1
|
Dietz E, Pritchard E, Pouwels K, Ehsaan M, Blake J, Gaughan C, Haduli E, Boothe H, Vihta KD, Peto T, Stoesser N, Matthews P, Taylor N, Diamond I, Studley R, Rourke E, Birrell P, De Angelis D, Fowler T, Watson C, Eyre D, House T, Walker AS. SARS-CoV-2, influenza A/B and respiratory syncytial virus positivity and association with influenza-like illness and self-reported symptoms, over the 2022/23 winter season in the UK: a longitudinal surveillance cohort. BMC Med 2024; 22:143. [PMID: 38532381 DOI: 10.1186/s12916-024-03351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Syndromic surveillance often relies on patients presenting to healthcare. Community cohorts, although more challenging to recruit, could provide additional population-wide insights, particularly with SARS-CoV-2 co-circulating with other respiratory viruses. METHODS We estimated the positivity and incidence of SARS-CoV-2, influenza A/B, and RSV, and trends in self-reported symptoms including influenza-like illness (ILI), over the 2022/23 winter season in a broadly representative UK community cohort (COVID-19 Infection Survey), using negative-binomial generalised additive models. We estimated associations between test positivity and each of the symptoms and influenza vaccination, using adjusted logistic and multinomial models. RESULTS Swabs taken at 32,937/1,352,979 (2.4%) assessments tested positive for SARS-CoV-2, 181/14,939 (1.2%) for RSV and 130/14,939 (0.9%) for influenza A/B, varying by age over time. Positivity and incidence peaks were earliest for RSV, then influenza A/B, then SARS-CoV-2, and were highest for RSV in the youngest and for SARS-CoV-2 in the oldest age groups. Many test positives did not report key symptoms: middle-aged participants were generally more symptomatic than older or younger participants, but still, only ~ 25% reported ILI-WHO and ~ 60% ILI-ECDC. Most symptomatic participants did not test positive for any of the three viruses. Influenza A/B-positivity was lower in participants reporting influenza vaccination in the current and previous seasons (odds ratio = 0.55 (95% CI 0.32, 0.95)) versus neither season. CONCLUSIONS Symptom profiles varied little by aetiology, making distinguishing SARS-CoV-2, influenza and RSV using symptoms challenging. Most symptoms were not explained by these viruses, indicating the importance of other pathogens in syndromic surveillance. Influenza vaccination was associated with lower rates of community influenza test positivity.
Collapse
Affiliation(s)
- Elisabeth Dietz
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK.
| | - Emma Pritchard
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
| | - Koen Pouwels
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Joshua Blake
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | | | - Eric Haduli
- Berkshire and Surrey Pathology Services, Camberley, UK
| | - Hugh Boothe
- Berkshire and Surrey Pathology Services, Camberley, UK
| | | | - Tim Peto
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Nicole Stoesser
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Philippa Matthews
- The Francis Crick Institute, 1 Midland Road, London, UK
- Division of Infection and Immunity, University College London, London, UK
| | | | | | | | | | - Paul Birrell
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- UK Health Security Agency, London, UK
| | | | - Tom Fowler
- UK Health Security Agency, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - David Eyre
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Ann Sarah Walker
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| |
Collapse
|
2
|
Abel K, Agnew E, Amos J, Armstrong N, Armstrong-James D, Ashfield T, Aston S, Baillie JK, Baldwin S, Barlow G, Bartle V, Bielicki J, Brown C, Carrol E, Clements M, Cooke G, Dane A, Dark P, Day J, de-Soyza A, Dowsey A, Evans S, Eyre D, Felton T, Fowler T, Foy R, Gannon K, Gerada A, Goodman A, Harman T, Hayward G, Holmes A, Hopkins S, Howard P, Howard A, Hsia Y, Knight G, Lemoine N, Koh J, Macgowan A, Marwick C, Moore C, O’Brien S, Oppong R, Peacock S, Pett S, Pouwels K, Queree C, Rahman N, Sculpher M, Shallcross L, Sharland M, Singh J, Stoddart K, Thomas-Jones E, Townsend A, Ustianowski A, Van Staa T, Walker S, White P, Wilson P, Buchan I, Woods B, Bower P, Llewelyn M, Hope W. System-wide approaches to antimicrobial therapy and antimicrobial resistance in the UK: the AMR-X framework. Lancet Microbe 2024:S2666-5247(24)00003-X. [PMID: 38461831 DOI: 10.1016/s2666-5247(24)00003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/05/2024] [Accepted: 01/05/2024] [Indexed: 03/12/2024]
Abstract
Antimicrobial resistance (AMR) threatens human, animal, and environmental health. Acknowledging the urgency of addressing AMR, an opportunity exists to extend AMR action-focused research beyond the confines of an isolated biomedical paradigm. An AMR learning system, AMR-X, envisions a national network of health systems creating and applying optimal use of antimicrobials on the basis of their data collected from the delivery of routine clinical care. AMR-X integrates traditional AMR discovery, experimental research, and applied research with continuous analysis of pathogens, antimicrobial uses, and clinical outcomes that are routinely disseminated to practitioners, policy makers, patients, and the public to drive changes in practice and outcomes. AMR-X uses connected data-to-action systems to underpin an evaluation framework embedded in routine care, continuously driving implementation of improvements in patient and population health, targeting investment, and incentivising innovation. All stakeholders co-create AMR-X, protecting the public from AMR by adapting to continuously evolving AMR threats and generating the information needed for precision patient and population care.
Collapse
|
3
|
Pufulete M, Harris J, Pouwels K, Reeves BC, Lasserson D, Loke YK, Mumford A, Mahadevan K, Johnson TW. Real-world bleeding in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) and prescribed different combinations of dual antiplatelet therapy (DAPT) in England: a population-based cohort study emulating a 'target trial'. Open Heart 2022; 9:openhrt-2022-001999. [PMID: 35961692 PMCID: PMC9379532 DOI: 10.1136/openhrt-2022-001999] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/12/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To estimate the incidence and HRs for bleeding for different dual antiplatelet therapies (DAPT) in a real-world population with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) in England. DESIGN A retrospective, population-based cohort study emulating a target randomised controlled trial (tRCT). DATA SOURCES Linked Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES). SETTING Primary and secondary care. PARTICIPANTS Patients ≥18 years old with ACS undergoing emergency PCI. INTERVENTIONS Aspirin and clopidogrel (AC, reference) versus aspirin and prasugrel (AP) or aspirin and ticagrelor (AT); AP evaluated only in patients with ST-elevation myocardial infarction (STEMI). MAIN OUTCOME MEASURES Primary: any bleeding up to 12 months after the index event (HES- or CPRD- recorded). Secondary: HES-recorded bleeding, CPRD-recorded bleeding, all-cause and cardiovascular mortality, mortality from bleeding, myocardial infarction, stroke, additional coronary intervention and major adverse cardiovascular and cerebrovascular events (MACCE). RESULTS In ACS, the rates of any bleeding for AC and AT were 89 per 1000 person years and 134 per 1000 person years, respectively. In STEMI, rates for AC, AP and AT were 93 per 1000 person years, 138 per 1000 person years and 143 per 100 person years, respectively. In ACS, compared with AC, AT increased the hazard of any bleeding (HR: 1.47, 95% CI 1.19 to 1.82) but did not reduce MACCE (HR: 1.06, 95% CI 0.89 to 1.27). In STEMI, compared with AC, AP and AT increased the hazard of any bleeding (HR: 1.77, 95% CI 1.21 to 2.59 and HR: 1.50, 95% CI 1.10 to 2.05, respectively) but did not reduce MACCE (HR: 1.10, 95% CI 0.80 to 1.51 and HR: 1.21, 95% CI 0.94 to 1.51, respectively). Non-adherence to the prescribed DAPT regimen was 28% in AC (29% in STEMI only), 31% in AP (STEMI only) and 33% in AT (32% in STEMI only). CONCLUSIONS In a real-world population with ACS, DAPT with ticagrelor or prasugrel are associated with increased bleeding compared with DAPT with clopidogrel. TRIAL REGISTRATION NUMBER ISRCTN76607611.
Collapse
Affiliation(s)
- Maria Pufulete
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK .,Bristol Heart Institute, University of Bristol, Bristol, UK
| | - Jessica Harris
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Koen Pouwels
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Barney C Reeves
- Bristol Trials Centre, Bristol Medical School, University of Bristol, Bristol, UK
| | - Daniel Lasserson
- Warwick Medical School, University of Warwick, Coventry, UK.,Department of Geratology/AGM, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yoon K Loke
- Norwich Medical School, University of East Anglia, Norfolk, UK
| | - Andrew Mumford
- School of Cellular and Molecular Medicine, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kalaivani Mahadevan
- School of Cellular and Molecular Medicine, Bristol Medical School, University of Bristol, Bristol, UK
| | - Thomas W Johnson
- School of Cellular and Molecular Medicine, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
4
|
Morvan M, Jacomo AL, Souque C, Wade MJ, Hoffmann T, Pouwels K, Lilley C, Singer AC, Porter J, Evens NP, Walker DI, Bunce JT, Engeli A, Grimsley J, O'Reilly KM, Danon L. An analysis of 45 large-scale wastewater sites in England to estimate SARS-CoV-2 community prevalence. Nat Commun 2022; 13:4313. [PMID: 35879277 PMCID: PMC9312315 DOI: 10.1038/s41467-022-31753-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 06/28/2022] [Indexed: 12/23/2022] Open
Abstract
Accurate surveillance of the COVID-19 pandemic can be weakened by under-reporting of cases, particularly due to asymptomatic or pre-symptomatic infections, resulting in bias. Quantification of SARS-CoV-2 RNA in wastewater can be used to infer infection prevalence, but uncertainty in sensitivity and considerable variability has meant that accurate measurement remains elusive. Here, we use data from 45 sewage sites in England, covering 31% of the population, and estimate SARS-CoV-2 prevalence to within 1.1% of estimates from representative prevalence surveys (with 95% confidence). Using machine learning and phenomenological models, we show that differences between sampled sites, particularly the wastewater flow rate, influence prevalence estimation and require careful interpretation. We find that SARS-CoV-2 signals in wastewater appear 4-5 days earlier in comparison to clinical testing data but are coincident with prevalence surveys suggesting that wastewater surveillance can be a leading indicator for symptomatic viral infections. Surveillance for viruses in wastewater complements and strengthens clinical surveillance, with significant implications for public health.
Collapse
Affiliation(s)
- Mario Morvan
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
- Department of Physics and Astronomy, University College London, London, WC1E 6BT, UK
| | - Anna Lo Jacomo
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
- Department of Engineering Mathematics, Ada Lovelace Building, University Walk, Bristol, BS8 1TW, UK
| | - Celia Souque
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
- Department of Zoology, University of Oxford, Oxford, OX1 3SZ, UK
| | - Matthew J Wade
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
- School of Engineering, Newcastle University, Newcastle-upon-Tyne, NE1 7RU, UK
| | - Till Hoffmann
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
- Department of Mathematics, Imperial College London, London, SW7 2AZ, UK
| | - Koen Pouwels
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with Public Health England, Oxford, UK
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Chris Lilley
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
| | - Andrew C Singer
- UK Centre for Ecology & Hydrology, Wallingford, OX10 8BB, UK
| | - Jonathan Porter
- Environment Agency, National Monitoring, Starcross, Exeter, EX6 8FD, UK
| | - Nicholas P Evens
- Environment Agency, National Monitoring, Starcross, Exeter, EX6 8FD, UK
| | - David I Walker
- Centre for Environment, Fisheries and Aquaculture Science, Weymouth, DT4 8UB, UK
| | - Joshua T Bunce
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
- School of Engineering, Newcastle University, Newcastle-upon-Tyne, NE1 7RU, UK
- Department for Environment, Food and Rural Affairs, London, SW1P 4DF, UK
| | - Andrew Engeli
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
| | - Jasmine Grimsley
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
| | - Kathleen M O'Reilly
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK.
- Centre for Mathematical Modelling of Infectious Diseases & Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
| | - Leon Danon
- Data, Analytics, and Surveillance Group, UK Health Security Agency (Formerly part of the Joint Biosecurity Centre, Department of Health and Social Care), London, SW1P 3JR, UK
- Department of Engineering Mathematics, Ada Lovelace Building, University Walk, Bristol, BS8 1TW, UK
| |
Collapse
|
5
|
Pouwels K, Hak E. Reporting of Confounding Bias in Observational Intervention Studies: are We Making Progress? Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
6
|
Mulder B, Pouwels K, Schuiling-Veninga C, Bos J, de Vries T, Jick S, Hak E. Antibiotic Use among Dutch Pregnant Woman and the Development of Toddler Asthma: the Influence of Confounding. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
7
|
Terpstra W, Ploemacher RE, Prins A, van Lom K, Pouwels K, Wognum AW, Wagemaker G, Löwenberg B, Wielenga JJ. Fluorouracil selectively spares acute myeloid leukemia cells with long-term growth abilities in immunodeficient mice and in culture. Blood 1996; 88:1944-50. [PMID: 8822911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
A subset of leukemic cells is assumed to maintain long-term growth of acute myeloid leukemia (AML) in vivo. Characterization of these AML progenitor cells may further define growth properties of human leukemia. In vitro incubations with 5-fluorouracil (5-FU) have been used for enrichment of normal primitive hematopoietic stem cells. By analogy to normal hematopoiesis, it was hypothesized that primitive leukemic stem cells might be kinetically more inactive than colony-forming cells (colony-forming units-AML [CFU-AML]). To examine this hypothesis, conditions were established for incubation with 5-FU that eliminated all CFU-AML. These conditions selected a 5-FU-resistant AML fraction that was evaluated for its capacity for long-term growth by transplantation into mice with severe combined immunodeficiency (SCID) and long-term culture in the quantitative cobblestone area-forming cell (CAFC) assay. Transplantation of the 5-FU-resistant fraction of four cases of AML into SCID mice resulted in growth of AML. Whereas no CFU-AML survived, 31% to 82% of primitive (week-6) CAFC were recovered from the 5-FU-treated cells. Hematopoietic cells proliferating in the CAFC assay were shown to be leukemic by cytologic, cytogenetic, or molecular analysis. The reduction of AML growth as determined by outgrowth of AML in SCID mice was in the same order of magnitude as the primitive (week-6) CAFC reduction. This indicates that both assays measure closely related cell populations and that the CAFC assay can be used to study long-term growth of AML. These results show a hierarchy of AML cells that includes 5-FU-resistant progenitors. These cells are characterized as primitive (week-6) CAFC and as leukemia-initiating cells in SCID mice.
Collapse
Affiliation(s)
- W Terpstra
- Institute of Hematology, Erasmus University, Rotterdam, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
van der Plas DC, Smiers F, Pouwels K, Hoefsloot LH, Löwenberg B, Touw IP. Interleukin-7 signaling in human B cell precursor acute lymphoblastic leukemia cells and murine BAF3 cells involves activation of STAT1 and STAT5 mediated via the interleukin-7 receptor alpha chain. Leukemia 1996; 10:1317-25. [PMID: 8709637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Interleukin-7 (IL-7) stimulates the proliferation of normal and leukemic B and T cell precursors and T lymphocytes. Activation of the JAK/STAT pathway has been implicated in IL-7R signaling. We investigated which STAT complexes are formed upon stimulation of B cell precursor acute lymphoblastic leukemia (BCP-ALL) cells with IL-7. Gel retardation assays with STAT-binding oligonucleotides showed that IL-7 induces the formation of two major STAT complexes in BCP-ALL cells. Supershifts with anti-STAT antibodies identified these as STAT1 and STAT5 complexes. This pattern of STAT activation was seen in all BCP-ALL cases that respond to IL-7 in proliferation assays. IL-7 also induced STAT/DNA binding in BCP-ALL cases that failed to proliferate in response to IL-7, suggesting that the ability of IL-7R to activate the JAK/STAT pathway per se is not sufficient for proliferation induction. To determine the contribution of the cytoplasmic domain of the IL-7 receptor alpha chain (IL-7R alpha) to activation of STAT proteins, transfectants of the murine pro-B cell line BAF3 were made that express chimeric receptors consisting of the extracellular domain of human granulocyte colony-stimulating factor receptor (G-CSF-R) and the transmembrane and intracellular domains of human IL-7R alpha. Activation of the chimeric G-CSF-R/IL-7R alpha with G-CSF resulted in a full proliferative response and induced the phosphorylation of JAK1 but not JAK2. Major STAT complexes activated by G-CSF-R/IL-7R alpha contained STAT1 or STAT5, while some formation of STAT3-containing complexes was also seen. These findings establish that STAT1 and STAT5, and possibly STAT3, are activated upon stimulation of precursor B cells with IL-7. The data further indicate that the IL-7R alpha chains are directly involved in the activation of JAKs and STATs and have a major role in proliferative signaling in precursor B cells.
Collapse
Affiliation(s)
- D C van der Plas
- Department of Hematology, Dr Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
9
|
Barge RM, de Koning JP, Pouwels K, Dong F, Löwenberg B, Touw IP. Tryptophan 650 of human granulocyte colony-stimulating factor (G-CSF) receptor, implicated in the activation of JAK2, is also required for G-CSF-mediated activation of signaling complexes of the p21ras route. Blood 1996; 87:2148-53. [PMID: 8630373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Granulocyte colony-stimulating factor (G-CSF) induces rapid phosphorylation of JAK kinases as well as activation of the p21ras route through interaction with its specific receptor (G-CSF-R). The cytoplasmic membrane-proximal region of G-CSF-R (amino acids 631 to 684) is necessary for proliferation induction and activation of JAK2. In contrast, activation of Shc and Syp, signaling molecules implicated in the p21ras signaling route, depends on the phosphorylation of tyrosine residues located in the membrane-distal region (amino acids 685 to 813) of G-CSF-R. We investigated whether G-CSF-induced activation of signaling complexes of the p21ras route depends on the function of the membrane-proximal cytoplasmic region of G-CSF-R. A G-CSF-R mutant was constructed in which tryptophan 650 was replaced by arginine and expressed in BAF3 cells (BAF/W650R). In contrast to BAF3 cell transfectants expressing wild-type G-CSF-R, BAF/W650-R cells did not proliferate and did not show activation of JAK2, STAT1, or STAT3 in response to G-CSF. Immunoprecipitations with anti-Shc and anti-Grb2 antisera showed that mutant W650R also failed to activate Syp and Shc. These data indicate that the membrane-proximal cytoplasmic domain of G-CSF-R is not only crucial for proliferative signaling and activation of JAK2 and STATs, but is also required for activation of the p21ras route, which occurs via the membrane-distal region of G-CSF-R.
Collapse
Affiliation(s)
- R M Barge
- Institute of Hematology, Erasmus University, Rotterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
10
|
Dong F, Pouwels K, Hoefsloot LH, Rozemuller H, Löwenberg B, Touw IP. The C-terminal cytoplasmic region of the granulocyte colony-stimulating factor receptor mediates apoptosis in maturation-incompetent murine myeloid cells. Exp Hematol 1996; 24:214-20. [PMID: 8641344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Granulocyte colony-stimulating factor (G-CSF) promotes the survival and proliferation of myeloid progenitors and induces maturation of these cells toward terminally differentiated neutrophils. Using transfectants of the murine IL-3-dependent myeloid cell line 32D that express the human G-CSF receptor (32D/WT cells), we show here that G-CSF can also exert adverse effects on myeloid cell survival. Although initially enhancing IL-3-driven proliferation of 32D/WT cells, G-CSF strongly inhibited cell survival at later stages of culture. The loss of viability of 32D/WT cells following sustained G-CSF stimulation was not accompanied by progressive neutrophilic maturation. Instead, 32D/WT cells exhibited features characteristic of apoptosis. The apoptosis-inducing effect of G-CSF was seen at concentrations of IL-3 that could support long-term proliferation and survival of 32D/WT cells in the absence of G-CSF. Experiments with 32D cells expressing mutant forms of the G-CSF receptor revealed that the death signals were mediated exclusively through the membrane-distal cytoplasmic part of the G-CSF receptor, a region also involved in maturation signaling.
Collapse
Affiliation(s)
- F Dong
- Department of Hematology, The Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
11
|
Smiers FJ, van Paassen M, Pouwels K, Beishuizen A, Hählen K, Löwenberg B, Touw IP. Heterogeneity of proliferative responses of human B cell precursor acute lymphoblastic leukemia (BCP-ALL) cells to interleukin 7 (IL-7): no correlation with immunoglobulin gene status and expression of IL-7 receptor or IL-2/IL-4/IL-7 receptor common gamma chain genes. Leukemia 1995; 9:1039-45. [PMID: 7596167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Interleukin 7 (IL-7) stimulates proliferation of normal human and murine B cell precursor (BCP) cells in a distinct fashion, depending on the stage of maturation of the cells. For instance, the productive rearrangement of the immunoglobulin heavy chain gene has been demonstrated to be essential for the response of BCP cells to IL-7 as the single proliferation stimulus. IL-7 activates a receptor that consists of the IL-7R protein and the common gamma chain (gamma c). BCP acute lymphoblastic leukemia (BCP-ALL) cells variably respond to IL-7. Among 72 cases of BCP-ALL IL-7 activated DNA synthesis in 34. In four cases inhibition of DNA synthesis was seen. In the remaining 38 cases IL-7 exerted no effects. We determined whether this heterogeneity in IL-7 response could be correlated with parameters that could influence the IL-7 response. Firstly we show that, in contrast to the murine BCP cells, the IL-7 response of human BCP-ALL cells did not correlate with the status of IgH chain gene rearrangement and expression, nor with the rearrangement of IgL chain genes. Subsequently, it is demonstrated that IL-7R protein and transcripts as well as gamma c transcripts are equally present in the IL-7 responsive and nonresponsive BCP-ALL samples, indicating that the defective expression of these chains could not be held responsible for IL-7 response failures. Finally, we observed that kit ligand (KL), known to synergize with IL-7 in the most primitive stages of normal B cell development, did not enhance the IL-7 responses of BCP-ALL cells.
Collapse
Affiliation(s)
- F J Smiers
- Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
12
|
Dong F, van Buitenen C, Pouwels K, Hoefsloot LH, Löwenberg B, Touw IP. Distinct cytoplasmic regions of the human granulocyte colony-stimulating factor receptor involved in induction of proliferation and maturation. Mol Cell Biol 1993; 13:7774-81. [PMID: 8246993 PMCID: PMC364849 DOI: 10.1128/mcb.13.12.7774-7781.1993] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [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: 01/29/2023] Open
Abstract
The granulocyte colony-stimulating factor receptor (G-CSF-R) transduces signals important for the proliferation and maturation of myeloid progenitor cells. To identify functionally important regions in the cytoplasmic domain of the G-CSF-R, we compared the actions of the wild-type receptor, two mutants, and a natural splice variant in transfectants of the mouse pro-B cell line BAF3 and two myeloid cell lines, 32D and L-GM. A region of 55 amino acids adjacent to the transmembrane domain was found to be sufficient for generating a growth signal. The immediate downstream sequence of 30 amino acids substantially enhanced the growth signaling in the three cell lines. In contrast, the carboxy-terminal part of 98 amino acids strongly inhibited growth signaling in the two myeloid cell lines but not in BAF3 cells. Truncation of this region lead to an inability of the G-CSF-R to transduce maturation signals in L-GM cells. An alternative carboxy tail present in a splice variant of the G-CSF-R also inhibited growth signaling, notably in both the myeloid cells and BAF3 cells, but appeared not to be involved in maturation.
Collapse
Affiliation(s)
- F Dong
- Department of Hematology, Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|
13
|
Budel LM, Hoogerbrugge H, Pouwels K, van Buitenen C, Delwel R, Löwenberg B, Touw IP. Granulocyte-macrophage colony-stimulating factor receptors alter their binding characteristics during myeloid maturation through up-regulation of the affinity converting beta subunit (KH97). J Biol Chem 1993; 268:10154-9. [PMID: 8486685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Acute myeloid leukemia blasts express dual affinity (high and low) granulocyte-macrophage colony-stimulating factor (GM-CSF) binding, and the high affinity GM-CSF binding is counteracted by excess interleukin-3 (IL-3). Neutrophils express a single class of GM-CSF-R with intermediate affinity that lack IL-3 cross-reactivity. Here we demonstrate the differentiation associated changes of GM-CSF binding characteristics in three models representative of different stages of myeloid maturation. We find that high affinity GM-CSF binding is converted into intermediate affinity binding, which still cross-reacts with IL-3, beyond the stage of promyelocytes. During terminal maturation towards neutrophils, IL-3 cross-reactivity is gradually lost. We sought to determine the mechanism underlying the affinity conversion of the GM-CSF-R. Northern and reverse transcriptase-polymerase chain reaction analysis of GM-CSF-R alpha and -beta c (KH97) transcripts did not provide indications for the involvement of GM-CSF-R splice variants in the formation of the intermediate affinity GM-CSFR complex. In COS-cell transfectants with increasing amounts of beta c in the presence of a fixed number of GM-CSF-R alpha chains, the high affinity GM-CSF binding converted into intermediate affinity GM-CSF binding. These results are discussed in view of the concept that increasing expression of beta c subunits may cause alternative oligomerization of the GM-CSF-R alpha and -beta c subunits resulting in the formation of intermediate rather than high affinity GM-CSFR alpha.beta c complexes.
Collapse
MESH Headings
- Acute Disease
- Animals
- Base Sequence
- Cell Line
- Granulocyte-Macrophage Colony-Stimulating Factor/metabolism
- Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology
- Humans
- Kinetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myeloid/metabolism
- Leukemia, Myeloid/pathology
- Leukemia, Promyelocytic, Acute
- Macromolecular Substances
- Molecular Sequence Data
- Oligodeoxyribonucleotides
- Polymerase Chain Reaction/methods
- RNA, Neoplasm/genetics
- RNA, Neoplasm/isolation & purification
- Receptors, Granulocyte-Macrophage Colony-Stimulating Factor/genetics
- Receptors, Granulocyte-Macrophage Colony-Stimulating Factor/metabolism
- Recombinant Proteins/metabolism
- Recombinant Proteins/pharmacology
- Sequence Deletion
- Transcription, Genetic
- Transfection
- Tretinoin/pharmacology
- Tumor Cells, Cultured
- Up-Regulation
Collapse
Affiliation(s)
- L M Budel
- Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
14
|
Budel L, Hoogerbrugge H, Pouwels K, van Buitenen C, Delwel R, Löwenberg B, Touw I. Granulocyte-macrophage colony-stimulating factor receptors alter their binding characteristics during myeloid maturation through up-regulation of the affinity converting beta subunit (KH97). J Biol Chem 1993. [DOI: 10.1016/s0021-9258(18)82185-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
15
|
Touw I, Donath J, Pouwels K, van Buitenen C, Schipper P, Santini V, Hagemeijer A, Löwenberg B, Delwel R. Acute myeloid leukemias with chromosomal abnormalities involving the 21q22 region identified by their in vitro responsiveness to interleukin-5. Leukemia 1991; 5:687-92. [PMID: 1715959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Among 52 patients diagnosed as acute myeloid leukemia (AML), nine cases were found in which interleukin-5 (IL-5) induced a proliferative response in the leukemic cells, as measured by the stimulation of DNA synthesis or colony formation in vitro. All cases (n = 7) with the cytogenetic abnormality t(8;21)(q22;q22) belonged to this group of IL-5 responders. Of the additional two cases, one had an apparently normal karyotype, but the other expressed a dicentric chromosome 21, an abnormality also involving the breakpoint region 21q22. The leukemic cells of the IL-5 responsive patients could also be stimulated to proliferate by IL-3, GM-CSF and G-CSF, and in some cases by IL-6 or M-CSF. Immunophenotypic analysis revealed the presence of the immature hematopoietic cell antigen CD34, the myelomonocytic maturation antigens CD13 and CD33, in association with the B-cell related surface marker CD19 on the leukemic cells. Immunoglobulin mu and T-cell receptor beta-genes in the leukemic cells were in germline configuration. Upon incubation in colony culture, clonogenic cells were capable of producing progeny showing eosinophilic or neutrophilic maturation following stimulation with IL-5 or G-CSF, respectively. It is concluded that IL-5 responsive AML represents a subgroup of leukemia with distinct immunotypic and cytogenetic features.
Collapse
MESH Headings
- Antigens, CD/analysis
- Cell Division/drug effects
- Chromosome Aberrations/genetics
- Chromosome Aberrations/immunology
- Chromosome Aberrations/pathology
- Chromosome Disorders
- Chromosomes, Human, Pair 21
- Female
- Gene Rearrangement, B-Lymphocyte
- Gene Rearrangement, T-Lymphocyte
- Genes, Immunoglobulin
- Granulocyte Colony-Stimulating Factor/pharmacology
- Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology
- Humans
- In Vitro Techniques
- Interleukin-3/pharmacology
- Interleukin-5/pharmacology
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/immunology
- Leukemia, Myeloid/pathology
- Male
- Receptors, Antigen, T-Cell/genetics
- Tumor Cells, Cultured
Collapse
Affiliation(s)
- I Touw
- Department of Hematology, Dr Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Touw IP, Pouwels K, van Agthoven AJ, van Gurp R, Delwel R, Hagemeijer A, Hählen K, Löwenberg B. Role of interleukin-7 in the growth of acute lymphoblastic leukemia. Bone Marrow Transplant 1990; 6 Suppl 1:36-8. [PMID: 2390640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- I P Touw
- Dr Daniel den Hoed Cancer Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Touw I, Pouwels K, van Agthoven T, van Gurp R, Budel L, Hoogerbrugge H, Delwel R, Goodwin R, Namen A, Löwenberg B. Interleukin-7 is a growth factor of precursor B and T acute lymphoblastic leukemia. Blood 1990; 75:2097-101. [PMID: 2189505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We investigated the proliferation-inducing effects of human recombinant interleukin-7 (IL-7) on acute lymphoblastic leukemia (ALL) cells. It is shown that IL-7 stimulates DNA synthesis in ALL cells of B-cell precursor (n = 5) as well as immature T-cell origin (n = 2). Cytogenetic analysis of the cells of four patients proliferating in IL7-supplemented cultures established the leukemic descendence of the IL-7-responsive cells. 125I-IL-7 binding experiments with the cells of one patient and with two ALL cell lines showed the presence of two types of IL-7 receptors: one with a high affinity (kd 29 to 51 pmol/L) and one with a low affinity (kd 2.3 to 76 nmol/L) for the ligand. We conclude that IL-7 is one of the cytokines involved in the complex regulation of ALL cell proliferation.
Collapse
Affiliation(s)
- I Touw
- Dr Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|