Preemptive administration of human αβ T cell receptor-targeting monoclonal antibody GZ-αβTCR potently abrogates aggressive graft-versus-host disease in vivo

GVHD, both acute and chronic, remains the major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. Thus, there is still a great need for therapeutic tools for the prevention and treatment of GVHD. Several biologics have shown promising results in salvage therapies but are attendant on an increased risk for opportunistic infections, lymphoproliferative disorders, and relapse. This is partly due to efficient T cell elimination that neither dissects alloreactive from non-alloreactive T cells nor considers functional and structural distinctiveness of pathogen- and malignancy-reactive γδ and iNKT T cells. A novel, humanized monoclonal antibody, GZ-αβTCR, specific for the human αβ T cell receptor, was evaluated in a xenogeneic GVHD model for its potential to prevent or ameliorate GVHD and prolong survival. We could show that GZ-αβTCR significantly attenuated clinical signs of GVHD and prolonged survival by preferential depletion of CD4 cells and the naïve T cell compartment, the trigger and driver of GVHD. In a regimen that included a preemptive dose, GZ-αβTCR treatment sufficiently abrogated GVHD. Importantly, GZ-αβTCR's specificity spared host cell-mediated immune competence of cell types other than αβT cells: namely γδT cells. GZ-αβTCR's outstanding capacity to prevent GVHD and ameliorate an ongoing GVHD while sparing immune cells other than αβT cells strongly recommends GZ-αβTCR for the prevention and treatment of acute GVHD in clinical settings.

Chronic graft-versus-host-disease in CD34(+)-humanized NSG mice is associated with human susceptibility HLA haplotypes for autoimmune disease

Chronic graft-versus-host disease (cGVHD) is a significant hurdle to long-term hematopoietic stem-cell transplantation success. Insights into the pathogenesis and mechanistical investigations of novel therapeutic strategies are limited as appropriate animal models are missing. The immunodeficient NSG mouse - when humanized with human bone marrow, fetal liver and thymus (BLT NSG) - is prone for cGVHD, yet mainly affects the skin. In contrast, the NSG mouse humanized exclusively with CD34(+)-selected, CD3(+)-depleted stem cells (CD34(+)NSG) has neither been described for acute nor chronic GVHD so far. This is the first report about the development of systemic autoimmune cGVHD ≥24 weeks post stem cell receipt involving lung, liver, skin, gingiva and intestine in two NSG cohorts humanized with CD34(+) grafts from different donors. Affected mice presented with sclerodermatous skin, fibrotic lung, severe hepatitis, and massive dental malformation/loss. CD4(+)-dominated, TH2-biased, bulky T-cell infiltrates featured highly skewed T cell receptor (TCR) repertoires, clonal expansions, and autoreactive TCRs. In affected tissues profibrotic IL-13 and -4 dominated over TH1 cytokines IFN-γ and TNF-α. Thus, the time point of manifestation and the phenotype match human systemic pleiotropic sclerodermatous GVHD. The CD34(+)NSG-model's intrinsic deficiency of thymus, thymus-derived regulatory T cells (nTreg) and B cells emphasizes the role of the genetic polymorphism and the cytokines in the pathogenesis of cGVHD. Importantly, the only factor discriminating diseased versus non-diseased CD34(+)NSG cohorts were two risk HLA haplotypes that in human mediate susceptibility for autoimmune disease (psoriasis). Thus, the CD34(+)NSG model may serve as a platform for addressing issues related to the pathophysiology and treatment of human autoimmunity and chronic GVHD.

Cancer-targeted IL-12 controls human rhabdomyosarcoma by senescence induction and myogenic differentiation

Stimulating the immune system to attack cancer is a promising approach, even for the control of advanced cancers. Several cytokines that promote interferon-γ-dominated immune responses show antitumor activity, with interleukin 12 (IL-12) being of major importance. Here, we used an antibody-IL-12 fusion protein (NHS-IL12) that binds histones of necrotic cells to treat human sarcoma in humanized mice. Following sarcoma engraftment, NHS-IL12 therapy was combined with either engineered IL-7 (FcIL-7) or IL-2 (IL-2MAB602) for continuous cytokine bioavailability. NHS-IL12 strongly induced innate and adaptive antitumor immunity when combined with IL-7 or IL-2. NHS-IL12 therapy significantly improved survival of sarcoma-bearing mice and caused long-term remissions when combined with IL-2. NHS-IL12 induced pronounced cancer cell senescence, as documented by strong expression of senescence-associated p16^INK4a and nuclear translocation of p-HP1γ, and permanent arrest of cancer cell proliferation. In addition, this cancer immunotherapy initiated the induction of myogenic differentiation, further promoting the hypothesis that efficient antitumor immunity includes mechanisms different from cytotoxicity for efficient cancer control in vivo.

Treatment of liver transplant graft-versus-host disease with antibodies against tumor necrosis factor-α

Acute graft-versus-host disease is uncommon after liver transplant. We recently treated a 60-year-old man with liver transplant for hepatocellular carcinoma. After the primary liver transplant graft did not function, revision liver transplant resulted in excellent function. Subsequently, the patient developed watery diarrhea, systemic inflammatory response syndrome, a skin rash on his limbs and trunk, and palmar erythema. Skin biopsy suggested viral exanthems consistent with cytomegalovirus. Despite treatment for cytomegalovirus, intestinal symptoms worsened. Analysis of peripheral blood with fluorescence-activated cell sorting showed a high proportion of T lymphocytes, with 5% to 10% T cells specific to the second donor, suggestive of graft-versus-host disease. Within 48 hours after beginning therapy with antibodies against tumor necrosis factor-α (infliximab), the skin rash disappeared and endoscopy showed slight improvement of the mucosal regeneration. However, despite antifungal prophylaxis with caspofungin, the patient developed angioinvasive pulmonary aspergillosis and multiple organ failure, and he died. In conclusion, typical clinical symptoms of graft-versus-host disease after liver transplant may include skin rash and gastrointestinal symptoms, and diagnosis may be confirmed by histologic examination and testing for blood chimerism. A consensus for the treatment of graft-versus-host disease still is lacking, but tumor necrosis factor-α is an encouraging target for therapy to decrease the symptoms of graft-versus-host disease and enable mucosal regeneration.

Histological characterization of appendectomy specimens with intraoperative appearance of vascular injection

BACKGROUND

Acute appendicitis frequently needs acute surgical intervention. Laparoscopic appendectomy (LA) and conventional open appendectomy (OA) are well established procedures, but appendectomy for intraoperative inconspicuous or vascular injected appendixes remains under debate because of potential postoperative morbidity. The aim of this study was to correlate intraoperative nonacute appendixes with histological and clinical outcome.

METHODS

Between 2005 and 2009, a total of 1,017 patients underwent OA or LA. A total of 1,005 patients were enrolled with inclusion criteria of suspicious acute appendicitis preoperatively. One hundred twenty-nine of 1,005 patients had intraoperative normal, vascular injected or chronic appendixes that were defined as nonacute appendicitis. Intraoperative findings were correlated with histological results and clinical outcome of patients.

RESULTS

Of 129 (12.8 %) of 1,005 patients with macroscopically nonacute appendicitis intraoperatively, 16.3 % had normal findings, 81.4 % vascular injection, and 2.3 % chronic alterations; and 94.6 % of nonacute appendixes had histopathological alterations: 38.9 % chronic, 14.0 % neurogenic, 26.4 % acute, 13.2 % phlegmonous, and 2.3 % malignant. Coproliths were found in 21.7 % of patients, most in vascular injected appendixes. Four of seven patients with histopathological normal appendixes had coproliths. Morbidity rate was 2.3 %, with no mortality.

CONCLUSIONS

Appendiceal resection for intraoperative nonacute appendixes should be recommended because of high incidence of histopathological findings with low morbidity. In particular, chronic and neurogenous alterations cannot be predicted clinically or verified by radiological examination, but may cause recurrent symptoms.

Adenocarcinoma arising in a cystic duplication of the small bowel: case report and review of literature

Enteric duplications are rare, but can occur anywhere along the digestive tract. Most of the patients become symptomatic in early childhood and only a few cases of adult patients have been reported in literature. Here we report a unique case of an adenocarcinoma arising in a coincidentally found cystic duplication of the small bowel.

Growth performance, gastrointestinal microbial activity, and nutrient digestibility in early-weaned pigs fed diets containing flaxseed and carbohydrase enzyme1,2

The effects of ground flaxseed (FS) and a multicarbohydrase enzyme (C) supplement on piglet performance, gastrointestinal microbial activity, and nutrient digestibility were investigated in a 28-d trial. The enzyme supplement provided 500 units of pectinase, 50 units of cellulase, 400 units of mannanase, 1,200 units of xylanase, 450 units of glucanase, and 45 units of galactanase per kilogram of diet. Ninety-six pigs were weaned at 17 d of age (BW, 6.1 +/- 0.4 kg, mean +/- SD) and assigned to treatments based on a 2 x 2 factorial arrangement in a completely randomized design, with 6 pens per diet (4 pigs per pen). The diets contained wheat, barley, peas, soybean meal, and canola meal with 0 or 12% FS, and were fed without or with C. Flaxseed was included by changing the levels of the other ingredients to balance the diets for DE and nutrients. Diets had similar nutrient contents and met the NRC (1998) nutrient specifications, with the exception of DE, CP, and AA, which were 95, 94, and 97% of the NRC requirements, respectively. Diets were fed in a 2-phase feeding program (2 wk/phase). Feed intake and BW were measured weekly, and 1 pig per pen with a BW nearest the pen average was bled weekly to evaluate plasma urea nitrogen. On d 28, fresh fecal samples were collected from each pen and 1 pig per pen with a BW nearest the pen average was killed to evaluate intestinal microbial activity and nutrient digestibility. A dietary effect on piglet performance was observed only in wk 3, when the FS diets decreased (P = 0.005) ADG and G:F, tended to decrease (P = 0.070) ADFI, and increased (P = 0.027) plasma urea nitrogen. An interaction between FS and C was observed for ileal digesta viscosity (P = 0.045), such that C increased viscosity in the FS diet but had no effect in the non-FS diet. Flaxseed and C interacted to affect ileal ammonia content (P = 0.049), such that in the absence of FS, pigs fed the diet with C had lower ammonia than those on the diet without C. Flaxseed and C affected other ileal parameters independently. Pigs fed the FS diets had decreased (P = 0.003 to 0.033) anaerobic spore counts, organic acid, DM, CP, and nonstarch polysaccharide (NSP) digestibility compared with pigs fed the non-FS diets, whereas pigs fed the C-supplemented diets had greater (P = 0.009 to 0.061) lactobacilli counts, lactate, DM, and NSP digestibility than pigs fed the unsupplemented diets. In conclusion, FS reduced ileal microbial activity, nutrient digestibilities, and piglet performance in wk 3. The multicarbohydrase supplement increased ileal DM and NSP digestibilities as well as lactobacilli counts and lactate.

Suitability of pea starch and calcium alginate as antimicrobial coatings on chicken skin

The effect of incorporating trisodium phosphate (TSP) in pea starch (PS) and acidified sodium chlorite (ASC) in calcium alginate upon the antimicrobial activity of TSP and ASC was studied against a 3-strain cocktail of Salmonella inoculated on chicken skin. The influence of polymer coating concentration on skin pH, coating-skin adhesion, and coating absorption upon antimicrobial performance were investigated. Aqueous solutions of 0.5 to 4.8% (wt/vol) PS were prepared with 10% (wt/vol) TSP (PS + TSP coating), and alginate + ASC coatings contained 1% (wt/vol) calcium chloride in 1,200 ppm of ASC mixed with an aqueous solution of 0.5, 1.0, or 1.5% (wt/vol) sodium alginate. Coating drops (10 microL) were placed on chicken skin thighs, and the angle formed by the tangent of the liquid surface at the skin interface (contact angle) was measured using a digital camera to assess coating-skin adhesion. Excised skins were mounted in a ring holder, and 5 mL of the coatings was applied to the skin. Weight changes in the skins that were related to coating absorptiveness were recorded. The TSP dissolved in 3.5% PS and ASC in 1% alginate reduced Salmonella by 1.6 log cfu/g and 1.4 log cfu/g, respectively, within 24 h. These reductions were significantly greater than those caused by TSP or ASC alone in water for up to 120 h. In coatings, TSP and ASC caused significant elevation or reduction of skin surface pH for up to 120 h, respectively. The TSP destabilized PS with 88% of the coating having dripped from the skin 1 h later. Coatings with 0.5% PS were absorbed quickly by the skin and had high skin adhesion, whereas those with >3.5% PS had low skin adhesion and slow absorption. Alginate coatings with or without ASC were stable, and about 50% of the coating weight was retained at 120 h. The latter coatings appeared to have low absorptiveness because the skin gained approximately 1.0% of its weight within 60 min following application. These findings indicate that effects of the agents in coatings on skin pH, the extent of coating adhesion, and absorption may contribute to overall antimicrobial behaviors.

Performance responses and indicators of gastrointestinal health in early-weaned pigs fed low-protein amino acid-supplemented diets1

The effects of low-protein AA-supplemented diets on piglet performance, visceral organ mass, incidence of diarrhea, intestinal microbial population, and fermentation were studied in a 3-wk trial. After a 7-d adaptation period, 96 piglets (approximately 6.2 kg of initial BW) were assigned to 4 corn-wheat, soybean meal-based dietary treatments in a completely randomized design to give 6 replicate pens per treatment (n = 4 piglets per pen). The treatments were a control wheat-corn-soybean meal-based phase I diet containing 23% CP, or the same diet with CP reduced to 21%, 19%, or 17% and supplemented with crystalline AA to achieve equal standardized ileal digestible contents of Lys, Met plus Cys, Thr, and Trp in all diets. Diets were formulated to similar nutrient levels and provided ad libitum. Blood from all pigs was taken on d 0, 7, 14, and 21 for determining plasma urea N. Weekly feed intake, BW changes, and G:F were determined. On d 21, 2 pigs per pen were randomly selected and killed to determine small intestinal morphology, digesta pH and ammonia levels, and luminal microbial counts. Average daily feed intake, ADG, and G:F were not affected (P > 0.10) by reducing CP to 21%, but a reduction to 19% or 17% decreased ADFI (P < 0.001) and ADG (linear, P < 0.001; quadratic, P < 0.05) over the 3-wk study period. Reducing CP to 19% had no effect (P > 0.10) on G:F; however, this response criterion was decreased linearly (P < 0.001) over the 3-wk study period as dietary CP declined. Water usage was only numerically decreased (P > 0.10) with dietary CP reduction. Plasma urea N was decreased linearly (P < 0.01) with CP reduction. Reducing CP from 23 to 17% had a linear (P < 0.05) and cubic effect on stomach and liver weights, respectively. Although histological data showed some differences among diets, no distinct trend was evident. Ammonia N in ileal digesta was reduced linearly (P < 0.01) as dietary CP was decreased. With the exception of valeric acid, VFA levels in ileal digesta of piglets fed low-protein diets were generally lower (P < 0.05) compared with the control diet. Diet had no effect on intestinal microbial counts (P > 0.10). The results show that piglet performance may suffer when dietary CP is reduced by 4 or more percentage units from 23% and support the hypothesis that low-CP diets help maintain enteric health in pigs by lowering toxic microbial metabolites such as ammonia.

Survival of Escherichia coli O157:H7 in frozen foods: impact of the cold shock response

The survival of Escherichia coli O157:H7 strains in both frozen foods and trypticase soy broth (TSB) was investigated following cold shocking at 10 degrees C for 1.5 h. Using both trypticase soy agar (TSA) and violet red bile agar (VRBA) as recovery media, it was demonstrated that survival levels between cold shocked (CS) and non-cold shocked (NS) E. coli in ground beef or pork were not significantly different (P < or = 0.05). In contrast, cold shocking E. coli in either milk, whole egg or sausage resulted in a significant(P < or = 0.05) enhancement in survival. For milk, survival levels of CS E. coli, by 28 days of frozen storage, were 1.89 and 1.66 log10 cfu/ml higher on TSA and VRBA, respectively, when compared to NS cells. In egg these values were 0.64 and 1.31, while in sausage, values of 0.74 and 1.19 were obtained. In TSB (pH 7) survival of CS E. coli for some strains was about 3 log10 cfu/ml higher when compared to NS cells. Acidification of TSB (pH 5), however, appeared to negate the protective effects of the cold shock treatment. In milk, increasing the differential between the growth and cold shock temperatures resulted in higher numbers of survivors. In this regard the growth-cold shock temperature protocol giving optimum protection was 37-10 degrees C. In contrast, growth of E. coli at 20 degrees C followed by cold shocking at 10 degrees C did not result in any significant freeze protection. In addition, increased protection due to cold shocking was correlated with the appearance of a novel protein appearing at pI 4.8 following isoelectric focusing analysis, thus demonstrating an alteration of protein synthesis.

Recovery of foodborne microorganisms from potentially lethal radiation damage

A two-stage recovery protocol was examined for microorganisms following gamma irradiation in phosphate buffer at 0 degrees C. In the first stage, survivors were recovered on basal yeast extract agar and held at various temperatures suboptimal for their growth for 20 h (resuscitation protocol). In the second stage the survivors were incubated for an additional 24 h, but in this case at their optimum temperature for growth. Controls consisted of survivors which were not subjected to the resuscitation protocol (direct incubation at their optimum growth temperature). The ratio of survivors enumerated with and without the resuscitation protocol (control) at each specified temperature was used to formulate a recovery factor(RF). An RF was determined for each treatment dose. Results of this study indicated that the number of Escherichia coli, Salmonella serotype typhimurium and Brochothrix thermosphacta survivors increased following a resuscitation protocol (RF > 2.0). Overall, optimum resuscitation temperatures ranged from 14 to 22 degrees C. The extent of recovery also appeared dose dependent, with larger treatment doses giving rise to a higher RF. S. serotype typhimurium irradiated at 1.5 kGy exhibited the highest RF, 161, when resuscitated at 22 degrees C. Listeria monocytogenes, Yersinia enterocolitica, Staphylococcus aureus, Aeromonas hydrophila and Saccharomyces cerevisiae exhibited an RF < 2.0 regardless of resuscitation temperature. Results of this study indicated that the use of suboptimal holding temperatures as part of a recovery protocol may have advantages, especially with respect to the enumeration of E. coli and salmonellae survivors in irradiated foods such as poultry.

An assessment of behavioral aging in the Mongolian gerbil

Male Mongolian gerbils (Meriones unguiculatus) 14-54 months old (n = 77) were evaluated in a battery of psychomotor (open field, locomotor, and runwheel activity, rotorod performance) and learning (one-way active avoidance in a straight runway and in 14-unit T-maze performance) tests. Body weight and seizure activity were also monitored. According to linear regression analysis, runwheel activity decreased with age; and the number of errors in the 14-unit T-maze increased as a function of age (ps < 0.05). None of the other behavioral measures or body weight were significantly correlated with age. This gerbil strain (Tumblebrook Farms; West Brookfield, MA) tended to be very prone to seizures with 64% of the gerbils experiencing at least one seizure while being tested. Seizures tended to occur when the gerbil was exposed to a novel situation (e.g., initial weighing, placement on the rotorod). An age-related decline in some aspects of psychomotor and learning performance was observed, suggesting the gerbil as an additional mammalian model of aging. The high incidence of seizure activity presented a complicating and confounding variable to the interpretation of the results of the behavioral tests used in the present study. Interventions to control seizure activity (e.g., systematic, controlled breeding; adaptation to apparati) in this model will likely increase its viability as a mammalian model of aging.

Microwave plasmas for low-temperature dry sterilization

The use of microwave plasmas for dry sterilization has been investigated. The dry-sterilization process is a process similar to plasma etching. Bacteria and viruses can be killed by chemical reactions which disintegrate their bodies and remove them from the surface to be sterilized. The removal of bacteria or viruses from material surfaces is caused by the reaction of activated oxygen species in the plasma with hydrocarbon bonds of the cell wall of the bacteria or the capsid of the viruses. Preliminary experiments indicate that the low-temperature dry sterilization method is easy to use, requires much less time than other methods for sterilization, and is also non-toxic. It is feasible for use in the field of sterilization in dental and medical clinics.

Comparison of resistance of fungal spores to gamma and electron beam radiation

The irradiation sensitivity of fungal spores to either gamma or electron beam irradiation was evaluated in distilled water. The D10 (the dose required to reduce the initial population by 90%) gamma values ranged from 0.236 to 0.416 kGy and from 0.209 to 0.319 kGy for Penicillium and Aspergillus species, respectively. The D10 electron beam values ranged from 0.194 to 0.341 and from 0.198 to 0.243 kGy for Penicillium and Aspergillus species, respectively. Of the aspergilli species evaluated, only half exhibited significantly (P < 0.05) greater sensitivity to the electron beam treatment compared to gamma irradiation. Four of the six penicillia species evaluated also exhibited significantly (P < 0.05) higher sensitivities to electron beam treatment.

Use of electron beam irradiation for mold decontamination on cheddar cheese

Cheddar cheese slices, surface-inoculated with either Penicillium cyclopium or Aspergillus ochraceus spores, were vacuum packaged and irradiated using an electron beam accelerator. Following treatment at .21 and .52 kGy, the shelf-life of cheese containing P. cyclopium was extended by 3 and 5.5 d, respectively, in comparison with inoculated, untreated samples. Under similar treatment and storage conditions, cheese containing A. ochraceus exhibited average shelf-life extensions of 42.5 and 52.2 d, respectively. Increasing the postirradiation storage temperature to 15 degrees C reduced the shelf-life of cheese, especially with samples containing A. ochraceus. The lowest dose required to inactivate ca. 50 to 60 spores/cm2 of either A. ochraceus or P. cyclopium on the surface of cheese was ca. .42 and .95 kGy, respectively. Irradiation survival curves of A. ochraceus and P. cyclopium spores in cheese yielded average values (the dose required to reduce initial population by 90%) of .21 and .42 kGy, respectively.