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Alleva DG, Feitsma EA, Janssen YF, Boersma HH, Lancaster TM, Sathiyaseelan T, Murikipudi S, Delpero AR, Scully MM, Ragupathy R, Kotha S, Haworth JR, Shah NJ, Rao V, Nagre S, Ronca SE, Green FM, Shaw SA, Aminetzah A, Kruijff S, Brom M, van Dam GM, Zion TC. Immunogenicity phase II study evaluating booster capacity of nonadjuvanted AKS-452 SARS-Cov-2 RBD Fc vaccine. NPJ Vaccines 2024; 9:40. [PMID: 38383578 PMCID: PMC10881471 DOI: 10.1038/s41541-024-00830-2] [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: 06/28/2023] [Accepted: 02/08/2024] [Indexed: 02/23/2024] Open
Abstract
AKS-452, a subunit vaccine comprising an Fc fusion of the ancestral wild-type (WT) SARS-CoV-2 virus spike protein receptor binding domain (SP/RBD), was evaluated without adjuvant in a single cohort, non-randomized, open-labelled phase II study (NCT05124483) at a single site in The Netherlands for safety and immunogenicity. A single 90 µg subcutaneous booster dose of AKS-452 was administered to 71 adults previously primed with a registered mRNA- or adenovirus-based vaccine and evaluated for 273 days. All AEs were mild and no SAEs were attributable to AKS-452. While all subjects showed pre-existing SP/RBD binding and ACE2-inhibitory IgG titers, 60-68% responded to AKS-452 via ≥2-fold increase from days 28 to 90 and progressively decreased back to baseline by day 180 (days 28 and 90 mean fold-increases, 14.7 ± 6.3 and 8.0 ± 2.2). Similar response kinetics against RBD mutant proteins (including omicrons) were observed but with slightly reduced titers relative to WT. There was an expected strong inverse correlation between day-0 titers and the fold-increase in titers at day 28. AKS-452 enhanced neutralization potency against live virus, consistent with IgG titers. Nucleocapsid protein (Np) titers suggested infection occurred in 66% (46 of 70) of subjects, in which only 20 reported mild symptomatic COVID-19. These favorable safety and immunogenicity profiles support booster evaluation in a planned phase III universal booster study of this room-temperature stable vaccine that can be rapidly and inexpensively manufactured to serve vaccination at a global scale without the need of a complex distribution or cold chain.
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Affiliation(s)
- David G Alleva
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Eline A Feitsma
- Department of Surgery, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Yester F Janssen
- Department of Nuclear Medicine and Molecular Imaging, UMCG, Groningen, The Netherlands
| | - Hendrikus H Boersma
- Department of Nuclear Medicine and Molecular Imaging, UMCG, Groningen, The Netherlands
- Department of Clinical Pharmacy and Pharmacology, UMCG, Groningen, The Netherlands
| | - Thomas M Lancaster
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | | | - Sylaja Murikipudi
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Andrea R Delpero
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Melanie M Scully
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Ramya Ragupathy
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Sravya Kotha
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Jeffrey R Haworth
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Nishit J Shah
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Vidhya Rao
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Shashikant Nagre
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA
| | - Shannon E Ronca
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Baylor, College of Medicine, 1102 Bates Ave, 300.15, Houston, TX, 77030, USA
| | - Freedom M Green
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Baylor, College of Medicine, 1102 Bates Ave, 300.15, Houston, TX, 77030, USA
| | - Stephen A Shaw
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Baylor, College of Medicine, 1102 Bates Ave, 300.15, Houston, TX, 77030, USA
| | - Ari Aminetzah
- TRACER BV, Aarhusweg 2-1/2-2, 9723 JJ, Groningen, The Netherlands
| | - Schelto Kruijff
- Department of Surgery, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700 RB, Groningen, The Netherlands
- Department of Nuclear Medicine and Molecular Imaging, UMCG, Groningen, The Netherlands
| | - Maarten Brom
- TRACER BV, Aarhusweg 2-1/2-2, 9723 JJ, Groningen, The Netherlands
| | - Gooitzen M van Dam
- Department of Nuclear Medicine and Molecular Imaging, UMCG, Groningen, The Netherlands
- TRACER BV, Aarhusweg 2-1/2-2, 9723 JJ, Groningen, The Netherlands
| | - Todd C Zion
- Akston Biosciences Corporation, 100 Cummings Center, Suite 454C, Beverly, MA, 01915, USA.
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Feitsma EA, Janssen YF, Boersma HH, van Sleen Y, van Baarle D, Alleva DG, Lancaster TM, Sathiyaseelan T, Murikipudi S, Delpero AR, Scully MM, Ragupathy R, Kotha S, Haworth JR, Shah NJ, Rao V, Nagre S, Ronca SE, Green FM, Aminetzah A, Sollie F, Kruijff S, Brom M, van Dam GM, Zion TC. A randomized phase I/II safety and immunogenicity study of the Montanide-adjuvanted SARS-CoV-2 spike protein-RBD-Fc vaccine, AKS-452. Vaccine 2023; 41:2184-2197. [PMID: 36842886 PMCID: PMC9946892 DOI: 10.1016/j.vaccine.2023.02.057] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 02/15/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Previous interim data from a phase I study of AKS-452, a subunit vaccine comprising an Fc fusion of the respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein receptor binding domain (SP/RBD) emulsified in the water-in-oil adjuvant, Montanide™ ISA 720, suggested a good safety and immunogenicity profile in healthy adults. This phase I study was completed and two dosing regimens were further evaluated in this phase II study. METHODS This phase II randomized, open-labelled, parallel group study was conducted at a single site in The Netherlands with 52 healthy adults (18 - 72 years) receiving AKS-452 subcutaneously at one 90 µg dose (cohort 1, 26 subjects) or two 45 µg doses 28 days apart (cohort 2, 26 subjects). Serum samples were collected at the first dose (day 0) and at days 28, 56, 90, and 180. Safety and immunogenicity endpoints were assessed, along with induction of IgG isotypes, cross-reactive immunity against viral variants, and IFN-γ T cell responses. RESULTS All AEs were mild/moderate (grades 1 or 2), and no SAEs were attributable to AKS-452. Seroconversion rates reached 100% in both cohorts, although cohort 2 showed greater geometric mean IgG titers that were stable through day 180 and associated with enhanced potencies of SP/RBD-ACE2 binding inhibition and live virus neutralization. AKS-452-induced IgG titers strongly bound mutant SP/RBD from several SARS-CoV-2 variants (including Omicrons) that were predominantly of the favorable IgG1/3 isotype and IFN-γ-producing T cell phenotype. CONCLUSION These favorable safety and immunogenicity profiles of the candidate vaccine as demonstrated in this phase II study are consistent with those of the phase I study (ClinicalTrials.gov: NCT04681092) and suggest that a total of 90 µg received in 2 doses may offer a greater duration of cross-reactive neutralizing titers than when given in a single dose.
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Affiliation(s)
- Eline A Feitsma
- Department of Surgery, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700 RB Groningen, the Netherlands
| | - Yester F Janssen
- Department of Nuclear Medicine and Molecular Imaging, UMCG, the Netherlands
| | - Hendrikus H Boersma
- Department of Nuclear Medicine and Molecular Imaging, UMCG, the Netherlands; Department of Clinical Pharmacy and Pharmacology, UMCG, the Netherlands
| | - Yannick van Sleen
- Department of Rheumatology and Clinical Immunology, UMCG, the Netherlands
| | - Debbie van Baarle
- Department of Rheumatology and Clinical Immunology, UMCG, the Netherlands
| | - David G Alleva
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Thomas M Lancaster
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | | | - Sylaja Murikipudi
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Andrea R Delpero
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Melanie M Scully
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Ramya Ragupathy
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Sravya Kotha
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Jeffrey R Haworth
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Nishit J Shah
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Vidhya Rao
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Shashikant Nagre
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Shannon E Ronca
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Baylor, College of Medicine, 1102 Bates Ave, 300.15, Houston, TX 77030, United States
| | - Freedom M Green
- Department of Pediatrics, Division of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Baylor, College of Medicine, 1102 Bates Ave, 300.15, Houston, TX 77030, United States
| | - Ari Aminetzah
- TRACER BV, L.J. Zielstraweg 1, 9766 GX Groningen, the Netherlands
| | - Frans Sollie
- ICON, van Swietenlaan 6, 9728 NZ Groningen, the Netherlands
| | - Schelto Kruijff
- Department of Surgery, University Medical Center Groningen (UMCG), Hanzeplein 1, 9700 RB Groningen, the Netherlands; Department of Nuclear Medicine and Molecular Imaging, UMCG, the Netherlands
| | - Maarten Brom
- TRACER BV, L.J. Zielstraweg 1, 9766 GX Groningen, the Netherlands
| | - Gooitzen M van Dam
- Department of Nuclear Medicine and Molecular Imaging, UMCG, the Netherlands; TRACER BV, L.J. Zielstraweg 1, 9766 GX Groningen, the Netherlands
| | - Todd C Zion
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States.
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Janssen YF, Feitsma EA, Boersma HH, Alleva DG, Lancaster TM, Sathiyaseelan T, Murikipudi S, Delpero AR, Scully MM, Ragupathy R, Kotha S, Haworth JR, Shah NJ, Rao V, Nagre S, Ronca SE, Green FM, Aminetzah A, Sollie F, Kruijff S, Brom M, van Dam GM, Zion TC. Phase I interim results of a phase I/II study of the IgG-Fc fusion COVID-19 subunit vaccine, AKS-452. Vaccine 2022; 40:1253-1260. [PMID: 35115195 PMCID: PMC8802018 DOI: 10.1016/j.vaccine.2022.01.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/13/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023]
Abstract
To address the coronavirus disease 2019 (COVID-19) pandemic caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a recombinant subunit vaccine, AKS-452, is being developed comprising an Fc fusion protein of the SARS-CoV-2 viral spike protein receptor binding domain (SP/RBD) antigen and human IgG1 Fc emulsified in the water-in-oil adjuvant, Montanide™ ISA 720. A single-center, open-label, phase I dose-finding and safety study was conducted with 60 healthy adults (18–65 years) receiving one or two doses 28 days apart of 22.5 µg, 45 µg, or 90 µg of AKS-452 (i.e., six cohorts, N = 10 subjects per cohort). Primary endpoints were safety and reactogenicity and secondary endpoints were immunogenicity assessments. No AEs ≥ 3, no SAEs attributable to AKS-452, and no SARS-CoV-2 viral infections occurred during the study. Seroconversion rates of anti-SARS-CoV-2 SP/RBD IgG titers in the 22.5, 45, and 90 µg cohorts at day 28 were 70%, 90%, and 100%, respectively, which all increased to 100% at day 56 (except 89% for the single-dose 22.5 µg cohort). All IgG titers were Th1-isotype skewed and efficiently bound mutant SP/RBD from several SARS-CoV-2 variants with strong neutralization potencies of live virus infection of cells (including alpha and delta variants). The favorable safety and immunogenicity profiles of this phase I study (ClinicalTrials.gov: NCT04681092) support phase II initiation of this room-temperature stable vaccine that can be rapidly and inexpensively manufactured to serve vaccination at a global scale without the need of a complex distribution or cold chain.
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Alleva DG, Delpero AR, Scully MM, Murikipudi S, Ragupathy R, Greaves EK, Sathiyaseelan T, Haworth JR, Shah NJ, Rao V, Nagre S, Lancaster TM, Webb SS, Jasa AI, Ronca SE, Green FM, Elyard HA, Yee J, Klein J, Karnes L, Sollie F, Zion TC. Development of an IgG-Fc fusion COVID-19 subunit vaccine, AKS-452. Vaccine 2021; 39:6601-6613. [PMID: 34642088 PMCID: PMC8491978 DOI: 10.1016/j.vaccine.2021.09.077] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/12/2022]
Abstract
AKS-452 is a biologically-engineered vaccine comprising an Fc fusion protein of the SARS-CoV-2 viral spike protein receptor binding domain antigen (Ag) and human IgG1 Fc (SP/RBD-Fc) in clinical development for the induction and augmentation of neutralizing IgG titers against SARS-CoV-2 viral infection to address the COVID-19 pandemic. The Fc moiety is designed to enhance immunogenicity by increasing uptake via Fc-receptors (FcγR) on Ag-presenting cells (APCs) and prolonging exposure due to neonatal Fc receptor (FcRn) recycling. AKS-452 induced approximately 20-fold greater neutralizing IgG titers in mice relative to those induced by SP/RBD without the Fc moiety and induced comparable long-term neutralizing titers with a single dose vs. two doses. To further enhance immunogenicity, AKS-452 was evaluated in formulations containing a panel of adjuvants in which the water-in-oil adjuvant, Montanide™ ISA 720, enhanced neutralizing IgG titers by approximately 7-fold after one and two doses in mice, including the neutralization of live SARS-CoV-2 virus infection of VERO-E6 cells. Furthermore, ISA 720-adjuvanted AKS-452 was immunogenic in rabbits and non-human primates (NHPs) and protected from infection and clinical symptoms with live SARS-CoV-2 virus in NHPs (USA-WA1/2020 viral strain) and the K18 human ACE2-trangenic (K18-huACE2-Tg) mouse (South African B.1.351 viral variant). These preclinical studies support the initiation of Phase I clinical studies with adjuvanted AKS-452 with the expectation that this room-temperature stable, Fc-fusion subunit vaccine can be rapidly and inexpensively manufactured to provide billions of doses per year especially in regions where the cold-chain is difficult to maintain.
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Affiliation(s)
- David G Alleva
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Andrea R Delpero
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Melanie M Scully
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Sylaja Murikipudi
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Ramya Ragupathy
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Emma K Greaves
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | | | - Jeffrey R Haworth
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Nishit J Shah
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Vidhya Rao
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Shashikant Nagre
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Thomas M Lancaster
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States
| | - Sarah S Webb
- Biomere Biomedical Research Models, 57 Union St., Worcester, MA 01608, United States
| | - Allison I Jasa
- Biomere Biomedical Research Models, 57 Union St., Worcester, MA 01608, United States
| | - Shannon E Ronca
- Feigin ABSL-3 Facility, Baylor, College of Medicine, 1102 Bates Ave, 300.15, Houston, TX 77030, United States
| | - Freedom M Green
- Feigin ABSL-3 Facility, Baylor, College of Medicine, 1102 Bates Ave, 300.15, Houston, TX 77030, United States
| | - Hanne Andersen Elyard
- BIOQUAL, Inc., 9600 Medical Center Drive, Suite 101, Rockville, MD 20850-3336, United States
| | - JoAnn Yee
- Primate Assay Laboratory, CA National Primate Research Center, University of California, Davis, CA 95616, United States
| | - Jeffrey Klein
- Sinclair Research Center, 562 State Road DD, Auxvasse, MO 65231, United States
| | - Larry Karnes
- Sinclair Research Center, 562 State Road DD, Auxvasse, MO 65231, United States
| | - Frans Sollie
- Pharmaceutical Research Associates Group B.V., Amerikaweg 18, 9407 TK Assen, Netherlands
| | - Todd C Zion
- Akston Biosciences Corporation., 100 Cummings Center, Suite 454C, Beverly, MA 01915, United States.
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Scully MM, Mickool SM, Rivelli ND, Jonca AJ, Arnal G, Culligan LG, Kou PM, Smith KC. New microfluidic system provides automated alternative to Ficoll® for leukocyte isolation. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.86.32] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Despite its limitations, Ficoll® has remained the primary method of leukocyte isolation for decades due to a lack of viable alternatives. To address this, MicroMedicine has developed SorterraTM, an automated microfluidic system that enables highly consistent label-free white blood cell separation and concentration.
In a comparative study, Sorterra recovered 25% more viable lymphocytes than Ficoll, 88 ± 7% and 69 ± 13%, respectively (n=48). Sorterra retained <0.01% red blood cells (RBCs) and <0.1% platelets, resulting in a highly pure leukocyte isolate, while Ficoll retained <0.01% RBCs and 8% platelets. Sorterra also demonstrated more consistent performance across operators than Ficoll.
Sorterra and Ficoll isolates were assessed for B cell and T cell functionality. To assess B cells, the isolates were stimulated with R848 and IL-2 (n=9), and total IgG and IgM secretion were evaluated with ELISpot. Secretion from Sorterra and Ficoll isolates was shown to be equivalent using distribution free resampling analysis. To assess T cell functionality, negatively selected T cells from Sorterra and Ficoll isolates were activated with CD3/28 beads and expanded with IL-2 (n=12). The isolates displayed similar T cell activation (89±4% vs. 88±5% CD25+/CD69+), proliferation, and T cell phenotypes (Tn TCM, TEM, TEFF) at 7 and 10 days post activation.
Compared to Ficoll, Sorterra enables rapid, automated isolation of leukocytes, consistently yielding more lymphocytes with negligible RBCs and platelet contamination while maintaining T cell and B cell function. By minimizing operator variability, Sorterra has the potential to transform cell separation by automating an outdated, variable, and labor-intensive process.
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Scully MM, Palacios-Helgeson LK, Wah LS, Jackson TA. Rapid estrogen signaling negatively regulates PTEN activity through phosphorylation in endometrial cancer cells. Discov Oncol 2014; 5:218-31. [PMID: 24844349 DOI: 10.1007/s12672-014-0184-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/05/2014] [Indexed: 01/16/2023] Open
Abstract
Hyperestrogenicity is a risk factor for endometrial cancer. 17β-estradiol (E2) is known to stimulate both genomic and nongenomic estrogen receptor-α (ERα) actions in a number of reproductive tissues. However, the contributions of transcription-independent ERα signaling on normal and malignant endometrium are not fully understood. Phosphatase and tensin homolog (PTEN) is a tumor suppressor that decreases cellular mitosis primarily through negative regulation of the phosphoinositide 3-kinase/AKT signaling axis. PTEN levels are elevated during the E2 dominated, mitotically active, proliferative phase of the menstrual cycle, indicating possible hormonal regulation of PTEN in the uterus. In order to determine if rapid E2 signaling regulates PTEN, we used ERα-positive, PTEN-positive, endometrial cells. We show that cytosolic E2/ERα signaling leads to increased phosphorylation of PTEN at key regulatory residues. Importantly, E2 stimulation decreased PTEN lipid phosphatase activity and caused consequent increases in phospho-AKT. We further demonstrate that cytosolic ERα forms a complex with PTEN in an E2-dependent manner, and that ERα constitutively complexes with protein kinase2-α (CK2α), a kinase previously shown to phosphorylate the C-terminal tail of PTEN. These results provide mechanistic support for an E2-dependent, ERα cytosolic signaling complex that negatively regulates PTEN activity through carboxy terminus phosphorylation. Using an animal model, we show that sustained E2 signaling results in increased phospho-PTEN (S380, T382, and T383), total PTEN, and phospho-AKT (S473). Taken together, we provide a novel mechanism in which transcription-independent E2/ERα signaling may promote a pro-tumorigenic environment in the endometrium.
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Affiliation(s)
- Melanie M Scully
- Department of Obstetrics and Gynecology, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA,
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Hirota SA, Fines K, Ng J, Traboulsi D, Lee J, Ihara E, Li Y, Willmore WG, Chung D, Scully MM, Louie T, Medlicott S, Lejeune M, Chadee K, Armstrong G, Colgan SP, Muruve DA, MacDonald JA, Beck PL. Hypoxia-inducible factor signaling provides protection in Clostridium difficile-induced intestinal injury. Gastroenterology 2010; 139:259-69.e3. [PMID: 20347817 PMCID: PMC3063899 DOI: 10.1053/j.gastro.2010.03.045] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [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: 08/21/2009] [Revised: 03/09/2010] [Accepted: 03/17/2010] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Clostridium difficile is the leading cause of nosocomial infectious diarrhea. Antibiotic resistance and increased virulence of strains have increased the number of C difficile-related deaths worldwide. The innate host response mechanisms to C difficile are not resolved; we propose that hypoxia-inducible factor (HIF-1) has an innate, protective role in C difficile colitis. We studied the impact of C difficile toxins on the regulation of HIF-1 and evaluated the role of HIF-1alpha in C difficile-mediated injury/inflammation. METHODS We assessed HIF-1alpha mRNA and protein levels and DNA binding in human mucosal biopsy samples and Caco-2 cells following exposure to C difficile toxins. We used the mouse ileal loop model of C difficile toxin-induced intestinal injury. Mice with targeted deletion of HIF-1alpha in the intestinal epithelium were used to assess the effects of HIF-1alpha signaling in response to C difficile toxin. RESULTS Mucosal biopsy specimens and Caco-2 cells exposed to C difficile toxin had a significant increase in HIF-1alpha transcription and protein levels. Toxin-induced DNA binding was also observed in Caco-2 cells. Toxin-induced HIF-1alpha accumulation was attenuated by nitric oxide synthase inhibitors. In vivo deletion of intestinal epithelial HIF-1alpha resulted in more severe, toxin-induced intestinal injury and inflammation. In contrast, stabilization of HIF-1alpha with dimethyloxallyl glycine attenuated toxin-induced injury and inflammation. This was associated with induction of HIF-1-regulated protective factors (such as vascular endothelial growth factor-alpha, CD73, and intestinal trefoil factor) and down-regulation of proinflammatory molecules such as tumor necrosis factor and Cxcl1. CONCLUSIONS HIF-1alpha protects the intestinal mucosa from C difficile toxins. The innate protective actions of HIF-1alpha in response to C difficile toxins be developed as therapeutics for C difficile-associated disease.
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Affiliation(s)
- Simon A. Hirota
- Department of Biochemistry & Molecular Biology, University of Calgary, Calgary, Canada,Department of Medicine, University of Calgary, Calgary, Canada
| | - Kyla Fines
- Department of Biochemistry & Molecular Biology, University of Calgary, Calgary, Canada,Department of Medicine, University of Calgary, Calgary, Canada
| | - Jeffery Ng
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Danya Traboulsi
- Department of Biochemistry & Molecular Biology, University of Calgary, Calgary, Canada
| | - Josh Lee
- Department of Biochemistry & Molecular Biology, University of Calgary, Calgary, Canada
| | - Eikichi Ihara
- Department of Biochemistry & Molecular Biology, University of Calgary, Calgary, Canada
| | - Yan Li
- Department of Medicine, University of Calgary, Calgary, Canada
| | | | - Daniel Chung
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Melanie M. Scully
- Mucosal Inflammation Program, Division of Gastroenterology, University of Colorado, Health Sciences Center, Denver, USA
| | - Thomas Louie
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Sean Medlicott
- Department of Pathology, University of Calgary, Calgary, Canada
| | - Manigandan Lejeune
- Department of Microbiology & Infectious Diseases, University of Calgary, Calgary, Canada
| | - Kris Chadee
- Department of Microbiology & Infectious Diseases, University of Calgary, Calgary, Canada
| | - Glen Armstrong
- Department of Microbiology & Infectious Diseases, University of Calgary, Calgary, Canada
| | - Sean P. Colgan
- Mucosal Inflammation Program, Division of Gastroenterology, University of Colorado, Health Sciences Center, Denver, USA
| | | | - Justin A. MacDonald
- Department of Biochemistry & Molecular Biology, University of Calgary, Calgary, Canada
| | - Paul L. Beck
- Department of Medicine, University of Calgary, Calgary, Canada
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Kakkos SK, Haddad GK, Weaver MR, Haddad RK, Scully MM. Basilic vein transposition: what is the optimal technique? Eur J Vasc Endovasc Surg 2010; 39:612-9. [PMID: 20172751 DOI: 10.1016/j.ejvs.2010.01.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2009] [Accepted: 01/10/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To compare the outcome of the one-stage basilic vein transposition (BVT) fistula with a modified, two-stage technique. DESIGN Retrospective case-controlled study, performed in an academic centre. MATERIAL A total of 173 candidates for BVT fistula (87 males, mean age 61 years). METHODS In one-stage BVT, the basilic vein is mobilised through a single incision, placed inside an anterolateral arm tunnel and anastomosed with the brachial artery. In two-stage procedures, the fistula-arterial anastomosis is created first, followed by the second stage, after fistula maturation several weeks later, when the basilic vein is mobilised through two skip incisions, transected near the anastomosis, placed inside an anterolateral arm tunnel and reanastomosed. Morbidity and fistula maturation rate were the main outcome measures. RESULTS In one-stage BVT (n=76), the incidence of venous hypertension, wound haematomas and all complications (17%, 13% and 43%, respectively) was significantly higher than in two-stage procedures (n=98) (4%, p=0.004, 3%, p=0.012 and 11%, p<0.001, respectively). Time (68 days) to fistula use was significantly decreased in one-stage BVT than in two-stage procedures (132 days, p<0.001) but failure to mature rate was equivalent (15% vs. 18%, p=0.49). CONCLUSIONS Our results indicate that the two-stage BVT fistula through two skip-arm incisions is superior to the established one-stage procedure in terms of less morbidity but at the cost of a second operation and longer time to access use. Further research comparing these two techniques is necessary. Until this issue is resolved, an individualised approach is suggested.
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Affiliation(s)
- S K Kakkos
- Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, K-8, 2799 W Grand Boulevard, Detroit, MI 48202, USA
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Keely S, Glover LE, MacManus CF, Campbell EL, Scully MM, Furuta GT, Colgan SP. Selective induction of integrin beta1 by hypoxia-inducible factor: implications for wound healing. FASEB J 2008; 23:1338-46. [PMID: 19103643 DOI: 10.1096/fj.08-125344] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Because of localized vascular damage and increased tissue oxygen demand, wound healing occurs in a relatively hypoxic microenvironment. These features are particularly relevant to wound healing and fibrosis in chronic inflammatory conditions, such as Crohn's disease and ulcerative colitis. In these studies, we sought to identify the contribution of hypoxia to mechanisms of wound repair in a model of the intestinal submucosa. Initial studies revealed that hypoxia promotes wound healing, as modeled by an increase in intestinal fibroblast-mediated collagen gel contraction. Guided by results from transcriptional profiling, we identified the selective induction of fibroblast integrin beta1 (ITGB1) by hypoxia. Further analysis revealed that hypoxia, as well as pharmacological activators of hypoxia-inducible factor (HIF), induce fibroblast beta1 integrin mRNA, protein, and function by as much as 4-fold. Cloning and analysis of the beta1 integrin gene promoter revealed a 10 +/- 0.8-fold increase in promoter activity in response to hypoxia, and subsequent studies identified a functional DNA binding region for HIF in the ITGB1 gene promoter. Mutational analysis of the HIF binding site within the ITGB1 promoter resulted in a significant loss of ITGB1 hypoxia-inducibility. As proof of principle, studies in a murine model of colitis revealed a correlation between colitic disease severity and tissue ITGB1 expression (R(2)=0.80). Taken together, these results demonstrate that hypoxia induces fibroblast ITGB1 expression and function by transcriptional mechanisms dependent on HIF.
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Affiliation(s)
- Simon Keely
- Mucosal Inflammation Program, Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA
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Garland A, Jordan JE, Necheles J, Alger LE, Scully MM, Miller RJ, Ray DW, White SR, Solway J. Hypertonicity, but not hypothermia, elicits substance P release from rat C-fiber neurons in primary culture. J Clin Invest 1995; 95:2359-66. [PMID: 7537764 PMCID: PMC295856 DOI: 10.1172/jci117928] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [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: 01/25/2023] Open
Abstract
Isocapnic dry gas hyperventilation provokes hyperpnea-induced bronchoconstriction in guinea pigs by releasing tachykinins from airway sensory C-fiber neurons. It is unknown whether dry gas hyperpnea directly stimulates C-fibers to release tachykinins, or whether this physical stimulus initiates a mediator cascade that indirectly stimulates C-fiber tachykinin release. We tested the hypotheses that mucosal hypothermia and/or hyperosmolarity--physical consequences of airway heat and water loss imposed by dry gas hyperpnea--can directly stimulate C-fiber tachykinin release. Neurons isolated from neonatal rat dorsal root ganglia were maintained in primary culture for 1 wk. Cells were then exposed for 30 min at 37 degrees C to graded concentrations of NaCl, mannitol, sucrose, or glycerol (0-600 mOsm) added to isotonic medium, or to isotonic medium at 25 degrees C without or with 462 mOsm mannitol added. Fractional release of substance P (SP) was calculated from supernatant and intracellular SP contents following exposure. Hyperosmolar solutions containing excess NaCl, mannitol, or sucrose all increased fractional SP release equivalently, in an osmolarity-dependent fashion. In marked contrast, hypothermia had no effect on fractional SP release under isotonic or hypertonic conditions. Thus, hyperosmolarity, but not hypothermia, can directly stimulate tachykinin release from cultured rat sensory C-fibers. The lack of effect of glycerol, a solute which quickly crosses cell membranes, suggests that neuronal volume change represents the physical stimulus transduced by C-fibers during hyperosmolar exposure.
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Affiliation(s)
- A Garland
- Department of Medicine, University of Chicago, Illinois 60637, USA
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Dykstra KH, Hsiao JK, Morrison PF, Bungay PM, Mefford IN, Scully MM, Dedrick RL. Quantitative examination of tissue concentration profiles associated with microdialysis. J Neurochem 1992; 58:931-40. [PMID: 1738000 DOI: 10.1111/j.1471-4159.1992.tb09346.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 3.8] [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: 12/28/2022]
Abstract
Spatial solute concentration profiles resulting from in vivo microdialysis were measured in rat caudate-putamen by quantitative autoradiography. Radiolabeled sucrose was included in the dialysate, and the tissue concentration profile measured after infusions of 14 min and 61.5 min in an acute preparation. In addition, the changes in sucrose extraction fraction over time were followed in vivo and in a simple in vitro system consisting of 0.5% agarose. These experimental results were then compared with mathematical simulations of microdialysis in vitro and in vivo. Simulations of in vitro microdialysis agreed well with experimental results. In vivo, the autoradiograms of the tissue concentration profiles showed clear evidence of substantial differences between 14 and 61.5 min, even though the change in extraction fraction was relatively small over that period. Comparison with simulated results showed that the model substantially underpredicted the observed extraction fraction and overall amount of sucrose in the tissue. A sensitivity analysis of the various model parameters suggested a tissue extracellular volume fraction of approximately 40% following probe implantation. We conclude that the injury from probe insertion initially causes disruption of the blood-brain barrier in the vicinity of the probe, and this disruption leads to an influx of water and plasma constituents, causing a vasogenic edema.
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Affiliation(s)
- K H Dykstra
- Biomedical Engineering and Instrumentation Program, NCRR, National Institutes of Health, Bethesda, Maryland 20892
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