1
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Jimenez A, Scholl AR, Wang B, Schilke M, Carlsen ED. Characteristics of isatuximab-derived interference in serum protein electrophoresis and immunofixation, and an absence of sustained in vivo interference due to belantamab mafodotin and denosumab. Clin Biochem 2024; 127-128:110761. [PMID: 38565341 DOI: 10.1016/j.clinbiochem.2024.110761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/18/2024] [Accepted: 03/30/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Some therapeutic monoclonal antibodies, like daratumumab and elotuzumab, produce interfering monoclonal bands on serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE). Whether other common therapeutic antibodies also produce interference has not been systematically evaluated. DESIGN AND METHODS SPEP/IFE from patients receiving isatuximab (48 patients), belantamab mafodotin (BM; 41), and denosumab (41) were retrospectively reviewed for therapeutic antibody interference. Cases exhibiting isatuximab interference were quantified and the maximum duration of isatuximab effect was evaluated. To characterize band position, neat human serum was spiked with BM or denosumab at supratherapeutic concentrations. Band migration patterns were compared on SPEP and IFE, with band position expressed relative to other constant protein fractions. RESULTS Isatuximab-induced IFE interference was common (81.3 % of evaluated patients) with a maximum observed duration of 8 weeks. 10.4 % of isatuximab patients had IgG kappa monoclonal gammopathies that co-migrated with the drug; this subset could benefit from HYDRASHIFT 2/4 isatuximab testing. 8.3 % of IFE cases were negative for an isatuximab band but showed large, endogenous M-spikes migrating elsewhere. All patients in this group expired within 1 year of this finding. We hypothesize that an inability to detect isatuximab in this setting corresponds to a large residual myeloma burden that reduces isatuximab serum concentration. This observation may serve as a negative prognostic factor. Spiking studies demonstrated that BM and denosumab produce interference in vitro, but sustained interference was not observed in >40 treated patients. CONCLUSIONS Therapeutic antibody interference in patients receiving isatuximab is common, and can persist for at least 8 weeks after administration. >10 % of patients receiving isatuximab may benefit from HYDRASHIFT testing post-therapy. In contrast, BM and denosumab fail to produce sustained interference in treated patients.
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Affiliation(s)
- Adam Jimenez
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Ashley Rose Scholl
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Bangchen Wang
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Michael Schilke
- Department of Pharmacy, Duke University Medical Center, Durham, NC, USA
| | - Eric D Carlsen
- Department of Pathology, Duke University Medical Center, Durham, NC, USA; Duke Cancer Institute, Durham, NC, USA.
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2
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Yu T, Xu-Monette ZY, Lagoo A, Shuai W, Wang B, Neff J, Carrillo LF, Carlsen ED, Pina-Oviedo S, Young KH. Flow cytometry quantification of tumor-infiltrating lymphocytes to predict the survival of patients with diffuse large B-cell lymphoma. Front Immunol 2024; 15:1335689. [PMID: 38348048 PMCID: PMC10859492 DOI: 10.3389/fimmu.2024.1335689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
Introduction Our previous studies have demonstrated that tumor-infiltrating lymphocytes (TILs), including normal B cells, T cells, and natural killer (NK) cells, in diffuse large B-cell lymphoma (DLBCL) have a significantly favorable impact on the clinical outcomes of patients treated with standard chemoimmunotherapy. In this study, to gain a full overview of the tumor immune microenvironment (TIME), we assembled a flow cytometry cohort of 102 patients diagnosed with DLBCL at the Duke University Medical Center. Methods We collected diagnostic flow cytometry data, including the proportion of T cells, abnormal B cells, normal B cells, plasma cells, NK cells, monocytes, and granulocytes in fresh biopsy tissues at clinical presentation, and analyzed the correlations with patient survival and between different cell populations. Results We found that low T cell percentages in all viable cells and low ratios of T cells to abnormal B cells correlated with significantly poorer survival, whereas higher percentages of normal B cells among total B cells (or high ratios of normal B cells to abnormal B cells) and high percentages of NK cells among all viable cells correlated with significantly better survival in patients with DLBCL. After excluding a small number of patients with low T cell percentages, the normal B cell percentage among all B cells, but not T cell percentage among all cells, continued to show a remarkable prognostic effect. Data showed significant positive correlations between T cells and normal B cells, and between granulocytes and monocytes. Furthermore, we constructed a prognostic model based on clinical and flow cytometry factors, which divided the DLBCL cohort into two equal groups with remarkable differences in patient survival and treatment response. Summary TILs, including normal B cells, T cells, and NK cells, are associated with favorable clinical outcomes in DLBCL, and flow cytometry capable of quantifying the TIME may have additional clinical utility for prognostication.
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Affiliation(s)
- Tiantian Yu
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Zijun Y. Xu-Monette
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
- Duke University Cancer Institute, Durham, NC, United States
| | - Anand Lagoo
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Wen Shuai
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Bangchen Wang
- Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Jadee Neff
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Luis F. Carrillo
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Eric D. Carlsen
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
- Duke University Cancer Institute, Durham, NC, United States
| | - Sergio Pina-Oviedo
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
| | - Ken H. Young
- Hematopathology Division and Department of Pathology, Duke University Medical Center, Durham, NC, United States
- Duke University Cancer Institute, Durham, NC, United States
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3
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Iranzad N, Carlsen ED. Eosinophil atypia in a myeloid/lymphoid neoplasm with PDGFRA rearrangement. Blood 2024; 143:92. [PMID: 38175674 DOI: 10.1182/blood.2023022256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
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4
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Carlsen ED, Aarabi M, Swerdlow SH. Unexpected MYC::DMD translocation after transformation of follicular lymphoma with IGH::BCL2 and IGH::MYC. Br J Haematol 2023; 203:e74-e77. [PMID: 37485649 DOI: 10.1111/bjh.18994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/08/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Eric D Carlsen
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Cancer Institute, Durham, North Carolina, USA
| | - Mahmoud Aarabi
- UPMC Medical Genetics and Genomics Laboratories, UPMC Magee-Womens Hospital, Pittsburgh, Pennsylvania, USA
- Department of Pathology, UPMC, Pittsburgh, Pennsylvania, USA
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Steven H Swerdlow
- Department of Pathology, UPMC, Pittsburgh, Pennsylvania, USA
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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5
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Wildes TJ, Dennison J, Dixon A, Rentas S, Carlsen ED. Bone marrow morphologic and neuroradiologic findings in a case of pediatric myelodysplastic syndrome arising in ataxia-pancytopenia syndrome. Pediatr Blood Cancer 2023; 70:e30145. [PMID: 36519557 DOI: 10.1002/pbc.30145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Tyler J Wildes
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA
| | - John Dennison
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Austin Dixon
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Stefan Rentas
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Eric D Carlsen
- Department of Pathology, Duke University School of Medicine, Durham, North Carolina, USA
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6
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Carlsen ED, Davis AR, Cook JR, Swerdlow SH. The Distinctive Nature of Thyroid MALT Lymphomas Including IRTA1 Expression. Am J Surg Pathol 2023; 47:370-378. [PMID: 36729757 DOI: 10.1097/pas.0000000000002005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Mucosa-associated lymphoid tissue (MALT) lymphomas often express IgM and IRTA1 with only a minority demonstrating plasmacytic differentiation. However, like primary cutaneous marginal zone lymphoproliferative disorders (PCMZLPD), thyroid MALT lymphomas (T-MALT-L) frequently show plasmacytic differentiation and IgG positivity. Whether T-MALT-L share other features with PCMZLPD, including frequent IgG4 positivity and infrequent IRTA1 expression, and how IRTA1 staining compares to that in Hashimoto thyroiditis (HT) are unknown. Therefore, the clinicopathologic features of 18 T-MALT-L were assessed, and their IRTA1 expression compared with that in 5 HT cases. All T-MALT-L cases included a B-lymphoid component. Plasmacytic differentiation was present in 15 cases and was extensive in 12. Fourteen cases were IgG+ including 2 IgG4+ (12 κ+, 2 κ-/λ-). One case was IgAλ+. Plasmacytic cells were uniformly CD19+/CD56- but CD138- in 7/15 cases. IRTA1+ cells were present in 16/16 cases, ranging from scattered cells to >50%. They were often concentrated in "MALT ball"-type lymphoepithelial lesions, perifollicular regions, and sometimes in germinal centers. IRTA1 positivity was also present in all HT cases, although it was never very extensive and often had a perifollicular distribution, occasionally with sparse aggregates and positive cells within rare thyroid follicles. Thus, T-MALT-L share some features with PCMZLPD but are more similar to noncutaneous MALT lymphomas, with prominent lymphoepithelial lesions, ubiquitous although variable IRTA1 positivity, and infrequent IgG4 positivity. Plasmacytic differentiation is also common although CD138 loss is frequent and light chain staining may be absent. IRTA1 staining may help in the differential diagnosis with HT, although there is some overlap in staining patterns.
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Affiliation(s)
- Eric D Carlsen
- Department of Pathology, Duke University Medical Center, Durham, NC
| | | | - James R Cook
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Steven H Swerdlow
- Department of Pathology, UPMC
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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7
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Scholl AR, Korentzelos D, Forns TE, Brenneman EK, Kelm M, Datto M, Wheeler SE, Carlsen ED. Characterization of Casirivimab Plus Imdevimab, Sotrovimab, and Bamlanivimab Plus Etesevimab-Derived Interference in Serum Protein Electrophoresis and Immunofixation Electrophoresis. J Appl Lab Med 2022; 7:1379-1387. [PMID: 35993812 PMCID: PMC9452102 DOI: 10.1093/jalm/jfac064] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/21/2022] [Indexed: 11/16/2022]
Abstract
Background Therapeutic monoclonal antibodies can be a source of assay interference in clinical serum protein electrophoresis (SPEP) and immunofixation electrophoresis (IFE), producing monoclonal bands that can be misinterpreted as a monoclonal gammopathy related to a B-cell or plasma cell neoplasm. The extent to which new anti-COVID-19 monoclonal antibodies produce this interference is unknown. Methods Casirivimab plus imdevimab, sotrovimab, and bamlanivimab plus etesevimab were spiked into patient serum samples to evaluate for SPEP/IFE interference, to characterize the position of therapy-derived bands relative to a reference band (either combined beta band or beta 1 band, depending on instrument platform), and to confirm heavy and light chain utilization of each medication. Serum samples from patients who had recently received casirivimab plus imdevimab or sotrovimab were also evaluated for comparison. Results When spiked into serum samples, all tested anti-COVID-19 monoclonal antibodies generated interference in SPEP/IFE. Importantly, the patterns of interference differed between spiked serum samples and serum from patients who had recently received casirivimab plus imdevimab or sotrovimab. Conclusions Imdevimab can be added to the growing list of therapeutic monoclonal antibodies that produce sustained interference in SPEP/IFE. Although casirivimab and sotrovimab also produce assay interference in vitro, these antibodies are not reliably detected in serum from recently infused patients. The value of relative band position in recognizing bands that may represent therapeutic monoclonal antibodies is also emphasized. Clinicians and laboratorians should consider therapeutic monoclonal antibody interference in diagnostic SPEP/IFE and review a patient’s medication list when new or transient monoclonal bands are identified.
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Affiliation(s)
- Ashley Rose Scholl
- Department of Pathology, Duke University Medical Center , Durham NC , USA
| | - Dimitrios Korentzelos
- Department of Pathology, University of Pittsburgh Medical Center , Pittsburgh PA , USA
| | - Taylor E Forns
- Department of Pathology, Duke University Medical Center , Durham NC , USA
| | - Ethan K Brenneman
- Department of Pharmacy, Duke University Medical Center , Durham NC , USA
| | - Matthew Kelm
- Department of Pharmacy, Duke University Medical Center , Durham NC , USA
| | - Michael Datto
- Department of Pathology, Duke University Medical Center , Durham NC , USA
| | - Sarah E Wheeler
- Department of Pathology, University of Pittsburgh Medical Center , Pittsburgh PA , USA
| | - Eric D Carlsen
- Department of Pathology, Duke University Medical Center , Durham NC , USA
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8
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Charles MGK, Carlsen ED. Marrow cryptococcosis in an autologous stem cell transplant patient after standard therapy for cryptococcal meningitis. J Hematop 2022. [DOI: 10.1007/s12308-022-00507-6] [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: 10/17/2022] Open
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9
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Carlsen ED, Cook N, Aggarwal N. Necrotizing herpes simplex lymphadenitis in a patient with chronic lymphocytic leukaemia/small lymphocytic lymphoma, clinically masquerading as Richter transformation. Int J Lab Hematol 2022; 44:1017-1018. [DOI: 10.1111/ijlh.13933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Eric D. Carlsen
- Department of Pathology Duke University Medical Center Durham North Carolina USA
| | - Nathan Cook
- Department of Pathology University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA
| | - Nidhi Aggarwal
- Department of Pathology University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA
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10
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Carlsen ED, Bhavsar S, Cook JR, Swerdlow SH. IRTA1 positivity helps identify a MALT-lymphoma-like subset of primary cutaneous marginal zone lymphomas, largely but not exclusively defined by IgM expression. J Cutan Pathol 2021; 49:55-60. [PMID: 34309899 DOI: 10.1111/cup.14111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/28/2021] [Accepted: 07/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND It has been proposed that primary cutaneous marginal zone lymphomas (PCMZLs) include a MALT-lymphoma-like IgM+ subset and a class-switched subset, which is unlike most other MALT lymphomas. Whether expression of the MALT lymphoma-associated biomarkers IRTA1 and MNDA would support this concept and whether they might help explain why some patients have both subtypes is uncertain. METHODS Twenty-five PCMZLs from 21 patients were stained for IRTA1 by in situ hybridization and for MNDA by immunohistochemistry. In two patients, polymerase chain reaction (PCR)-based B-cell clonality studies were performed on biopsy specimens of metachronous lesions, which expressed different heavy chains. All results were correlated with the histopathologic and clinical findings. RESULTS Five of six IgM+ PCMZLs were IRTA1+ vs three of 18 evaluable class-switched cases (P = 0.0069). Two of the class-switched IRTA1+ cases were in patients with clonally-related IRTA1+ IgM+ PCMZLs. IRTA1 positivity showed a statistically significant correlation with several MALT-lymphoma-associated histopathologic findings. In contrast, all PCMZL cases showed at least some MNDA expression with no differences between IgM+ and class-switched cases. CONCLUSIONS IRTA1 identifies MALT-lymphoma-like PCMZLs that are largely but not exclusively IgM+. This supports the concept of two PCMZL subsets but suggests their distinction should not be based solely on their heavy chain expression.
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Affiliation(s)
- Eric D Carlsen
- Department of Pathology, UPMC, Pittsburgh, Pennsylvania, USA
| | - Shweta Bhavsar
- Department of Pathology, UPMC, Pittsburgh, Pennsylvania, USA
| | - James R Cook
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Steven H Swerdlow
- Department of Pathology, University of Pittsburgh School of Medicine and UPMC, Pittsburgh, Pennsylvania, USA
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11
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Carlsen ED, Aggarwal N, Bailey NG. Molecular methods for measurable residual disease in acute myeloid leukemia: where are we and where are we going? J Hematop 2021. [DOI: 10.1007/s12308-020-00440-6] [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: 10/22/2022] Open
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12
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Carlsen ED, Smith JA, Wheeler SE, Peck Palmer OM. Considerations for "Disappearing" Analyte Concentrations: Undetectable Luteinizing Hormone in a Precocious Puberty Evaluation. J Appl Lab Med 2020; 6:774-778. [PMID: 32995834 DOI: 10.1093/jalm/jfaa101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/01/2020] [Indexed: 11/14/2022]
Affiliation(s)
- Eric D Carlsen
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jacob A Smith
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sarah E Wheeler
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.,Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Octavia M Peck Palmer
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.,Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
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13
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Carlsen ED, Smith JA, Tamama K. Utilization of GC-MS to Confirm Etiology in a Case of New-Onset Coagulopathy. J Appl Lab Med 2018; 3:319-323. [PMID: 33636949 DOI: 10.1373/jalm.2018.026005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/07/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Eric D Carlsen
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA.,Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA
| | - Jacob A Smith
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA.,Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA
| | - Kenichi Tamama
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA.,Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA.,Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
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14
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Lopez LV, Bhattacharyya S, Carlsen ED, Bartlett D, Rao UNM. NF2 and ATRX gene copy number losses on a case of ovarian ependymoma. Hum Pathol 2018; 83:204-211. [PMID: 29944970 DOI: 10.1016/j.humpath.2018.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/21/2018] [Accepted: 06/08/2018] [Indexed: 10/28/2022]
Abstract
Ovarian ependymomas are rare glial neoplasms that typically occur in women on their third to fourth decades of life. They are histologically similar to ependymomas of the central nervous system but may have a broader immunophenotype. We describe a 27-year-old woman who presented to the emergency department with a 3-week history of cough and shortness of breath. Further workup disclosed a left pelvic mass and extensive intra-abdominal metastases. Pathology revealed sheets of monomorphic cells within a fibrillary stroma, papillary projections, true ependymal rosettes, and pseudorosettes consistent with an ependymoma of ovarian origin. Next-generation sequencing showed ATRX and NF2 copy number losses. Fluorescence in situ hybridization for EWSR1 demonstrated monosomy of 22q in greater than 90% of cells. These molecular alterations have not been previously reported in ovarian or extra-central nervous system ependymomas.
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Affiliation(s)
- Liurka V Lopez
- Bone and Soft Tissue Pathology Department, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PA 15232, USA.
| | - Siddharth Bhattacharyya
- Molecular Anatomic Pathology Department, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
| | - Eric D Carlsen
- Department of Pathology, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA 15213, USA.
| | - David Bartlett
- Department of Surgical Oncology, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PA 15232, USA.
| | - Uma N M Rao
- Bone and Soft Tissue Pathology Department, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PA 15232, USA.
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15
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Chen F, Cao A, Yao S, Evans-Marin HL, Liu H, Wu W, Carlsen ED, Dann SM, Soong L, Sun J, Zhao Q, Cong Y. mTOR Mediates IL-23 Induction of Neutrophil IL-17 and IL-22 Production. J Immunol 2016; 196:4390-9. [PMID: 27067005 PMCID: PMC4868807 DOI: 10.4049/jimmunol.1501541] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 03/11/2016] [Indexed: 12/31/2022]
Abstract
It has been shown recently that neutrophils are able to produce IL-22 and IL-17, which differentially regulate the pathogenesis of inflammatory bowel disease. However, it is still largely unknown how the neutrophil production of IL-22 and IL-17 is regulated, and their role in the pathogenesis of inflammatory bowel disease. In this study, we found that IL-23 promoted neutrophil production of IL-17 and IL-22. IL-23 stimulated the neutrophil expression of IL-23R as well as rorc and ahr. Retinoid acid receptor-related orphan receptor γ t and aryl-hydrocarbon receptor differentially regulated IL-23 induction of neutrophil IL-17 and IL-22. In addition, IL-23 induced the activation of mTOR in neutrophils. Blockade of the mTOR pathway inhibited IL-23-induced expression of rorc and ahr, as well as IL-17 and IL-22 production. By using a microbiota Ag-specific T cell-mediated colitis model, we demonstrated that depletion of neutrophils, as well as blockade of IL-22, resulted in a significant increase in the severity of colitis, thereby indicating a protective role of neutrophils and IL-22 in chronic colitis. Collectively, our data revealed that neutrophils negatively regulate microbiota Ag-specific T cell induction of colitis, and IL-23 induces neutrophil production of IL-22 and IL-17 through induction of rorc and ahr, which is mediated by the mTOR pathway.
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MESH Headings
- Animals
- Cecum/pathology
- Cell Differentiation
- Colitis/immunology
- Colitis/pathology
- Colon/pathology
- Interleukin-17/biosynthesis
- Interleukin-23/metabolism
- Interleukin-23/pharmacology
- Interleukins/biosynthesis
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Neutrophils/metabolism
- Nuclear Receptor Subfamily 1, Group F, Member 3/genetics
- Nuclear Receptor Subfamily 1, Group F, Member 3/metabolism
- Phosphatidylinositol 3-Kinases/metabolism
- Receptors, Aryl Hydrocarbon/genetics
- Receptors, Aryl Hydrocarbon/metabolism
- Receptors, Interleukin/genetics
- Receptors, Interleukin/metabolism
- Signal Transduction
- TOR Serine-Threonine Kinases/genetics
- Th17 Cells/immunology
- Interleukin-22
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Affiliation(s)
- Feidi Chen
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555
| | - Anthony Cao
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555
| | - Suxia Yao
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555
| | - Heather L Evans-Marin
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555
| | - Han Liu
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555; Department of Gastroenterology, The Qilu Hospital, Shandong University, Shandong 250012, China
| | - Wei Wu
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555; Department of Gastroenterology, The Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China
| | - Eric D Carlsen
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555; Department of Medicine, University of Texas Medical Branch, Galveston, TX 77555; and
| | - Sara M Dann
- Department of Medicine, University of Texas Medical Branch, Galveston, TX 77555; and
| | - Lynn Soong
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555
| | - Jiaren Sun
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555
| | | | - Yingzi Cong
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555;
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16
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Carlsen ED, Liang Y, Shelite TR, Walker DH, Melby PC, Soong L. Permissive and protective roles for neutrophils in leishmaniasis. Clin Exp Immunol 2015; 182:109-18. [PMID: 26126690 DOI: 10.1111/cei.12674] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2015] [Indexed: 12/11/2022] Open
Abstract
Leishmania parasites are the causative agents of leishmaniasis, a neglected tropical disease that causes substantial morbidity and considerable mortality in many developing areas of the world. Recent estimates suggest that roughly 10 million people suffer from cutaneous leishmaniasis (CL), and approximately 76,000 are afflicted with visceral leishmaniasis (VL), which is universally fatal without treatment. Efforts to develop therapeutics and vaccines have been greatly hampered by an incomplete understanding of the parasite's biology and a lack of clear protective correlates that must be met in order to achieve immunity. Although parasites grow and divide preferentially in macrophages, a number of other cell types interact with and internalize Leishmania parasites, including monocytes, dendritic cells and neutrophils. Neutrophils appear to be especially important shortly after parasites are introduced into the skin, and may serve a dual protective and permissive role during the establishment of infection. Curiously, neutrophil recruitment to the site of infection appears to continue into the chronic phase of disease, which may persist for many years. The immunological impact of these cells during chronic leishmaniasis is unclear at this time. In this review we discuss the ways in which neutrophils have been observed to prevent and promote the establishment of infection, examine the role of anti-neutrophil antibodies in mouse models of leishmaniasis and consider recent findings that neutrophils may play a previously unrecognized role in influencing chronic parasite persistence.
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Affiliation(s)
- E D Carlsen
- Department of Internal Medicine, Division of Infectious Diseases, MD-PhD Combined Degree Program.,Department of Microbiology and Immunology
| | - Y Liang
- Department of Microbiology and Immunology
| | | | | | - P C Melby
- Department of Microbiology and Immunology.,Department of Pathology.,Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - L Soong
- Department of Microbiology and Immunology.,Department of Pathology
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Carlsen ED, Jie Z, Liang Y, Henard CA, Hay C, Sun J, de Matos Guedes H, Soong L. Interactions between Neutrophils and Leishmania braziliensis Amastigotes Facilitate Cell Activation and Parasite Clearance. J Innate Immun 2015; 7:354-63. [PMID: 25766649 PMCID: PMC4485586 DOI: 10.1159/000373923] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 01/08/2015] [Accepted: 01/08/2015] [Indexed: 01/14/2023] Open
Abstract
Leishmania braziliensis and Leishmania amazonensis are both causative agents of cutaneous leishmaniasis in South America. However, patient prognosis and the host immune response differ considerably depending on the infecting parasite species. The mechanisms underlying these differences appear to be multifactorial, with both host and parasite components contributing to disease outcome. As neutrophils are a prominent component of the inflammatory infiltrate in chronic cutaneous, diffuse cutaneous and mucocutaneous lesions, we examined neutrophil activation and microbicidal activity against amastigotes of L. amazonensis and L. braziliensis. We found that murine neutrophils internalized L. braziliensis amastigotes with greater efficiency than did L. amazonensis amastigotes. Additionally, L. braziliensis infection was a potent trigger for neutrophil activation, oxidative burst, degranulation and the production of interleukin (IL)-22 and IL-10, while L. amazonensis amastigotes poorly induced these responses. Finally, neutrophils were able to kill L. braziliensis amastigotes, especially when cells were activated with phorbol myristate acetate. L. amazonensis amastigotes, however, were highly resistant to neutrophil microbicidal mechanisms. This study reveals, for the first time, differential neutrophil responsiveness to distinct species of Leishmania amastigotes and highlights the complexity of neutrophil-amastigote interactions during chronic leishmaniasis.
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Affiliation(s)
- Eric D. Carlsen
- MD-PhD Combined Degree Program, University of Texas Medical Branch, Galveston, Tex., USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Tex., USA
| | - Zuliang Jie
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Tex., USA
| | - Yuejin Liang
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Tex., USA
| | - Calvin A. Henard
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Tex., USA
| | - Christie Hay
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Tex., USA
| | - Jiaren Sun
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Tex., USA
| | - Herbert de Matos Guedes
- Laboratório de Inflamação, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Polo avançado de Xerém, Rio de Janeiro, Brazil
| | - Lynn Soong
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Tex., USA
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Henard CA, Carlsen ED, Hay C, Kima PE, Soong L. Leishmania amazonensis amastigotes highly express a tryparedoxin peroxidase isoform that increases parasite resistance to macrophage antimicrobial defenses and fosters parasite virulence. PLoS Negl Trop Dis 2014; 8:e3000. [PMID: 25033301 PMCID: PMC4102420 DOI: 10.1371/journal.pntd.0003000] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [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: 10/21/2013] [Accepted: 05/31/2014] [Indexed: 12/21/2022] Open
Abstract
Professional phagocytes generate a myriad of antimicrobial molecules to kill invading microorganisms, of which nitrogen oxides are integral in controlling the obligate intracellular pathogen Leishmania. Although reactive nitrogen species produced by the inducible nitric oxide synthase (iNOS) can promote the clearance of intracellular parasites, some Leishmania species/stages are relatively resistant to iNOS-mediated antimicrobial activity. The underlying mechanism for this resistance remains largely uncharacterized. Here, we show that the amastigote form of L. amazonensis is hyper-resistant to the antimicrobial actions of cytokine-activated murine and human macrophages as compared to its promastigote counterpart. Amastigotes exhibit a marked ability to directly counter the cytotoxicity of peroxynitrite (ONOO−), a leishmanicidal oxidant that is generated during infection through the combined enzymatic activities of NADPH oxidase and iNOS. The enhanced antinitrosative defense of amastigotes correlates with the increased expression of a tryparedoxin peroxidase (TXNPx) isoform that is also upregulated in response to iNOS enzymatic activity within infected macrophages. Accordingly, ectopic over-expression of the TXNPx isoform by L. amazonensis promastigotes significantly enhances parasite resistance against ONOO− cytotoxicity. Moreover, TXNPx-overexpressing parasites exhibit greater intra-macrophage survival, and increased parasite growth and lesion development in a murine model of leishmaniasis. Our investigations indicate that TXNPx isoforms contribute to Leishmania's ability to adapt to and antagonize the hostile microenvironment of cytokine-activated macrophages, and provide a mechanistic explanation for persistent infection in experimental and human leishmaniasis. Pathogens of the genus Leishmania are the causative agents of leishmaniasis, a neglected tropical disease responsible for significant morbidity and mortality worldwide. Although it is well accepted that host-derived leishmanicidal molecules mediate resolution of Leishmania infection, some Leishmania species/stages are relatively resistant to host cell antimicrobial activity. These intracellular pathogens have developed evasive strategies to subvert host antimicrobials, and promote pathogen survival within the harsh intracellular environment. However, the underlying mechanisms remain largely uncharacterized. Here, we show that L. amazonensis, an agent of persistent infection in humans and non-healing skin lesions in mice, antagonize macrophage antimicrobial activity. The superb ability of the amastigote form to survive within host cells is related to its increased expression of a tryparedoxin peroxidase isoform that confers resistance to the cytotoxicity of host-derived antimicrobial molecules. Parasites induce higher expression of the TXNPx in response to iNOS activity during infection of macrophages, indicating that parasites can “sense” the microenvironment of host cells and regulate the expression of relevant virulence factors accordingly. Our investigations are consistent with a model by which Leishmania amastigotes utilize TXNPx to defend against host-derived molecules thereby promoting their intracellular survival and persistent infection.
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Affiliation(s)
- Calvin A. Henard
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Eric D. Carlsen
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
- M.D.-Ph.D. Combined Degree Program, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Christie Hay
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Peter E. Kima
- Department of Microbiology and Cell Science, University of Florida, Gainesville, Florida, United States of America
| | - Lynn Soong
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
- * E-mail:
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Aguilar-Valenzuela R, Carlsen ED, Liang Y, Soong L, Sun J. Hepatocyte growth factor in dampening liver immune-mediated pathology in acute viral hepatitis without compromising antiviral activity. J Gastroenterol Hepatol 2014; 29:878-86. [PMID: 24224701 PMCID: PMC3983911 DOI: 10.1111/jgh.12456] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2013] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIM Hepatocyte growth factor (HGF) is a pleiotropic cytokine related with cell proliferation and survival; however, its role in viral hepatitis is not elucidated. In this study, we studied HGF immune role in viral hepatitis. METHODS Mice received hydrodynamically delivered HGF plasmid or control plasmid and then infected with adenovirus, and parameters of immune-mediated liver damage were evaluated. We studied dendritic cell (DC) activation in the presence of HGF. T cells collected from infected mice were restimulated with virally infected DC to measure cytokine production in vitro. RESULTS HGF ameliorated the liver inflammation during viral hepatitis as alanine transferase, intrahepatic lymphocytes, and splenocyte counts were diminished by HGF. Lower histological scores of liver pathology were observed in the HGF group. DC from the HGF group expressed reduced CD40. The hepatic expression and serum concentration of IL-12p40 were diminished in HGF-transfected mice. In vitro experiments with DC confirmed that HGF diminished CD40 expression and IL-12p40 production. The expression and serum levels of IFN-γ, IL-6 and CXCL9 were significantly decreased in the HGF group. HGF overexpression diminished the expression and concentration of IL-10 and TGF-β. The frequency of PD-1(+) Tim-3(+) in CD8 T cells was decreased by HGF overexpression. Moreover, T cells in the HGF group at day 14 secreted more IFN-γ and TNF-α than those in the control group when restimulated with virally infected DC. CONCLUSION HGF modulated DC activation and T cell priming, thereby limiting the immune-mediated damage in the liver. However, viral clearance was not compromised by HGF.
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Affiliation(s)
- Renan Aguilar-Valenzuela
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas, 77555-1070, USA
| | - Eric D. Carlsen
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas, 77555-1070, USA
| | - Yuejin Liang
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas, 77555-1070, USA
| | - Lynn Soong
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas, 77555-1070, USA,Department of Pathology, The University of Texas Medical Branch, Galveston, Texas 77555, USA
| | - Jiaren Sun
- Department of Microbiology and Immunology, The University of Texas Medical Branch, 301 University Boulevard, Galveston, Texas, 77555-1070, USA
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Xue X, Cao AT, Cao X, Yao S, Carlsen ED, Soong L, Liu CG, Liu X, Liu Z, Duck LW, Elson CO, Cong Y. Downregulation of microRNA-107 in intestinal CD11c(+) myeloid cells in response to microbiota and proinflammatory cytokines increases IL-23p19 expression. Eur J Immunol 2014; 44:673-82. [PMID: 24293139 DOI: 10.1002/eji.201343717] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 10/30/2013] [Accepted: 11/22/2013] [Indexed: 12/31/2022]
Abstract
Commensal flora plays an important role in the development of the mucosal immune system and in maintaining intestinal homeostasis. However, the mechanisms involved in regulation of host-microbiota interaction are still not completely understood. In this study, we examined how microbiota and intestinal inflammatory conditions regulate host microRNA expression and observed lower microRNA-107 (miR-107) expression in the inflamed intestines of colitic mice, compared with that in normal control mice. miR-107 was predominantly reduced in epithelial cells and CD11c(+) myeloid cells including dendritic cells and macrophages in the inflamed intestines. We demonstrate that IL-6, IFN-γ, and TNF-α downregulated, whereas TGF-β promoted, miR-107 expression. In addition, miR-107 expression was higher in the intestines of germ-free mice than in mice housed under specific pathogen-free conditions, and the presence of microbiota downregulated miR-107 expression in DCs and macrophages in a MyD88- and NF-κB-dependent manner. We determined that the ectopic expression of miR-107 specifically repressed the expression of IL-23p19, a key molecule in innate immune responses to commensal bacteria. We concluded that regulation of miR-107 by intestinal microbiota and proinflammatory cytokine serve as an important pathway for maintaining intestinal homeostasis.
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Affiliation(s)
- Xiaochang Xue
- Department of Microbiology and Immunology, The University of Texas Medical Branch, Galveston, TX, USA; Department of Biopharmaceutics, School of Pharmacy, Fourth Military Medical University, Xi'an, China
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Eaves-Pyles T, Patel J, Arigi E, Cong Y, Cao A, Garg N, Dhiman M, Pyles RB, Arulanandam B, Miller AL, Popov VL, Soong L, Carlsen ED, Coletta C, Szabo C, Almeida IC. Immunomodulatory and antibacterial effects of cystatin 9 against Francisella tularensis. Mol Med 2013; 19:263-75. [PMID: 23922243 DOI: 10.2119/molmed.2013.00081] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 08/01/2013] [Indexed: 12/26/2022] Open
Abstract
Cystatin 9 (CST9) is a member of the type 2 cysteine protease inhibitor family, which has been shown to have immunomodulatory effects that restrain inflammation, but its functions against bacterial infections are unknown. Here, we report that purified human recombinant (r)CST9 protects against the deadly bacterium Francisella tularensis (Ft) in vitro and in vivo. Macrophages infected with the Ft human pathogen Schu 4 (S4), then given 50 pg of rCST9 exhibited significantly decreased intracellular bacterial replication and increased killing via preventing the escape of S4 from the phagosome. Further, rCST9 induced autophagy in macrophages via the regulation of the mammalian target of rapamycin (mTOR) signaling pathways. rCST9 promoted the upregulation of macrophage proteins involved in antiinflammation and antiapoptosis, while restraining proinflammatory-associated proteins. Interestingly, the viability and virulence of S4 also was decreased directly by rCST9. In a mouse model of Ft inhalation, rCST9 significantly decreased organ bacterial burden and improved survival, which was not accompanied by excessive cytokine secretion or subsequent immune cell migration. The current report is the first to show the immunomodulatory and antimicrobial functions of rCST9 against Ft. We hypothesize that the attenuation of inflammation by rCST9 may be exploited for therapeutic purposes during infection.
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Affiliation(s)
- Tonyia Eaves-Pyles
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas 77555, USA.
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Vargas-Inchaustegui DA, Espinosa D, Carlsen ED, Tulliano G, Pacheco R, Llanos-Cuentas A, Arevalo J, Soong L. The Expression of Inflammatory Mediators and its Association with the Susceptibility to Mucosal Leishmaniasis in Peru (136.6). The Journal of Immunology 2009. [DOI: 10.4049/jimmunol.182.supp.136.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Leishmania braziliensis can cause cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML) in humans, and the latter is characterized by excessive T- and B-cell responses. We hypothesized that conversion from CL to ML is partially due to an imbalanced production of proinflammatory and regulatory cytokines, leading to uncontrolled host responses to the parasites. To test this hypothesis, we first examined the -2518 SNP of the MCP-1 promoter because its G/G genotype is associated with autoimmune disorders and infectious diseases. We genotyped 142 Peruvian subjects (18 controls, 65 CL and 59 ML patients) using PCR-RFLP on genomic DNA. Our pilot studies suggested that ML patients showed a relatively frequency for the MCP-1 G/G genotype (28/62, 45%) than the A/A (9/22, 41%) or A/G genotypes (2/58, 38%), respectively. Using dot blot analysis, we detected higher levels of MCP-1, IFN-γ, IL-8, IP10, MIP-1β, -1d, and soluble TNF receptors in the sera of CL and ML patients as compared with the healthy controls. Additional quantitative studies confirmed that sera of ML patients contained significantly higher levels of IP-10, MIP-1β and sTNFRII when compared to CL and healthy controls. This study suggests that the over-production of inflammatory cytokines is a contributing factor to the pathogenesis of mucosal lesions. Studies are ongoing to define the sources of these inflammatory mediators.
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Affiliation(s)
| | - Diego Espinosa
- 2Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eric D. Carlsen
- 1Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas
| | - Gianfranco Tulliano
- 2Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rosa Pacheco
- 3Universidad Nacional de San Antonio Abad del Cusco, Cusco, Peru
| | | | - Jorge Arevalo
- 2Instituto de Medicina Tropical, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lynn Soong
- 1Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas
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