shanxi, Women Health Center of Shanxi, Taiyuan 030013, China
| | - L Jin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
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19
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Ramchandar N, Burns J, Coufal NG, Pennock A, Briggs B, Stinnett R, Bradley J, Arnold J, Liu GY, Pring M, Upasani VV, Rickert K, Dimmock D, Chiu C, Farnaes L, Cannavino C. Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections. Open Forum Infect Dis 2021; 8:ofab346. [PMID: 34322569 PMCID: PMC8314938 DOI: 10.1093/ofid/ofab346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/23/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Osteoarticular infections (OAIs) are frequently encountered in children. Treatment may be guided by isolation of a pathogen; however, operative cultures are often negative. Metagenomic next-generation sequencing (mNGS) allows for broad and sensitive pathogen detection that is culture-independent. We sought to evaluate the diagnostic utility of mNGS in comparison to culture and usual care testing to detect pathogens in acute osteomyelitis and/or septic arthritis in children. METHODS This was a single-site study to evaluate the use of mNGS in comparison to culture to detect pathogens in acute pediatric osteomyelitis and/or septic arthritis. Subjects admitted to a tertiary children's hospital with suspected OAI were eligible for enrollment. We excluded subjects with bone or joint surgery within 30 days of admission or with chronic osteomyelitis. Operative samples were obtained at the surgeon's discretion per standard care (fluid or tissue) and based on imaging and operative findings. We compared mNGS to culture and usual care testing (culture and polymerase chain reaction [PCR]) from the same site. RESULTS We recruited 42 subjects over the enrollment period. mNGS of the operative samples identified a pathogen in 26 subjects compared to 19 subjects in whom culture identified a pathogen. In 4 subjects, mNGS identified a pathogen where combined usual care testing (culture and PCR) was negative. Positive predictive agreement and negative predictive agreement both were 93.0% for mNGS. CONCLUSIONS In this single-site prospective study of pediatric OAI, we demonstrated the diagnostic utility of mNGS testing in comparison to culture and usual care (culture and PCR) from operative specimens.
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Affiliation(s)
- Nanda Ramchandar
- Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA
| | - Jessica Burns
- Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA
| | - Nicole G Coufal
- Pediatric Critical Care, University of California, San Diego, San Diego, California, USA
| | - Andrew Pennock
- Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA
| | | | | | - John Bradley
- Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA
| | - John Arnold
- Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA
| | - George Y Liu
- Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA
| | - Maya Pring
- Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA
| | - Vidyadhar V Upasani
- Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA
| | - Kathleen Rickert
- Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA
| | - David Dimmock
- Rady Children’s Institute for Genomic Medicine, San Diego, California, USA
| | - Charles Chiu
- Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Lauge Farnaes
- Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA
- IDbyDNA, Salt Lake City, Utah, USA
| | - Christopher Cannavino
- Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA
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20
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Tsai CM, Soper N, Bennett M, Fallon JK, Michell AR, Alter G, Liu GY, Thomsen I. Adoptive Transfer of Serum Samples From Children With Invasive Staphylococcal Infection and Protection Against Staphylococcus aureus Sepsis. J Infect Dis 2021; 223:1222-1231. [PMID: 32990305 PMCID: PMC8030728 DOI: 10.1093/infdis/jiaa482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 07/31/2020] [Indexed: 11/14/2022] Open
Abstract
A successful Staphylococcus aureus vaccine remains elusive, and one controversy in the field is whether humans generate a protective adaptive immune response to infection. We developed a bacterial challenge murine assay that directly assesses the protective capacity of adoptively transferred human serum samples. We first validated the model by showing that postpneumococcal vaccine serum samples from humans induced effective clearance of Streptococcus pneumoniae in mice. We then found that human serum samples adoptively transferred from children with invasive S. aureus infections exhibited protection from disease in a murine model, with some samples conferring near complete protection. These findings demonstrate that human serum samples are capable of conferring a protective adaptive response generated by humans during invasive staphylococcal disease, allowing for the study of protective factors in a murine model. Identification of the protective factors present in the most efficacious serum samples would be of high interest as potential staphylococcal vaccine candidates or passive therapeutics.
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Affiliation(s)
- Chih-Ming Tsai
- Department of Pediatrics, Division of Infectious Diseases, University of California, San Diego, California, USA
| | - Nicole Soper
- Department of Pediatrics, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Monique Bennett
- Department of Pediatrics, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jonathan K Fallon
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Ashlin R Michell
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, Massachusetts, USA
| | - George Y Liu
- Department of Pediatrics, Division of Infectious Diseases, University of California, San Diego, California, USA
| | - Isaac Thomsen
- Department of Pediatrics, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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21
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Zhao XY, Liu GY, Sui YT, Xu M, Tong L. Denoising method for Raman spectra with low signal-to-noise ratio based on feature extraction. Spectrochim Acta A Mol Biomol Spectrosc 2021; 250:119374. [PMID: 33422882 DOI: 10.1016/j.saa.2020.119374] [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] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/27/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
Raman spectroscopy is a non-destructive technique utilizing lasers to observe scattered light in order to determine things such as vibrational modes in the molecular system. A major problem inherent to this technique is that due to their short exposure time and the low power of the excitation laser, Raman signals are very weak. They tend to be much weaker than the noise and can even be drowned out. Conventional denoising methods are currently unable to extract Raman peaks with precision so it is necessary to specifically study Raman signal extraction methods that involve a low signal-to-noise ratio (SNR). In this study, a denoising method for Raman spectra with low SNR based on feature extraction was proposed. Based on the Hilbert Vibration Decomposition (HVD) method, the Raman spectra was decomposed into two components. The peaks were located in the first component and compensated by those in the second component. Then based on the position and height of the peaks, their full widths at half maximum (FWHM) are calculated. Finally, based on the position, height and FWHM of the peaks, Gaussian signals are used to reconstruct the Raman peaks from strong noise and baseline. In the data simulation experiment, the denoising method used improved the SNR from 3.5316 to 130.6386 and the mean square error (MSE) was reduced from 213.8635 to 14.0404. In the actual experiment, this method successfully extracted the characteristic peaks of melamine despite the noise from employing a low excitation laser (10 mW). The characteristics such as the amplitude and position of the peaks were identical to those obtained under a high excitation laser (150 mW). The error of the FWHM under different excitation laser powers (10 and 150 mW) was less than the spectral resolution. Using the method proposed in this paper, the Raman signal of biological samples such as rice leaves were extracted from the raw spectrum, and information on the spectral peak position, amplitude and FWHM were obtained with clarity. The characteristic peaks of the carotene molecule, protein amide I, protein phenylalanine, nucleic acid cytosine, cellulose, DNA phosphodiester, RNA phosphodiester, D-glucose, α-D glucose, chlorophyll, lignin and cellulose were all accurate as well. The results from the simulation data and actual experiments show that a method based on feature extraction can effectively extract Raman peaks even when they are submerged in background noise. It should be noted that the practicality of this method lies in the fact that it requires few parameters and is simple to operate and implement.
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Affiliation(s)
- X Y Zhao
- College of Electrical and Information, Heilongjiang Bayi Agricultural University, Daqing 163319, China.
| | - G Y Liu
- College of Electrical and Information, Heilongjiang Bayi Agricultural University, Daqing 163319, China
| | - Y T Sui
- College of Electrical and Information, Heilongjiang Bayi Agricultural University, Daqing 163319, China
| | - M Xu
- College of Electrical and Information, Heilongjiang Bayi Agricultural University, Daqing 163319, China
| | - L Tong
- Communication and Electronic Engineering Institute, Qiqihar University, 161000, China
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22
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Jusuf S, Dong PT, Hui J, Ulloa ER, Liu GY, Cheng JX. Granadaene Photobleaching Reduces the Virulence and Increases Antimicrobial Susceptibility of Streptococcus agalactiae. Photochem Photobiol 2021; 97:816-825. [PMID: 33502005 DOI: 10.1111/php.13389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022]
Abstract
Streptococcus agalactiae, also known as Group B Streptococcus (GBS), is increasingly recognized as a major cause of soft tissue and invasive diseases in the elderly and diabetic populations. Antibiotics like penicillin are used with great frequency to treat these infections, although antimicrobial resistance is increasing among GBS strains and underlines a need for alternative methods not reliant on traditional antibiotics. GBS granadaene pigment is related to the hemolysin/cytolysin of GBS, which is critical for the pathogenesis of GBS diseases. Here, we show that photobleaching granadaene dampens the hemolytic activity of GBS. Furthermore, photobleaching of this antioxidant was found to increase GBS susceptibility to killing by reactive oxygen species like hydrogen peroxide. Treatment with light was also shown to affect GBS membrane permeability and contribute to increased susceptibility to the cell membrane-targeting antibiotic daptomycin. Overall, our study demonstrates dual effects of photobleaching on the virulence and antimicrobial susceptibility of GBS and suggests a novel approach for the treatment of GBS infection.
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Affiliation(s)
- Sebastian Jusuf
- Department of Biomedical Engineering, Boston University, Boston, MA
| | - Pu-Ting Dong
- Department of Chemistry, Boston University, Boston, MA
| | - Jie Hui
- Department of Electrical & Computer Engineering, Boston University, Boston, MA
| | - Erlinda R Ulloa
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA
| | - George Y Liu
- Division of Pediatric Infectious Diseases, University of California San Diego School of Medicine, La Jolla, CA
| | - Ji-Xin Cheng
- Department of Biomedical Engineering, Boston University, Boston, MA.,Department of Chemistry, Boston University, Boston, MA.,Department of Electrical & Computer Engineering, Boston University, Boston, MA.,Photonics Center, Boston University, Boston, MA
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23
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Abstract
Widespread methicillin-resistant Staphylococcus aureus (S. aureus) infections within community and healthcare settings are responsible for accelerated development of antibiotic resistance. As the antibiotic pipeline began drying up, alternative strategies were sought for future treatment of S. aureus infections. Here, we review immune-based anti-staphylococcal strategies that, unlike conventional antibiotics, target non-essential gene products elaborated by the pathogen. These strategies stimulate narrow or broad host immune mechanisms that are critical for anti-staphylococcal defenses. Alternative approaches aim to disrupt bacterial virulence mechanisms that enhance pathogen survival or induce immunopathology. Although immune-based therapeutics are unlikely to replace antibiotics in patient treatment in the near term, they have the potential to significantly improve upon the performance of antibiotics for treatment of invasive staphylococcal diseases.
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Affiliation(s)
- Bonggoo Park
- Cedars Sinai Medical Center, Division of Pediatric Infectious Diseases and the Immunobiology Research Institute, Los Angeles, CA 90048, USA;
| | - George Y. Liu
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA
- Correspondence:
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24
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Armentrout EI, Liu GY, Martins GA. T Cell Immunity and the Quest for Protective Vaccines against Staphylococcus aureus Infection. Microorganisms 2020; 8:microorganisms8121936. [PMID: 33291260 PMCID: PMC7762175 DOI: 10.3390/microorganisms8121936] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 12/14/2022] Open
Abstract
Staphylococcus aureus is a wide-spread human pathogen, and one of the top causative agents of nosocomial infections. The prevalence of antibiotic-resistant S. aureus strains, which are associated with higher mortality and morbidity rates than antibiotic-susceptible strains, is increasing around the world. Vaccination would be an effective preventive measure against S. aureus infection, but to date, every vaccine developed has failed in clinical trials, despite inducing robust antibody responses. These results suggest that induction of humoral immunity does not suffice to confer protection against the infection. Evidence from studies in murine models and in patients with immune defects support a role of T cell-mediated immunity in protective responses against S. aureus. Here, we review the current understanding of the mechanisms underlying adaptive immunity to S. aureus infections and discuss these findings in light of the recent S. aureus vaccine trial failures. We make the case for the need to develop anti-S. aureus vaccines that can specifically elicit robust and durable protective memory T cell subsets.
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Affiliation(s)
- Erin I. Armentrout
- Lung Institute, Cedars-Sinai Medical Center (CSMC), Los Angeles, CA 90048, USA;
- Division of Pulmonary and Critical Care Medicine, CSMC, Los Angeles, CA 90048, USA
| | - George Y. Liu
- Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92161, USA;
- Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Gislâine A. Martins
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute (IBIRI), CSMC, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Research Division of Immunology, CSMC, Los Angeles, CA 90048, USA
- Department of Medicine, Division of Gastroenterology, CSMC, Los Angeles, CA 90048, USA
- Correspondence:
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Abstract
Hyper-immunoglobulin E syndrome (HIES) is a primary immunodeficiency disease characterized by recurrent Staphylococcus aureus (S. aureus) infections, eczema, skeletal abnormalities and high titers of serum immunoglobulin E. Although the genetic basis of HIES was not known for almost a half century, HIES most frequently exhibits autosomal dominant trait that is transmitted with variable expressivity. Careful genetic studies in recent years identified dominant-negative mutations in human signal transducer and activator of transcription 3 (STAT3) gene as the cause of sporadic and dominant forms of HIES. The STAT3 mutations were localized to DNA-binding, SRC homology 2 (SH2) and transactivating domains and disrupted T helper 17 (TH17) cell differentiation and downstream expression of TH17 cytokines IL-17 and IL-22. Deficiency of IL-17 and IL-22 in turn is responsible for suboptimal expression of anti-staphylococcal host factors, such as neutrophil-recruiting chemokines and antimicrobial peptides, by human keratinocytes and bronchial epithelial cells. TH17 cytokines deficiency thereby explains the recurrent staphylococcal lung and skin infections of HIES patients.
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Affiliation(s)
- Bonggoo Park
- Division of Pediatric Infectious Diseases and the Immunobiology Research Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA;
| | - George Y. Liu
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA
- Correspondence:
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Affiliation(s)
- S Y Wang
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - G Y Liu
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
| | - Z D Du
- Department of Cardiology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
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Zhao LF, Iwasaki Y, Han BL, Wang J, Zhang Y, Han J, Liu GY, Jiang X. TRIIODOTHYRONINE ACTIVATES GLYCEROL-3-PHOSPHATE ACYLTRANSFERASE 3 VIA AGGTCA-LIKE-DIRECT-REPEAT-4 TYPE THYROID HORMONE RESPONSE ELEMENT. Acta Endocrinol (Buchar) 2020; 16:129-135. [PMID: 33029227 DOI: 10.4183/aeb.2020.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Thyroid hormone participates in lipid metabolism regulation. However, the effects on triacyleride or triacylglycerol metabolism are complex and not fully clarified yet. In this study, we try to identify novel thyroid hormone-targeting lipogenic metabolic genes and analyze their molecular regulative mechanism. Method Thirty-five promoters of twenty-nine human lipogenic regulative enzyme genes were constructed into pXP1 luciferase reporter plasmid (PFK2/FBP2-luc) and transfected into HeGP2 cells, respectively. Gene expression induced by triiodothyronine (T3) was detected by luciferase assay. The T3-activated gene promoter was then analyzed by sequence analysis, deletion and mutation, and electrophoretic mobility shift assay (EMSA). Results After 10 nM T3 stimulation for 36 h, phosphogluconate dehydrogenase, malic enzyme, Glycerol-3-phosphate acyltransferase (GPAT) 3, and 1-acylglycerol-3-phosphate O-acyltransferase (AGPAT) 2 were significantly activated, respectively. A AGGTCA-like-direct-repeat-4 consensus thyroid hormone response element (DR4-TRE)-like sequence was found in the GPAT3 promoter, which was then verified to be necessary for T3-induced GPAT3 activation by gene deletion and mutation analysis. EMSA further identified that T3-thyroid receptor (TR) α-retinoid-X receptor (RXR) complex directly bound on the GPAT3 promoter. Conclusion Triiodothyronine could activate the GPAT3 through DR4-TRE-like sequence binding to participate in lipogenic regulation. AGPAT2 may be another thyroid hormone target enzyme.
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Affiliation(s)
- L F Zhao
- Tianjin First Center Hospital, Department of Endocrinology, Tianjin, China
| | - Y Iwasaki
- Kochi University, The Health Care Center, Kochi, Japan
| | - B L Han
- Tianjin First Center Hospital, Department of Endocrinology, Tianjin, China
| | - J Wang
- Tianjin First Center Hospital, Department of Endocrinology, Tianjin, China
| | - Y Zhang
- Tianjin First Center Hospital, Department of Endocrinology, Tianjin, China
| | - J Han
- Tianjin First Center Hospital, Department of Endocrinology, Tianjin, China
| | - G Y Liu
- Tianjin First Center Hospital, Department of Endocrinology, Tianjin, China
| | - X Jiang
- Tianjin First Center Hospital, Department of Endocrinology, Tianjin, China
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28
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Wozniak JM, Mills RH, Olson J, Caldera JR, Sepich-Poore GD, Carrillo-Terrazas M, Tsai CM, Vargas F, Knight R, Dorrestein PC, Liu GY, Nizet V, Sakoulas G, Rose W, Gonzalez DJ. Mortality Risk Profiling of Staphylococcus aureus Bacteremia by Multi-omic Serum Analysis Reveals Early Predictive and Pathogenic Signatures. Cell 2020; 182:1311-1327.e14. [PMID: 32888495 PMCID: PMC7494005 DOI: 10.1016/j.cell.2020.07.040] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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: 03/12/2020] [Revised: 06/11/2020] [Accepted: 07/29/2020] [Indexed: 12/15/2022]
Abstract
Staphylococcus aureus bacteremia (SaB) causes significant disease in humans, carrying mortality rates of ∼25%. The ability to rapidly predict SaB patient responses and guide personalized treatment regimens could reduce mortality. Here, we present a resource of SaB prognostic biomarkers. Integrating proteomic and metabolomic techniques enabled the identification of >10,000 features from >200 serum samples collected upon clinical presentation. We interrogated the complexity of serum using multiple computational strategies, which provided a comprehensive view of the early host response to infection. Our biomarkers exceed the predictive capabilities of those previously reported, particularly when used in combination. Last, we validated the biological contribution of mortality-associated pathways using a murine model of SaB. Our findings represent a starting point for the development of a prognostic test for identifying high-risk patients at a time early enough to trigger intensive monitoring and interventions.
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Affiliation(s)
- Jacob M Wozniak
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA
| | - Robert H Mills
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA; Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA; Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Joshua Olson
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - J R Caldera
- Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Gregory D Sepich-Poore
- Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Marvic Carrillo-Terrazas
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA
| | - Chih-Ming Tsai
- Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Fernando Vargas
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Division of Biological Sciences, University of California, San Diego, La Jolla, CA 92093, USA
| | - Rob Knight
- Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA; Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA; Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Pieter C Dorrestein
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA
| | - George Y Liu
- Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Victor Nizet
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - George Sakoulas
- Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA 92093, USA
| | - Warren Rose
- School of Pharmacy, School of Medicine and Public Health University of Wisconsin-Madison, Madison, WI 53705, USA; Department of Medicine, School of Medicine and Public Health University of Wisconsin-Madison, Madison, WI 53705, USA
| | - David J Gonzalez
- Department of Pharmacology, University of California, San Diego, La Jolla, CA 92093, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Collaborative to Halt Antibiotic-Resistant Microbes, University of California, San Diego, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA 92093, USA.
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Almeida CMVB, Frugoli AD, Agostinho F, Liu GY, Giannetti BF. Integrating or Des-integrating agribusiness systems: Outcomes of emergy evaluation. Sci Total Environ 2020; 729:138733. [PMID: 32498157 DOI: 10.1016/j.scitotenv.2020.138733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/27/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
The agribusiness contributes significantly to the Brazilian domestic production, and the search for environmentally friendly systems, exploring the maximum possible use of renewable resources and reducing the use of non-renewable ones, affects the agribusiness' productivity and competitivity. An agribusiness producing corn, eggs, pork and milk was evaluated using emergy accounting. The effects of the (des)integration of the production processes on the efficiency and environmental sustainability of the system were assessed using seven scenarios. The first is the existing integrated system and the others are scenarios in which one of the productive subsystems is removed. Efficiency is measured by the global productivity relative to the amount of protein produced. The most environmentally advantageous scenario, in terms of sustainability and productivity, is the one in which pork production is increased and egg production is ceased. This result suggests that increasing integration per se cannot assure gains in environmental sustainability. The integrated management of the residues of the poultry and pig production as organic fertilizer resulted an advantage for the seven scenarios. The scenarios presented should help to evaluate organizational innovations and to identify trade-offs that could influence the environmental performance of agricultural integrated systems.
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Affiliation(s)
- C M V B Almeida
- Laboratório de Produção e Meio Ambiente, Programa de Pós-Graduação em Engenharia de Produção, Universidade Paulista, R. Dr. Bacelar 1212, Cep 04026-002 São Paulo, Brazil.
| | - A D Frugoli
- Laboratório de Produção e Meio Ambiente, Programa de Pós-Graduação em Engenharia de Produção, Universidade Paulista, R. Dr. Bacelar 1212, Cep 04026-002 São Paulo, Brazil
| | - F Agostinho
- Laboratório de Produção e Meio Ambiente, Programa de Pós-Graduação em Engenharia de Produção, Universidade Paulista, R. Dr. Bacelar 1212, Cep 04026-002 São Paulo, Brazil
| | - G Y Liu
- State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing 100875, China; Beijing Engineering Research Center for Watershed Environmental Restoration & Integrated Ecological Regulation, Beijing 100875, China
| | - B F Giannetti
- Laboratório de Produção e Meio Ambiente, Programa de Pós-Graduação em Engenharia de Produção, Universidade Paulista, R. Dr. Bacelar 1212, Cep 04026-002 São Paulo, Brazil; State Key Joint Laboratory of Environment Simulation and Pollution Control, School of Environment, Beijing Normal University, Beijing 100875, China
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30
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Paterson MJ, Caldera JR, Nguyen C, Sharma P, Castro AM, Kolar SL, Tsai CM, Limon JJ, Becker CA, Martins GA, Liu GY, Underhill DM. Harnessing antifungal immunity in pursuit of a Staphylococcus aureus vaccine strategy. PLoS Pathog 2020; 16:e1008733. [PMID: 32817694 PMCID: PMC7446838 DOI: 10.1371/journal.ppat.1008733] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 11/08/2019] [Accepted: 06/22/2020] [Indexed: 02/03/2023] Open
Abstract
Staphylococcus aureus (S. aureus) is one of the most common bacterial infections worldwide, and antibiotic resistant strains such as Methicillin-Resistant S. aureus (MRSA) are a major threat and burden to public health. MRSA not only infects immunocompromised patients but also healthy individuals and has rapidly spread from the healthcare setting to the outside community. However, all vaccines tested in clinical trials to date have failed. Immunocompromised individuals such as patients with HIV or decreased levels of CD4+ T cells are highly susceptible to S. aureus infections, and they are also at increased risk of developing fungal infections. We therefore wondered whether stimulation of antifungal immunity might promote the type of immune responses needed for effective host defense against S. aureus. Here we show that vaccination of mice with a fungal β-glucan particle (GP) loaded with S. aureus antigens provides protective immunity to S. aureus. We generated glucan particles loaded with the four S. aureus proteins ClfA, IsdA, MntC, and SdrE, creating the 4X-SA-GP vaccine. Vaccination of mice with three doses of 4X-SA-GP promoted protection in a systemic model of S. aureus infection with a significant reduction in the bacterial burden in the spleen and kidneys. 4X-SA-GP vaccination induced antigen-specific Th1 and Th17 CD4+ T cell and antibody responses and provided long-term protection. This work suggests that the GP vaccine system has potential as a novel approach to developing vaccines for S. aureus.
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Affiliation(s)
- Marissa J. Paterson
- F. Widjaja Foundation Inflammatory Bowel & Immunobiology Research Institute, and the Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - JR Caldera
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Infectious Diseases, Department of Pediatics, UCSD, San Diego, California, United States of America
| | - Christopher Nguyen
- F. Widjaja Foundation Inflammatory Bowel & Immunobiology Research Institute, and the Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Purnima Sharma
- F. Widjaja Foundation Inflammatory Bowel & Immunobiology Research Institute, and the Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Anthony M. Castro
- F. Widjaja Foundation Inflammatory Bowel & Immunobiology Research Institute, and the Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Stacey L. Kolar
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Chih-Ming Tsai
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Infectious Diseases, Department of Pediatics, UCSD, San Diego, California, United States of America
| | - Jose J. Limon
- F. Widjaja Foundation Inflammatory Bowel & Immunobiology Research Institute, and the Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Courtney A. Becker
- F. Widjaja Foundation Inflammatory Bowel & Immunobiology Research Institute, and the Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Gislâine A. Martins
- F. Widjaja Foundation Inflammatory Bowel & Immunobiology Research Institute, and the Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Department of Medicine, Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - George Y. Liu
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Infectious Diseases, Department of Pediatics, UCSD, San Diego, California, United States of America
| | - David M. Underhill
- F. Widjaja Foundation Inflammatory Bowel & Immunobiology Research Institute, and the Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Department of Medicine, Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
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Hui J, Dong PT, Liang L, Mandal T, Li J, Ulloa ER, Zhan Y, Jusuf S, Zong C, Seleem MN, Liu GY, Cui Q, Cheng JX. Photo-Disassembly of Membrane Microdomains Revives Conventional Antibiotics against MRSA. Adv Sci (Weinh) 2020; 7:1903117. [PMID: 32195102 PMCID: PMC7080515 DOI: 10.1002/advs.201903117] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/29/2019] [Indexed: 05/21/2023]
Abstract
Confronted with the rapid evolution and dissemination of antibiotic resistance, there is an urgent need to develop alternative treatment strategies for drug-resistant pathogens. Here, an unconventional approach is presented to restore the susceptibility of methicillin-resistant S. aureus (MRSA) to a broad spectrum of conventional antibiotics via photo-disassembly of functional membrane microdomains. The photo-disassembly of microdomains is based on effective photolysis of staphyloxanthin, the golden carotenoid pigment that gives its name. Upon pulsed laser treatment, cell membranes are found severely disorganized and malfunctioned to defense antibiotics, as unveiled by membrane permeabilization, membrane fluidification, and detachment of membrane protein, PBP2a. Consequently, the photolysis approach increases susceptibility and inhibits development of resistance to a broad spectrum of antibiotics including penicillins, quinolones, tetracyclines, aminoglycosides, lipopeptides, and oxazolidinones. The synergistic therapy, without phototoxicity to the host, is effective in combating MRSA both in vitro and in vivo in a mice skin infection model. Collectively, this endogenous chromophore-targeted phototherapy concept paves a novel platform to revive conventional antibiotics to combat drug-resistant S. aureus infections as well as to screen new lead compounds.
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Affiliation(s)
- Jie Hui
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- Boston University Photonics Center Boston MA 02215 USA
| | - Pu-Ting Dong
- Boston University Photonics Center Boston MA 02215 USA
- Department of Chemistry Boston University Boston MA 02215 USA
| | - Lijia Liang
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- State Key Laboratory of Supramolecular Structure and Materials Institute of Theoretical Chemistry Jilin University Changchun 130012 China
| | | | - Junjie Li
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- Boston University Photonics Center Boston MA 02215 USA
| | - Erlinda R Ulloa
- Collaborative to Halt Antibiotic-Resistant Microbes (CHARM) Department of Pediatrics University of California San Diego School of Medicine La Jolla CA 92093 USA
- Division of Infectious Disease Department of Pediatrics Children's Hospital of Philadelphia Philadelphia PA 19104 USA
| | - Yuewei Zhan
- Department Biomedical Engineering Boston University Boston MA 02215 USA
| | - Sebastian Jusuf
- Department Biomedical Engineering Boston University Boston MA 02215 USA
| | - Cheng Zong
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- Boston University Photonics Center Boston MA 02215 USA
| | - Mohamed N Seleem
- College of Veterinary Medicine Purdue University West Lafayette IN 47907 USA
| | - George Y Liu
- Collaborative to Halt Antibiotic-Resistant Microbes (CHARM) Department of Pediatrics University of California San Diego School of Medicine La Jolla CA 92093 USA
- Division of Infectious Diseases Rady Children's Hospital San Diego CA 92123 USA
| | - Qiang Cui
- Department of Chemistry Boston University Boston MA 02215 USA
- Department Biomedical Engineering Boston University Boston MA 02215 USA
| | - Ji-Xin Cheng
- Department of Electrical and Computer Engineering Boston University Boston MA 02215 USA
- Boston University Photonics Center Boston MA 02215 USA
- Department of Chemistry Boston University Boston MA 02215 USA
- Department Biomedical Engineering Boston University Boston MA 02215 USA
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32
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Tian Y, Rong L, Nian WD, Wang X, Cai YL, Liu GY, Zhang JX, Liang JY. [Clinical short-term and long-term efficacy of endoscopic submucosal dissection in the treatment of early low rectal cancer and precancerous lesions]. Zhonghua Wei Chang Wai Ke Za Zhi 2019; 22:639-642. [PMID: 31302961 DOI: 10.3760/cma.j.issn.1671-0274.2019.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the short-term and long-term efficacy of endoscopic submucosal dissection (ESD) in the treatment of early low rectal cancer and precancerous lesions. Methods: Inclusion criteria: (1) Distance from the lower margin of tumor to the anal was ≤ 5 cm. (2) Early low rectal cancers were any size rectal epithelial tumors with infiltration depth limited to the mucosa and submucosa, which were diagnosed by postoperative pathology as high-grade intraepithelial neoplasia or adenocarcinoma of the rectum with infiltration depth of intramucosal or submucosal cancer (M or SM stage). (3) Precancerous lesions included adenoma and low-grade intraepithelial neoplasia of the rectum. (4) Patients received ESD treatment. Patients with tumor invasion depth over submucosa by pathology were excluded. From January 2008 to January 2018, 63 patients meeting the above criteria in Peking University First Hospital were enrolled in this descriptive cohort study. The disease characteristics, clinical manifestations, pathological types, treatment time, hospitalization time, en bloc resection rate (resection of the whole lesion), complete resection rate (both the horizontal and vertical incision margins were negative), postoperative complications and follow-up results were analyzed. Cummulative survival rate was calculated by Kaplan-Meier. Results: The diameter of the lesion was (29.0±23.4) mm and the distance from the lesion to the anus was (2.7±1.8) cm. The median operation time was 45.0 (range, 10.0 to 360.0) minutes, the median hospitalization time was 3.0 (range, 2.0 to 12.0) days, en bloc resection rate was 100%, complete resection rate was 96.8% (61/63), and 1 case (1.6%) had postoperative bleeding. The follow-up rate was 87.3% (55/63) and the median follow-up time was 57.9 (range, 15.6 to 121.1) months. No local recurrence was found during the follow-up period and the 5-year survival rate was 100%. Conclusion: Short- and long-term efficacy of ESD are quite good in the treatment of patients with early low rectal cancer and precancerous lesions.
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Affiliation(s)
- Y Tian
- Department of Endoscopy, the First Hospital of Peking University, Beijing 100034, China
| | - L Rong
- Department of Endoscopy, the First Hospital of Peking University, Beijing 100034, China
| | - W D Nian
- Department of Endoscopy, the First Hospital of Peking University, Beijing 100034, China
| | - X Wang
- Department of General Surgery, the First Hospital of Peking University, Beijing 100034, China
| | - Y L Cai
- Department of Endoscopy, the First Hospital of Peking University, Beijing 100034, China
| | - G Y Liu
- Department of Endoscopy, the First Hospital of Peking University, Beijing 100034, China
| | - J X Zhang
- Department of Pathology, the First Hospital of Peking University, Beijing 100034, China
| | - J Y Liang
- Department of Endoscopy, the First Hospital of Peking University, Beijing 100034, China
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Donegan NP, Manna AC, Tseng CW, Liu GY, Cheung AL. CspA regulation of Staphylococcus aureus carotenoid levels and σ B activity is controlled by YjbH and Spx. Mol Microbiol 2019; 112:532-551. [PMID: 31074903 DOI: 10.1111/mmi.14273] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2019] [Indexed: 01/06/2023]
Abstract
Staphyloxanthin, a carotenoid in S. aureus, is a powerful antioxidant against oxidative stresses. The crtOPQMN operon driving pigment synthesis is under the control of σB . CspA, a cold shock protein, is known to control σB activity. To ascertain genes that regulate cspA, we screened a transposon library that exhibited reduced cspA expression and pigmentation. We found that the adaptor protein YjbH activates cspA expression. Spx, the redox-sensitive transcriptional regulator and a proteolytic target for YjbH and ClpXP, complexes with αCTD of RNAP prior to binding the cspA promoter to repress cspA activity. Increased cspA expression in trans in the inactive spx C10A mutant of JE2 did not enhance pigment production while it did in JE2, suggesting that cspA is downstream to Spx in pigmentation control. As the staphyloxanthin pigment is critical to S. aureus survival in human hosts, we demonstrated that the cspA and yjbH mutants survived less well than the parent in whole blood killing assay. Collectively, our studies suggest a pathway wherein YjbH and ClpXP proteolytically cleave Spx, a repressor of cspA transcription, to affect σB -dependent carotenoid expression, thus providing a critical link between intracellular redox sensing by Spx and carotenoid production to improve S. aureus survival during infections.
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Affiliation(s)
- Niles P Donegan
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Adhar C Manna
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Ching Wen Tseng
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - George Y Liu
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Ambrose L Cheung
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Khan Z, Cao DY, Giani JF, Bernstein EA, Veiras L, Fuchs S, Liu GY, Bernstein KE. Increased activity of the angiotensin converting enzyme C‐domain reduces melanoma growth by stimulating M1 macrophage polarization. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.576.5] [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: 11/11/2022]
Affiliation(s)
- Zakir Khan
- Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Duo Yao Cao
- Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Jorge F. Giani
- Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | | | - Luciana Veiras
- Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
| | - Sebastien Fuchs
- Basic Medical SciencesWestern University of Health SciencesPomonaCA
| | - George Y. Liu
- Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCA
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Kolar SL, Tsai CM, Torres J, Fan X, Li H, Liu GY. Propionibacterium acnes-induced immunopathology correlates with health and disease association. JCI Insight 2019; 4:124687. [PMID: 30843879 DOI: 10.1172/jci.insight.124687] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 01/31/2019] [Indexed: 11/17/2022] Open
Abstract
Genomic studies revealed the existence of health- and acne-associated P. acnes strains and suggested novel approaches for broadening understanding of acne vulgaris. However, clinical association of P. acnes with disease or health has yet to be corroborated experimentally. Current animal models of acne do not closely mimic human disease and have unclear translational value. We have developed a murine model of acne by combining P. acnes inoculation with topical application of a synthetic human sebum. We showed that human sebum promoted persistence of intradermally injected P. acnes with little loss of viability after 1 week and permitted use of more physiologic inoculums. Application of acne-associated P. acnes RT4/5 strains led to development of moderate to severe skin pathology compared with application of health-associated type II P. acnes strains (RT2/6). RT4/5 P. acnes strains uniformly induced higher levels of KC (IL-8), IL-1α, IL-1β, and IL-6 in vitro and in vivo compared with type II P. acnes strains. Overall, our data provide immunopathologic corroboration of health and disease association of clinical P. acnes strains and inform on a platform to query putative virulence factors uncovered by genomic studies.
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Affiliation(s)
- Stacey L Kolar
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Chih-Ming Tsai
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Division of Infectious Diseases, Department of Pediatrics, UCSD, San Diego, California, USA
| | - Juan Torres
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Xuemo Fan
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Huiying Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.,UCLA-DOE Institute for Genomics and Proteomics, Los Angeles, California, USA
| | - George Y Liu
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Division of Infectious Diseases, Department of Pediatrics, UCSD, San Diego, California, USA
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36
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Mikheyeva IV, Thomas JM, Kolar SL, Corvaglia AR, Gaϊa N, Leo S, Francois P, Liu GY, Rawat M, Cheung AL. YpdA, a putative bacillithiol disulfide reductase, contributes to cellular redox homeostasis and virulence in Staphylococcus aureus. Mol Microbiol 2019; 111:1039-1056. [PMID: 30636083 DOI: 10.1111/mmi.14207] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 11/28/2022]
Abstract
The intracellular redox environment of Staphylococcus aureus is mainly buffered by bacillithiol (BSH), a low molecular weight thiol. The identity of enzymes responsible for the recycling of oxidized bacillithiol disulfide (BSSB) to the reduced form (BSH) remains elusive. We examined YpdA, a putative bacillithiol reductase, for its role in maintaining intracellular redox homeostasis. The ypdA mutant showed increased levels of BSSB and a lower bacillithiol redox ratio vs. the isogenic parent, indicating a higher level of oxidative stress within the bacterial cytosol. We showed that YpdA consumed NAD(P)H; and YpdA protein levels were augmented in response to stress. Wild type strains overexpressing YpdA showed increased tolerance to oxidants and electrophilic agents. Importantly, YpdA overexpression in the parental strain caused an increase in BSH levels accompanied by a decrease in BSSB concentration in the presence of stress, resulting in an increase in bacillithiol redox ratio vs. the vector control. Additionally, the ypdA mutant exhibited decreased survival in human neutrophils (PMNs) as compared with the parent, while YpdA overexpression protected the resulting strain from oxidative stress in vitro and from killing by human neutrophils ex vivo. Taken together, these data present a new role for YpdA in S. aureus physiology and virulence through the bacillithiol system.
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Affiliation(s)
- Irina V Mikheyeva
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Jason M Thomas
- Biology Department, California State University, Fresno, Fresno, CA 93740, USA
| | - Stacey L Kolar
- Department of Pediatrics, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Anna-Rita Corvaglia
- Genomic Research Laboratory, Service of Infectious Diseases, University Hospital of Geneva, 1205 Geneva 4, Switzerland
| | - Nadia Gaϊa
- Genomic Research Laboratory, Service of Infectious Diseases, University Hospital of Geneva, 1205 Geneva 4, Switzerland
| | - Stefano Leo
- Genomic Research Laboratory, Service of Infectious Diseases, University Hospital of Geneva, 1205 Geneva 4, Switzerland
| | - Patrice Francois
- Genomic Research Laboratory, Service of Infectious Diseases, University Hospital of Geneva, 1205 Geneva 4, Switzerland
| | - George Y Liu
- Department of Pediatrics, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Mamta Rawat
- Biology Department, California State University, Fresno, Fresno, CA 93740, USA
| | - Ambrose L Cheung
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
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Khan Z, Cao DY, Giani JF, Bernstein EA, Veiras LC, Fuchs S, Wang Y, Peng Z, Kalkum M, Liu GY, Bernstein KE. Overexpression of the C-domain of angiotensin-converting enzyme reduces melanoma growth by stimulating M1 macrophage polarization. J Biol Chem 2019; 294:4368-4380. [PMID: 30670595 DOI: 10.1074/jbc.ra118.006275] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/04/2019] [Indexed: 12/17/2022] Open
Abstract
Angiotensin-converting enzyme (ACE) can hydrolyze many peptides and plays a central role in controlling blood pressure. Moreover, ACE overexpression in monocytes and macrophages increases resistance of mice to tumor growth. ACE is composed of two independent catalytic domains. Here, to investigate the specific role of each domain in tumor resistance, we overexpressed either WT ACE (Tg-ACE mice) or ACE lacking N- or C-domain catalytic activity (Tg-NKO and Tg-CKO mice) in the myeloid cells of mice. Tg-ACE and Tg-NKO mice exhibited strongly suppressed growth of B16-F10 melanoma because of increased ACE expression in macrophages, whereas Tg-CKO mice resisted melanoma no better than WT animals. The effect of ACE overexpression reverted to that of the WT enzyme with an ACE inhibitor but not with an angiotensin II type 1 (AT1) receptor antagonist. ACE C-domain overexpression in macrophages drove them toward a pronounced M1 phenotype upon tumor stimulation, with increased activation of NF-κB and signal transducer and activator of transcription 1 (STAT1) and decreased STAT3 and STAT6 activation. Tumor necrosis factor α (TNFα) is important for M1 activation, and TNFα blockade reverted Tg-NKO macrophages to a WT phenotype. Increased ACE C-domain expression increased the levels of reactive oxygen species (ROS) and of the transcription factor C/EBPβ in macrophages, important stimuli for TNFα expression, and decreased expression of several M2 markers, including interleukin-4Rα. Natural ACE C-domain-specific substrates are not well-described, and we propose that the peptide(s) responsible for the striking ACE-mediated enhancement of myeloid function are substrates/products of the ACE C-domain.
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Affiliation(s)
- Zakir Khan
- From the Departments of Biomedical Sciences and.,Pathology
| | - Duo-Yao Cao
- From the Departments of Biomedical Sciences and
| | | | | | | | - Sebastien Fuchs
- the Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California 91766, and
| | - Yizhou Wang
- From the Departments of Biomedical Sciences and.,the Genomic Core, and
| | - Zhenzi Peng
- From the Departments of Biomedical Sciences and
| | - Markus Kalkum
- the Department of Molecular Imaging and Therapy, Beckman Research Institute of City of Hope, Duarte, California 91010
| | - George Y Liu
- From the Departments of Biomedical Sciences and.,the Division of Pediatric Infectious Diseases and Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, California 90048
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Abstract
The emergence of community-associated methicillin-resistant Staphylococcus aureus during the past decade along with an impending shortage of effective antistaphylococcal antibiotics have fueled impressive advances in our understanding of how S. aureus overcomes the host environment to establish infection. Backed by recent technologic advances, studies have uncovered elaborate metabolic, nutritional, and virulence strategies deployed by S. aureus to survive the restrictive and hostile environment imposed by the host, leading to a plethora of promising antimicrobial approaches that have potential to remedy the antibiotic resistance crisis. In this Review, we highlight some of the critical and recently elucidated bacterial strategies that are potentially amenable to intervention, discuss their relevance to human diseases, and address the translational challenges posed by current animal models.
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Affiliation(s)
- Isaac P Thomsen
- Department of Pediatrics, Division of Pediatric Infectious Diseases, and Vanderbilt Vaccine Research Program, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - George Y Liu
- Division of Pediatric Infectious Diseases and Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Abstract
Some pathogens block generation of reactive oxygen species to evade neutrophil killing, but how that is accomplished is poorly understood. In this issue of Cell Host & Microbe, Vareechon et al. (2017) describe ADP-ribosylation of Ras as a strategy to inhibit assembly of neutrophil NADPH oxidase.
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Affiliation(s)
- Stacey L Kolar
- Division of Pediatric Infectious Diseases and the Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - George Y Liu
- Division of Pediatric Infectious Diseases and the Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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Wu F, Mo M, Qin XX, Fang H, Zhao GM, Liu GY, Chen YY, Cao ZG, Yan YJ, Lyu LL, Xu WH, Shao ZM. [Cost-effectiveness of multiple screening modalities on breast cancer in Chinese women from Shanghai]. Zhonghua Liu Xing Bing Xue Za Zhi 2017; 38:1665-1671. [PMID: 29294584 DOI: 10.3760/cma.j.issn.0254-6450.2017.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To determine the most cost-effective modality for breast cancer screening in women living in Shanghai. Methods: A Markov model for breast cancer was redeveloped based on true effect which was derived from a project for detection of women at high risk of breast cancer and an organized breast cancer screening program conducted simultaneously in Minhang district, Shanghai, during 2008 to 2012. Parameters of the model were derived from literatures. General principles related to cost-effectiveness analysis were used to compare the costs and effects of 12 different screening modalities in a simulated cohort involving 100 000 women aged 45 years. Incremental cost-effectiveness ratio (ICER) was used to determine the most cost-effective modality. Sensitivity analysis was conducted to evaluate how these factors affected the estimated cost-effectiveness. Results: The modality of biennial CBE followed by ultrasonic and mammography among those with positive CBE was observed as the most cost-effective one. The costs appeared as 182 526 Yuan RMB per life year gained and 144 386 Yuan RMB per quality adjusted life-year (QALY) saved, which were within the threshold of 2-3 times of local per capita Gross Domestic Product. Results from sensitivity analysis showed that, due to higher incidence rate of breast cancer in Shanghai, the cost per QALY would be 64 836 Yuan RMB lower in Shanghai than the average level in China. Conclusion: Our research findings showed that the biennial CBE program followed by ultrasonic and mammography for those with positive CBE results might serve as the optimal breast cancer screening modality for Chinese women living in Shanghai, and thus be widely promoted in this population elsewhere.
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Affiliation(s)
- F Wu
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China; Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - M Mo
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - X X Qin
- Department of Hospital Management, School of Public Health, Fudan University, Key Laboratory of Health Technology Assessment, Ministry of Education, Shanghai 200032, China
| | - H Fang
- Center for Disease Control and Prevention of Minhang District of Shanghai, Shanghai 201103, China
| | - G M Zhao
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China
| | - G Y Liu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Y Y Chen
- Department of Hospital Management, School of Public Health, Fudan University, Key Laboratory of Health Technology Assessment, Ministry of Education, Shanghai 200032, China
| | - Z G Cao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Y J Yan
- Center for Disease Control and Prevention of Minhang District of Shanghai, Shanghai 201103, China
| | - L L Lyu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - W H Xu
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China
| | - Z M Shao
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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41
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Liu GY, Cao GL, Tian FM, Song HP, Yuan LL, Geng LD, Zheng ZY, Zhang L. Parathyroid hormone (1-34) promotes fracture healing in ovariectomized rats with type 2 diabetes mellitus. Osteoporos Int 2017; 28:3043-3053. [PMID: 28808745 DOI: 10.1007/s00198-017-4148-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
UNLABELLED Ovariectomized (OVX) rats with type 2 diabetes mellitus (T2DM) with femur fracture received vehicle, insulin, or insulin plus parathyroid hormone (PTH) treatment for 2 and 3 weeks. Radiography, histomorphometry, histology, and immunohistochemistry in callus were evaluated. INTRODUCTION Reports about effects of PTH plus insulin on callus formation of osteoporotic fracture with T2DM were limited. This study was designed to investigate the effects of the combination of PTH and insulin on fracture healing in OVX rats with T2DM. METHODS Two-month-old female rats were randomly divided into five groups: normal fracture (F), OVX fracture (OF), T2DM + OVX fracture (DOF), insulin-treated (2-4 u/daylight, 4-6 u/night, DOFI), and treated with insulin and PTH (50 μg/kg/day, 5 days/week, DOFIP). A closed mid-shaft fracture was established in the right femurs of all rats after 6 weeks of OVX. Rats were euthanized at 2 and 3 weeks post-fracture according to the time schedule, respectively. RESULTS The administration of insulin alone or insulin combined with PTH significantly increased mineralized bone volume fraction (BV/TV) and connectivity density (Conn.D) compared with those of the DOF group at 3 weeks post-fracture and also increased cartilaginous callus area ratio in the DOFI and DOFIP groups at 2 weeks and bony callus area ratio in the DOFIP groups at both the 2 and 3 weeks post-fracture. CONCLUSIONS OVX rats with T2DM exhibited a marked delay in the fracture healing process; insulin treatment ameliorated these effects, and the healing process was enhanced following treatment with a combination of insulin and PTH.
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Affiliation(s)
- G Y Liu
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - G L Cao
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China
| | - F M Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, China
| | - H P Song
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L L Yuan
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L D Geng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - Z Y Zheng
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China
| | - L Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, China.
- Department of Orthopedic Surgery, The Affiliated Hospital of North China University of Science and Technology, Tangshan, China.
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42
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Sanchez M, Kolar SL, Müller S, Reyes CN, Wolf AJ, Ogawa C, Singhania R, De Carvalho DD, Arditi M, Underhill DM, Martins GA, Liu GY. O-Acetylation of Peptidoglycan Limits Helper T Cell Priming and Permits Staphylococcus aureus Reinfection. Cell Host Microbe 2017; 22:543-551.e4. [PMID: 28943328 DOI: 10.1016/j.chom.2017.08.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/14/2017] [Accepted: 08/16/2017] [Indexed: 12/13/2022]
Abstract
Humans do not usually develop effective immunity to Staphylococcus aureus reinfection. Using a murine model that mimics human infection, we show that lack of protective immunity to S. aureus systemic reinfection is associated with robust interleukin-10 (IL-10) production and impaired protective Th17 responses. In dendritic cell co-culture assays, priming with S. aureus promotes robust T cell proliferation, but limits Th cells polarization and production of IL-1β and other cytokines important for Th1 and Th17 differentiation. We show that O-acetylation of peptidoglycan, a mechanism utilized by S. aureus to block bacterial cell wall breakdown, limits the induction of pro-inflammatory signals required for optimal Th17 polarization. IL-10 deficiency in mice restores protective immunity to S. aureus infection, and adjuvancy with a staphylococcal peptidoglycan O-acetyltransferase mutant reduces IL-10, increases IL-1β, and promotes development of IL-17-dependent, Th cell-transferable protective immunity. Overall, our study suggests a mechanism whereby S. aureus modulates cytokines critical for induction of protective Th17 immunity.
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Affiliation(s)
- Marisel Sanchez
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center (CSMC), Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA
| | - Stacey L Kolar
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center (CSMC), Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA
| | - Sabrina Müller
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center (CSMC), Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, CSMC, Los Angeles, CA 90048, USA
| | - Christopher N Reyes
- Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, CSMC, Los Angeles, CA 90048, USA
| | - Andrea J Wolf
- Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, CSMC, Los Angeles, CA 90048, USA
| | - Chihiro Ogawa
- Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, CSMC, Los Angeles, CA 90048, USA
| | - Rajat Singhania
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada
| | - Daniel D De Carvalho
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 2M9, Canada
| | - Moshe Arditi
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center (CSMC), Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA
| | - David M Underhill
- Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, CSMC, Los Angeles, CA 90048, USA
| | - Gislâine A Martins
- Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, CSMC, Los Angeles, CA 90048, USA; Department of Medicine, Division of Gastroenterology, CSMC, Los Angeles, CA 90048, USA.
| | - George Y Liu
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center (CSMC), Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, CSMC, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, CSMC, Los Angeles, CA 90048, USA.
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Kaplan A, Lee MW, Wolf AJ, Limon JJ, Becker CA, Ding M, Murali R, Lee EY, Liu GY, Wong GCL, Underhill DM. Direct Antimicrobial Activity of IFN-β. J Immunol 2017; 198:4036-4045. [PMID: 28411186 DOI: 10.4049/jimmunol.1601226] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 03/10/2017] [Indexed: 01/08/2023]
Abstract
Type I IFNs are a cytokine family essential for antiviral defense. More recently, type I IFNs were shown to be important during bacterial infections. In this article, we show that, in addition to known cytokine functions, IFN-β is antimicrobial. Parts of the IFN-β molecular surface (especially helix 4) are cationic and amphipathic, both classic characteristics of antimicrobial peptides, and we observed that IFN-β can directly kill Staphylococcus aureus Further, a mutant S. aureus that is more sensitive to antimicrobial peptides was killed more efficiently by IFN-β than was the wild-type S. aureus, and immunoblotting showed that IFN-β interacts with the bacterial cell surface. To determine whether specific parts of IFN-β are antimicrobial, we synthesized IFN-β helix 4 and found that it is sufficient to permeate model prokaryotic membranes using synchrotron x-ray diffraction and that it is sufficient to kill S. aureus These results suggest that, in addition to its well-known signaling activity, IFN-β may be directly antimicrobial and be part of a growing family of cytokines and chemokines, called kinocidins, that also have antimicrobial properties.
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Affiliation(s)
- Amber Kaplan
- Department of Microbiology, Immunology, and Molecular Genetics, University of California, Los Angeles, Los Angeles, CA 90095
| | - Michelle W Lee
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095.,Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, CA 90095.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095
| | - Andrea J Wolf
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Jose J Limon
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Courtney A Becker
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Minna Ding
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Ramachandran Murali
- Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, CA 90048; and
| | - Ernest Y Lee
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095.,Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, CA 90095.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095
| | - George Y Liu
- Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, CA 90095.,Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | - Gerard C L Wong
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095; .,Department of Chemistry and Biochemistry, University of California, Los Angeles, Los Angeles, CA 90095.,California NanoSystems Institute, University of California, Los Angeles, Los Angeles, CA 90095
| | - David M Underhill
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048; .,Research Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, CA 90048; and
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Liu GY, Bian S, Li F, Li XF, Fan K, An HZ, Jia XX. [Effect of allogenic mesenchymal stem cells transplantation on the expression of interleukin-22 and matrix metalloproteinase-3 in rats with collagen induced arthritis]. Zhonghua Yi Xue Za Zhi 2017; 97:698-702. [PMID: 28297833 DOI: 10.3760/cma.j.issn.0376-2491.2017.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the effect of allogeneic bone marrow mesenchymal stem cells transplantation on the expression of interleukin -22 (IL-22), matrix metalloproteinase -3 (MMP-3) in serum and synovial of rats with collagen induced arthritis. Methods: Type Ⅱ collagen were injected twice to establish the collagen induced arthritis (CIA) rat model. Forty-eight rats were randomly divided into 3 groups: control group, CIA control group, CIA experiment group. Rat bone marrow mesenchymal stem cells were cultured by bone marrow method combined with adherent culture method. After identify, the remaining cells were injected in the CIA experimental group. Enzyme linked immunosorbent assay (ELISA) and immunohistochemistry were used to detect the expression of IL-22 and MMP-3 in serum and anklebone joint's synovium of rats, respectively. Synovial cells were isolated and cultured, and were treated with different concentrations of IL-22. MMP-3 protein and mRNA were detected before and after stimulation by Western blot and real-time quantitative polymerase chain reaction (RT-qPCR). Results: After MSC transplantation, arthritis index, X-ray, HE staining of CIA rat showed that joint damage significantly reduced compared with the control group. The ELISA results showed that the expression of MMP-3 and IL-22 in CIA control group was higher than those in the control group (125.79±9.12 vs 102.00±7.63 ng/ml, P<0.05), (292.35±31.23 vs 257.27±13.99 ng/ml, P<0.05) and CIA experiment group (125.79±9.12 vs 97.94±9.50 ng/ml, P<0.05), (292.35±31.23 vs 262.16±22.02 ng/ml, P<0.05) with statistically significant difference (P<0.05). There was no significant difference between the control group and CIA experimental group. Immunohistochemical showed similar results with ELISA. Western blotting and RT-qPCR showed that MMP-3 protein and mRNA expression was increased after IL-22 stimulation in a dose-dependent manner. Conclusion: IL-22 and MMP-3 play an important role in the pathogenesis of rheumatoid arthritis. IL-22 could regulate the expression of MMP-3, and bone marrow mesenchymal stem cells could reduce the expression of MMP-3 in the treatment of rheumatoid arthritis by reducing the expression of IL-22.
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Affiliation(s)
- G Y Liu
- Department of Rheumatism, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China
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Liu GY, Gao ZH, Li L, Song TT, Sheng XG. [Expression of Jagged1 mRNA in human epithelial ovarian carcinoma tissues and effect of RNA interference of Jagged1 on growth of xenograft in nude mice]. Zhonghua Fu Chan Ke Za Zhi 2016; 51:448-53. [PMID: 27356481 DOI: 10.3760/cma.j.issn.0529-567x.2016.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the expression of Jagged1 in human epithelial ovarian carcinoma tissues and the effect of Jagged1 on growth of xenograft in nude mice. METHODS (1) Forty-eight cases of ovarian cancer and 30 cases of patients with benign epithelial ovarian tumor in the Henan Province Xinxiang Central Hospital during Feb. 2011 to Mar. 2014 were enrolled in this study. The mRNA expression of Jagged1, Notch1 and the downstream target genes Hes1, Hey1 were analyzed by using realtime PCR method. (2) The ovarian cancer xenograft models in nude mice were constructed by injecting SKOV3 cells in axillary subcutaneouswere. The nude mice were randomly divided into Jagged1 interference group, blank plasmid group and control group. Each group had 10 mice. They were transfected with pcDNA3.1(+)-siRNA-Jagged1, blank plasmid pDC3.1 and phosphate buffer, respectively. The tumor volumes and tumor masses were measured 14 days after transfection and the inhibition rate was calculated. The relative mRNA expression of Jagged1, Notch1, Hes1 and Hey1 in xenograft tissues after transfection in each group was detected by using realtime PCR technique and the relative protein expression of Jagged1, Notch1, Hes1 and Hey1 in xenograft tissues was detected by utilizing western blot method. RESULTS (1) The relative mRNA expression of Jagged1, Notch1, Hes1 and Hey1 in ovarian cancer tissues were higher than benign ovarian tumor tissues, the differences were statistically significant (P<0.01). (2) The tumor volume was (491± 68) mm(3) and tumor mass was (2.6±0.4) g in Jagged1 interference group, which were significantly lower than that in the blank plasmid group [(842±88) mm(3) and (4.4±0.8) g, respectively] and that in the control group [(851±90) mm(3) and (4.5±0.9) g, respectively; P<0.05], the tumor inhibition rate was 42.2% in Jagged1 interference group, which was significantly higher than that in the blank plasmid group and that in the control group (2.2% and 0, respectively), the differences were statistically significant (P<0.05). The relative mRNA and protein expression of Jagged1, Hes1 and Hey1 in xenograft tissues of nude micein Jagged1 interference group were lower than that in the other two groups, the differences were statistically significant (P<0.05). There were no differences of relative mRNA and protein expression of Notch1 in xenograft tissues of nude mice among the three groups (P>0.05). CONCLUSIONS Jagged1 is highly expressed in epithelial ovarian carcinoma. Jagged1 gene interference in xenograft tumor can inhibit ovarian cancer cell growth and improve tumor suppressor rate, which probably play roles by inhibiting Notch1 signaling pathway.
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Affiliation(s)
- G Y Liu
- Department of Gynecologic Oncology, Henan Province Xinxiang Central Hospital, Xinxiang 453000, China
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Kolar SL, Kyme P, Tseng CW, Soliman A, Kaplan A, Liang J, Nizet V, Jiang D, Murali R, Arditi M, Underhill DM, Liu GY. Group B Streptococcus Evades Host Immunity by Degrading Hyaluronan. Cell Host Microbe 2016; 18:694-704. [PMID: 26651945 DOI: 10.1016/j.chom.2015.11.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/27/2015] [Accepted: 11/05/2015] [Indexed: 12/21/2022]
Abstract
In response to tissue injury, hyaluronan (HA) polymers are cleaved by host hyaluronidases, generating small fragments that ligate Toll-like receptors (TLRs) to elicit inflammatory responses. Pathogenic bacteria such as group B Streptococcus (GBS) express and secrete hyaluronidases as a mechanism for tissue invasion, but it is not known how this activity relates to immune detection of HA. We found that bacterial hyaluronidases secreted by GBS and other Gram-positive pathogens degrade pro-inflammatory HA fragments to their component disaccharides. In addition, HA disaccharides block TLR2/4 signaling elicited by both host-derived HA fragments and other TLR2/4 ligands, including lipopolysaccharide. Application of GBS hyaluronidase or HA disaccharides reduced pulmonary pathology and pro-inflammatory cytokine levels in an acute lung injury model. We conclude that breakdown of host-generated pro-inflammatory HA fragments to disaccharides allows bacterial pathogens to evade immune detection and could be exploited as a strategy to treat inflammatory diseases.
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Affiliation(s)
- Stacey L Kolar
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Pierre Kyme
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ching Wen Tseng
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Antoine Soliman
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Amber Kaplan
- Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jiurong Liang
- Division of Pulmonary, Department of Medicine, and Women's Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Victor Nizet
- Department of Pediatrics and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA
| | - Dianhua Jiang
- Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Division of Pulmonary, Department of Medicine, and Women's Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Ramachandran Murali
- Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Moshe Arditi
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - David M Underhill
- Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - George Y Liu
- Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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Müller S, Wolf AJ, Iliev ID, Berg BL, Underhill DM, Liu GY. Poorly Cross-Linked Peptidoglycan in MRSA Due to mecA Induction Activates the Inflammasome and Exacerbates Immunopathology. Cell Host Microbe 2016; 18:604-12. [PMID: 26567511 DOI: 10.1016/j.chom.2015.10.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/23/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Abstract
Methicillin-resistant S. aureus (MRSA) is a leading health problem. Compared to methicillin-sensitive S. aureus, MRSA infections are associated with greater morbidity and mortality, but the mechanisms underlying MRSA pathogenicity are unclear. Here we show that the protein conferring β-lactam antibiotic resistance, penicillin-binding protein 2A (encoded by the mecA gene), directly contributes to pathogenicity during MRSA infection. MecA induction leads to a reduction in peptidoglycan cross-linking that allows for enhanced degradation and detection by phagocytes, resulting in robust IL-1β production. Peptidoglycan isolated from β-lactam-challenged MRSA strongly induces the NLRP3 inflammasome in macrophages, but these effects are lost upon peptidoglycan solubilization. Mutant MRSA bacteria with naturally occurring reduced peptidoglycan cross-links induce high IL-1β levels in vitro and cause increased pathology in vivo. β-lactam treatment of MRSA skin infection exacerbates immunopathology, which is IL-1 dependent. Thus, antibiotic-induced expression of mecA during MRSA skin infection contributes to immunopathology by altering peptidoglycan structure.
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Affiliation(s)
- Sabrina Müller
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Andrea J Wolf
- Division of Biomedical Sciences and the F. Widjaja Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Iliyan D Iliev
- Division of Biomedical Sciences and the F. Widjaja Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Bethany L Berg
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - David M Underhill
- Division of Biomedical Sciences and the F. Widjaja Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
| | - George Y Liu
- Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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Wolf AJ, Liu GY, Underhill DM. Inflammatory properties of antibiotic-treated bacteria. J Leukoc Biol 2016; 101:127-134. [PMID: 27576461 DOI: 10.1189/jlb.4mr0316-153rr] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 03/26/2016] [Revised: 08/02/2016] [Accepted: 08/05/2016] [Indexed: 12/12/2022] Open
Abstract
Antibiotics have proven to be enormously effective tools in combating infectious diseases. A common roadblock to the effective use of antibiotics is the development of antibiotic resistance. We have recently observed that the very mechanism by which methicillin-resistant Staphylococcus aureus (MRSA) becomes antibiotic resistant causes the organism to be more inflammatory to innate immune cells. In this review, we offer some thoughts on the ways in which antibiotics have been observed to influence immune responses to bacteria.
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Affiliation(s)
- Andrea J Wolf
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA; and
| | - George Y Liu
- Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA; and.,Division of Pediatric Infectious Diseases, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - David M Underhill
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA; .,Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA; and
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Zhang Q, Jin Y, Zhao CF, Wang WJ, Liu GY. Receptor for advanced glycation end-products (RAGE) is overexpressed in human osteosarcoma and promotes the proliferation of osteosarcoma U-2OS cells in vitro. Genet Mol Res 2016; 15:gmr7817. [PMID: 27323159 DOI: 10.4238/gmr.15027817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Osteosarcoma (OS) is an aggressive cancer of the long bones, and usually affects children and young adults. The receptor for advanced glycation end-products (RAGE) has recently been recognized as an oncogenic receptor that binds to different ligands, and promotes the progression of various cancers. However, little is known about the association between RAGE and the pathogenesis of OS. In this study, we first examined the expression of RAGE in OS tissues using immunohistochemical staining, western blotting, and reverse transcription quantitative polymerase chain reaction. We then determined the influence of the overexpressed RAGE on the proliferation of U-2OS cells in vitro. The results showed that RAGE was overexpressed in OS tissues compared with peritumor tissues, at both the mRNA and protein levels, and there was a significant association between overexpressed RAGE and clinicopathological characteristics, such as clinical stage and distant metastasis. Moreover, the overexpression of RAGE in U-2OS cells significantly promoted their proliferation in vitro. In conclusion, this study indicated that RAGE is overexpressed in OS tissue and promotes the proliferation of U-2OS cells. These data imply that RAGE promotes the growth of OS, and is a potential diagnostic biomarker and therapeutic target for the disorder.
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Affiliation(s)
- Q Zhang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Y Jin
- Department of Ophthalmology, Second Hospital of Jilin University, Changchun, China
| | - C F Zhao
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - W J Wang
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
| | - G Y Liu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, China
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Jia XQ, Hong Q, Cheng JY, Li JW, Wang YJ, Mo M, Shao ZM, Shen ZZ, Liu GY. Nodal ratio of positive to excised nodes, but not number of positive lymph nodes is better to predict group to avoid chemotherapy among postmenopausal ER-positive, lymph node-positive T1-T2 breast cancer patients. J Cancer Res Ther 2016; 11:740-5. [PMID: 26881511 DOI: 10.4103/0973-1482.154937] [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: 11/04/2022]
Abstract
AIM OF STUDY To identify whether nodal ratio (NR) of positive to excised nodes is superior to number of positive lymph nodes to predict group to avoid chemotherapy among postmenopausal ER-positive, lymph node-positive, T1-T2 breast cancer patients. MATERIALS AND METHODS Postmenopausal estrogen receptor (ER)-positive, lymph node-positive patients who received endocrine therapy (n = 173) with complete baseline data in our hospital between 2000 and 2006 were included. The disease-free survival (DFS) was compared. Survival analysis was performed using Kaplan-Meier method. Cox proportional hazard models were used to evaluate the prognostic value of chemotherapy with different NR for DFS. P--values less than 0.05 were regarded as significant. RESULTS The median follow-up was 72 months. Three of 13 variables analyzed remained significantly prognostic for survival in the Cox proportional hazards model. These included age (hazard ratio (HR) =1.642, 95% confidence interval (CI) =1.154-2.337, P = 0.006); histological grade (HR = 2.463,95% CI = 1.389-4.367, P = 0.002); and NR (HR = 2.280, 95% CI = 1.113-4.671, P = 0.024). Subgroup analysis by NR status showed that in patients with NR ≥ 0.20, chemotherapy significantly improves DFS (HR = 0.360, 95% CI = 0.195-0.663, P = 0.001); while in patients with NR < 0.20, chemotherapy did not significantly affect DFS (HR = 0.677, 95% CI = 0.227-2.107, P = 0.493). Radiotherapy is an important factor that improves DFS in lymph node-positive patients, so it is considered in all analysis. CONCLUSION This retrospective analysis demonstrates that NR of positive to excised nodes, but not number of positive lymph nodes is better to predict group to avoid chemotherapy among postmenopausal ER-positive, lymph node-positive T1-T2 breast cancer patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - G Y Liu
- Department of Breast Surgery, School of Public Health, Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Shanghai, China
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