1
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Qu R, Cheng X, Sefik E, Stanley Iii JS, Landa B, Strino F, Platt S, Garritano J, Odell ID, Coifman R, Flavell RA, Myung P, Kluger Y. Gene trajectory inference for single-cell data by optimal transport metrics. Nat Biotechnol 2024:10.1038/s41587-024-02186-3. [PMID: 38580861 DOI: 10.1038/s41587-024-02186-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/26/2024] [Indexed: 04/07/2024]
Abstract
Single-cell RNA sequencing has been widely used to investigate cell state transitions and gene dynamics of biological processes. Current strategies to infer the sequential dynamics of genes in a process typically rely on constructing cell pseudotime through cell trajectory inference. However, the presence of concurrent gene processes in the same group of cells and technical noise can obscure the true progression of the processes studied. To address this challenge, we present GeneTrajectory, an approach that identifies trajectories of genes rather than trajectories of cells. Specifically, optimal transport distances are calculated between gene distributions across the cell-cell graph to extract gene programs and define their gene pseudotemporal order. Here we demonstrate that GeneTrajectory accurately extracts progressive gene dynamics in myeloid lineage maturation. Moreover, we show that GeneTrajectory deconvolves key gene programs underlying mouse skin hair follicle dermal condensate differentiation that could not be resolved by cell trajectory approaches. GeneTrajectory facilitates the discovery of gene programs that control the changes and activities of biological processes.
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Affiliation(s)
- Rihao Qu
- Computational Biology & Bioinformatics Program, Yale University, New Haven, CT, USA
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Xiuyuan Cheng
- Department of Mathematics, Duke University, Durham, NC, USA
| | - Esen Sefik
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | | | - Boris Landa
- Program in Applied Mathematics, Yale University, New Haven, CT, USA
| | | | - Sarah Platt
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
| | - James Garritano
- Program in Applied Mathematics, Yale University, New Haven, CT, USA
| | - Ian D Odell
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
| | - Ronald Coifman
- Program in Applied Mathematics, Yale University, New Haven, CT, USA
- Department of Mathematics, Yale University, New Haven, CT, USA
- Department of Electrical Engineering, Yale University, New Haven, CT, USA
| | - Richard A Flavell
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT, USA
| | - Peggy Myung
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
| | - Yuval Kluger
- Computational Biology & Bioinformatics Program, Yale University, New Haven, CT, USA.
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA.
- Program in Applied Mathematics, Yale University, New Haven, CT, USA.
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2
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Odell ID, Agrawal K, Sefik E, Odell AV, Caves E, Kirkiles-Smith NC, Horsley V, Hinchcliff M, Pober JS, Kluger Y, Flavell RA. IL-6 trans-signaling in a humanized mouse model of scleroderma. Proc Natl Acad Sci U S A 2023; 120:e2306965120. [PMID: 37669366 PMCID: PMC10500188 DOI: 10.1073/pnas.2306965120] [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: 04/27/2023] [Accepted: 07/31/2023] [Indexed: 09/07/2023] Open
Abstract
Fibrosis is regulated by interactions between immune and mesenchymal cells. However, the capacity of cell types to modulate human fibrosis pathology is poorly understood due to lack of a fully humanized model system. MISTRG6 mice were engineered by homologous mouse/human gene replacement to develop an immune system like humans when engrafted with human hematopoietic stem cells (HSCs). We utilized MISTRG6 mice to model scleroderma by transplantation of healthy or scleroderma skin from a patient with pansclerotic morphea to humanized mice engrafted with unmatched allogeneic HSC. We identified that scleroderma skin grafts contained both skin and bone marrow-derived human CD4 and CD8 T cells along with human endothelial cells and pericytes. Unlike healthy skin, fibroblasts in scleroderma skin were depleted and replaced by mouse fibroblasts. Furthermore, HSC engraftment alleviated multiple signatures of fibrosis, including expression of collagen and interferon genes, and proliferation and activation of human T cells. Fibrosis improvement correlated with reduced markers of T cell activation and expression of human IL-6 by mesenchymal cells. Mechanistic studies supported a model whereby IL-6 trans-signaling driven by CD4 T cell-derived soluble IL-6 receptor complexed with fibroblast-derived IL-6 promoted excess extracellular matrix gene expression. Thus, MISTRG6 mice transplanted with scleroderma skin demonstrated multiple fibrotic responses centered around human IL-6 signaling, which was improved by the presence of healthy bone marrow-derived immune cells. Our results highlight the importance of IL-6 trans-signaling in pathogenesis of scleroderma and the ability of healthy bone marrow-derived immune cells to mitigate disease.
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Affiliation(s)
- Ian D. Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, CT06520
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT06520
| | - Kriti Agrawal
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT06511
- Program in Applied Mathematics, Yale University, New Haven, CT06511
| | - Esen Sefik
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT06520
| | - Anahi V. Odell
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT06520
| | - Elizabeth Caves
- Department of Molecular, Cellular, and Developmental Biology, Yale University, New Haven, CT06520
| | | | - Valerie Horsley
- Department of Dermatology, Yale University School of Medicine, New Haven, CT06520
- Department of Molecular, Cellular, and Developmental Biology, Yale University, New Haven, CT06520
| | - Monique Hinchcliff
- Department of Internal Medicine, Section of Rheumatology, Allergy and Immunology, Yale School of Medicine, New Haven, CT06520
| | - Jordan S. Pober
- Department of Dermatology, Yale University School of Medicine, New Haven, CT06520
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT06520
- Department of Pathology, Yale University, New Haven, CT06511
| | - Yuval Kluger
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT06511
- Program in Applied Mathematics, Yale University, New Haven, CT06511
- Department of Pathology, Yale University, New Haven, CT06511
| | - Richard A. Flavell
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT06520
- HHMI, Chevy Chase, MD20815
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Odell ID, Steach H, Gauld SB, Reinke-Breen L, Karman J, Carr TL, Wetter JB, Phillips L, Hinchcliff M, Flavell RA. Epiregulin is a dendritic cell-derived EGFR ligand that maintains skin and lung fibrosis. Sci Immunol 2022; 7:eabq6691. [PMID: 36490328 PMCID: PMC9840167 DOI: 10.1126/sciimmunol.abq6691] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Immune cells are fundamental regulators of extracellular matrix (ECM) production by fibroblasts and have important roles in determining extent of fibrosis in response to inflammation. Although much is known about fibroblast signaling in fibrosis, the molecular signals between immune cells and fibroblasts that drive its persistence are poorly understood. We therefore analyzed skin and lung samples of patients with diffuse cutaneous systemic sclerosis, an autoimmune disease that causes debilitating fibrosis of the skin and internal organs. Here, we define a critical role of epiregulin-EGFR signaling between dendritic cells and fibroblasts to maintain elevated ECM production and accumulation in fibrotic tissue. We found that epiregulin expression marks an inducible state of DC3 dendritic cells triggered by type I interferon and that DC3-derived epiregulin activates EGFR on fibroblasts, driving a positive feedback loop through NOTCH signaling. In mouse models of skin and lung fibrosis, epiregulin was essential for persistence of fibrosis in both tissues, which could be abrogated by epiregulin genetic deficiency or a neutralizing antibody. Therapeutic administration of epiregulin antibody reversed fibrosis in patient skin and lung explants, identifying it as a previously unexplored biologic drug target. Our findings reveal epiregulin as a crucial immune signal that maintains skin and lung fibrosis in multiple diseases and represents a promising antifibrotic target.
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Affiliation(s)
- Ian D. Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | - Holly Steach
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
| | | | | | | | | | | | | | - Monique Hinchcliff
- Department of Internal Medicine, Section of Rheumatology, Allergy & Immunology, Yale School of Medicine, New Haven, CT, USA
| | - Richard A. Flavell
- Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA
- Howard Hughes Medical Institute, Chevy Chase, MD, USA
- Correspondence to: , Department of Immunobiology, Yale School of Medicine, 300 Cedar Street, TAC S-569, Post Office Box 208011, New Haven, CT 06520-8011
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Kim DJ, Odell ID. Improvement of pterygium inversum unguis and Raynaud phenomenon with interdigital botulinum toxin injections. JAAD Case Rep 2022; 26:79-81. [PMID: 35942355 PMCID: PMC9356022 DOI: 10.1016/j.jdcr.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Daniel J Kim
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Ian D Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
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Damsky W, Wang A, Kim DJ, Young BD, Singh K, Murphy MJ, Daccache J, Clark A, Ayasun R, Ryu C, McGeary MK, Odell ID, Fazzone-Chettiar R, Pucar D, Homer R, Gulati M, Miller EJ, Bosenberg M, Flavell RA, King B. Inhibition of type 1 immunity with tofacitinib is associated with marked improvement in longstanding sarcoidosis. Nat Commun 2022; 13:3140. [PMID: 35668129 PMCID: PMC9170782 DOI: 10.1038/s41467-022-30615-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/05/2022] [Indexed: 01/05/2023] Open
Abstract
Sarcoidosis is an idiopathic inflammatory disorder that is commonly treated with glucocorticoids. An imprecise understanding of the immunologic changes underlying sarcoidosis has limited therapeutic progress. Here in this open-label trial (NCT03910543), 10 patients with cutaneous sarcoidosis are treated with tofacitinib, a Janus kinase inhibitor. The primary outcome is the change in the cutaneous sarcoidosis activity and morphology instrument (CSAMI) activity score after 6 months of treatment. Secondary outcomes included change in internal organ involvement, molecular parameters, and safety. All patients experience improvement in their skin with 6 patients showing a complete response. Improvement in internal organ involvement is also observed. CD4+ T cell-derived IFN-γ is identified as a central cytokine mediator of macrophage activation in sarcoidosis. Additional type 1 cytokines produced by distinct cell types, including IL-6, IL-12, IL-15 and GM-CSF, also associate with pathogenesis. Suppression of the activity of these cytokines, especially IFN-γ, correlates with clinical improvement. Our results thus show that tofacitinib treatment is associated with improved sarcoidosis symptoms, and predominantly acts by inhibiting type 1 immunity.
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Affiliation(s)
- William Damsky
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA. .,Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
| | - Alice Wang
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, CT USA
| | - Daniel J. Kim
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, CT USA
| | - Bryan D. Young
- grid.47100.320000000419368710Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT USA
| | - Katelyn Singh
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, CT USA
| | - Michael J. Murphy
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, CT USA
| | - Joseph Daccache
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, CT USA
| | - Abigale Clark
- grid.258405.e0000 0004 0539 5056Kansas City University of Medicine and Biosciences, Kansas City, MO USA
| | - Ruveyda Ayasun
- grid.240324.30000 0001 2109 4251Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, NY USA
| | - Changwan Ryu
- grid.47100.320000000419368710Seciton of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT USA
| | - Meaghan K. McGeary
- grid.47100.320000000419368710Department of Pathology, Yale School of Medicine, New Haven, CT USA
| | - Ian D. Odell
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, CT USA ,grid.47100.320000000419368710Department of Immunobiology, Yale School of Medicine, New Haven, CT USA
| | - Ramesh Fazzone-Chettiar
- grid.47100.320000000419368710Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT USA
| | - Darko Pucar
- grid.47100.320000000419368710Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT USA
| | - Robert Homer
- grid.47100.320000000419368710Department of Pathology, Yale School of Medicine, New Haven, CT USA
| | - Mridu Gulati
- grid.47100.320000000419368710Seciton of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT USA
| | - Edward J. Miller
- grid.47100.320000000419368710Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT USA
| | - Marcus Bosenberg
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, CT USA ,grid.47100.320000000419368710Department of Pathology, Yale School of Medicine, New Haven, CT USA ,grid.47100.320000000419368710Department of Immunobiology, Yale School of Medicine, New Haven, CT USA
| | - Richard A. Flavell
- grid.47100.320000000419368710Department of Immunobiology, Yale School of Medicine, New Haven, CT USA ,grid.47100.320000000419368710Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT USA
| | - Brett King
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA.
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Odell ID, Flavell RA, Silver FH. Vibrational optical coherence tomography detects unique skin fibrotic states: Preliminary results of animal and human studies. J Am Acad Dermatol 2021; 85:780-782. [PMID: 32860914 PMCID: PMC9793292 DOI: 10.1016/j.jaad.2020.08.091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/11/2020] [Revised: 08/18/2020] [Accepted: 08/22/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Ian D Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.
| | - Richard A Flavell
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut; Howard Hughes Medical Institute, Chevy Chase, Maryland
| | - Frederick H Silver
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers, the State University of New Jersey, Piscataway, New Jersey; OptoVibronex, LLC, Mt Bethel, Pennsylvania
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Belzer A, Olamiju B, Antaya RJ, Odell ID, Bia M, Perkins SH, Cohen JM. A novel medical student initiative to enhance provision of teledermatology in a resident continuity clinic during the COVID-19 pandemic: a pilot study. Int J Dermatol 2020; 60:128-129. [PMID: 33226121 PMCID: PMC7753449 DOI: 10.1111/ijd.15322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 12/01/2022]
Affiliation(s)
| | | | - Richard J Antaya
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Ian D Odell
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Margaret Bia
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Sara H Perkins
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
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Xie CB, Cowper S, Odell ID. Morphea after Borrelia-induced facial nerve palsy. Journal of Scleroderma and Related Disorders 2020; 6:111-113. [DOI: 10.1177/2397198320956892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/13/2020] [Indexed: 11/17/2022]
Abstract
Morphea, also known as localized scleroderma, is characterized by inflammation and fibrosis of the skin. The exact pathogenesis of morphea is unknown, but generally includes genetic predisposition to autoimmunity combined with an environmental insult. Previous cases have been associated with active Borrelia infection; however, Borrelia infection as a direct cause of morphea was not generalizable to most patients. Within endemic areas, Borrelia burgdorferi is the most common cause of facial nerve paralysis, another autoimmune phenomenon. We report a case of facial morphea in a young man with family history of autoimmune disease who developed morphea in the same location as two previous episodes of Borrelia-induced facial nerve palsy. This case is remarkable because it suggests Borrelia burgdorferi induced loss of local immune tolerance to host antigens, first with facial nerve palsy and followed years later by development of morphea.
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Affiliation(s)
- Catherine B Xie
- Department of Immunobiology, School of Medicine, Yale University, New Haven, CT, USA
| | - Shawn Cowper
- Department of Dermatology, School of Medicine, Yale University, New Haven, CT, USA
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, USA
| | - Ian D Odell
- Department of Dermatology, School of Medicine, Yale University, New Haven, CT, USA
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9
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Odell ID, Flavell RA. Publisher Correction: HER2 joins AKT to inhibit STING immunity. Nat Cell Biol 2019; 21:1301. [PMID: 31444402 DOI: 10.1038/s41556-019-0395-1] [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: 11/09/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- Ian D Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Richard A Flavell
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA. .,Howard Hughes Medical Institute, Chevy Chase, Maryland, USA.
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10
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Affiliation(s)
- Ian D Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Richard A Flavell
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA. .,Howard Hughes Medical Institute, Chevy Chase, Maryland, USA.
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Kibbi N, Totonchy M, Suozzi KC, Ko CJ, Odell ID. A case of subungual tumors of incontinentia pigmenti: A rare manifestation and association with bipolar disease. JAAD Case Rep 2018; 4:737-741. [PMID: 30167449 PMCID: PMC6113656 DOI: 10.1016/j.jdcr.2018.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Nour Kibbi
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Mariam Totonchy
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Kathleen C Suozzi
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Christine J Ko
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Ian D Odell
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
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Affiliation(s)
- Ian D Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Richard A Flavell
- Department of Immunobiology, School of Medicine, Yale University, New Haven, Connecticut 06520, USA
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Shi VJ, Galan A, Odell ID, Choi JN. Cutaneous Vasculopathy as an Adverse Effect of the Anti-Vascular Endothelial Growth Factor Agent Axitinib. JAMA Dermatol 2016; 152:222-3. [PMID: 26509864 DOI: 10.1001/jamadermatol.2015.3209] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Veronica J Shi
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Anjela Galan
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut2Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Ian D Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Jennifer N Choi
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
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14
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Leventhal JS, Odell ID, Imaeda S, Maverakis E, King BA. Treatment of melanoma in-transit metastases with combination intralesional interleukin-2, topical imiquimod, and tretinoin 0.1% cream. JAAD Case Rep 2016; 2:114-6. [PMID: 27051847 PMCID: PMC4810288 DOI: 10.1016/j.jdcr.2016.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Jonathan S. Leventhal
- Yale University School of Medicine, Department of Dermatology, New Haven, Connecticut
| | - Ian D. Odell
- Yale University School of Medicine, Department of Dermatology, New Haven, Connecticut
| | - Suguru Imaeda
- Yale University School of Medicine, Department of Dermatology, New Haven, Connecticut
- Department of Veterans Affairs, West Haven, Connecticut
| | | | - Brett A. King
- Yale University School of Medicine, Department of Dermatology, New Haven, Connecticut
- Department of Veterans Affairs, West Haven, Connecticut
- Correspondence to: Brett A. King, MD, PhD, Yale University School of Medicine, Department of Dermatology, 15 York Street, LMP 5040, New Haven, CT 06510.Yale University School of MedicineDepartment of Dermatology15 York StreetLMP 5040New HavenCT06510
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15
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Affiliation(s)
- Ian D Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Evelyn Lilly
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Katharine Reeve
- Department of Podiatric Surgery, Yale University School of Medicine, New Haven, Connecticut
| | - Marcus W Bosenberg
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut3Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Leonard M Milstone
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
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Abstract
IMPORTANCE Inhibition of angiogenesis is an effective anticancer strategy because neoplasms require a rich blood supply. Ramucirumab, approved by the US Food and Drug Administration in 2014 to treat gastric adenocarcinomas and non-small cell lung carcinomas, targets vascular endothelial growth factor 2 (VEGFR2). We identified a patient prescribed a regimen of irinotecan hydrochloride, cetuximab, and ramucirumab for metastatic rectal cancer (diagnosed in November 2013 and treated through early January 2015) who developed a new-onset, expanding vascular lesion on his right leg. Via exome sequencing, we found that the lesion contained a single somatic mutation in KDR (encodes VEGFR2), possibly in response to ramucirumab. Vascular tumors are not a known complication of antiangiogenic therapeutics. OBSERVATIONS Exome sequencing of the well-demarcated, blanching vascular lesion on the lateral right shin revealed a somatic p.T771R mutation in KDR, without evidence of other somatic mutations or loss of heterozygosity. Histological features included lobules of small vessels within the dermis, resembling a tufted angioma. CONCLUSIONS AND RELEVANCE A potential adverse effect of ramucirumab in combination therapy is the development of sporadic angiomas. The p.T771R mutation was previously implicated in autophosphorylation of VEGFR2 and reported in angiosarcomas alongside other driver mutations. Our observations suggest that this mutation confers a proliferative advantage in the setting of ramucirumab therapy. Patients receiving ramucirumab should be monitored for the development of new vascular lesions.
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Affiliation(s)
- Young H Lim
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut2Department of Pathology, Yale University School of Medicine, New Haven, Connecticut3Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
| | - Ian D Odell
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut
| | - Christine J Ko
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut2Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Keith A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut2Department of Pathology, Yale University School of Medicine, New Haven, Connecticut3Department of Genetics, Yale University School of Medicine, New Haven, Connecticut
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17
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Affiliation(s)
- Ian D Odell
- Department of Dermatology, Yale University, New Haven, CT, USA.
| | - Amer M Zeidan
- Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT, USA
| | - Terri L Parker
- Section of Hematology, Department of Internal Medicine, Yale University, New Haven, CT, USA
| | - Oscar R Colegio
- Department of Dermatology, Yale University, New Haven, CT, USA
| | - Antonio Subtil
- Department of Dermatology, Yale University, New Haven, CT, USA
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Abstract
Most of the DNA in eukaryotes is packaged in tandemly arrayed nucleosomes that, together with numerous DNA- and nucleosome-associated enzymes and regulatory factors, make up chromatin. Chromatin modifying and remodeling agents help regulate access to selected DNA segments in chromatin, thereby facilitating transcription and DNA replication and repair. Studies of nucleotide excision repair (NER), single strand break repair (SSBR), and the homology-directed repair (HDR), and non-homologous end-joining (NHEJ) double strand break repair pathways have led to an "access-repair-restore" paradigm, in which chromatin in the vicinity of damaged DNA is disrupted, thereby enabling efficient repair and the subsequent repackaging of DNA into nucleosomes. When damage is extensive, these repair processes are accompanied by cell cycle checkpoint activation, which provides cells with sufficient time to either complete the repair or initiate apoptosis. It is not clear, however, if base excision repair (BER) of the ~20,000 or more oxidative DNA damages that occur daily in each nucleated human cell can be viewed through this same lens. Until recently, we did not know if BER requires or is accompanied by nucleosome disruption, and it is not yet clear that anything short of overwhelming oxidative damage (resulting in the shunting of DNA substrates into other repair pathways) results in checkpoint activation. This review highlights studies of how oxidatively damaged DNA in nucleosomes is discovered and repaired, and offers a working model of events associated with BER in chromatin that we hope will have heuristic value.
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Affiliation(s)
- Ian D Odell
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, Vermont 05405, USA
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Odell ID, Cloud JL, Seipp M, Wittwer CT. Rapid species identification within the Mycobacterium chelonae-abscessus group by high-resolution melting analysis of hsp65 PCR products. Am J Clin Pathol 2005; 123:96-101. [PMID: 15762284 DOI: 10.1309/wdr082x9ffjbqqgb] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Polymerase chain reaction (PCR) amplification of the heat shock protein 65 (hsp65) gene followed by high-resolution melting analysis with LCGreen I (Idaho Technology, Salt Lake City, UT) was used to differentiate the mycobacteria species Mycobacterium chelonae, Mycobacterium abscessus, and Mycobacterium immunogenum in less than 20 minutes. A 105-base-pair amplicon that clustered the different species by predicted melting temperature was found from available GenBank hsp65 sequences. We identified 24 clinical isolates within the M chelonae-abscessus group by proximal 16S ribosomal RNA and hsp65 gene sequencing. Rapid-cycle PCR followed by high-resolution melting analysis clustered these samples into the following groups: M abscessus, 12; M abscessus sequence variant, 2; M chelonae, 7; unexpected M chelonae sequence variant, 1; and M immunogenum, 2. The M chelonae variant had a single base change not found in reported GenBank sequences. Advantages of the method include speed, low risk of amplicon contamination (closed-tube), and no need for separation steps (sequencing, electrophoresis, high-performance liquid chromatography) or real-time monitoring.
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Affiliation(s)
- Ian D Odell
- Department of Pathology, University of Utah Medical School, Salt Lake City, 84132, USA
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