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Gill T, Stauffer P, Asquith M, Laderas T, Martin TM, Davin S, Schleisman M, Ramirez C, Ogle K, Lindquist I, Nguyen J, Planck SR, Shaut C, Diamond S, Rosenbaum JT, Karstens L. Axial spondyloarthritis patients have altered mucosal IgA response to oral and fecal microbiota. Front Immunol 2022; 13:965634. [PMID: 36248884 PMCID: PMC9556278 DOI: 10.3389/fimmu.2022.965634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
Axial spondyloarthritis (axSpA) is an inflammatory arthritis involving the spine and the sacroiliac joint with extra-articular manifestations in the eye, gut, and skin. The intestinal microbiota has been implicated as a central environmental component in the pathogenesis of various types of spondyloarthritis including axSpA. Additionally, alterations in the oral microbiota have been shown in various rheumatological conditions, such as rheumatoid arthritis (RA). Therefore, the aim of this study was to investigate whether axSpA patients have an altered immunoglobulin A (IgA) response in the gut and oral microbial communities. We performed 16S rRNA gene (16S) sequencing on IgA positive (IgA+) and IgA negative (IgA-) fractions (IgA-SEQ) from feces (n=17 axSpA; n=14 healthy) and saliva (n=14 axSpA; n=12 healthy), as well as on IgA-unsorted fecal and salivary samples. PICRUSt2 was used to predict microbial metabolic potential in axSpA patients and healthy controls (HCs). IgA-SEQ analyses revealed enrichment of several microbes in the fecal (Akkermansia, Ruminococcaceae, Lachnospira) and salivary (Prevotellaceae, Actinobacillus) microbiome in axSpA patients as compared with HCs. Fecal microbiome from axSpA patients showed a tendency towards increased alpha diversity in IgA+ fraction and decreased diversity in IgA- fraction in comparison with HCs, while the salivary microbiome exhibits a significant decrease in alpha diversity in both IgA+ and IgA- fractions. Increased IgA coating of Clostridiales Family XIII in feces correlated with disease severity. Inferred metagenomic analysis suggests perturbation of metabolites and metabolic pathways for inflammation (oxidative stress, amino acid degradation) and metabolism (propanoate and butanoate) in axSpA patients. Analyses of fecal and salivary microbes from axSpA patients reveal distinct populations of immunoreactive microbes compared to HCs using the IgA-SEQ approach. These bacteria were not identified by comparing their relative abundance alone. Predictive metagenomic analysis revealed perturbation of metabolites/metabolic pathways in axSpA patients. Future studies on these immunoreactive microbes may lead to better understanding of the functional role of IgA in maintaining microbial structure and human health.
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Affiliation(s)
- Tejpal Gill
- Division of Arthritis and Rheumatic Diseases, Department of Medicine, Oregon Health & Science University, Portland, OR, United States
- *Correspondence: Tejpal Gill,
| | - Patrick Stauffer
- Casey Eye Institute/Department of Ophthalmology, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Mark Asquith
- Division of Arthritis and Rheumatic Diseases, Department of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Ted Laderas
- Division of Bioinformatics and Computational Biomedicine, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States
| | - Tammy M. Martin
- Casey Eye Institute/Department of Ophthalmology, School of Medicine, Oregon Health & Science University, Portland, OR, United States
- Department of Molecular Microbiology & Immunology, Oregon Health & Science University, Portland, OR, United States
| | - Sean Davin
- Casey Eye Institute/Department of Ophthalmology, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Matthew Schleisman
- Casey Eye Institute/Department of Ophthalmology, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Claire Ramirez
- Casey Eye Institute/Department of Ophthalmology, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Kimberly Ogle
- Casey Eye Institute/Department of Ophthalmology, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Ingrid Lindquist
- Division of Arthritis and Rheumatic Diseases, Department of Medicine, Oregon Health & Science University, Portland, OR, United States
- Department of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Justine Nguyen
- Division of Bioinformatics and Computational Biomedicine, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States
| | - Stephen R. Planck
- Casey Eye Institute/Department of Ophthalmology, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Carley Shaut
- Laboratory of Immunogenetics, Oregon Health & Science University, Portland, OR, United States
| | - Sarah Diamond
- Department of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - James T. Rosenbaum
- Division of Arthritis and Rheumatic Diseases, Department of Medicine, Oregon Health & Science University, Portland, OR, United States
- Casey Eye Institute/Department of Ophthalmology, School of Medicine, Oregon Health & Science University, Portland, OR, United States
- Department of Cell Biology, Oregon Health & Science University, Portland, OR, United States
- Legacy Devers Eye Institute, Portland, OR, United States
| | - Lisa Karstens
- Division of Bioinformatics and Computational Biomedicine, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States
- Division of Urogynecology, Department of Obstetrics and Gynecology Oregon Health & Science University, Portland, OR, United States
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Stauffer P, Ahn J. Pneumocystis jiroveci pneumonia prophylaxis in patients with autoimmune hepatitis. Clin Liver Dis (Hoboken) 2022; 20:86-89. [PMID: 36187372 PMCID: PMC9512474 DOI: 10.1002/cld.1233] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023] Open
Abstract
Content available: Author Interview and Audio Recording.
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Affiliation(s)
- Patrick Stauffer
- Department of MedicineOregon Health & Science UniversityPortlandOregonUSA
| | - Joseph Ahn
- Division of Gastroenterology and HepatologyOregon Health & Science UniversityPortlandOregonUSA
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3
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Rosenbaum JT, Choi D, Harrington CA, Wilson DJ, Grossniklaus HE, Sibley CH, Salek SS, Ng JD, Dailey RA, Steele EA, Hayek B, Craven CM, Edward DP, Maktabi AMY, Al Hussain H, White VA, Dolman PJ, Czyz CN, Foster JA, Harris GJ, Bee YS, Tse DT, Alabiad CR, Dubovy SR, Kazim M, Selva D, Yeatts RP, Korn BS, Kikkawa DO, Silkiss RZ, Sivak-Callcott JA, Stauffer P, Planck SR. Gene Expression Profiling and Heterogeneity of Nonspecific Orbital Inflammation Affecting the Lacrimal Gland. JAMA Ophthalmol 2017; 135:1156-1162. [PMID: 28975236 DOI: 10.1001/jamaophthalmol.2017.3458] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Importance Although a variety of well-characterized diseases, such as sarcoidosis and granulomatosis with polyangiitis, affect the lacrimal gland, many patients with dacryoadenitis are diagnosed as having nonspecific orbital inflammation (NSOI) on the basis of histology and systemic disease evaluation. The ability to further classify the disease in these patients should facilitate selection of effective therapies. Objective To test the a priori hypothesis that gene expression profiles would complement clinical and histopathologic evaluations in identifying well-characterized diseases and in subdividing NSOI into clinically relevant groups. Design, Setting, and Participants In this cohort study, gene expression levels in biopsy specimens of inflamed and control lacrimal glands were measured with microarrays. Stained sections of the same biopsy specimens were used for evaluation of histopathology. Tissue samples of patients were obtained from oculoplastic surgeons at 7 international centers representing 4 countries (United States, Saudi Arabia, Canada, and Taiwan). Gene expression analysis was done at Oregon Health & Science University. Participants were 48 patients, including 3 with granulomatosis with polyangiitis, 28 with NSOI, 7 with sarcoidosis, 4 with thyroid eye disease, and 6 healthy controls. The study dates were March 2012 to April 2017. Main Outcomes and Measures The primary outcome was subdivision of biopsy specimens based on gene expression of a published list of approximately 40 differentially expressed transcripts in blood, lacrimal gland, and orbital adipose tissue from patients with sarcoidosis. Stained sections were evaluated for inflammation (none, mild, moderate, or marked), granulomas, nodules, or fibrosis by 2 independent ocular pathologists masked to the clinical diagnosis. Results Among 48 patients (mean [SD] age, 41.6 [19.0] years; 32 [67%] female), the mclust algorithm segregated the biopsy specimens into 4 subsets, with the differences illustrated by a heat map and multidimensional scaling plots. Most of the sarcoidosis biopsy specimens were in subset 1, which had the highest granuloma score. Three NSOI biopsy specimens in subset 1 had no apparent granulomas. Thirty-two percent (9 of 28) of the NSOI biopsy specimens could not be distinguished from biopsy specimens of healthy controls in subset 4, while other examples of NSOI tended to group with gene expression resembling granulomatosis with polyangiitis or thyroid eye disease. The 4 subsets could also be partially differentiated by their fibrosis, granulomas, and inflammation pathology scores but not their lymphoid nodule scores. Conclusions and Relevance Gene expression profiling discloses clear heterogeneity among patients with lacrimal inflammatory disease. Comparison of the expression profiles suggests that a subset of patients with nonspecific dacryoadenitis might have a limited form of sarcoidosis, while other patients with NSOI cannot be distinguished from healthy controls.
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Affiliation(s)
- James T Rosenbaum
- Casey Eye Institute, Oregon Health & Science University, Portland.,Devers Eye Institute, Legacy Health System, Portland, Oregon.,Department of Medicine, Oregon Health & Science University, Portland
| | - Dongseok Choi
- Casey Eye Institute, Oregon Health & Science University, Portland.,Oregon Health and Science University-Portland State University School of Public Health, Oregon Health & Science University, Portland.,Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | | | - David J Wilson
- Casey Eye Institute, Oregon Health & Science University, Portland
| | | | - Cailin H Sibley
- Department of Medicine, Oregon Health & Science University, Portland
| | - Sherveen S Salek
- Casey Eye Institute, Oregon Health & Science University, Portland.,Devers Eye Institute, Legacy Health System, Portland, Oregon
| | - John D Ng
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Roger A Dailey
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Eric A Steele
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Brent Hayek
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | | | - Deepak P Edward
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Azza M Y Maktabi
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hailah Al Hussain
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Valerie A White
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter J Dolman
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Craig N Czyz
- Department of Ophthalmology, Ohio University, Columbus.,Ophthalmic Surgeons and Consultants of Ohio, Columbus
| | - Jill A Foster
- Ophthalmic Surgeons and Consultants of Ohio, Columbus.,Department of Ophthalmology, The Ohio State University, Columbus
| | - Gerald J Harris
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee
| | - Youn-Shen Bee
- Department of Ophthalmology, Kaohsiung Veteran's General Hospital, Kaohsiung City, Taiwan
| | - David T Tse
- Department of Ophthalmology, University of Miami, Miami, Florida
| | | | - Sander R Dubovy
- Department of Ophthalmology, University of Miami, Miami, Florida
| | - Michael Kazim
- Department of Ophthalmology, Columbia University, New York, New York
| | - Dinesh Selva
- Ophthalmology Network, Royal Adelaide Hospital, Adelaide, Australia
| | - R Patrick Yeatts
- Department of Ophthalmology, Wake Forest University, Winston-Salem, North Carolina
| | - Bobby S Korn
- Department of Ophthalmology, University of California, San Diego
| | - Don O Kikkawa
- Department of Ophthalmology, University of California, San Diego
| | | | | | - Patrick Stauffer
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Stephen R Planck
- Casey Eye Institute, Oregon Health & Science University, Portland.,Devers Eye Institute, Legacy Health System, Portland, Oregon.,Department of Medicine, Oregon Health & Science University, Portland
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Asquith M, Davin S, Stauffer P, Michell C, Janowitz C, Lin P, Ensign-Lewis J, Kinchen JM, Koop DR, Rosenbaum JT. Intestinal Metabolites Are Profoundly Altered in the Context of HLA-B27 Expression and Functionally Modulate Disease in a Rat Model of Spondyloarthritis. Arthritis Rheumatol 2017; 69:1984-1995. [PMID: 28622455 PMCID: PMC5623151 DOI: 10.1002/art.40183] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [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] [Received: 08/24/2016] [Accepted: 06/13/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE HLA-B27-associated spondyloarthritides are associated with an altered intestinal microbiota and bowel inflammation. We undertook this study to identify HLA-B27-dependent changes in both host and microbial metabolites in the HLA-B27/β2 -microglobulin (β2 m)-transgenic rat and to determine whether microbiota-derived metabolites could impact disease in this major model of spondyloarthritis. METHODS Cecal contents were collected from Fischer 344 33-3 HLA-B27/β2 m-transgenic rats and wild-type controls at 6 weeks (before disease) and 16 weeks (with active bowel inflammation). Metabolomic profiling was performed by high-throughput gas and liquid chromatography-based mass spectrometry. HLA-B27/β2 m-transgenic rats were treated with the microbial metabolites propionate or butyrate in drinking water for 10 weeks, and disease activity was subsequently assessed. RESULTS Our screen identified 582 metabolites, of which more than half were significantly altered by HLA-B27 expression at 16 weeks. Both microbial and host metabolites were altered, with multiple pathways affected, including those for amino acid, carbohydrate, xenobiotic, and medium-chain fatty acid metabolism. Differences were even observed at 6 weeks, with up-regulation of histidine, tyrosine, spermidine, N-acetylmuramate, and glycerate in HLA-B27/β2 m-transgenic rats. Administration of the short-chain fatty acid propionate significantly attenuated HLA-B27-associated inflammatory disease, although this was not associated with increased FoxP3+ T cell induction or with altered expression of the immunomodulatory cytokines interleukin-10 (IL-10) or IL-33 or of the tight junction protein zonula occludens 1. HLA-B27 expression was also associated with altered host expression of messenger RNA for the microbial metabolite receptors free fatty acid receptor 2 (FFAR2), FFAR3, and niacin receptor 1. CONCLUSION HLA-B27 expression profoundly impacts the intestinal metabolome, with changes evident in rats even at age 6 weeks. Critically, we demonstrate that a microbial metabolite, propionate, attenuates development of HLA-B27-associated inflammatory disease. These and other microbiota-derived bioactive mediators may provide novel treatment modalities in HLA-B27-associated spondyloarthritides.
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Affiliation(s)
- Mark Asquith
- Oregon Health and Science University, Division of Arthritis and
Rheumatic Diseases, 3181 SW Sam Jackson Park Rd, Portland, OR, USA, 97239
| | - Sean Davin
- Oregon Health and Science University, Division of Arthritis and
Rheumatic Diseases, 3181 SW Sam Jackson Park Rd, Portland, OR, USA, 97239
| | - Patrick Stauffer
- Oregon Health and Science University, Division of Arthritis and
Rheumatic Diseases, 3181 SW Sam Jackson Park Rd, Portland, OR, USA, 97239
| | - Claire Michell
- Oregon Health and Science University, Division of Arthritis and
Rheumatic Diseases, 3181 SW Sam Jackson Park Rd, Portland, OR, USA, 97239
| | - Cathleen Janowitz
- Oregon Health and Science University, Division of Arthritis and
Rheumatic Diseases, 3181 SW Sam Jackson Park Rd, Portland, OR, USA, 97239
| | - Phoebe Lin
- Oregon Health and Science University, Casey Eye Institute, Portland,
OR, USA, 97239
| | - Joe Ensign-Lewis
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic
Center Blvd, Philadelphia, PA, USA, 19104
| | | | - Dennis R Koop
- Oregon Health and Science University, Department of Physiology and
Pharmacology, 3181 SW Sam Jackson Park Rd, Portland, OR, USA, 97239
| | - James T. Rosenbaum
- Oregon Health and Science University, Division of Arthritis and
Rheumatic Diseases, 3181 SW Sam Jackson Park Rd, Portland, OR, USA, 97239
- Oregon Health and Science University, Department of Physiology and
Pharmacology, 3181 SW Sam Jackson Park Rd, Portland, OR, USA, 97239
- Devers Eye Institute, 1040 Nw 22nd Ave, Suite 200, Portland, OR,
USA, 97210
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5
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Benedek G, Zhang J, Nguyen H, Kent G, Seifert HA, Davin S, Stauffer P, Vandenbark AA, Karstens L, Asquith M, Offner H. Estrogen protection against EAE modulates the microbiota and mucosal-associated regulatory cells. J Neuroimmunol 2017; 310:51-59. [PMID: 28778445 PMCID: PMC5570519 DOI: 10.1016/j.jneuroim.2017.06.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 06/19/2017] [Indexed: 01/22/2023]
Abstract
Sex hormones promote immunoregulatory effects on multiple sclerosis. In the current study we evaluated the composition of the gut microbiota and the mucosal-associated regulatory cells in estrogen or sham treated female mice before and after autoimmune encephalomyelitis (EAE) induction. Treatment with pregnancy levels of estrogen induces changes in the composition and diversity of gut microbiota. Additionally, estrogen prevents EAE-associated changes in the gut microbiota and might promote the enrichment of bacteria that are associated with immune regulation. Our results point to a possible cross-talk between the sex hormones and the gut microbiota, which could promote neuroprotection.
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MESH Headings
- Animals
- Antigens, CD/metabolism
- Disease Models, Animal
- Encephalomyelitis, Autoimmune, Experimental/chemically induced
- Encephalomyelitis, Autoimmune, Experimental/drug therapy
- Encephalomyelitis, Autoimmune, Experimental/pathology
- Estrogens/therapeutic use
- Feces/microbiology
- Female
- Interleukin-10/genetics
- Interleukin-10/metabolism
- Intestines/drug effects
- Intestines/microbiology
- Leukocytes/drug effects
- Lymph Nodes/drug effects
- Lymph Nodes/pathology
- Mice
- Mice, Inbred C57BL
- Mice, Transgenic
- Microbiota/drug effects
- Mucous Membrane/drug effects
- Mucous Membrane/pathology
- Myelin-Oligodendrocyte Glycoprotein/toxicity
- Peptide Fragments/toxicity
- RNA, Ribosomal, 16S/genetics
- RNA, Ribosomal, 16S/metabolism
- Spinal Cord/pathology
- Time Factors
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Affiliation(s)
- Gil Benedek
- Neuroimmunology Research, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd, Portland, OR 97239, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Jun Zhang
- Neuroimmunology Research, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd, Portland, OR 97239, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Ha Nguyen
- Neuroimmunology Research, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd, Portland, OR 97239, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Gail Kent
- Neuroimmunology Research, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd, Portland, OR 97239, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Hilary A Seifert
- Neuroimmunology Research, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd, Portland, OR 97239, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Sean Davin
- Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Patrick Stauffer
- Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Arthur A Vandenbark
- Neuroimmunology Research, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd, Portland, OR 97239, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA; Department of Molecular Microbiology & Immunology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Lisa Karstens
- Division of Bioinformatics and Computational Biology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA; Division of Urogynecology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Mark Asquith
- Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
| | - Halina Offner
- Neuroimmunology Research, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd, Portland, OR 97239, USA; Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA; Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
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Asquith MJ, Stauffer P, Davin S, Mitchell C, Lin P, Rosenbaum JT. Perturbed Mucosal Immunity and Dysbiosis Accompany Clinical Disease in a Rat Model of Spondyloarthritis. Arthritis Rheumatol 2017; 68:2151-62. [PMID: 26992013 DOI: 10.1002/art.39681] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 03/10/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The HLA-B27/β2 -microglobulin (β2 m)-transgenic (Tg) rat is a leading model of B27-associated spondyloarthritis (SpA), and the disease is dependent on the presence of intestinal bacteria. Previous studies have shown that adult HLA-B27/β2 m-Tg rats have an altered intestinal microbiota. This study sought to better define the age-dependent changes to both mucosal immune function and dysbiosis in this rat model of SpA. METHODS Intestinal contents were collected from wild-type and HLA-B27/β2 m-Tg rats postweaning (ages 3 and 6 weeks), at disease onset (age 10 weeks), and after the establishment of disease (ages ≥16 weeks). The microbial community structure was determined by 16S ribosomal RNA sequencing and quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Mucosal and systemic Th1, Th17, and Treg cell responses were analyzed by flow cytometry, as was the frequency of IgA-coated intestinal bacteria. Intestinal expression of inflammatory cytokines and antimicrobial peptides (AMPs) was determined by qRT-PCR. RESULTS An inflammatory cytokine signature and elevated AMP expression during the postweaning period preceded the development of clinical bowel inflammation and dysbiosis in HLA-B27/β2 m-Tg rats. An early and sustained expansion of the Th17 cell pool was specifically observed in the cecal and colonic mucosa of HLA-B27/β2 m-Tg rats. Strongly elevated intestinal colonization of Akkermansia muciniphila and an increased frequency of IgA-coated fecal bacteria were significantly associated with expression of HLA-B27 and arthritis development. CONCLUSION HLA-B27/β2 m expression in this rat model renders the host hyperresponsive to microbial antigens from infancy. Early activation of innate immunity and expansion of a mucosal Th17 signature are soon followed by dysbiosis in HLA-B27/β2 m-Tg animals. The pathologic processes of perturbed mucosal immunity and dysbiosis strongly merit further study in both prediseased and diseased populations of patients with SpA.
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Affiliation(s)
| | | | - Sean Davin
- Oregon Health & Science University, Portland
| | | | - Phoebe Lin
- Oregon Health & Science University and Casey Eye Institute, Portland
| | - James T Rosenbaum
- Oregon Health & Science University, Casey Eye Institute, and Devers Eye Institute, Portland
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Karstens L, Asquith M, Davin S, Stauffer P, Fair D, Gregory WT, Rosenbaum JT, McWeeney SK, Nardos R. Does the Urinary Microbiome Play a Role in Urgency Urinary Incontinence and Its Severity? Front Cell Infect Microbiol 2016; 6:78. [PMID: 27512653 PMCID: PMC4961701 DOI: 10.3389/fcimb.2016.00078] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [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: 04/21/2016] [Accepted: 07/12/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Traditionally, the urinary tract has been thought to be sterile in the absence of a clinically identifiable infection. However, recent evidence suggests that the urinary tract harbors a variety of bacterial species, known collectively as the urinary microbiome, even when clinical cultures are negative. Whether these bacteria promote urinary health or contribute to urinary tract disease remains unknown. Emerging evidence indicates that a shift in the urinary microbiome may play an important role in urgency urinary incontinence (UUI). The goal of this prospective pilot study was to determine how the urinary microbiome is different between women with and without UUI. We also sought to identify if characteristics of the urinary microbiome are associated with UUI severity. METHODS We collected urine from clinically well-characterized women with UUI (n = 10) and normal bladder function (n = 10) using a transurethral catheter to avoid bacterial contamination from external tissue. To characterize the resident microbial community, we amplified the bacterial 16S rRNA gene by PCR and performed sequencing using Illumina MiSeq. Sequences were processed using the workflow package QIIME. We identified bacteria that had differential relative abundance between UUI and controls using DESeq2 to fit generalized linear models based on the negative binomial distribution. We also identified relationships between the diversity of the urinary microbiome and severity of UUI symptoms with Pearson's correlation coefficient. RESULTS We successfully extracted and sequenced bacterial DNA from 95% of the urine samples and identified that there is a polymicrobial community in the female bladder in both healthy controls and women with UUI. We found the relative abundance of 14 bacteria significantly differed between control and UUI samples. Furthermore, we established that an increase in UUI symptom severity is associated with a decrease in microbial diversity in women with UUI. CONCLUSIONS Our study provides further characterization of the urinary microbiome in both healthy controls and extensively phenotyped women with UUI. Our results also suggest that the urinary microbiome may play an important role in the pathophysiology of UUI and that the loss of microbial diversity may be associated with clinical severity.
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Affiliation(s)
- Lisa Karstens
- Division of Bioinformatics and Computational Biology, Oregon Health and Science UniversityPortland, OR, USA
- Division of Urogynecology, Oregon Health and Science UniversityPortland, OR, USA
| | - Mark Asquith
- Division of Arthritis and Rheumatology, Oregon Health and Science UniversityPortland, OR, USA
| | - Sean Davin
- Division of Arthritis and Rheumatology, Oregon Health and Science UniversityPortland, OR, USA
| | - Patrick Stauffer
- Division of Arthritis and Rheumatology, Oregon Health and Science UniversityPortland, OR, USA
| | - Damien Fair
- Department of Behavioral Neuroscience, Oregon Health and Science UniversityPortland, OR, USA
- Department of Psychiatry, Oregon Health and Science UniversityPortland, OR, USA
- Advanced Imaging Research Center, Oregon Health and Science UniversityPortland, OR, USA
| | - W. Thomas Gregory
- Division of Urogynecology, Oregon Health and Science UniversityPortland, OR, USA
| | - James T. Rosenbaum
- Division of Arthritis and Rheumatology, Oregon Health and Science UniversityPortland, OR, USA
- Devers Eye Institute, Oregon Health and Science UniversityPortland, OR, USA
| | - Shannon K. McWeeney
- Division of Bioinformatics and Computational Biology, Oregon Health and Science UniversityPortland, OR, USA
| | - Rahel Nardos
- Division of Urogynecology, Oregon Health and Science UniversityPortland, OR, USA
- Kaiser PermanenteClackamas, OR, USA
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8
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Rosenbaum JT, Choi D, Wilson DJ, Grossniklaus HE, Harrington CA, Sibley CH, Dailey RA, Ng JD, Steele EA, Czyz CN, Foster JA, Tse D, Alabiad C, Dubovy S, Parekh PK, Harris GJ, Kazim M, Patel PJ, White VA, Dolman PJ, Korn BS, Kikkawa DO, Edward DP, Alkatan HM, al-Hussain H, Yeatts RP, Selva D, Stauffer P, Planck SR. Orbital pseudotumor can be a localized form of granulomatosis with polyangiitis as revealed by gene expression profiling. Exp Mol Pathol 2015; 99:271-8. [PMID: 26163757 PMCID: PMC4591186 DOI: 10.1016/j.yexmp.2015.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/02/2015] [Indexed: 01/05/2023]
Abstract
Biopsies and ANCA testing for limited forms of granulomatosis with polyangiitis (GPA) are frequently non-diagnostic. We characterized gene expression in GPA and other causes of orbital inflammation. We tested the hypothesis that a sub-set of patients with non-specific orbital inflammation (NSOI, also known as pseudotumor) mimics a limited form of GPA. Formalin-fixed, paraffin-embedded orbital biopsies were obtained from controls (n=20) and patients with GPA (n=6), NSOI (n=25), sarcoidosis (n=7), or thyroid eye disease (TED) (n=20) and were divided into discovery and validation sets. Transcripts in the tissues were quantified using Affymetrix U133 Plus 2.0 microarrays. Distinct gene expression profiles for controls and subjects with GPA, TED, or sarcoidosis were evident by principal coordinate analyses. Compared with healthy controls, 285 probe sets had elevated signals in subjects with GPA and 1472 were decreased (>1.5-fold difference, false discovery rate adjusted p<0.05). The immunoglobulin family of genes had the most dramatic increase in expression. Although gene expression in GPA could be readily distinguished from gene expression in TED, sarcoidosis, or controls, a comparison of gene expression in GPA versus NSOI found no statistically significant differences. Thus, forms of orbital inflammation can be distinguished based on gene expression. NSOI/pseudotumor is heterogeneous but often may be an unrecognized, localized form of GPA.
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Affiliation(s)
- James T Rosenbaum
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA; Devers Eye Institute, Legacy Health Systems, Portland, OR 97210, USA.
| | - Dongseok Choi
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA; Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
| | - David J Wilson
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
| | | | - Christina A Harrington
- Integrated Genomics Laboratory, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Cailin H Sibley
- Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Roger A Dailey
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
| | - John D Ng
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Eric A Steele
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Craig N Czyz
- Division of Ophthalmology, Ohio University, Columbus, OH 43228, USA.
| | - Jill A Foster
- Department of Ophthalmology, The Ohio State University, Columbus, OH 43215, USA.
| | - David Tse
- Department of Ophthalmology, University of Miami, FL 33101, USA.
| | - Chris Alabiad
- Department of Ophthalmology, University of Miami, FL 33101, USA.
| | - Sander Dubovy
- Department of Ophthalmology, University of Miami, FL 33101, USA.
| | | | - Gerald J Harris
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
| | - Michael Kazim
- Department of Ophthalmology, Columbia University, New York, NY 10032, USA.
| | - Payal J Patel
- Department of Ophthalmology, Columbia University, New York, NY 10032, USA.
| | - Valerie A White
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia V5Z 3N9, Canada.
| | - Peter J Dolman
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia V5Z 3N9, Canada.
| | - Bobby S Korn
- Department of Ophthalmology, University of California, San Diego, CA 92037, USA.
| | - Don O Kikkawa
- Department of Ophthalmology, University of California, San Diego, CA 92037, USA.
| | - Deepak P Edward
- Research Department, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia.
| | - Hind M Alkatan
- Research Department, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia.
| | - Hailah al-Hussain
- Research Department, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia.
| | - R Patrick Yeatts
- Department of Ophthalmology, Wake Forrest University, Winston-Salem, NC 27103, USA.
| | - Dinesh Selva
- Ophthalmology Network, Royal Adelaide Hospital, Adelaide 5000, Australia.
| | - Patrick Stauffer
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Stephen R Planck
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA; Devers Eye Institute, Legacy Health Systems, Portland, OR 97210, USA.
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Rosenbaum JT, Choi D, Wilson DJ, Grossniklaus HE, Harrington CA, Sibley CH, Dailey RA, Ng JD, Steele EA, Czyz CN, Foster JA, Tse D, Alabiad C, Dubovy S, Parekh P, Harris GJ, Kazim M, Patel P, White V, Dolman P, Korn BS, Kikkawa D, Edward DP, Alkatan H, Al-Hussain H, Yeatts RP, Selva D, Stauffer P, Planck SR. Parallel Gene Expression Changes in Sarcoidosis Involving the Lacrimal Gland, Orbital Tissue, or Blood. JAMA Ophthalmol 2015; 133:770-7. [PMID: 25880323 DOI: 10.1001/jamaophthalmol.2015.0726] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Sarcoidosis is a major cause of ocular or periocular inflammation. The pathogenesis of sarcoidosis is incompletely understood and diagnosis often requires a biopsy. OBJECTIVE To determine how gene expression in either orbital adipose tissue or the lacrimal gland affected by sarcoidosis compares with gene expression in other causes of orbital disease and how gene expression in tissue affected by sarcoidosis compares with gene expression in peripheral blood samples obtained from patients with sarcoidosis. DESIGN, SETTING, AND PARTICIPANTS In a multicenter, international, observational study, gene expression profiling of formalin-fixed biopsy specimens, using GeneChipp U133 Plus 2 microarrays (Affymetrix), was conducted between October 2012 and January 2014 on tissues biopsied from January 2000 through June 2013. Participants included 12 patients with orbital sarcoidosis (7 in adipose tissue; 5 affecting the lacrimal gland) as well as comparable tissue from 6 healthy individuals serving as controls or patients with thyroid eye disease, nonspecific orbital inflammation, or granulomatosis with polyangiitis. In addition, results were compared with gene expression in peripheral blood samples obtained from 12 historical individuals with sarcoidosis. MAIN OUTCOMES AND MEASURES Significantly differentially expressed transcripts defined as a minimum of a 1.5-fold increase or a comparable decrease and a false discovery rate of P < .05. RESULTS Signals from 2449 probe sets (transcripts from approximately 1522 genes) were significantly increased in the orbital adipose tissue from patients with sarcoidosis. Signals from 4050 probe sets (approximately 2619 genes) were significantly decreased. Signals from 3069 probe sets (approximately 2001 genes) were significantly higher and 3320 (approximately 2283 genes) were significantly lower in the lacrimal gland for patients with sarcoidosis. Ninety-two probe sets (approximately 69 genes) had significantly elevated signals and 67 probe sets (approximately 56 genes) had significantly lower signals in both orbital tissues and in peripheral blood from patients with sarcoidosis. The transcription factors, interferon-response factor 1, interferon-response factor 2, and nuclear factor κB, were strongly implicated in the expression of messenger RNA upregulated in common in the 3 tissues. CONCLUSIONS AND RELEVANCE Gene expression in sarcoidosis involving the orbit or lacrimal gland can be distinguished from gene expression patterns in control tissue and overlaps with many transcripts upregulated or downregulated in the peripheral blood of patients with sarcoidosis. These observations suggest that common pathogenic mechanisms contribute to sarcoidosis in different sites. The observations support the hypothesis that a pattern of gene expression profiles could provide diagnostic information in patients with sarcoidosis.
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Affiliation(s)
- James T Rosenbaum
- Casey Eye Institute, Oregon Health & Science University, Portland2Department of Medicine, School of Medicine, Oregon Health & Science University, Portland3Devers Eye Institute, Legacy Health Systems, Portland, Oregon
| | - Dongseok Choi
- Casey Eye Institute, Oregon Health & Science University, Portland4Department of Public Health and Preventive Medicine, School of Medicine, Oregon Health & Science University, Portland
| | - David J Wilson
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Hans E Grossniklaus
- Department of Ophthalmology, Emory School of Medicine, Emory University, Atlanta, Georgia
| | | | - Cailin H Sibley
- Department of Medicine, School of Medicine, Oregon Health & Science University, Portland
| | - Roger A Dailey
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - John D Ng
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Eric A Steele
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Craig N Czyz
- Division of Ophthalmology, Ohio University, Athens
| | - Jill A Foster
- Department of Ophthalmology, College of Medicine and Public Health, The Ohio State University, Columbus
| | - David Tse
- Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Chris Alabiad
- Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Sander Dubovy
- Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Prashant Parekh
- Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Gerald J Harris
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee
| | - Michael Kazim
- Department of Ophthalmology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Payal Patel
- Department of Ophthalmology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Valerie White
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Dolman
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bobby S Korn
- Department of Ophthalmology, School of Medicine, University of California, San Diego
| | - Don Kikkawa
- Department of Ophthalmology, School of Medicine, University of California, San Diego
| | - Deepak P Edward
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hind Alkatan
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hailah Al-Hussain
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - R Patrick Yeatts
- Department of Ophthalmology, School of Medicine, Wake Forrest University, Winston-Salem, North Carolina
| | - Dinesh Selva
- Ophthalmology Network, Royal Adelaide Hospital, Adelaide, Australia
| | - Patrick Stauffer
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Stephen R Planck
- Casey Eye Institute, Oregon Health & Science University, Portland2Department of Medicine, School of Medicine, Oregon Health & Science University, Portland3Devers Eye Institute, Legacy Health Systems, Portland, Oregon
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10
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Rosenbaum JT, Choi D, Wong A, Wilson DJ, Grossniklaus HE, Harrington CA, Dailey RA, Ng JD, Steele EA, Czyz CN, Foster JA, Tse D, Alabiad C, Dubovy S, Parekh PK, Harris GJ, Kazim M, Patel PJ, White VA, Dolman PJ, Edward DP, Alkatan HM, al Hussain H, Selva D, Yeatts RP, Korn BS, Kikkawa DO, Stauffer P, Planck SR. The Role of the Immune Response in the Pathogenesis of Thyroid Eye Disease: A Reassessment. PLoS One 2015; 10:e0137654. [PMID: 26371757 PMCID: PMC4570801 DOI: 10.1371/journal.pone.0137654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 08/20/2015] [Indexed: 01/05/2023] Open
Abstract
Background Although thyroid eye disease is a common complication of Graves’ disease, the pathogenesis of the orbital disease is poorly understood. Most authorities implicate the immune response as an important causal factor. We sought to clarify pathogenesis by using gene expression microarray. Methods An international consortium of ocular pathologists and orbital surgeons contributed formalin fixed orbital biopsies. RNA was extracted from orbital tissue from 20 healthy controls, 25 patients with thyroid eye disease (TED), 25 patients with nonspecific orbital inflammation (NSOI), 7 patients with sarcoidosis and 6 patients with granulomatosis with polyangiitis (GPA). Tissue was divided into a discovery set and a validation set. Gene expression was quantified using Affymetrix U133 Plus 2.0 microarrays which include 54,000 probe sets. Results Principal component analysis showed that gene expression from tissue from patients with TED more closely resembled gene expression from healthy control tissue in comparison to gene expression characteristic of sarcoidosis, NSOI, or granulomatosis with polyangiitis. Unsupervised cluster dendrograms further indicated the similarity between TED and healthy controls. Heat maps based on gene expression for cytokines, chemokines, or their receptors showed that these inflammatory markers were associated with NSOI, sarcoidosis, or GPA much more frequently than with TED. Conclusion This is the first study to compare gene expression in TED to gene expression associated with other causes of exophthalmos. The juxtaposition shows that inflammatory markers are far less characteristic of TED relative to other orbital inflammatory diseases.
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Affiliation(s)
- James T. Rosenbaum
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- Devers Eye Institute, Legacy Health Systems, Portland, Oregon, United States of America
- * E-mail:
| | - Dongseok Choi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Amanda Wong
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - David J. Wilson
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Hans E. Grossniklaus
- Department of Ophthalmology, Emory University, Atlanta, Georgia, United States of America
| | - Christina A. Harrington
- Integrated Genomics Laboratory, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Roger A. Dailey
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - John D. Ng
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Eric A. Steele
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Craig N. Czyz
- Division of Ophthalmology, Ohio University, Athens, Ohio, United States of America
| | - Jill A. Foster
- Department of Ophthalmology, The Ohio State University, Columbus, Ohio, United States of America
| | - David Tse
- Department of Ophthalmology, University of Miami, Miami, Florida, United States of America
| | - Chris Alabiad
- Department of Ophthalmology, University of Miami, Miami, Florida, United States of America
| | - Sander Dubovy
- Department of Ophthalmology, University of Miami, Miami, Florida, United States of America
| | - Prashant K. Parekh
- Department of Ophthalmology, University of Miami, Miami, Florida, United States of America
| | - Gerald J. Harris
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Michael Kazim
- Department of Ophthalmology, Columbia University, New York, New York, United States of America
| | - Payal J. Patel
- Department of Ophthalmology, Columbia University, New York, New York, United States of America
| | - Valerie A. White
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Peter J. Dolman
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Deepak P. Edward
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hind M. Alkatan
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hailah al Hussain
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Dinesh Selva
- Ophthalmology Network, Royal Adelaide Hospital, Adelaide, SA 5000, Australia
| | - R. Patrick Yeatts
- Department of Ophthalmology, Wake Forrest University, Winston-Salem, North Carolina, United States of America
| | - Bobby S. Korn
- Department of Ophthalmology, University of California, San Diego, California, United States of America
| | - Don O. Kikkawa
- Department of Ophthalmology, University of California, San Diego, California, United States of America
| | - Patrick Stauffer
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Stephen R. Planck
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- Devers Eye Institute, Legacy Health Systems, Portland, Oregon, United States of America
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11
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Rosenbaum JT, Choi D, Wilson DJ, Grossniklaus HE, Harrington CA, Dailey RA, Ng JD, Steele EA, Czyz CN, Foster JA, Tse D, Alabiad C, Dubovy S, Parekh P, Harris GJ, Kazim M, Patel P, White V, Dolman P, Edward DP, Alkatan H, Al Hussain H, Selva D, Yeatts P, Korn B, Kikkawa D, Stauffer P, Planck SR. Fibrosis, gene expression and orbital inflammatory disease. Br J Ophthalmol 2015; 99:1424-9. [PMID: 26038391 DOI: 10.1136/bjophthalmol-2015-306614] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 05/13/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIMS To clarify the pathogenesis of fibrosis in inflammatory orbital diseases, we analysed the gene expression in orbital biopsies and compared our results with those reported for idiopathic pulmonary fibrosis. METHODS We collected 140 biopsies from 138 patients (58 lacrimal glands; 82 orbital fat). Diagnoses included healthy controls (n=27), non-specific orbital inflammation (NSOI) (n=61), thyroid eye disease (TED) (n=29), sarcoidosis (n=14) and granulomatosis with polyangiitis (GPA) (n=7). Fibrosis was scored on a 0-3 scale by two experts, ophthalmic pathologists. Gene expression was quantified using Affymetrix U133 plus 2.0 microarray. RESULTS Within orbital fat, fibrosis was greatest among subjects with GPA (2.75±0.46) and significantly increased in tissue from subjects with GPA, NSOI or sarcoidosis (p<0.01), but not for TED, compared with healthy controls (1.13±0.69). For lacrimal gland, the average score among controls (1.36±0.48) did not differ statistically from any of the four disease groups. Seventy-three probe sets identified transcripts correlating with fibrosis in orbital fat (false discovery rate <0.05) after accounting for batch effects, disease type, age and sex. Transcripts with increased expression included fibronectin, lumican, thrombospondin and collagen types I and VIII, each of which has been reported upregulated in pulmonary fibrosis. CONCLUSIONS A pathologist's recognition of fibrosis in orbital tissue correlates well with increased expression of transcripts that are considered essential in fibrosis. Many transcripts implicated in orbital fibrosis have been previously implicated in pulmonary fibrosis. TED differs from other causes of orbital fat inflammation because fibrosis is not a major component. Marked fibrosis is less common in the lacrimal gland compared with orbital adipose tissue.
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Affiliation(s)
- James T Rosenbaum
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA Devers Eye Institute, Legacy Health Systems, Portland, Oregon, USA
| | - Dongseok Choi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - David J Wilson
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Christina A Harrington
- Integrated Genomics Laboratory, Oregon Health & Science University, Portland, Oregon, USA
| | - Roger A Dailey
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - John D Ng
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Eric A Steele
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Craig N Czyz
- Division of Ophthalmology, Ohio University, Columbus, Ohio, USA
| | - Jill A Foster
- Department of Ophthalmology, The Ohio State University, Columbus, Ohio, USA
| | - David Tse
- Department of Ophthalmology, University of Miami, Miami, Florida, USA
| | - Chris Alabiad
- Department of Ophthalmology, University of Miami, Miami, Florida, USA
| | - Sander Dubovy
- Department of Ophthalmology, University of Miami, Miami, Florida, USA
| | - Prashant Parekh
- Department of Ophthalmology, University of Miami, Miami, Florida, USA
| | - Gerald J Harris
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Michael Kazim
- Department of Ophthalmology, Columbia University, New York, New York, USA
| | - Payal Patel
- Department of Ophthalmology, Columbia University, New York, New York, USA
| | - Valerie White
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Dolman
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Deepak P Edward
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hind Alkatan
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hailah Al Hussain
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Dinesh Selva
- Department of Ophthalmology Network, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Patrick Yeatts
- Department of Ophthalmology, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Bobby Korn
- Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Don Kikkawa
- Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Patrick Stauffer
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Stephen R Planck
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA Devers Eye Institute, Legacy Health Systems, Portland, Oregon, USA
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12
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Wong AJ, Planck SR, Choi D, Harrington CA, Troxell ML, Houghton DC, Stauffer P, Wilson DJ, Grossniklaus HE, Dailey RA, Ng JD, Steele EA, Harris GJ, Czyz C, Foster JA, White VA, Dolman PJ, Kazim M, Patel PJ, Edward DP, Katan HA, Hussain HA, Selva D, Yeatts RP, Korn BS, Kikkawa DO, Rosenbaum JT. IgG4 immunostaining and its implications in orbital inflammatory disease. PLoS One 2014; 9:e109847. [PMID: 25303270 PMCID: PMC4193851 DOI: 10.1371/journal.pone.0109847] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 09/03/2014] [Indexed: 12/24/2022] Open
Abstract
Objective IgG4-related disease is an emerging clinical entity which frequently involves tissue within the orbit. In order to appreciate the implications of IgG4 immunostaining, we analyzed gene expression and the prevalence of IgG4- immunostaining among subjects with orbital inflammatory diseases. Methods We organized an international consortium to collect orbital biopsies from 108 subjects including 22 with no known orbital disease, 42 with nonspecific orbital inflammatory disease (NSOI), 26 with thyroid eye disease (TED), 12 with sarcoidosis, and 6 with granulomatosis with polyangiitis (GPA). Lacrimal gland and orbital adipose tissue biopsies were immunostained for IgG4 or IgG secreting plasma cells. RNA transcripts were quantified by Affymetrix arrays. Results None of the healthy controls or subjects with TED had substantial IgG4 staining. Among the 63 others, the prevalence of significant IgG4-immunostaining ranged from 11 to 39% depending on the definition for significant. IgG4 staining was detectable in the majority of tissues from subjects with GPA and less commonly in tissue from subjects with sarcoidosis or NSOI. The detection of IgG4+ cells correlated with inflammation in the lacrimal gland based on histology. IgG4 staining tissue expressed an increase in transcripts associated with inflammation, especially B cell-related genes. Functional annotation analysis confirmed this. Conclusion IgG4+ plasma cells are common in orbital tissue from patients with sarcoidosis, GPA, or NSOI. Even using the low threshold of 10 IgG4+ cells/high powered field, IgG4 staining correlates with increased inflammation in the lacrimal gland based on histology and gene expression.
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Affiliation(s)
- Amanda J. Wong
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Stephen R. Planck
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- Devers Eye Institute, Legacy Health Systems, Portland, Oregon, United States of America
| | - Dongseok Choi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Christina A. Harrington
- Integrated Genomics Laboratory, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Megan L. Troxell
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Donald C. Houghton
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Patrick Stauffer
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - David J. Wilson
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Hans E. Grossniklaus
- Department of Ophthalmology, Emory University, Atlanta, Georgia, United States of America
| | - Roger A. Dailey
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - John D. Ng
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Eric A. Steele
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Gerald J. Harris
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Craig Czyz
- Division of Ophthalmology, Ohio University, Columbus, Ohio, United States of America
| | - Jill A. Foster
- Department of Ophthalmology, The Ohio State University, Columbus, Ohio, United States of America
| | - Valerie A. White
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Peter J. Dolman
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Michael Kazim
- Department of Ophthalmology, Columbia University, New York, New York, United States of America
| | - Payal J. Patel
- Department of Ophthalmology, Columbia University, New York, New York, United States of America
| | - Deepak P. Edward
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hind al Katan
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hailah al Hussain
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Dinesh Selva
- Ophthalmology Network, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - R. Patrick Yeatts
- Department of Ophthalmology, Wake Forrest University, Winston-Salem, North Carolina, United States of America
| | - Bobby S. Korn
- Department of Ophthalmology, University of California San Diego, San Diego, California, United States of America
| | - Don O. Kikkawa
- Department of Ophthalmology, University of California San Diego, San Diego, California, United States of America
| | - James T. Rosenbaum
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- Devers Eye Institute, Legacy Health Systems, Portland, Oregon, United States of America
- * E-mail:
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Lin P, Bach M, Asquith M, Lee AY, Akileswaran L, Stauffer P, Davin S, Pan Y, Cambronne ED, Dorris M, Debelius JW, Lauber CL, Ackermann G, Baeza YV, Gill T, Knight R, Colbert RA, Taurog JD, Van Gelder RN, Rosenbaum JT. HLA-B27 and human β2-microglobulin affect the gut microbiota of transgenic rats. PLoS One 2014; 9:e105684. [PMID: 25140823 PMCID: PMC4139385 DOI: 10.1371/journal.pone.0105684] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 07/22/2014] [Indexed: 11/18/2022] Open
Abstract
The HLA-B27 gene is a major risk factor for clinical diseases including ankylosing spondylitis, acute anterior uveitis, reactive arthritis, and psoriatic arthritis, but its mechanism of risk enhancement is not completely understood. The gut microbiome has recently been shown to influence several HLA-linked diseases. However, the role of HLA-B27 in shaping the gut microbiome has not been previously investigated. In this study, we characterize the differences in the gut microbiota mediated by the presence of the HLA-B27 gene. We identified differences in the cecal microbiota of Lewis rats transgenic for HLA-B27 and human β2-microglobulin (hβ2m), compared with wild-type Lewis rats, using biome representational in situ karyotyping (BRISK) and 16S rRNA gene sequencing. 16S sequencing revealed significant differences between transgenic animals and wild type animals by principal coordinates analysis. Further analysis of the data set revealed an increase in Prevotella spp. and a decrease in Rikenellaceae relative abundance in the transgenic animals compared to the wild type animals. By BRISK analysis, species-specific differences included an increase in Bacteroides vulgatus abundance in HLA-B27/hβ2m and hβ2m compared to wild type rats. The finding that HLA-B27 is associated with altered cecal microbiota has not been shown before and can potentially provide a better understanding of the clinical diseases associated with this gene.
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Affiliation(s)
- Phoebe Lin
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- * E-mail:
| | - Mary Bach
- Division of Rheumatology, University of Washington, VA Medical Center, Seattle, Washington, United States of America
| | - Mark Asquith
- Division of Rheumatology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Aaron Y. Lee
- Moorfield's Eye Institute of London, London, United Kingdom
| | - Lakshmi Akileswaran
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States of America
| | - Patrick Stauffer
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Sean Davin
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Yuzhen Pan
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Eric D. Cambronne
- Department of Molecular Microbiology & Immunology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Martha Dorris
- Department of Rheumatology, University of Texas Southwestern, Dallas, Texas, United States of America
| | | | | | - Gail Ackermann
- University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Yoshiki V. Baeza
- University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Tejpal Gill
- Pediatric Translational Research Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Rob Knight
- University of Colorado Boulder, Boulder, Colorado, United States of America
- Howard Hughes Medical Institute, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Robert A. Colbert
- Pediatric Translational Research Branch, National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Joel D. Taurog
- Department of Rheumatology, University of Texas Southwestern, Dallas, Texas, United States of America
| | - Russell N. Van Gelder
- Department of Ophthalmology, University of Washington, Seattle, Washington, United States of America
| | - James T. Rosenbaum
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States of America
- Division of Rheumatology, Oregon Health & Science University, Portland, Oregon, United States of America
- Dever's Eye Institute, Portland, Oregon, United States of America
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14
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Surdam R, Jiao Z, Ganshin Y, Bentley R, Garcia-Gonzalez M, Quillinan S, McLaughlin J, Stauffer P, Deng H. Characterizations of the CCUS Attributes of a High-priority CO2 Storage Site in Wyoming, USA. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.egypro.2013.06.289] [Citation(s) in RCA: 4] [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: 10/26/2022]
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15
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Sánchez Mazón J, Arunachalam K, McMahon R, Steffey B, Stauffer P, Chino J, Craciunescu O. PO-329 DOSIMETRIC ANALYSIS OF A THERMOBRACHYTHERAPY APPLICATOR IN THE CONTEXT OF A POSITIONING REPRODUCIBILITY STUDY. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72295-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Vujaskovic Z, Craciunescu OI, Stauffer P, Carroll M, Lan L, Dewhirst M, Inman BA. Pilot study of external hyperthermia and intravesical mitomycin-C to treat recurrent bladder cancer after failed standard therapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Klemetsen O, Birkelund Y, Maccarini PF, Stauffer P, Jacobsen SK. Design of Small-sized and Low-cost Front End to Medical Microwave Radiometer. Prog Electromagn Res Symp 2010; 2010:932-936. [PMID: 25324916 PMCID: PMC4196692] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We have investigated the possibility of building a Dicke radiometer that is inexpensive, small-sized, stable, high sensitivity and consists of readily available microwave components. The selected frequency band is at 3-4 GHz and can be used for breast cancer detection, with sufficient spatial resolution. We have found microwave components that are small (< 5mm × 5 mm) and provide sufficient sensitivity. We have built two different Dicke radiometers: One is of conventional design with Dicke switch at front end to select antenna or noise rererence and the other with a low noise amplifier before the Dicke Switch. We have tested this concept with simulations and built prototypes. The two designs provide a gain of approximately 50 dB, and bandwidth of about 500 MHz. One of the designs has a stability μ > 1 and the other design provide instability μ < 1 for a part of the pass band. The prototypes are tested for sensitivity after calibration in two different known temperature waterbaths. The results show that the design with the low noise amplifier before the Dicke switch has 36% higher sensitivity than the other design with Dicke switch in front.
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18
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Craciunescu O, MacFall J, Soher B, Stauffer P, Maccarini P, Jones E, Larrier N, Wong T, Carroll M, Dewhirst M, Vujaskovic Z. WE-C-BRC-02: Combined Dynamic Contrast Enhanced Magnetic Resonance Imaging (DCE-MRI) and Magnetic Resonance Thermal Imaging (MRTI) for Optimal Hyperthermia Treatment of Advanced Extremity Sarcomas: Fifteen Patients Update. Med Phys 2009. [DOI: 10.1118/1.3182470] [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: 11/07/2022] Open
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19
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Kim D, Blackwell K, Vujaskovic Z, Craciunescu O, Stauffer P, Liotcheva V, Jones E. A Phase I/II Study of Neoadjuvant Liposomal Doxorubicin, Paclitaxel and Hyperthermia in Locally Advanced Breast Cancer. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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20
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Cheng K, Stakhursky V, Craciunescu O, Stauffer P, Dewhirst M, Das S. SU-GG-T-367: Fast Hyperthermia Temperature Optimization for Pelvic Carcinoma Patient Treated in Sigma-Eye Applicator. Med Phys 2008. [DOI: 10.1118/1.2962119] [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: 11/07/2022] Open
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21
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Cheng K, Li Z, Stauffer P, Joines W, Dewhirst M, Das S. SU-GG-T-366: Hyperthermia Treatment for a Patient with Two Shank Sarcomas Treated by a Fast Pre-Treatment Optimization Method. Med Phys 2008. [DOI: 10.1118/1.2962118] [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: 11/07/2022] Open
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22
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Stakhursky V, Cheng K, MacFall J, Maccarini P, Stauffer P, Das S. SU-GG-J-164: Real-Time Magnetic Resonance Imaging (MRI) Guidance and Thermal Modeling to Focus Hyperthermia Delivery. Med Phys 2008. [DOI: 10.1118/1.2961713] [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: 11/07/2022] Open
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23
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Stauffer P, Schlorff J, Taschereau R, Juang T, Neuman D, Maccarini P, Pouliot J, Hsu J. Combination applicator for simultaneous heat and radiation. Conf Proc IEEE Eng Med Biol Soc 2007; 2004:2514-7. [PMID: 17270784 DOI: 10.1109/iembs.2004.1403724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We present the development of operator and patient friendly conformal applicators that can deliver moderate temperature hyperthermia simultaneously with radiation in superficial tissue overlying contoured anatomy. This applicator combines the uniform heating capabilities of large area conformal microwave array (CMA) flexible printed circuit board applicators with a patient interface (coupling bolus) that facilitates positioning of brachytherapy sources at a fixed distance (e.g. 1.5 cm) from the skin. A customized inverse treatment planning program (IPSA) was used to optimize spacing of a parallel array of source catheters and separation distance from skin, and to characterize the effects of bolus thickness and conformal array curvature on radiation dose uniformity. Performance of a 15 cmx15 cm combination applicator was evaluated in flat and contoured homogenous muscle tissue models. Results demonstrate effective heating and radiation distributions to 1-1.5 cm depth and out to the periphery of the array. This applicator should prove useful for treatment of diffuse chestwall disease located over contoured anatomy that is difficult to treat with external beam radiation. By applying heat and radiation simultaneously for maximum synergism of modalities, this device should expand the number of patients that can benefit from effective thermoradiotherapy for superficial disease.
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Affiliation(s)
- P Stauffer
- Dept. of Radiat. Oncology, California Univ., San Francisco, CA, USA
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24
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Munster PN, Marchion DC, Bicaku E, Schmitt ML, Padilla B, Stauffer P, Garrett C, Chiappori A, Sullivan DM, Daud AI. Phase I trial of a sequence-specific combination of the HDAC inhibitor, valproic acid (VPA), and the topoisomerase II inhibitor, epirubicin, in advanced solid tumors: Clinical results and correlative studies. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3068 Background: Multiple lines of evidence indicate that histone deacetylase inhibitors (HDACi) potentiate topoisomerase (topo) inhibitors. The HDACi-induced histone acetylation and chromatin modulation facilitates DNA access and target recruitment for topo II inhibitors. Methods: This Phase I trial explored a sequence-specific combination of VPA and epirubicin in solid tumors. A VPA loading dose and 6 oral doses (q12h) were given prior to epirubicin in 3-week cycles. Histone acetylation and topo II expression were evaluated in pre-and post-VPA peripheral blood mononuclear cells and tumor samples. Results: To date, 42 patients [median age 53 (39–78)] have been treated in 12 cohorts: IV VPA loading (mg/kg)/epirubicin (mg/m2): 15/75, 30/75, 45/75, 60/75, 75/75 and 75/100, oral loading: 75/100, 90/100, 100/100, 120/100, 140/100 and 160/100. Tumor types included: breast (10), melanoma (11), lung (6), sarcoma (2), GYN (2), GI (5) and others (6). Dose-limiting toxicities included somnolence (1) and neutropenia (1). No exacerbation of epirubicin-related toxicities was observed. Objective responses were seen across different tumor types in anthracycline-resistant and -refractory tumors, despite a median number of 3 (0–6) prior regimens: Partial response; 7/37 (19%), stable disease/minor response: 16/37 (43%). Patients received a median number of 4 (1–10) treatment cycles. Study treatment was stopped despite a clinical benefit or response in 4/33 patients after reaching maximal epirubicin doses (≤750 mg/m2). VPA peak and trough plasma concentrations increased linearly up to 120 mg/m2. MTD is being defined at 160/100 mg/kg/d VPA. H3 and H4 histone acetylation and topo II expression have been correlated with VPA dose, plasma concentration and response. Conclusion: A sequence-specific combination of VPA and epirubicin is active without exacerbation of epirubicin toxicity. VPA plasma peak and trough levels exceeding concentrations needed for biological effects and in vitro synergy are easily achievable with minimal toxicity. The noteworthy anti-tumor activity seen in this heavily pretreated Phase I population warrants further exploration. [Table: see text]
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Affiliation(s)
| | | | - E. Bicaku
- H. Lee Moffitt Cancer Center, Tampa, FL
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25
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Jacobsen S, Stauffer P. Non-invasive temperature profile estimation in a lossy medium based on multi-band radiometric signals sensed by a microwave dual-purpose body-contacting antenna. Int J Hyperthermia 2002; 18:86-103. [PMID: 11911486 DOI: 10.1080/02656730110092341] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [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: 10/17/2022] Open
Abstract
Microwave radiometry has during the past two decades been investigated as a non-invasive scheme for measurement of subcutaneous tissue temperatures, basically for monitoring and control in hyperthermic treatment of cancer. In this effort, we test a contact-type, dual-purpose antenna with integral water bolus. To overcome conflicting optimization criteria in the integration of this thermometry technique with heat applicators exhibiting a large effective field size during superficial hyperthermia, a stacked configuration design is proposed, where the radiometer receive antenna (Archimedean spiral) is located on the front (skin) surface of the water bolus and the heating antenna (Dual-Concentric Conductor aperture) is placed on the bolus back surface. The motivation is to achieve homogeneous tissue heating simultaneously with non-invasive thermography of the target tissue under the applicator. This paper addresses the feasibility of predicting one-dimensional depth temperature profiles from multi-band brightness temperatures. The performance is investigated statistically by a Monte Carlo technique on both simulated and real heated-phantom data using up to six radiometric bands. Analysis of measured data shows that during the transient heating period in a solid lossy phantom, the inversion technique exhibits a precision (2sigmaT) and skewness (bias) of estimated compared to actual temperature profiles of better than +/-0.38 degrees C and +/-0.55 degrees C, respectively.
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Affiliation(s)
- S Jacobsen
- Electrical Engineering Group, Institute of Physics, Faculty of Science, University of Tromsø, Norway.
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26
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Stauffer P. Making lab tests more accurate: Ghanaian effort offers model process. Impact HIV 1999; 1:23-4. [PMID: 12322329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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27
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Robey B, Stauffer P. Helping the news media cover family planning. Popul Rep J 1995:1-27. [PMID: 8706967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
To make informed choices about family planning, women and men need accurate information in the media as well as in the clinic. The media are looking for news important to the millions of people they reach each day. Thus helping the news media cover family planning fully and accurately merits the efforts of every family planning program.
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28
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Abstract
Mechanisms of uveal melanoma response to therapy are poorly understood. There are a paucity of changes that have been detected immediately after tumor treatment to differentiate successful from ineffective therapy. In this study we used in vivo 31P magnetic resonance spectroscopy (MRS) to assess intra-tumor treatment alterations. The metabolic consequences of effective and ineffective levels of solitary hyperthermia and combined hyperthermia-radiation were investigated. We have previously noted a characteristic 31P MRS pattern with successful hyperthermia in this intraocular melanoma model. The metabolic response after effective or ineffective combined radiation/hyperthermia therapy was indistinguishable from solitary radiation therapy and opposite to that with successful hyperthermia therapy. In contrast to solitary hyperthermia therapy, early changes in 31P spectral ratios following radiation or combined hyperthermia/radiation therapy of uveal melanoma were not predictive of treatment response. Twenty-four to 48 hours after effective or ineffective radiation or combined treatment the Pi/beta-NTP ratio decreased significantly (delta Pi/beta-NTP = -0.433 +/- 0.08 and -0.478 +/- .13 and .10 +/- 0.2, respectively). There was over a 2.0 thermal enhancement of radiation with heat. The increased tumor cell death after combined therapy was reflected by a two-fold larger decrease in beta-NTP signal-to-noise (S/N).
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Affiliation(s)
- J Kurhanewicz
- Department of Ophthalmology, University of California, San Francisco
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29
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Shideler S, Shackieton C, Moràn F, Stauffer P, Lohstroh P, Lasley B. Enzyme immunoassays for ovarian steroid metabolites in the urine ofMacaca fascicularis. J Med Primatol 1993. [DOI: 10.1111/j.1600-0684.1993.tb00675.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S.E. Shideler
- Institute of Toxicology and Environmental HealthUniversity of CaliforniaDavisCA
- California Regional Primate Research CenterUniversity of CaliforniaDavisCA
| | - C.H.L. Shackieton
- Children's Hospital Oakland Research Institute of Northern CaliforniaOaklandCAU.S.A
| | - F.M. Moràn
- California Regional Primate Research CenterUniversity of CaliforniaDavisCA
| | - P. Stauffer
- Institute of Toxicology and Environmental HealthUniversity of CaliforniaDavisCA
| | - P.N. Lohstroh
- Institute of Toxicology and Environmental HealthUniversity of CaliforniaDavisCA
| | - B.L. Lasley
- Institute of Toxicology and Environmental HealthUniversity of CaliforniaDavisCA
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30
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Shideler SE, Shackleton CH, Moràn FM, Stauffer P, Lohstroh PN, Lasley BL. Enzyme immunoassays for ovarian steroid metabolites in the urine of Macaca fascicularis. J Med Primatol 1993; 22:301-12. [PMID: 8289219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In vivo studies using carbon 14 labeled estradiol (E2) and progesterone (Po) were performed to characterize the time course and metabolic fate of circulating E2 and Po. Co-chromatography of human, orangutan, and macaque luteal phase urine samples demonstrated the presence of a steroid conjugate peak in all three species that was identified as being androsterone and etiocholanolone glucuronides. An enzyme immunoassay for urinary metabolites of Po was developed subsequently for Macaca spp. using a monoclonal antibody that cross-reacted with both C-19 and C-21 metabolites.
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Affiliation(s)
- S E Shideler
- Institute of Toxicology and Environmental Health, University of California, Davis 95616
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31
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Abstract
Previous attempts to use ultrasound (less than or equal to 1-MHz frequency and 1 to 3-W/cm2 intensity) to enhance transdermal drug delivery (so-called sonophoresis) have produced inconsistent results. Theoretical analysis of ultrasound propagation in tissue predicts that higher-frequency ultrasound (greater than 1 MHz) will increase the concentration of energy deposition in the stratum corneum (SC) (typically, the rate-limiting barrier to percutaneous penetration). This hypothesis was tested by comparing the passive transdermal delivery of salicylic acid with that under the influence of ultrasound at 2-, 10-, and 16-MHz frequency; measurements were performed in vivo in hairless guinea pigs. Total drug absorbed was quantified by determining the amount of salicylic acid (1) present in SC tape strips and (2) eliminated in urine. Sonophoresis for 20 min at 2 MHz caused no significant increase in salicylic acid delivery over passive diffusion; treatment with ultrasound at 10 and 16 MHz, on the other hand, significantly elevated salicylic acid transport, by 4-fold and 2.5-fold, respectively. Kinetic analysis of the sonophoretic data at 10 and 16 MHz also revealed that the diffusion lag time associated with transdermal drug delivery (TDD) was reduced. A shorter period (5 min) of sonophoresis again resulted in enhanced TDD (relative to the corresponding control) at the higher frequencies; the delivered dose, and the level of enhancement, however, were lower than those after the 20-min treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- D Bommannan
- Graduate Group in Bioengineering, University of California, Berkeley
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32
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Mack C, Steal B, Kittelson J, Shim D, Sneed P, Phillips T, Swift P, Luk K, Stauffer P, Chan K, Steeves R, Cassady J, Cetas T. A phase I study of interstitial ferromagnetic implants for the treatment of advanced and/or recurrent extracranial tumors. Int J Radiat Oncol Biol Phys 1992. [DOI: 10.1016/0360-3016(92)90419-i] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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33
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Langberg JJ, Wonnell T, Chin MC, Finkbeiner W, Scheinman M, Stauffer P. Catheter ablation of the atrioventricular junction using a helical microwave antenna: a novel means of coupling energy to the endocardium. Pacing Clin Electrophysiol 1991; 14:2105-13. [PMID: 1723193 DOI: 10.1111/j.1540-8159.1991.tb06481.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Catheter ablation with either direct current defibrillator discharges or radiofrequency energy produces tissue injury via current flow from an electrode into the adjacent myocardium. In order to affect tissue at a distance, excessive power density may be produced at the electrode-tissue interface with the possibility of explosive gas formation or coagulum formation. A novel microwave catheter was developed with a helical antenna distally. This coil, although not in direct contact with the endocardium, radiates an electromagnetic field into the tissue that, in turn, causes thermal injury. The utility of this system for ablation was assessed in six dogs. The antenna catheter was introduced percutaneously and positioned so as to record the largest His electrogram. Microwave power (50 watts at 2,450 MHz) was applied for 114 +/- 118 seconds. Complete AV block was produced in all six animals with 1.8 +/- 1.2 applications. There was no ventricular ectopy or change in blood pressure during microwave ablation. One dog died 6 days after ablation. The remaining five dogs had persistent, complete AV block during 6 weeks of follow-up. Pathological analysis at 6 weeks revealed a large (mean 2.8 x 4.7 mm) fibrovascular scar in the region of the AV junction. Percutaneous microwave ablation of the endocardium appears feasible. By radiating an electromagnetic field without direct contact, this system can produce large lesions without being limited by desiccation of tissue and impedance rise.
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Affiliation(s)
- J J Langberg
- Department of Medicine, University of California, San Francisco
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34
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Waterman FM, Dewhirst MW, Fessenden P, Samulski TV, Stauffer P, Emami B, Corry P, Prionas SD, Sapozink M, Herman T. RTOG quality assurance guidelines for clinical trials using hyperthermia administered by ultrasound. Int J Radiat Oncol Biol Phys 1991; 20:1099-107. [PMID: 2022512 DOI: 10.1016/0360-3016(91)90211-l] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [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: 12/29/2022]
Abstract
Clinical quality assurance guidelines are established for RTOG hyperthermia protocols in which unfocused planar ultrasound may be used to administer hyperthermia. Measurement of temperature at a few fixed points is no longer considered to be adequate. Thermal mapping is required to obtain profiles of the temperature across the tumor dimensions, including margins of normal tissue. The thermometry strategies established for microwaves are to be adhered to with oblique insertion of the probes recommended. Two types of errors arise which are generally not present with microwaves. A measurement error, commonly referred to as a temperature artifact, arises because of absorption and/or viscous heating of the probe. Another error arises when thermocouples are used due to the conduction of heat along the wire leads, especially the copper wire. Several thermometry systems are evaluated with regard to the expected artifact and conduction errors. Acceptable systems include: a) indexing a polyurethane sheathed single sensor thermocouple in a polyurethane catheter, b) indexing a fiberoptic probe in a steel needle, c) indexing a single sensor thermocouple in a steel needle, and d) use of manganin-constantan multisensor thermocouples. Unacceptable systems include: a) fixed or static probes that do not provide profiles of the temperature across the tumor dimensions, b) copper-constantan multisensor thermocouples, and c) teflon sheathed thermocouples inserted into a teflon catheter.
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Affiliation(s)
- F M Waterman
- Dept. Radiation Oncology and Nuclear Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107
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35
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Emami B, Stauffer P, Dewhirst MW, Prionas S, Ryan T, Corry P, Herman T, Kapp DS, Myerson RJ, Samulski T. RTOG quality assurance guidelines for interstitial hyperthermia. Int J Radiat Oncol Biol Phys 1991; 20:1117-24. [PMID: 2022514 DOI: 10.1016/0360-3016(91)90213-n] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [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: 12/29/2022]
Abstract
This document specifies the current recommendations for quality assurance for hyperthermia administration with interstitial techniques as specified by the Radiation Therapy Oncology Group (RTOG). The document begins by providing a brief description of the physical principles behind the use of the three most commonly used methods of interstitial hyperthermia: radiofrequency (RF-LCF), microwave antennas, and ferromagnetic seeds. Emphasis is placed on features that effect quality assurance. Specific recommendations are provided for: a) Pretreatment planning and equipment performance checks, b) Implant considerations and documentation, c) Thermometry, and d) Safety procedures. Specific details regarding quality assurance issues that are common to all local and regional hyperthermia methods are outlined in previous documents sponsored by the RTOG. It is anticipated that technological advances may lead to future modifications of this document.
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Affiliation(s)
- B Emami
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
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Sathiaseelan V, Leybovich L, Emami B, Stauffer P, Straube W. Characteristics of improved microwave interstitial antennas for local hyperthermia. Int J Radiat Oncol Biol Phys 1991; 20:531-9. [PMID: 1995539 DOI: 10.1016/0360-3016(91)90066-d] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The heating potentials of two newly-developed microwave interstitial antennas are reported in this paper. The longitudinal (parallel to the antenna) and transverse (over a plane perpendicular to the antenna) specific absorption rate (SAR) distributions of single and an array of four parallel antennas were measured in a muscle equivalent phantom and their performance characterized at 915 MHz in terms of the following parameters: peak depth (location of the profile peak with respect to the surface), 50% HL (effective heating length over which SAR greater than 50% of the peak normalized SAR), dead length (axial length at the antenna tip with SAR less than 50% of peak normalized SAR), and the variations of the specific absorption rate pattern relative to the depth of insertion. The results are analyzed and discussed in terms of these parameters and other factors important in the clinical use of these antennas for effective interstitial hyperthermia.
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Affiliation(s)
- V Sathiaseelan
- Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
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Dewhirst MW, Phillips TL, Samulski TV, Stauffer P, Shrivastava P, Paliwal B, Pajak T, Gillim M, Sapozink M, Myerson R. RTOG quality assurance guidelines for clinical trials using hyperthermia. Int J Radiat Oncol Biol Phys 1990; 18:1249-59. [PMID: 2347733 DOI: 10.1016/0360-3016(90)90466-w] [Citation(s) in RCA: 114] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- M W Dewhirst
- Duke University Medical Center, Durham, N.C. 27710
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Abstract
An improved method has been developed to measure temperature at both the DEJ and the PDJ during cavity preparation. This method allows a more realistic determination of the effects on the pulp tissue of various tooth reduction procedures. In future studies, the same method could also be used to determine pulpal effects from various restorative materials.
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Affiliation(s)
- H E Goodis
- University of California, School of Dentistry, San Francisco
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Goodis HE, Schein B, Stauffer P. Temperature changes measured in vivo at the dentinoenamel junction and pulpodentin junction during cavity preparation in the Macaca fascicularis monkey. J Endod 1988; 14:336-9. [PMID: 3251994 DOI: 10.1016/s0099-2399(88)80194-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Onik G, Cosman E, Wells T, Goldberg HI, Moss A, Kane R, Moore S, Stauffer P, Costello P, Hoddick W. CT body stereotaxic system for placement of needle arrays. Int J Radiat Oncol Biol Phys 1987; 13:121-8. [PMID: 3542915 DOI: 10.1016/0360-3016(87)90269-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A new CT body stereotaxic system that is particularly suited to multiple placements of needles precisely in parallel is described. By scanning through a right triangle placed on the patient's skin, the stereotaxic method defines an entry point for the first needle placement. An articulating arm is then used to aim the needle at the entry point and hold the needle at the correct angle. The arm can be angled so that the complex approaches from one scan plane to another can be made to place needle arrays through inaccessible lesions, for instance, beneath the diaphragm. Animal and phantom studies have shown that placement of multiple needle arrays in parallel from CT scan data is possible.
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