1
|
Keller MD, Hanley PJ, Chi YY, Aguayo-Hiraldo P, Dvorak CC, Verneris MR, Kohn DB, Pai SY, Dávila Saldaña BJ, Hanisch B, Quigg TC, Adams RH, Dahlberg A, Chandrakasan S, Hasan H, Malvar J, Jensen-Wachspress MA, Lazarski CA, Sani G, Idso JM, Lang H, Chansky P, McCann CD, Tanna J, Abraham AA, Webb JL, Shibli A, Keating AK, Satwani P, Muranski P, Hall E, Eckrich MJ, Shereck E, Miller H, Mamcarz E, Agarwal R, De Oliveira SN, Vander Lugt MT, Ebens CL, Aquino VM, Bednarski JJ, Chu J, Parikh S, Whangbo J, Lionakis M, Zambidis ET, Gourdine E, Bollard CM, Pulsipher MA. Antiviral cellular therapy for enhancing T-cell reconstitution before or after hematopoietic stem cell transplantation (ACES): a two-arm, open label phase II interventional trial of pediatric patients with risk factor assessment. Nat Commun 2024; 15:3258. [PMID: 38637498 PMCID: PMC11026387 DOI: 10.1038/s41467-024-47057-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
Viral infections remain a major risk in immunocompromised pediatric patients, and virus-specific T cell (VST) therapy has been successful for treatment of refractory viral infections in prior studies. We performed a phase II multicenter study (NCT03475212) for the treatment of pediatric patients with inborn errors of immunity and/or post allogeneic hematopoietic stem cell transplant with refractory viral infections using partially-HLA matched VSTs targeting cytomegalovirus, Epstein-Barr virus, or adenovirus. Primary endpoints were feasibility, safety, and clinical responses (>1 log reduction in viremia at 28 days). Secondary endpoints were reconstitution of antiviral immunity and persistence of the infused VSTs. Suitable VST products were identified for 75 of 77 clinical queries. Clinical responses were achieved in 29 of 47 (62%) of patients post-HSCT including 73% of patients evaluable at 1-month post-infusion, meeting the primary efficacy endpoint (>52%). Secondary graft rejection occurred in one child following VST infusion as described in a companion article. Corticosteroids, graft-versus-host disease, transplant-associated thrombotic microangiopathy, and eculizumab treatment correlated with poor response, while uptrending absolute lymphocyte and CD8 T cell counts correlated with good response. This study highlights key clinical factors that impact response to VSTs and demonstrates the feasibility and efficacy of this therapy in pediatric HSCT.
Collapse
Affiliation(s)
- Michael D Keller
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
- Division of Allergy and Immunology, Children's National Hospital, Washington, DC, USA
- GW Cancer Center, George Washington University School of Medicine, Washington, DC, USA
| | - Patrick J Hanley
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
- GW Cancer Center, George Washington University School of Medicine, Washington, DC, USA
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Yueh-Yun Chi
- Department of Pediatrics and Preventative Medicine, University of Southern California, Los Angeles, CA, USA
| | - Paibel Aguayo-Hiraldo
- Cancer and blood disease institute, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Christopher C Dvorak
- Division of Pediatric Allergy, Immunology, and BMT, University of California San Francisco, San Francisco, CA, USA
| | - Michael R Verneris
- Department of Pediatrics and Division of Child's Cancer and Blood Disorders, Children's Hospital Colorado and University of Colorado, Denver, CO, USA
| | - Donald B Kohn
- Department of Microbiology, Immunology & Molecular Genetics and Department of Pediatrics David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sung-Yun Pai
- Immune Deficiency Cellular Therapy Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Blachy J Dávila Saldaña
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Benjamin Hanisch
- Division of Pediatric Infectious Diseases, Children's National Hospital, Washington, DC, USA
| | - Troy C Quigg
- Pediatric Blood & Bone Marrow Transplant and Cellular Therapy, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
| | - Roberta H Adams
- Center for Cancer and Blood Disorders, Phoenix Children's/Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Ann Dahlberg
- Clinical Research Division, Fred Hutch Cancer Center/Seattle Children's Hospital/University of Washington, Seattle, WA, USA
| | | | - Hasibul Hasan
- Cancer and blood disease institute, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Jemily Malvar
- Cancer and blood disease institute, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | | | - Christopher A Lazarski
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Gelina Sani
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
| | - John M Idso
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Haili Lang
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Pamela Chansky
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Chase D McCann
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Jay Tanna
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Allistair A Abraham
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
- GW Cancer Center, George Washington University School of Medicine, Washington, DC, USA
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Jennifer L Webb
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
- Division of Hematology, Children's National Hospital, Washington, DC, USA
| | - Abeer Shibli
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Amy K Keating
- Pediatric Stem Cell Transplant, Dana-Farber Cancer Institute and Boston Children's Hospital, Boston, MA, USA
| | - Prakash Satwani
- Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Columbia University Medical Center, New York, NY, USA
| | - Pawel Muranski
- Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Columbia University Medical Center, New York, NY, USA
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - Erin Hall
- Division of Pediatric Hematology/Oncology/Bone Marrow Transplant, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Michael J Eckrich
- Pediatric Transplant and Cellular Therapy, Levine Children's Hospital, Wake Forest School of Medicine, Charlotte, NC, USA
| | - Evan Shereck
- Division of Hematology and Oncology, Oregon Health & Science Univ, Portland, OR, USA
| | - Holly Miller
- Center for Cancer and Blood Disorders, Phoenix Children's/Mayo Clinic Arizona, Phoenix, AZ, USA
| | - Ewelina Mamcarz
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Rajni Agarwal
- Division of Pediatric Hematology/Oncology, Stem Cell Transplantation and Regenerative Medicine, Stanford University, Palo Alto, CA, USA
| | - Satiro N De Oliveira
- Division of Hematology/Oncology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Mark T Vander Lugt
- Division of Pediatric Hematology/Oncology/BMT, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA
| | - Christen L Ebens
- Division of Pediatric Blood and Marrow Transplant & Cellular Therapy, University of Minnesota MHealth Fairview Masonic Children's Hospital, Minneapolis, MI, USA
| | - Victor M Aquino
- Division of Pediatric Hematology/Oncology, University of Texas, Southwestern Medical Center Dallas, Dallas, TX, USA
| | - Jeffrey J Bednarski
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Washington University School of Medicine, St Louis, MO, USA
| | - Julia Chu
- Division of Pediatric Allergy, Immunology, and BMT, University of California San Francisco, San Francisco, CA, USA
| | - Suhag Parikh
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Jennifer Whangbo
- Cancer and Blood Disorders Center, Dana Farber Institute and Boston Children's Hospital, Boston, MA, USA
| | - Michail Lionakis
- Laboratory of Clinical Immunology & Microbiology, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Elias T Zambidis
- Pediatric Blood and Marrow Transplantation Program, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Gourdine
- Cancer and blood disease institute, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Catherine M Bollard
- Center for Cancer & Immunology Research, Children's National Hospital, Washington, DC, USA
- GW Cancer Center, George Washington University School of Medicine, Washington, DC, USA
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Michael A Pulsipher
- Division of Pediatric Hematology/Oncology, Intermountain Primary Children's Hospital, Huntsman Cancer Institute, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA.
| |
Collapse
|
2
|
Listl S, van Ardenne O, Grytten J, Gyrd-Hansen D, Lang H, Melo P, Nemeth O, Tubert-Jeannin S, Vassallo P, van Veen E, Vernazza C, Waitzberg R, Winkelmann J, Woods N. Prioritization, Incentives, and Resource Use for Sustainable Dentistry: The EU PRUDENT Project. JDR Clin Trans Res 2024; 9:180-184. [PMID: 37486021 PMCID: PMC10943613 DOI: 10.1177/23800844231189485] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
KNOWLEDGE TRANSFER STATEMENT The EU PRUDENT project aims to enhance the financing of oral health systems through novel evidence and implementation of better financing solutions together with citizens, patients, providers, and policy makers. The multicountry nature of the project offers unique windows of opportunity for rapid learning and improving within and across various contexts. PRUDENT is anticipated to strengthen capacities for better oral care financing in the EU and worldwide.
Collapse
Affiliation(s)
- S. Listl
- Radboud University Medical Center, Radboud Institute of Health Sciences (RIHS), Department of Dentistry, Quality and Safety of Oral Healthcare, Nijmegen, Gelderland, the Netherlands
| | | | - J. Grytten
- Department of Community Dentistry, University of Oslo, Oslo, Norway
| | - D. Gyrd-Hansen
- Danish Center for Health Economics, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - H. Lang
- Estonian Dental Association, Tallinn, Estonia
| | - P. Melo
- Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - O. Nemeth
- Department of Community Dentistry, Semmelweis University, Budapest, Hungary
| | - S. Tubert-Jeannin
- University of Clermont-Auvergne, UFR d’Odontologie, Clermont-Ferrand, France
| | - P. Vassallo
- Ministry for Health, Health Promotion and Disease Prevention Directorate, Valetta, Malta
| | | | - C. Vernazza
- Newcastle University, School of Dental Sciences, Newcastle, Tyne and Wear, UK
| | - R. Waitzberg
- Department of Health Care Management, Technische Universität Berlin, Faculty of Economics & Management, Berlin, Germany
| | - J. Winkelmann
- European Observatory on Health Systems and Policies, Brussels, Belgium
| | - N. Woods
- University College Cork, Cork University Business School, Centre for Policy Studies, Cork, Ireland
| |
Collapse
|
3
|
Keller MD, Schattgen SA, Chandrakasan S, Allen EK, Jensen-Wachspress MA, Lazarski CA, Qayed M, Lang H, Hanley PJ, Tanna J, Pai SY, Parikh S, Berger SI, Gottschalk S, Pulsipher MA, Thomas PG, Bollard CM. Secondary bone marrow graft loss after third-party virus-specific T cell infusion: Case report of a rare complication. Nat Commun 2024; 15:2749. [PMID: 38553461 PMCID: PMC10980733 DOI: 10.1038/s41467-024-47056-3] [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: 09/19/2022] [Accepted: 12/20/2023] [Indexed: 04/02/2024] Open
Abstract
Virus-specific T cells (VST) from partially-HLA matched donors have been effective for treatment of refractory viral infections in immunocompromised patients in prior studies with a good safety profile, but rare adverse events have been described. Here we describe a unique and severe adverse event of VST therapy in an infant with severe combined immunodeficiency, who receives, as part of a clinical trial (NCT03475212), third party VSTs for treating cytomegalovirus viremia following bone marrow transplantation. At one-month post-VST infusion, rejection of graft and reversal of chimerism is observed, as is an expansion of T cells exclusively from the VST donor. Single-cell gene expression and T cell receptor profiling demonstrate a narrow repertoire of predominantly activated CD4+ T cells in the recipient at the time of rejection, with the repertoire overlapping more with that of peripheral blood from VST donor than the infused VST product. This case thus demonstrates a rare but serious side effect of VST therapy.
Collapse
Affiliation(s)
- Michael D Keller
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
- Division of Allergy and Immunology, Children's National Hospital, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
| | - Stefan A Schattgen
- Department of Immunology, St Jude Children's Research Hospital, Memphis, TN, USA
| | | | - E Kaitlynn Allen
- Department of Immunology, St Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Christopher A Lazarski
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Muna Qayed
- Aflac Cancer and Blood Disorders Center, Children's Hospital of Atlanta, Atlanta, GA, USA
| | - Haili Lang
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Patrick J Hanley
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Jay Tanna
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Sung-Yun Pai
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Suhag Parikh
- Aflac Cancer and Blood Disorders Center, Children's Hospital of Atlanta, Atlanta, GA, USA
| | - Seth I Berger
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC, USA
| | - Stephen Gottschalk
- Department of Immunology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael A Pulsipher
- Division of Pediatric Hematology/Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Paul G Thomas
- Department of Immunology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Catherine M Bollard
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA.
- GW Cancer Center, George Washington University, Washington, DC, USA.
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA.
| |
Collapse
|
4
|
Ye Z, Li X, Lang H, Fang Y. Income inequality and depressive symptoms among Chinese adults: a quasi-experimental study. Public Health 2024; 226:58-65. [PMID: 38007842 DOI: 10.1016/j.puhe.2023.10.042] [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: 07/06/2023] [Revised: 10/08/2023] [Accepted: 10/25/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE There is a lack of causal evidence on the impact of income inequality on depressive symptoms. The impact of China's Targeted Poverty Alleviation (TPA) policy on depressive symptoms is also unclear. Using a quasi-experimental design, this study aims to investigate the causal effects of TPA and income inequality on depressive symptoms among Chinese adults. STUDY DESIGN This is a population-based study. METHODS Three waves (2012, 2016, and 2018) of the China Family Panel Studies (CFPS), a nationally representative sample of China, were included in this study. We performed difference-in-difference (DID) models to assess the effect of TPA and income inequality on depressive symptoms. We further conducted the mixed effect models to examine the impact of income inequality on depressive symptoms. The study considered a range of spatial factors and spatial splines to address spatial autocorrelations. RESULTS This study included valid measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D-8] score) from 14,442 adults of CFPS. The DID results indicated that at the provincial level, the CES-D-8 score of the TPA treatment group was on average 0.570 (95% confidence interval [CI]: 0.358-0.783) less than the control group. Furthermore, a 0.1 increase in Gini index would lead to a 0.256 (95% CI: 0.064-0.448) increase in CES-D-8 score. The mixed effect model showed that income inequality was a risk factor for depressive symptoms at the provincial level (excess risk = 5.602% [95% CI: 3.047%-8.219%]). CONCLUSIONS Our findings suggest that income inequality adversely affects mental health, but China's Targeted Poverty Alleviation improves the mental health of the Chinese population.
Collapse
Affiliation(s)
- Z Ye
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - X Li
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - H Lang
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Y Fang
- State Key Laboratory of Molecular Vaccine and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China; Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China; National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China.
| |
Collapse
|
5
|
Huettl F, Lang H. [Surgery for primary splenic tumors and metastases of the spleen]. Chirurgie (Heidelb) 2023; 94:994-999. [PMID: 37946024 DOI: 10.1007/s00104-023-01978-8] [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] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/12/2023]
Abstract
The correct indications for surgical treatment of primary splenic tumors as well as metastases of the spleen are challenging due to the rarity of the various entities. Primary solid splenic tumors include benign lesions, such as hemangiomas, hamartomas and sclerosing angiomatous nodular transformation (SANT) of the spleen. In these cases, surgical treatment is indicated only in the case of inconclusive imaging and after careful consideration of the risk-benefit ratio, even in the case of pronounced symptoms. In contrast, primary angiosarcoma or undifferentiated pleomorphic sarcoma as highly malignant tumors represent an urgent indication for surgery. Although more frequent than primary splenic malignancies, secondary splenic tumors are also not that frequent. Solitary splenic metastases are rare; however, from an oncological point of view they can be treated by resection. In the case of oligometastasis with splenic involvement, splenectomy is used only as part of a palliative concept in cases of pronounced symptoms or in the context of cytoreductive surgery. In general, the laparoscopic approach is to be preferred when the operation is technically feasible as it is associated with fewer pulmonary and infectious complications and a shorter hospital stay. In addition, to reduce the risk of severe infections after splenectomy, the option of partial splenectomy should be considered, especially for benign lesions. A thorough informing of the patient regarding both intraoperative and perioperative risks as well as potential long-term sequelae, especially severe infectious diseases, is an essential component of informed consent before surgery.
Collapse
Affiliation(s)
- F Huettl
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - H Lang
- Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| |
Collapse
|
6
|
Schmidt BMW, Lang H, Tian ZJ, Becker S, Melk A. Cytokine removal: do not ban it, but learn in whom and when to use it. Crit Care 2023; 27:444. [PMID: 37974262 PMCID: PMC10655290 DOI: 10.1186/s13054-023-04736-8] [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: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Affiliation(s)
- Bernhard M W Schmidt
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Strasse 1, 30655, Hannover, Germany.
| | - H Lang
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Strasse 1, 30655, Hannover, Germany
| | - Z J Tian
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Strasse 1, 30655, Hannover, Germany
| | - S Becker
- Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Strasse 1, 30655, Hannover, Germany
| | - A Melk
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Strasse 1, 30655, Hannover, Germany
| |
Collapse
|
7
|
Mann C, Jezycki T, Berlth F, Hadzijusufovic E, Uzun E, Mähringer-Kunz A, Lang H, Klöckner R, Grimminger PP. Effect of thoracic cage width on surgery time and postoperative outcome in minimally invasive esophagectomy. Surg Endosc 2023; 37:8301-8308. [PMID: 37679581 PMCID: PMC10615966 DOI: 10.1007/s00464-023-10340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/30/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION Minimally invasive esophagectomy (MIE) for esophageal cancer is a complex procedure that reduces postoperative morbidity in comparison to open approach. In this study, thoracic cage width as a factor to predict surgical difficulty in MIE was evaluated. METHODS All patients of our institution receiving either total MIE or robotic-assisted MIE (RAMIE) with intrathoracic anastomosis between February 2016 and April 2021 for esophageal cancer were included in this study. Right unilateral thoracic cage width on the level of vena azygos crossing the esophagus was measured by the horizontal distance between the esophagus and parietal pleura on preoperative computer tomography. Patients' data as well as operative and postoperative details were collected in a prospective database. Correlation between thoracic cage width with duration of the thoracic procedure and postoperative complication rates was analyzed. RESULTS Overall, 313 patients were eligible for this study. Thoracic width on vena azygos level ranged from 85 to 149 mm with a mean of 116.5 mm. In univariate analysis, a small thoracic width significantly correlated with longer duration of the thoracic procedure (p = 0.014). In multivariate analysis, small thoracic width and neoadjuvant therapy were identified as independent factors for long duration of the thoracic procedure (p = 0.006). Regarding postoperative complications, thoracic cage width was a significant risk factor for occurrence of postoperative pneumonia in the multivariate analysis (p = 0.045). Dividing the cohort into two groups of patients with narrow (≤ 107 mm, 19.5%) and wide thoraces (≥ 108 mm, 80.5%), the thoracic procedure was significantly prolonged by 17 min (204 min vs. 221 min, p = 0.014). CONCLUSION A small thoracic cage width is significantly correlated with longer operation time during thoracic phase of a MIE in Europe, which suggests increased surgical difficulty. Patients with small thoracic cage width may preferably be operated by MIE-experienced surgeons.
Collapse
Affiliation(s)
- C Mann
- Department of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany
| | - T Jezycki
- Department of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - F Berlth
- Department of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany
| | - E Hadzijusufovic
- Department of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany
| | - E Uzun
- Department of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany
| | - A Mähringer-Kunz
- Department of Diagnostic and Interventional Radiology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - H Lang
- Department of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany
| | - R Klöckner
- Department for Interventional Radiology, University Medical Center Lübeck, Lübeck, Germany
| | - P P Grimminger
- Department of General-, Visceral- and Transplantation Surgery, University Medical Center Mainz, Mainz, Germany.
| |
Collapse
|
8
|
Huber T, Boedecker C, Borchardt T, Vradelis L, Wachter N, Grimminger PP, Musholt TJ, Mädge S, Griemert EV, Heinrich S, Huettl F, Lang H. Education Team Time Out in Oncologic Visceral Surgery Optimizes Surgical Resident Training and Team Communication-Results of a Prospective Trial. J Surg Educ 2023; 80:1215-1220. [PMID: 37455191 DOI: 10.1016/j.jsurg.2023.06.026] [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] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/09/2023] [Accepted: 06/18/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Surgical education is highly dependent on intraoperative communication. Trainers must know the trainee's training level to ensure high-quality surgical training. A systematic preoperative dialogue (Educational Team Time Out, ETO) was established to discuss the steps of each surgical procedure. METHODS Over 6 months, ETO was performed within a time limit of 3 minutes. Digital surveys on the utility of ETO and its impact on performance were conducted immediately after surgery and at the end of the study period among the staff of the participating disciplines (trainer, trainee, surgical nursing staff, anaesthesiologists, and medical students). The number of surgical substeps performed was recorded and compared with the equivalent period one year earlier. RESULTS ETO was performed in 64 of the 103 eligible operations (62%). Liver resection (n = 37) was the most frequent procedure, followed by left-sided colorectal surgery (n = 12), partial pancreaticoduodenectomy (n = 6), right-sided hemicolectomies (n = 5), and thyroidectomies (n = 4). Anaesthesiologists most frequently reported that ETO had a direct impact on their work during surgery (90.9%). The influence scores were 46.8% for trainees, 8.8% for trainers, 53.3% for surgical nursing staff and 66.6% for medical students. During the implementation of ETO, a trend towards more assisted substeps in oncologic visceral surgery was seen compared to the corresponding period one year earlier (51% vs.40%; p = 0.11). CONCLUSION ETO leads to improved intraoperative communication and more performed substeps during complex procedures, which increases motivation and practical training. This concept can easily be implemented in all surgical specialties to improve surgical education.
Collapse
Affiliation(s)
- T Huber
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany.
| | - C Boedecker
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - T Borchardt
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - L Vradelis
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - N Wachter
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - P P Grimminger
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - T J Musholt
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - S Mädge
- Central OR Management, University Medical Center Mainz, Mainz, Germany
| | - E V Griemert
- Department of Anaesthesiology University Medical Center Mainz, Mainz, Germany
| | - S Heinrich
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - F Huettl
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - H Lang
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| |
Collapse
|
9
|
Jamaludin A, Kadir T, Zisserman A, McCall I, Williams FMK, Lang H, Buchanan E, Urban JPG, Fairbank JCT. ISSLS PRIZE in Clinical Science 2023: comparison of degenerative MRI features of the intervertebral disc between those with and without chronic low back pain. An exploratory study of two large female populations using automated annotation. Eur Spine J 2023; 32:1504-1516. [PMID: 36995419 DOI: 10.1007/s00586-023-07604-9] [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] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES The relationship of degeneration to symptoms has been questioned. MRI detects apparently similar disc degeneration and degenerative changes in subjects both with and without back pain. We aimed to overcome these problems by re-annotating MRIs from asymptomatic and symptomatics groups onto the same grading system. METHODS We analysed disc degeneration in pre-existing large MRI datasets. Their MRIs were all originally annotated on different scales. We re-annotated all MRIs independent of their initial grading system, using a verified, rapid automated MRI annotation system (SpineNet) which reported degeneration on the Pfirrmann (1-5) scale, and other degenerative features (herniation, endplate defects, marrow signs, spinal stenosis) as binary present/absent. We compared prevalence of degenerative features between symptomatics and asymptomatics. RESULTS Pfirrmann degeneration grades in relation to age and spinal level were very similar for the two independent groups of symptomatics over all ages and spinal levels. Severe degenerative changes were significantly more prevalent in discs of symptomatics than asymptomatics in the caudal but not the rostral lumbar discs in subjects < 60 years. We found high co-existence of degenerative features in both populations. Degeneration was minimal in around 30% of symptomatics < 50 years. CONCLUSIONS We confirmed age and disc level are significant in determining imaging differences between asymptomatic and symptomatic populations and should not be ignored. Automated analysis, by rapidly combining and comparing data from existing groups with MRIs and information on LBP, provides a way in which epidemiological and 'big data' analysis could be advanced without the expense of collecting new groups. LEVEL OF EVIDENCE I Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
Collapse
Affiliation(s)
- A Jamaludin
- Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK
| | - T Kadir
- Plexalis Ltd, 30 Upper High Street, Thame, OX9 3EZ, UK
| | - A Zisserman
- Department of Engineering Science, University of Oxford, Oxford, OX1 3PJ, UK
| | - I McCall
- Emeritus, Department of Radiology, Robert Jones and Agnes Hunt Hospital, Oswestry, SY10 7AG, UK
| | - F M K Williams
- Department of Twin Research and Genetic Epidemiology, King's College London, London, SE1 7EH, UK
| | - H Lang
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
| | - E Buchanan
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, OX3 7HE, UK
| | - J P G Urban
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, OX3 7LD, UK
| | - J C T Fairbank
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK.
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, OX3 7HE, UK.
| |
Collapse
|
10
|
Bonn EL, Rohrhofer A, Audebert FX, Lang H, Auer DL, Scholz KJ, Schuster P, Wenzel JJ, Hiller KA, Buchalla W, Gottsauner JM, Vielsmeier V, Schmidt B, Cieplik F. Efficacy of a Mouthwash Containing CHX and CPC in SARS-CoV-2-Positive Patients: A Randomized Controlled Clinical Trial. J Dent Res 2023; 102:608-615. [PMID: 36942423 PMCID: PMC10030878 DOI: 10.1177/00220345231156415] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Soon after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, preprocedural mouthwashes were recommended for temporarily reducing intraoral viral load and infectivity of individuals potentially infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in order to protect medical personnel. Particularly, the antiseptic cetylpyridinium chloride (CPC) has shown virucidal effects against SARS-CoV-2 in vitro. Therefore, the aim of this randomized controlled clinical trial was to investigate the efficacy of a commercially available mouthwash containing CPC and chlorhexidine digluconate (CHX) at 0.05% each in SARS-CoV-2-positive patients as compared to a placebo mouthwash. Sixty-one patients who tested positive for SARS-CoV-2 with onset of symptoms within the last 72 h were included in this study. Oropharyngeal specimens were taken at baseline, whereupon patients had to gargle mouth and throat with 20 mL test or placebo (0.9% NaCl) mouthwash for 60 s. After 30 min, further oropharyngeal specimens were collected. Viral load was analyzed by quantitative reverse transcriptase polymerase chain reaction, and infectivity of oropharyngeal specimens was analyzed by virus rescue in cell culture and quantified via determination of tissue culture infectious doses 50% (TCID50). Data were analyzed nonparametrically (α = 0.05). Viral load slightly but significantly decreased upon gargling in the test group (P = 0.0435) but not in the placebo group. Viral infectivity as measured by TCID50 also significantly decreased in the test group (P = 0.0313), whereas there was no significant effect but a trend in the placebo group. Furthermore, it was found that the specimens from patients with a vaccine booster exhibited significantly lower infectivity at baseline as compared to those without vaccine booster (P = 0.0231). This study indicates that a preprocedural mouthwash containing CPC and CHX could slightly but significantly reduce the viral load and infectivity in SARS-CoV-2-positive patients. Further studies are needed to corroborate these results and investigate whether the observed reductions in viral load and infectivity could translate into clinically useful effects in reducing COVID-19 transmission (German Clinical Trials Register DRKS00027812).
Collapse
Affiliation(s)
- E L Bonn
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - A Rohrhofer
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - F X Audebert
- Praxiszentrum Alte Mälzerei, Regensburg, Germany
| | - H Lang
- Praxiszentrum Alte Mälzerei, Regensburg, Germany
| | - D L Auer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - K J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - P Schuster
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - J J Wenzel
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - K-A Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - W Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - J M Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - V Vielsmeier
- Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - B Schmidt
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - F Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
11
|
Stolze T, Franke S, Haybaeck J, Moehler M, Grimminger PP, Lang H, Roth W, Gockel I, Kreuser N, Bläker H, Wittekind C, Lordick F, Vieth M, Veits L, Waidmann O, Lingohr P, Peitz U, Schildberg C, Kruschewski M, Vassos N, Goni E, Bruns CJ, Ridwelski K, Wolff S, Lippert H, Schumacher J, Malfertheiner P, Venerito M. Mismatch repair deficiency, chemotherapy and survival for resectable gastric cancer: an observational study from the German staR cohort and a meta-analysis. J Cancer Res Clin Oncol 2023; 149:1007-1017. [PMID: 35211781 PMCID: PMC9984318 DOI: 10.1007/s00432-022-03953-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/08/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE In a post hoc analysis of the MAGIC trial, patients with curatively resected gastric cancer (GC) and mismatch repair (MMR) deficiency (MMRd) had better median overall survival (OS) when treated with surgery alone but worse median OS when treated with additional chemotherapy. Further data are required to corroborate these findings. METHODS Between April 2013 and December 2018, 458 patients with curatively resected GC, including cancers of the esophagogastric junction Siewert type II and III, were identified in the German centers of the staR consortium. Tumor sections were assessed for expression of MLH1, MSH2, MSH6 and PMS2 by immunohistochemistry. The association between MMR status and survival was assessed. Similar studies published up to January 2021 were then identified in a MEDLINE search for a meta-analysis. RESULTS MMR-status and survival data were available for 223 patients (median age 66 years, 62.8% male), 23 patients were MMRd (10.3%). After matching for baseline clinical characteristics, median OS was not reached in any subgroup. Compared to perioperative chemotherapy, patients receiving surgery alone with MMRd and MMRp had a HR of 0.67 (95% CI 0.13-3.37, P = 0.63) and 1.44 (95% CI 0.66-3.13, P = 0.36), respectively. The meta-analysis included pooled data from 385 patients. Compared to perioperative chemotherapy, patients receiving surgery alone with MMRd had an improved OS with a HR of 0.36 (95% CI 0.14-0.91, P = 0.03), whereas those with MMRp had a HR of 1.18 (95% CI 0.89-1.58, P = 0.26). CONCLUSION Our data support a positive prognostic effect for MMRd in GC patients treated with surgery only and a differentially negative prognostic effect in patients treated with perioperative chemotherapy. MMR status determined by preoperative biopsies may be used as a predictive biomarker to select patients for perioperative chemotherapy in curatively resectable GC.
Collapse
Affiliation(s)
- T Stolze
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital Magdeburg, Magdeburg, Germany
| | - S Franke
- Institute of Pathology, Otto-von-Guericke University Hospital Magdeburg, Magdeburg, Germany
| | - J Haybaeck
- Institute of Pathology, Otto-von-Guericke University Hospital Magdeburg, Magdeburg, Germany.,Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria.,Diagnostic and Research Center for Molecular BioMedicine, Institute of Pathology, Medical University Graz, Graz, Austria
| | - M Moehler
- Department of Internal Medicine I, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - P P Grimminger
- Department of General, Visceral and Transplant Surgery, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - H Lang
- Department of General, Visceral and Transplant Surgery, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - W Roth
- Institute of Pathology, University Hospital Mainz, Mainz, Germany
| | - I Gockel
- Department of Medicine II and University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany
| | - N Kreuser
- Department of Medicine II and University Cancer Center Leipzig (UCCL), Leipzig University Medical Center, Leipzig, Germany
| | - H Bläker
- Institute of Pathology, University Hospital Leipzig, Leipzig, Germany
| | - C Wittekind
- Institute of Pathology, University Hospital Leipzig, Leipzig, Germany
| | - F Lordick
- University Cancer Center Leipzig, University Hospital Leipzig, Leipzig, Germany
| | - M Vieth
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
| | - L Veits
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, Klinikum Bayreuth, Bayreuth, Germany
| | - O Waidmann
- Department of Internal Medicine 1, Main Area Gastroenterology and Hepatology, University Hospital Frankfurt, Frankfurt am Main, Germany.,University Cancer Center, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - P Lingohr
- Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany
| | - U Peitz
- Department of Gastroenterology, Raphaelshospital, Münster, Germany
| | - C Schildberg
- Department of General and Visceral Surgery, Brandenburg, University Hospital of Visceral Surgery, Brandenburg, Germany
| | - M Kruschewski
- Department of General and Visceral Surgery, Hospital Frankfurt (Oder), Frankfurt (Oder), Germany
| | - N Vassos
- Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - E Goni
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
| | - C J Bruns
- Department of General, Tumor and Transplantation Surgery, University Hospital Cologne, Köln, Germany
| | - K Ridwelski
- Department of General and Visceral Surgery, Municipal Hospital, Magdeburg, Germany.,AN-Institute of Quality Assurance in Operative Medicine, Otto-von-Guericke University Hospital, Magdeburg, Germany
| | - S Wolff
- Department of General, Visceral, Vascular and Transplantation Surgery, Otto-von-Guericke University Hospital, Magdeburg, Germany
| | - H Lippert
- AN-Institute of Quality Assurance in Operative Medicine, Otto-von-Guericke University Hospital, Magdeburg, Germany.,Department of General, Visceral, Vascular and Transplantation Surgery, Otto-von-Guericke University Hospital, Magdeburg, Germany
| | - J Schumacher
- Human Genetics Center, Philipps University of Marburg, Marburg, Germany
| | - P Malfertheiner
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital Magdeburg, Magdeburg, Germany.,Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
| | - M Venerito
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital Magdeburg, Magdeburg, Germany. .,Department of Gastroenterology, Hepatology and Infectious Diseases, Medizinische Fakultät der Otto-Von-Guericke-Universität, Leipziger Straße 66, 39120, Magdeburg, Germany.
| |
Collapse
|
12
|
Chaudhry K, Geiger A, Dowlati E, Lang H, Sohai DK, Hwang EI, Lazarski CA, Yvon E, Holdhoff M, Jones R, Savoldo B, Cruz CRY, Bollard CM. Co Transducing B7H3 CAR-NK cells with the DNR preserves their cytolytic function against GBM in the presence of exogenous TGF-β. Mol Ther Methods Clin Dev 2022; 27:415-430. [PMID: 36381305 PMCID: PMC9661497 DOI: 10.1016/j.omtm.2022.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 03/04/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
Cord blood (CB)-derived natural killer (NK) cells that are genetically engineered to express a chimeric antigen receptor (CAR) are an attractive off-the-shelf therapy for the treatment of cancer, demonstrating a robust safety profile in vivo. For poor prognosis brain tumors such as glioblastoma multiforme (GBM), novel therapies are urgently needed. Although CAR-T cells demonstrate efficacy in preclinical GBM models, an off-the-shelf product may exhibit unwanted side effects like graft-versus-host disease. Hence, we developed an off-the-shelf CAR-NK cell approach using a B7H3 CAR and showed that CAR-transduced NK cells have robust cytolytic activity against GBM cells in vitro. However, transforming growth factor (TGF)-β within the tumor microenvironment has devastating effects on the cytolytic activity of both unmodified and CAR-transduced NK cells. To overcome this potent immune suppression, we demonstrated that co-transducing NK cells with a B7H3 CAR and a TGF-β dominant negative receptor (DNR) preserves cytolytic function in the presence of exogenous TGF-β. This study demonstrates that a novel DNR and CAR co-expression strategy may be a promising therapeutic for recalcitrant CNS tumors like GBM.
Collapse
Affiliation(s)
- Kajal Chaudhry
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, USA
| | - Ashley Geiger
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, USA
| | - Ehsan Dowlati
- Department of Neurosurgery, Georgetown University Medical Center, Washington, DC, USA
| | - Haili Lang
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, USA
| | - Danielle K. Sohai
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, USA
| | - Eugene I. Hwang
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, USA
| | - Christopher A. Lazarski
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, USA
| | - Eric Yvon
- GW Cancer Center, George Washington University, Washington, DC, USA
| | - Matthias Holdhoff
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | - Richard Jones
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | - Barbara Savoldo
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Conrad Russell Y. Cruz
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
- Corresponding author Conrad Russell Y. Cruz, Center for Cancer and Immunology Research, Children’s National Hospital, 111 Michigan Ave, NW, Washington, DC 20010, USA.
| | - Catherine M. Bollard
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
- Corresponding author Catherine M. Bollard, Center for Cancer and Immunology Research, Children’s National Hospital, 111 Michigan Ave, NW, Washington, DC 20010, USA.
| |
Collapse
|
13
|
Durkee-Shock J, Lazarski CA, Jensen-Wachspress MA, Zhang A, Son A, Kankate VV, Field NE, Webber K, Lang H, Conway SR, Hanley PJ, Bollard CM, Keller MD, Schwartz DM. Transcriptomic analysis reveals optimal cytokine combinations for SARS-CoV-2-specific T cell therapy products. Mol Ther Methods Clin Dev 2022; 25:439-447. [PMID: 35506060 PMCID: PMC9050197 DOI: 10.1016/j.omtm.2022.04.013] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/25/2022] [Indexed: 10/29/2022]
Abstract
Adoptive T cell immunotherapy has been used to restore immunity against multiple viral targets in immunocompromised patients after bone-marrow transplantation and has been proposed as a strategy for preventing coronavirus 2019 (COVID-19) in this population. Ideally, expanded severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-virus-specific T cells (CSTs) should demonstrate marked cell expansion, T cell specificity, and CD8+ T cell skewing prior to adoptive transfer. However, current methodologies using IL-4 + IL-7 result in suboptimal specificity, especially in CD8+ cells. Using a microexpansion platform, we screened various cytokine cocktails (IL-4 + IL-7, IL-15, IL-15 + IL-4, IL-15 + IL-6, and IL-15 + IL-7) for the most favorable culture conditions. IL-15 + IL-7 optimally balanced T cell expansion, polyfunctionality, and CD8+ T cell skewing of a final therapeutic T cell product. Additionally, the transcriptomes of CD4+ and CD8+ T cells cultured with IL-15 + IL-7 displayed the strongest induction of antiviral type I interferon (IFN) response genes. Subsequently, microexpansion results were successfully translated to a Good Manufacturing Practice (GMP)-applicable format where IL-15 + IL-7 outperformed IL-4 + IL-7 in specificity and expansion, especially in the desirable CD8+ T cell compartment. These results demonstrate the functional implications of IL-15-, IL-4-, and IL-7-containing cocktails for therapeutic T cell expansion, which could have broad implication for cellular therapy, and pioneer the use of RNA sequencing (RNA-seq) to guide viral-specific T cell (VST) product manufacturing.
Collapse
Affiliation(s)
- Jessica Durkee-Shock
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA.,National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Christopher A Lazarski
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | | | - Anqing Zhang
- GW Cancer Center, George Washington University, Washington, DC, USA
| | - Aran Son
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Vaishnavi V Kankate
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Naomi E Field
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Kathleen Webber
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Haili Lang
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Susan R Conway
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Patrick J Hanley
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA.,GW Cancer Center, George Washington University, Washington, DC, USA.,Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Catherine M Bollard
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA.,GW Cancer Center, George Washington University, Washington, DC, USA.,Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Michael D Keller
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA.,GW Cancer Center, George Washington University, Washington, DC, USA.,Division of Allergy and Immunology, Children's National Hospital, Washington, DC, USA
| | - Daniella M Schwartz
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
14
|
Hwang E, Fortiz F, Cruz R, Geiger A, Grant M, Lang H, Shibli A, Burnett S, Lazarski C, Tanna J, McCann C, Hoq F, Hanley P, Kilburn L, Rood B, Packer R, Bollard C. IMMU-19. Outcomes of Pediatric Patients with High-Risk CNS Tumors Treated with Multi-tumor associated antigen specific T cell (TAA-T) therapy: the ReMIND trial. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac079.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: The ReMIND trial hypothesizes that autologous T-cells specific for three tumor-associated antigens (TAA) -WT1, PRAME, and survivin- will be safe and elicit anti-tumor immunity in pediatric patients with CNS cancer. METHODS: Patients (n=25) received autologous TAA-T for newly-diagnosed DIPG (Stratum A, up to 4x107/m2) or recurrent CNS malignancies (Stratum B, up to 8x107/m2) in this dose-escalation study (NCT03652545) and were monitored for toxicity and response. RESULTS: Autologous TAAT products were successfully manufactured from 28 patients. Using IFN-γ ELISPOT assay, 10/11 evaluable products had specificity for 1-3 TAAs. 25 patients received TAA-T (6 in Stratum A and 19 in Stratum B) and completed the 45-day safety monitoring period. Twenty-four (96%) had no dose limiting toxicities (DLT), but 1 (4%) patient with DIPG experienced a DLT related to potential immune-mediated pseudoprogression. Median overall survival for patients with DIPG (Stratum A) was 14 months (range, 6-32 months). Median progression-free survival (PFS) for Stratum B patients was 8 months (range, 2-26+ months), which exceeded their preceding median duration of disease stability of 2 months (range, 1-5 months). Plasma cytokine profiles demonstrated infusion-related immune cytokine responses. CONCLUSIONS: In summary, TAAT had a favorable toxicity profile (4%) especially compared to CAR-T therapy and may elicit anti-tumor immune responses that contribute to prolonged survival. Immunobiology studies and response assessments are ongoing for both strata. Based on these encouraging preliminary results, we have added a stratum that includes prescribed lymphodepletion pre TAA-T administration at a cell dose of 8x107/m2. Further, we plan to add an additional stratum to allow direct administration of TAA-T into the CNS via an Ommaya reservoir.
Collapse
Affiliation(s)
- Eugene Hwang
- Children's National Hospital , Washington, DC , USA
| | | | - Russell Cruz
- Children's National Hospital , Washington, DC , USA
| | | | | | - Haili Lang
- Children's National Hospital , Washington, DC , USA
| | - Abeer Shibli
- Children's National Hospital , Washington, DC , USA
| | | | | | - Jay Tanna
- Children's National Hospital , Washington, DC , USA
| | - Chase McCann
- Children's National Hospital , Washington, DC , USA
| | - Fahmida Hoq
- Children's National Hospital , Washington, DC , USA
| | | | | | - Brian Rood
- Children's National Hospital , Washington, DC , USA
| | - Roger Packer
- Children's National Hospital , Washington, DC , USA
| | | |
Collapse
|
15
|
Chaudhry K, Dowlati E, Long MD, Geiger A, Lang H, Gomez EC, Muniraj N, Sanchez CE, Singh PK, Liu S, Bollard CM, Cruz CRY. Comparable transforming growth factor beta-mediated immune suppression in ex vivo-expanded natural killer cells from cord blood and peripheral blood: implications for adoptive immunotherapy. Cytotherapy 2022; 24:802-817. [PMID: 35589475 PMCID: PMC10258734 DOI: 10.1016/j.jcyt.2022.04.001] [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] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 11/27/2022]
Abstract
T cell-based therapies like genetically modified immune cells expressing chimeric antigen receptors have shown robust anti-cancer activity in vivo, especially in patients with blood cancers. However, extending this approach to an "off-the-shelf" setting can be challenging, as allogeneic T cells carry a significant risk of graft-versus-host disease (GVHD). By contrast, allogeneic natural killer (NK) cells recognize malignant cells without the need for prior antigen exposure and have been used safely in multiple cancer settings without the risk of GVHD. However, similar to T cells, NK cell function is negatively impacted by tumor-induced transforming growth factor beta (TGF-β) secretion, which is a ubiquitous and potent immunosuppressive mechanism employed by most malignancies. Allogeneic NK cells for adoptive immunotherapy can be sourced from peripheral blood (PB) or cord blood (CB), and the authors' group and others have previously shown that ex vivo expansion and gene engineering can overcome CB-derived NK cells' functional immaturity and poor cytolytic activity, including in the presence of exogenous TGF-β. However, a direct comparison of the effects of TGF-β-mediated immune suppression on ex vivo-expanded CB- versus PB-derived NK cell therapy products has not previously been performed. Here the authors show that PB- and CB-derived NK cells have distinctive gene signatures that can be overcome by ex vivo expansion. Additionally, exposure to exogenous TGF-β results in an upregulation of inhibitory receptors on NK cells, a novel immunosuppressive mechanism not previously described. Finally, the authors provide functional and genetic evidence that both PB- and CB-derived NK cells are equivalently susceptible to TGF-β-mediated immune suppression. The authors believe these results provide important mechanistic insights to consider when using ex vivo-expanded, TGF-β-resistant PB- or CB-derived NK cells as novel immunotherapy agents for cancer.
Collapse
Affiliation(s)
- Kajal Chaudhry
- Center for Cancer and Immunology Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA
| | - Ehsan Dowlati
- Department of Neurosurgery, Georgetown University Medical Center, Washington, DC, USA
| | - Mark D Long
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Ashley Geiger
- Center for Cancer and Immunology Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA
| | - Haili Lang
- Center for Cancer and Immunology Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA
| | - Eduardo C Gomez
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Nethaji Muniraj
- Center for Cancer and Immunology Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA
| | - Carlos E Sanchez
- Center for Cancer and Immunology Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA
| | - Prashant K Singh
- Genomics Shared Resource, Department of Cancer Genetics and Genomics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Song Liu
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Catherine M Bollard
- Center for Cancer and Immunology Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA; George Washington University Cancer Center, George Washington University, Washington, DC, USA.
| | - Conrad Russell Y Cruz
- Center for Cancer and Immunology Research, Children's National Hospital, 111 Michigan Ave NW, Washington, DC 20010, USA; George Washington University Cancer Center, George Washington University, Washington, DC, USA.
| |
Collapse
|
16
|
Chaudhry K, Geiger A, Dowlati E, Lang H, Yvon E, Holdoff M, Jones R, Savoldo B, Cruz C, Bollard C. Immunotherapy: B7H3-CAR NK CELLS AND DNR CO-TRANSDUCED NK SHOWS MAINTAIN THEIR POTENCY AGAINST TGF-B MEDIATED IMMUNE SUPPRESSION. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00148-7] [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: 11/03/2022]
|
17
|
Geiger A, Stanojevic M, Hont A, Lazarski C, Datar A, Lang H, Hanley P, Bollard C, Nazarian J, Hwang E, Cruz C. Immunotherapy: DEVELOPING OFF THE SHELF T CELL THERAPIES FOR HIGH-GRADE GLIOMAS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00308-5] [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]
|
18
|
Kinoshita H, Cooke KR, Grant M, Stanojevic M, Cruz CR, Keller M, Fortiz MF, Hoq F, Lang H, Barrett AJ, Liang H, Tanna J, Zhang N, Shibli A, Datar A, Fulton K, Kukadiya D, Zhang A, Williams KM, Dave H, Dome JS, Jacobsohn D, Hanley PJ, Jones RJ, Bollard CM. Outcome of donor-derived TAA-T cell therapy in patients with high-risk or relapsed acute leukemia post allogeneic BMT. Blood Adv 2022; 6:2520-2534. [PMID: 35244681 PMCID: PMC9043933 DOI: 10.1182/bloodadvances.2021006831] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 12/15/2021] [Accepted: 02/14/2022] [Indexed: 12/02/2022] Open
Abstract
Patients with hematologic malignancies relapsing after allogeneic blood or marrow transplantation (BMT) have limited response to conventional salvage therapies, with an expected 1-year overall survival (OS) of <20%. We evaluated the safety and clinical outcomes following administration of a novel T-cell therapeutic targeting 3 tumor-associated antigens (TAA-T) in patients with acute leukemia who relapsed or were at high risk of relapse after allogeneic BMT. Lymphocytes obtained from the BMT donor were manufactured to target TAAs WT1, PRAME, and survivin, which are over-expressed and immunogenic in most hematologic malignancies. Patients received TAA-T infusions at doses of 0.5 to 4 × 107/m2. Twenty-three BMT recipients with relapsed/refractory (n = 11) and/or high-risk (n = 12) acute myeloid leukemia (n = 20) and acute lymphoblastic leukemia (n = 3) were infused posttransplant. No patient developed cytokine-release syndrome or neurotoxicity, and only 1 patient developed grade 3 graft-versus-host disease. Of the patients who relapsed post-BMT and received bridging therapy, the majority (n = 9/11) achieved complete hematologic remission before receiving TAA-T. Relapsed patients exhibited a 1-year OS of 36% and 1-year leukemia-free survival of 27.3% post-TAA-T. The poorest prognosis patients (relapsed <6 months after transplant) exhibited a 1-year OS of 42.8% postrelapse (n = 7). Median survival was not reached for high-risk patients who received preemptive TAA-T posttransplant (n = 12). Although as a phase 1 study, concomitant antileukemic therapy was allowed, TAA-T were safe and well tolerated, and sustained remissions in high-risk and relapsed patients were observed. Moreover, adoptively transferred TAA-T detected by T-cell receptor V-β sequencing persisted up to at least 1 year postinfusion. This trial was registered at clinicaltrials.gov as #NCT02203903.
Collapse
Affiliation(s)
- Hannah Kinoshita
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
- Division of Blood and Marrow Transplantation, Children’s National Hospital, Washington, DC
- Division of Oncology, Children’s National Hospital, Washington, DC
| | - Kenneth R. Cooke
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Melanie Grant
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Maja Stanojevic
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - C. Russell Cruz
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
- Stem Cell Transplantation and Cell Therapy Program, George Washington Cancer Center, Washington, DC
| | - Michael Keller
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Maria Fernanda Fortiz
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - Fahmida Hoq
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - Haili Lang
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - A. John Barrett
- Stem Cell Transplantation and Cell Therapy Program, George Washington Cancer Center, Washington, DC
| | - Hua Liang
- Department of Statistics, The George Washington University, Washington, DC; and
| | - Jay Tanna
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - Nan Zhang
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - Abeer Shibli
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - Anushree Datar
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - Kenneth Fulton
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - Divyesh Kukadiya
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
| | - Anqing Zhang
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Kirsten M. Williams
- Department of Pediatric Hematology/Oncology, Aflac Cancer & Blood Disorders Center, Children’s Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA
| | - Hema Dave
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
- Division of Oncology, Children’s National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Jeffrey S. Dome
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
- Division of Oncology, Children’s National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - David Jacobsohn
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
- Division of Blood and Marrow Transplantation, Children’s National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Patrick J. Hanley
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Richard J. Jones
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Catherine M. Bollard
- Center for Cancer and Immunology Research, Children’s National Research Institute, Children’s National Hospital, Washington, DC
- Division of Blood and Marrow Transplantation, Children’s National Hospital, Washington, DC
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
- Stem Cell Transplantation and Cell Therapy Program, George Washington Cancer Center, Washington, DC
| |
Collapse
|
19
|
Lang H, Schmidt JJ, Wedemeyer H, Busch M. [Erratum to: Sepsis with hemolysis due to a liver abscess in a 60-year-old male patient]. Internist (Berl) 2022; 63:556. [PMID: 35441881 DOI: 10.1007/s00108-022-01336-6] [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] [Indexed: 11/25/2022]
Affiliation(s)
- H Lang
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - J J Schmidt
- Klinik für Nieren- und Hochdruckerkrankungen, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - M Busch
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| |
Collapse
|
20
|
Nagel H, Lang H, Sole Guitart A, Lean N, Allavena R, Sprohnle‐Barrera C, Young A. Multi‐modality imaging of aggressive submural neoplasia of the hoof in two horses. Aust Vet J 2022; 100:336-341. [DOI: 10.1111/avj.13161] [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: 09/11/2021] [Revised: 02/24/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Affiliation(s)
- H Nagel
- REC Equine Specialists Horsley Park New South Wales Australia
| | - H Lang
- REC Equine Specialists Horsley Park New South Wales Australia
| | - A Sole Guitart
- The University of Queensland – Gatton Campus, School of Veterinary Science Gatton Queensland Australia
| | - N Lean
- The University of Queensland – Gatton Campus, School of Veterinary Science Gatton Queensland Australia
| | - R Allavena
- The University of Queensland – Gatton Campus, School of Veterinary Science Gatton Queensland Australia
| | - C Sprohnle‐Barrera
- The University of Queensland – Gatton Campus, School of Veterinary Science Gatton Queensland Australia
| | - A Young
- The University of Queensland – Gatton Campus, School of Veterinary Science Gatton Queensland Australia
| |
Collapse
|
21
|
Bitzer M, Voesch S, Albert J, Bartenstein P, Bechstein W, Blödt S, Brunner T, Dombrowski F, Evert M, Follmann M, La Fougère C, Freudenberger P, Geier A, Gkika E, Götz M, Hammes E, Helmberger T, Hoffmann RT, Hofmann WP, Huppert P, Kautz A, Knötgen G, Körber J, Krug D, Lammert F, Lang H, Langer T, Lenz P, Mahnken A, Meining A, Micke O, Nadalin S, Nguyen HP, Ockenga J, Oldhafer K, Paprottka P, Paradies K, Pereira P, Persigehl T, Plauth M, Plentz R, Pohl J, Riemer J, Reimer P, Ringwald J, Ritterbusch U, Roeb E, Schellhaas B, Schirmacher P, Schmid I, Schuler A, von Schweinitz D, Seehofer D, Sinn M, Stein A, Stengel A, Steubesand N, Stoll C, Tannapfel A, Taubert A, Trojan J, van Thiel I, Tholen R, Vogel A, Vogl T, Vorwerk H, Wacker F, Waidmann O, Wedemeyer H, Wege H, Wildner D, Wittekind C, Wörns MA, Galle P, Malek N. S3-Leitlinie: Diagnostik und Therapie biliärer Karzinome. Z Gastroenterol 2022; 60:219-238. [PMID: 35148562 DOI: 10.1055/a-1589-7638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Bitzer
- Medizinische Klinik I, Universitätsklinikum Tübingen
| | - S Voesch
- Medizinische Klinik I, Universitätsklinikum Tübingen
| | - J Albert
- Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart
| | - P Bartenstein
- Klinik und Poliklinik für Nuklearmedizin, LMU Klinikum, München
| | - W Bechstein
- Klinik für Allgemein-, Viszeral-, Transplantations- und Thoraxchirurgie, Universitätsklinikum Frankfurt
| | - S Blödt
- AWMF-Geschäftsstelle, Berlin
| | - T Brunner
- Klinik für Strahlentherapie, Universitätsklinikum Magdeburg
| | - F Dombrowski
- Institut für Pathologie, Universitätsmedizin Greifswald
| | - M Evert
- Institut für Pathologie, Regensburg
| | - M Follmann
- Office des Leitlinienprogrammes Onkologie, c/o Deutsche Krebsgesellschaft e.V., Berlin
| | - C La Fougère
- Nuklearmedizin und Klinische Molekulare Bildgebung, Tübingen
| | | | - A Geier
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg
| | - E Gkika
- Klinik für Strahlenheilkunde, Department für Radiologische Diagnostik und Therapie, Universitätsklinikum Freiburg
| | | | - E Hammes
- Lebertransplantierte Deutschland e. V., Ansbach
| | - T Helmberger
- Institut für Radiologie, Neuroradiologie und minimal-invasive Therapie, München Klinik Bogenhausen, München
| | - R T Hoffmann
- Institut und Poliklinik für Diagnostische und Interventionelle Radiologie, Dresden
| | - W P Hofmann
- Gastroenterologie am Bayerischen Platz, medizinisches Versorgungszentrum, Berlin
| | - P Huppert
- Radiologisches Zentrum, Max Grundig Klinik, Bühl
| | - A Kautz
- Deutsche Leberhilfe e.V., Köln
| | - G Knötgen
- Konferenz onkologischer Kranken- und Kinderkrankenpflege, Hamburg
| | - J Körber
- Klinik Nahetal, Fachklinik für onkologische Rehabilitation und Anschlussrehabilitation, Bad Kreuznach
| | - D Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel
| | | | - H Lang
- Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - T Langer
- Office des Leitlinienprogrammes Onkologie, c/o Deutsche Krebsgesellschaft e.V., Berlin
| | - P Lenz
- Universitätsklinikum Münster, Zentrale Einrichtung Palliativmedizin, Münster
| | - A Mahnken
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Gießen und Marburg GmbH, Marburg
| | - A Meining
- Medizinische Klinik und Poliklinik II des Universitätsklinikums Würzburg
| | - O Micke
- Klinik für Strahlentherapie und Radioonkologie, Franziskus Hospital Bielefeld
| | - S Nadalin
- Universitätsklinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen
| | | | - J Ockenga
- Medizinische Klinik II, Klinikum Bremen-Mitte, Bremen
| | - K Oldhafer
- Klinik für Leber-, Gallenwegs- und Pankreaschirurgie, Semmelweis Universität, Asklepios Campus Hamburg
| | - P Paprottka
- Abteilung für interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München
| | - K Paradies
- Konferenz onkologischer Kranken- und Kinderkrankenpflege, Hamburg
| | - P Pereira
- Abteilung für interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München
| | - T Persigehl
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln
| | | | - R Plentz
- Klinikum Bremen-Nord, Innere Medizin, Bremen
| | - J Pohl
- Interventionelles Endoskopiezentrum und Schwerpunkt Gastrointestinale Onkologie, Asklepios Klinik Altona, Hamburg
| | - J Riemer
- Lebertransplantierte Deutschland e. V., Bretzfeld
| | - P Reimer
- Institut für diagnostische und interventionelle Radiologie, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe
| | - J Ringwald
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | | | - E Roeb
- Medizinische Klinik II, Universitätsklinikum Gießen und Marburg GmbH, Gießen
| | - B Schellhaas
- Medizinische Klinik I, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
| | - P Schirmacher
- Pathologisches Institut, Universitätsklinikum Heidelberg
| | - I Schmid
- Zentrum Pädiatrische Hämatologie und Onkologie, Dr. von Haunersches Kinderspital, Klinikum der Universität München
| | - A Schuler
- Medizinische Klinik, Alb Fils Kliniken GmbH, Göppingen
| | | | - D Seehofer
- Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig
| | - M Sinn
- Medizinische Klinik II, Universitätsklinikum Hamburg-Eppendorf
| | - A Stein
- Hämatologisch-Onkologischen Praxis Eppendorf, Hamburg
| | - A Stengel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | | | - C Stoll
- Klinik Herzoghöhe Bayreuth, Bayreuth
| | - A Tannapfel
- Institut für Pathologie der Ruhr-Universität Bochum am Berufsgenossenschaftlichen Universitätsklinikum Bergmannsheil, Bochum
| | - A Taubert
- Kliniksozialdienst, Universitätsklinikum Heidelberg, Bochum
| | - J Trojan
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main
| | | | - R Tholen
- Deutscher Verband für Physiotherapie e. V., Köln
| | - A Vogel
- Klinik für Gastroenterologie, Hepatologie, Endokrinologie der Medizinischen Hochschule Hannover, Hannover
| | - T Vogl
- Universitätsklinikum Frankfurt, Institut für Diagnostische und Interventionelle Radiologie, Frankfurt
| | - H Vorwerk
- Klinik für Strahlentherapie, Universitätsklinikum Gießen und Marburg GmbH, Marburg
| | - F Wacker
- Institut für Diagnostische und Interventionelle Radiologie der Medizinischen Hochschule Hannover, Hannover
| | - O Waidmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie Medizinische Hochschule Hannover, Hannover
| | - H Wege
- Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - D Wildner
- Innere Medizin, Krankenhäuser Nürnberger Land GmbH, Lauf an der Pegnitz
| | - C Wittekind
- Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig
| | - M A Wörns
- Medizinische Klinik und Poliklinik, Universitätsklinikum Mainz, Mainz
| | - P Galle
- Medizinische Klinik und Poliklinik, Universitätsklinikum Mainz, Mainz
| | - N Malek
- Medizinische Klinik I, Universitätsklinikum Tübingen, Tübingen
| |
Collapse
|
22
|
Bitzer M, Voesch S, Albert J, Bartenstein P, Bechstein W, Blödt S, Brunner T, Dombrowski F, Evert M, Follmann M, La Fougère C, Freudenberger P, Geier A, Gkika E, Götz M, Hammes E, Helmberger T, Hoffmann RT, Hofmann WP, Huppert P, Kautz A, Knötgen G, Körber J, Krug D, Lammert F, Lang H, Langer T, Lenz P, Mahnken A, Meining A, Micke O, Nadalin S, Nguyen HP, Ockenga J, Oldhafer K, Paprottka P, Paradies K, Pereira P, Persigehl T, Plauth M, Plentz R, Pohl J, Riemer J, Reimer P, Ringwald J, Ritterbusch U, Roeb E, Schellhaas B, Schirmacher P, Schmid I, Schuler A, von Schweinitz D, Seehofer D, Sinn M, Stein A, Stengel A, Steubesand N, Stoll C, Tannapfel A, Taubert A, Trojan J, van Thiel I, Tholen R, Vogel A, Vogl T, Vorwerk H, Wacker F, Waidmann O, Wedemeyer H, Wege H, Wildner D, Wittekind C, Wörns MA, Galle P, Malek N. S3-Leitlinie – Diagnostik und Therapie biliärer Karzinome. Z Gastroenterol 2022; 60:e186-e227. [PMID: 35148560 DOI: 10.1055/a-1589-7854] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- M Bitzer
- Medizinische Klinik I, Universitätsklinikum Tübingen
| | - S Voesch
- Medizinische Klinik I, Universitätsklinikum Tübingen
| | - J Albert
- Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Robert-Bosch-Krankenhaus, Stuttgart
| | - P Bartenstein
- Klinik und Poliklinik für Nuklearmedizin, LMU Klinikum, München
| | - W Bechstein
- Klinik für Allgemein-, Viszeral-, Transplantations- und Thoraxchirurgie, Universitätsklinikum Frankfurt
| | - S Blödt
- AWMF-Geschäftsstelle, Berlin
| | - T Brunner
- Klinik für Strahlentherapie, Universitätsklinikum Magdeburg
| | - F Dombrowski
- Institut für Pathologie, Universitätsmedizin Greifswald
| | - M Evert
- Institut für Pathologie, Regensburg
| | - M Follmann
- Office des Leitlinienprogrammes Onkologie, c/o Deutsche Krebsgesellschaft e.V., Berlin
| | - C La Fougère
- Nuklearmedizin und Klinische Molekulare Bildgebung, Tübingen
| | | | - A Geier
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg
| | - E Gkika
- Klinik für Strahlenheilkunde, Department für Radiologische Diagnostik und Therapie, Universitätsklinikum Freiburg
| | | | - E Hammes
- Lebertransplantierte Deutschland e. V., Ansbach
| | - T Helmberger
- Institut für Radiologie, Neuroradiologie und minimal-invasive Therapie, München Klinik Bogenhausen, München
| | - R T Hoffmann
- Institut und Poliklinik für Diagnostische und Interventionelle Radiologie, Dresden
| | - W P Hofmann
- Gastroenterologie am Bayerischen Platz, medizinisches Versorgungszentrum, Berlin
| | - P Huppert
- Radiologisches Zentrum, Max Grundig Klinik, Bühl
| | - A Kautz
- Deutsche Leberhilfe e.V., Köln
| | - G Knötgen
- Konferenz onkologischer Kranken- und Kinderkrankenpflege, Hamburg
| | - J Körber
- Klinik Nahetal, Fachklinik für onkologische Rehabilitation und Anschlussrehabilitation, Bad Kreuznach
| | - D Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel
| | | | - H Lang
- Klinik für Allgemein-, Viszeral und Transplantationschirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz
| | - T Langer
- Office des Leitlinienprogrammes Onkologie, c/o Deutsche Krebsgesellschaft e.V., Berlin
| | - P Lenz
- Universitätsklinikum Münster, Zentrale Einrichtung Palliativmedizin, Münster
| | - A Mahnken
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Gießen und Marburg GmbH, Marburg
| | - A Meining
- Medizinische Klinik und Poliklinik II des Universitätsklinikums Würzburg
| | - O Micke
- Klinik für Strahlentherapie und Radioonkologie, Franziskus Hospital Bielefeld
| | - S Nadalin
- Universitätsklinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen
| | | | - J Ockenga
- Medizinische Klinik II, Klinikum Bremen-Mitte, Bremen
| | - K Oldhafer
- Klinik für Leber-, Gallenwegs- und Pankreaschirurgie, Semmelweis Universität, Asklepios Campus Hamburg
| | - P Paprottka
- Abteilung für interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München
| | - K Paradies
- Konferenz onkologischer Kranken- und Kinderkrankenpflege, Hamburg
| | - P Pereira
- Abteilung für interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München
| | - T Persigehl
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Köln
| | | | - R Plentz
- Klinikum Bremen-Nord, Innere Medizin, Bremen
| | - J Pohl
- Interventionelles Endoskopiezentrum und Schwerpunkt Gastrointestinale Onkologie, Asklepios Klinik Altona, Hamburg
| | - J Riemer
- Lebertransplantierte Deutschland e. V., Bretzfeld
| | - P Reimer
- Institut für diagnostische und interventionelle Radiologie, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe
| | - J Ringwald
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | | | - E Roeb
- Medizinische Klinik II, Universitätsklinikum Gießen und Marburg GmbH, Gießen
| | - B Schellhaas
- Medizinische Klinik I, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen
| | - P Schirmacher
- Pathologisches Institut, Universitätsklinikum Heidelberg
| | - I Schmid
- Zentrum Pädiatrische Hämatologie und Onkologie, Dr. von Haunersches Kinderspital, Klinikum der Universität München
| | - A Schuler
- Medizinische Klinik, Alb Fils Kliniken GmbH, Göppingen
| | | | - D Seehofer
- Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig
| | - M Sinn
- Medizinische Klinik II, Universitätsklinikum Hamburg-Eppendorf
| | - A Stein
- Hämatologisch-Onkologischen Praxis Eppendorf, Hamburg
| | - A Stengel
- Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen
| | | | - C Stoll
- Klinik Herzoghöhe Bayreuth, Bayreuth
| | - A Tannapfel
- Institut für Pathologie der Ruhr-Universität Bochum am Berufsgenossenschaftlichen Universitätsklinikum Bergmannsheil, Bochum
| | - A Taubert
- Kliniksozialdienst, Universitätsklinikum Heidelberg, Bochum
| | - J Trojan
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main
| | | | - R Tholen
- Deutscher Verband für Physiotherapie e. V., Köln
| | - A Vogel
- Klinik für Gastroenterologie, Hepatologie, Endokrinologie der Medizinischen Hochschule Hannover, Hannover
| | - T Vogl
- Universitätsklinikum Frankfurt, Institut für Diagnostische und Interventionelle Radiologie, Frankfurt
| | - H Vorwerk
- Klinik für Strahlentherapie, Universitätsklinikum Gießen und Marburg GmbH, Marburg
| | - F Wacker
- Institut für Diagnostische und Interventionelle Radiologie der Medizinischen Hochschule Hannover, Hannover
| | - O Waidmann
- Medizinische Klinik I, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - H Wedemeyer
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie Medizinische Hochschule Hannover, Hannover
| | - H Wege
- Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - D Wildner
- Innere Medizin, Krankenhäuser Nürnberger Land GmbH, Lauf an der Pegnitz
| | - C Wittekind
- Institut für Pathologie, Universitätsklinikum Leipzig, Leipzig
| | - M A Wörns
- Medizinische Klinik und Poliklinik, Universitätsklinikum Mainz, Mainz
| | - P Galle
- Medizinische Klinik und Poliklinik, Universitätsklinikum Mainz, Mainz
| | - N Malek
- Medizinische Klinik I, Universitätsklinikum Tübingen, Tübingen
| |
Collapse
|
23
|
Surlemont L, Bernhard JC, Bensalah CK, Audenet F, Bigot P, Doumerc N, De La Taille A, Roupret M, Olivier J, Bruyère F, Parier B, Lang H, Brenier M, Waeckel T, Long JA, Durand M, Branger N, Tambwe R, Cussenot O, Boissier R, Charles T, Nouhaud FX. Impact of obesity in the management of kidney cancer, study URO-CCR n°87. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00294-9] [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]
|
24
|
Conway SR, Lazarski CA, Field NE, Jensen-Wachspress M, Lang H, Kankate V, Durkee-Shock J, Kinoshita H, Suslovic W, Webber K, Smith K, Cohen JI, Burbelo PD, Zhang A, Teach SJ, Ibeh T, Delaney M, DeBiasi RL, Keller MD, Bollard CM. SARS-CoV-2-Specific T Cell Responses Are Stronger in Children With Multisystem Inflammatory Syndrome Compared to Children With Uncomplicated SARS-CoV-2 Infection. Front Immunol 2022; 12:793197. [PMID: 35116027 PMCID: PMC8803660 DOI: 10.3389/fimmu.2021.793197] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/22/2021] [Indexed: 12/21/2022] Open
Abstract
Background Despite similar rates of infection, adults and children have markedly different morbidity and mortality related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Compared to adults, children have infrequent severe manifestations of acute infection but are uniquely at risk for the rare and often severe Multisystem Inflammatory Syndrome in Children (MIS-C) following infection. We hypothesized that these differences in presentation are related to differences in the magnitude and/or antigen specificity of SARS-CoV-2-specific T cell (CST) responses between adults and children. We therefore set out to measure the CST response in convalescent adults versus children with and without MIS-C following SARS-CoV-2 infection. Methods CSTs were expanded from blood collected from convalescent children and adults post SARS-CoV-2 infection and evaluated by intracellular flow cytometry, surface markers, and cytokine production following stimulation with SARS-CoV-2-specific peptides. Presence of serum/plasma antibody to spike and nucleocapsid was measured using the luciferase immunoprecipitation systems (LIPS) assay. Findings Twenty-six of 27 MIS-C patients, 7 of 8 non-MIS-C convalescent children, and 13 of 14 adults were seropositive for spike and nucleocapsid antibody. CST responses in MIS-C patients were significantly higher than children with uncomplicated SARS-CoV-2 infection, but weaker than CST responses in convalescent adults. Interpretation Age-related differences in the magnitude of CST responses suggest differing post-infectious immunity to SARS-CoV-2 in children compared to adults post uncomplicated infection. Children with MIS-C have CST responses that are stronger than children with uncomplicated SARS-CoV-2 infection and weaker than convalescent adults, despite near uniform seropositivity.
Collapse
Affiliation(s)
- Susan R. Conway
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
- Division of Critical Care Medicine, Children’s National Hospital, Washington, DC, United States
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Christopher A. Lazarski
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
| | - Naomi E. Field
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
| | - Mariah Jensen-Wachspress
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
| | - Haili Lang
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
| | - Vaishnavi Kankate
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
| | - Jessica Durkee-Shock
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
- Laboratory of Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Hannah Kinoshita
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
- Division of Hematology and Oncology, Children’s National Hospital, Washington, DC, United States
| | - William Suslovic
- Division of Pathology and Laboratory Medicine, Children’s National Hospital, Washington, DC, United States
| | - Kathleen Webber
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
| | - Karen Smith
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- Department of Pediatrics, Children’s National Hospital, Washington, DC, United States
| | - Jeffrey I. Cohen
- Laboratory of Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Peter D. Burbelo
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, United States
| | - Anqing Zhang
- Division of Biostatistics and Study Methodology, Children’s National Hospital, Washington, DC, United States
| | - Stephen J. Teach
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- Center for Translational Research, Children’s National Hospital, Washington, DC, United States
| | - Trisha Ibeh
- Center for Translational Research, Children’s National Hospital, Washington, DC, United States
| | - Meghan Delaney
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- Division of Pathology and Laboratory Medicine, Children’s National Hospital, Washington, DC, United States
| | - Roberta L. DeBiasi
- Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
- Division of Infectious Diseases, Children’s National Hospital, Washington, DC, United States
| | - Michael D. Keller
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
- Division of Allergy and Immunology, Children’s National Hospital, Washington, DC, United States
- GW Cancer Center, George Washington University, Washington, DC, United States
| | - Catherine M. Bollard
- Center for Cancer and Immunology Research, Children’s National Hospital, Washington, DC, United States
- GW Cancer Center, George Washington University, Washington, DC, United States
- *Correspondence: Catherine M. Bollard,
| |
Collapse
|
25
|
Pignot G, Thiery-vuillemin A, Walz J, Lang H, Balssa L, Leblanc L, Borchiellini D, Parier B, Albiges L, Bensalah K, Schlurmann F, Mourey E, Bigot P, Ingels A, Bernhard J, Piechaud T, Roubaud G, Klifa D, Gravis G, Barthelemy P. Résultats oncologiques de la néphrectomie différée après réponse complète à l’immunothérapie pour cancer du rein métastatique au diagnostic. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.154] [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: 10/19/2022]
|
26
|
Gaillard V, Tricard T, Somme G, Rebel S, Schumacher C, Lang H. Lien ville–hôpital pour le suivi postopératoire en onco-urologie : résultats à 3 ans du réseau LiVHOU. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.068] [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: 11/26/2022]
|
27
|
Surlemont L, Bernarhd J, Bensalah K, Bigot P, Doumerc N, De la taille A, Rouprêt M, Villers A, Bruyere F, Lebacle C, Lang H, Durand X, Tillou X, Long J, Rouget B, Durand M, Pignot G, Larre S, Cussenot O, Nouhaud F. Impact de l’obésité dans la prise en charge du cancer du rein, étude URO-CCR N°87. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.132] [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: 11/26/2022]
|
28
|
Lopez-Lopez V, Gomez-Perez B, de Vicente E, Jiménez-Galanes S, Mora-Oliver I, Sabater L, Huber T, Lang H, Brusadin R, López Conesa A, Melendez R, Castro Santiago MJ, Ferreras D, Crespo MJ, Cayuela V, Robles-Campos R. Next-generation three-dimensional modelling software for personalized surgery decision-making in perihilar cholangiocarcinoma: multicentre study. Br J Surg 2021; 108:e394-e395. [PMID: 34542590 DOI: 10.1093/bjs/znab320] [Citation(s) in RCA: 6] [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] [Received: 06/26/2021] [Accepted: 08/17/2021] [Indexed: 01/04/2023]
Abstract
Next-generation three-dimensional modelling software for personalized surgery allows spatially accurate depiction of the hepatic and vasculature anatomy based on the complexity and individual variation in each patient, and could facilitate decision-making about preoperative strategy in perihilar cholangiocarcinoma.
Collapse
Affiliation(s)
- V Lopez-Lopez
- Department of Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, Murcia, Spain
| | - B Gomez-Perez
- Department of Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, Murcia, Spain
| | - E de Vicente
- Department of Surgery, HM Sanchinarro University Hospital, Madrid, Spain
| | - S Jiménez-Galanes
- Department of Surgery, University Hospital Infanta Elena, Madrid, Spain
| | - I Mora-Oliver
- Department of Surgery, Hospital Clinico Valencia, University of Valencia, Biomedical Research Institute (INCLIVA), Valencia, Spain
| | - L Sabater
- Department of Surgery, Hospital Clinico Valencia, University of Valencia, Biomedical Research Institute (INCLIVA), Valencia, Spain
| | - T Huber
- Department of General, Visceral and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - H Lang
- Department of General, Visceral and Transplantation Surgery, Universitätsmedizin Mainz, Mainz, Germany
| | - R Brusadin
- Department of Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, Murcia, Spain
| | - A López Conesa
- Department of Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, Murcia, Spain
| | - R Melendez
- Department of Surgery, University Hospital, Vigo, Spain
| | | | - D Ferreras
- Department of Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, Murcia, Spain
| | - M J Crespo
- Department of Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, Murcia, Spain
| | - V Cayuela
- Department of Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, Murcia, Spain
| | - R Robles-Campos
- Department of Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, Murcia, Spain
| |
Collapse
|
29
|
Stanojevic M, Geiger A, Ostermeier B, Sohai D, Lazarski C, Lang H, Jensen-Wachspress M, Webber K, Burbelo P, Cohen J, Keller MD, Bollard CM, Cruz CRY. Spike-directed vaccination elicits robust spike-specific T-cell response, including to mutant strains. Cytotherapy 2021; 24:10-15. [PMID: 34483067 PMCID: PMC8411349 DOI: 10.1016/j.jcyt.2021.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/23/2021] [Accepted: 07/09/2021] [Indexed: 01/24/2023]
Abstract
Although most studies describing coronavirus disease 2019 vaccine responses have focused on antibodies, there is increasing evidence that T cells play a critical role. Here the authors evaluated T-cell responses in seronegative donors before and after vaccination to define responses to the severe acute respiratory syndrome coronavirus 2 reference strain as well as to mutations in the variant strains Alpha/B.1.1.7 and Beta/B.1.351. The authors observed enhanced T-cell responses to reference and variant spike strains post-vaccination.
Collapse
Affiliation(s)
- Maja Stanojevic
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA
| | - Ashley Geiger
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA
| | - Brita Ostermeier
- Institute for Biomedical Sciences, George Washington University, Washington, DC, USA
| | - Danielle Sohai
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA
| | - Christopher Lazarski
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA
| | - Haili Lang
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA
| | - Mariah Jensen-Wachspress
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA
| | - Kathleen Webber
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA
| | - Peter Burbelo
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeffrey Cohen
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, USA
| | - Michael D Keller
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA
| | - Catherine M Bollard
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA.
| | - Conrad Russell Y Cruz
- Program for Cell Enhancement and Technologies for Immunotherapy, Children's National Medical Center, Washington, DC, USA.
| |
Collapse
|
30
|
Rau B, Lang H, Königsrainer A, Gockel I, Rau HG, Seeliger H, Lerchenmüller C, Reim D, Wahba R, Angele M, Heeg S, Keck T, Weimann A, Topp S, Piso P, Brandl A, Trips E, Heinemann V, Thuss-Patience P. 1376O The effect of hyperthermic intraperitoneal chemotherapy (HIPEC) upon cytoreductive surgery (CRS) in gastric cancer (GC) with synchronous peritoneal metastasis (PM): A randomized multicentre phase III trial (GASTRIPEC-I-trial). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1485] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
31
|
Stanojevic M, Hont AB, Geiger A, O'Brien S, Ulrey R, Grant M, Datar A, Lee PH, Lang H, Cruz CRY, Hanley PJ, Barrett AJ, Keller MD, Bollard CM. Identification of novel HLA-restricted preferentially expressed antigen in melanoma peptides to facilitate off-the-shelf tumor-associated antigen-specific T-cell therapies. Cytotherapy 2021; 23:694-703. [PMID: 33832817 PMCID: PMC8316284 DOI: 10.1016/j.jcyt.2021.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/09/2020] [Revised: 02/02/2021] [Accepted: 03/03/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND AIMS Preferentially expressed antigen in melanoma (PRAME) is a cancer/testis antigen that is overexpressed in many human malignancies and poorly expressed or absent in healthy tissues, making it a good target for anti-cancer immunotherapy. Development of an effective off-the-shelf adoptive T-cell therapy for patients with relapsed or refractory solid tumors and hematological malignancies expressing PRAME antigen requires the identification of major histocompatibility complex (MHC) class I and II PRAME antigens recognized by the tumor-associated antigen (TAA) T-cell product. The authors therefore set out to extend the repertoire of HLA-restricted PRAME peptide epitopes beyond the few already characterized. METHODS Peptide libraries of 125 overlapping 15-mer peptides spanning the entire PRAME protein sequence were used to identify HLA class I- and II-restricted epitopes. The authors also determined the HLA restriction of the identified epitopes. RESULTS PRAME-specific T-cell products were successfully generated from peripheral blood mononuclear cells of 12 healthy donors. Ex vivo-expanded T cells were polyclonal, consisting of both CD4+ and CD8+ T cells, which elicited anti-tumor activity in vitro. Nine MHC class I-restricted PRAME epitopes were identified (seven novel and two previously described). The authors also characterized 16 individual 15-mer peptide sequences confirmed as CD4-restricted epitopes. CONCLUSIONS TAA T cells derived from healthy donors recognize a broad range of CD4+ and CD8+ HLA-restricted PRAME epitopes, which could be used to select suitable donors for generating off-the-shelf TAA-specific T cells.
Collapse
Affiliation(s)
- Maja Stanojevic
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Amy B Hont
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Ashley Geiger
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Samuel O'Brien
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Robert Ulrey
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Melanie Grant
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Anushree Datar
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Ping-Hsien Lee
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Haili Lang
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA
| | - Conrad R Y Cruz
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA; GW Cancer Center, George Washington University, Washington, DC, USA
| | - Patrick J Hanley
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA; GW Cancer Center, George Washington University, Washington, DC, USA; Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - A John Barrett
- GW Cancer Center, George Washington University, Washington, DC, USA
| | - Michael D Keller
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA; Division of Allergy and Immunology, Children's National Hospital, Washington, DC, USA
| | - Catherine M Bollard
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, USA; GW Cancer Center, George Washington University, Washington, DC, USA; Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA.
| |
Collapse
|
32
|
Sun J, Zhou X, Wu J, Xiao R, Chen Y, Lu Y, Lang H. Ligustilide enhances hippocampal neural stem cells activation to restore cognitive function in the context of postoperative cognitive dysfunction. Eur J Neurosci 2021; 54:5000-5015. [PMID: 34192824 DOI: 10.1111/ejn.15363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/26/2020] [Revised: 05/16/2021] [Accepted: 06/16/2021] [Indexed: 12/27/2022]
Abstract
Ligustilide exerts potential neuroprotective effects against various cerebral ischaemic insults and neurodegenerative disorders. However, the function and mechanisms of LIG-mediated hippocampal neural stem cells (H-NSCs) activation as well as cognitive recovery in the context of post-operative cognitive dysfunction (POCD) remain elusive and need to be explored. Mice were subjected to transient global cerebral ischaemia and reperfusion (tGCI/R) injury and treated with LIG (80 mg/kg) or vehicle for 1 month. Morris water maze test and western blot were employed to assess cognitive function. Nissl staining and immunofluorescence (IF) staining were used to detect H-NSCs proliferation and neurogenesis in hippocampus. Subsequently, primary H-NSCs were treated with LIG, and the level of H-NSCs proliferation and neuronal-differentiation was examined by IF staining for Edu and β-Tubulin III. The protein levels of ERK1/2, β-catenin, NICD, TLR4, Akt and FoxO1 were examined using western blotting. Finally, pretreatment with the ERK agonist SCH772984 was performed to observe the change in ERK expression. LIG treatment promoted H-NSCs proliferation and neurogenesis, increased the number of neurons in the hippocampal subfields, and ultimately reversed cognitive impairment in tGCI/R injury. Furthermore, LIG also promoted primary H-NSCs proliferation and neuronal-differentiation, as well as ERK1/2 phosphorylation. Pretreatment with SCH772984 effectively reversed the ability of LIG to induce ERK1/2 phosphorylation and promote H-NSCs proliferation and neuronal-differentiation. LIG can promote cognitive recovery after tGCI/R injury by activating ERK1/2 in H-NSCs to promote their proliferation and neurogenesis in the hippocampus. Therefore, LIG has potential for use in the prevention and/or treatment of POCD.
Collapse
Affiliation(s)
- Jing Sun
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiang Zhou
- Department of Neurosurgery, The Fifth Affiliated Hospital of Nanchang University, Fuzhou, China
| | - Jusheng Wu
- Department of Anesthesiology, The Zhuji People's Hospital of Zhejiang Province, Zhuji, China
| | - Renjie Xiao
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yong Chen
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yimei Lu
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haili Lang
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| |
Collapse
|
33
|
Liu D, Lang H, Romain B. Parastomal hernia repair using Pauli's technique (with video). J Visc Surg 2021; 158:358-359. [PMID: 34092527 DOI: 10.1016/j.jviscsurg.2021.05.001] [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] [Indexed: 11/25/2022]
Affiliation(s)
- D Liu
- Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - H Lang
- Service de Chirurgie Urologique, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, 1, place de l'Hôpital, 67000 Strasbourg cedex, France
| | - B Romain
- Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| |
Collapse
|
34
|
Pignot G, Thiery-Vuillemin A, Walz J, Lang H, Balssa L, Geoffrois L, Leblanc L, Albiges L, Bensalah K, Ladoire S, Bigot P, Ingels A, Saldana C, Roubaud G, Piechaud T, Cassuto O, Klifa D, Parier B, Bernhard J, Malouf G, Gravis G, Barthelemy P. Nephrectomy after complete response to immune checkpoint inhibitors for Metastatic Renal Cell Carcinoma (mRCC): A surgical challenge allowing favorable oncological outcomes. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01024-1] [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: 10/20/2022]
|
35
|
Grant M, Fortiz M, Wang L, Lang H, Datar A, Reynolds E, Terpilowski M, Geiger A, Lazarski C, Tanna J, Pitino A, Zhang N, Hoq F, Hanley P, Cruz CR, Kilburn L, Packer R, Rood B, Bollard C. EPCT-24 THE REMIND TRIAL: MULTI-ANTIGEN TARGETED T CELLS FOR PEDIATRIC CNS TUMORS. Neuro Oncol 2021. [PMCID: PMC8168094 DOI: 10.1093/neuonc/noab090.210] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Patients with relapsed CNS malignancies or DIPG face terrible prognoses. We hypothesized that T cells specific for 3 tumor-associated antigens (TAA), WT1, PRAME and survivin, would be safe and elicit anti-tumor immunity. Methods Patients (n=18) received autologous tumor antigen-associated T cells (TAAT) (up to 8x107/m2) for newly diagnosed DIPG (Group A) or recurrent CNS malignancies (Group B) on a Phase I dose-escalation study (NCT03652545) and were monitored for safety and response. Results/Discussion 16/18 patients who received TAAT completed the 45-day safety monitoring phase with no dose-limiting toxicities. Adverse events were minimal despite multiple pretreatments in Group B. Infused cells were predominantly CD3+ T cells (median 96%; range: 87–99%), with CD4+ and CD8+ comprising 16% (range: 5–87%) and 40% (range: 4–67%) respectively. Specificity for 1–3 TAAs was demonstrated in 11/18 TAAT by a-IFN-γ ELISPOT. Dose escalation is complete, and clinical and immunologic response assessments are ongoing. Plasma cytokine and proteomic analyses demonstrated dynamic post-infusion immune cytokine and protein responses. Consistent with an infusion-mediated immune response all patients in Grp A showed increased T cell effector, inflammatory and immune-stimulatory cytokines IFN-γ, TNF-α, IL-2, IL-5, IL-7, IL-1β, IL-6, IL-8, IL-12p70, IL-17A and GM-CSF at Weeks 1 and 2 post-infusion (n = 6). Of 9 patients who have been tested, 29/92 plasma proteins showed significant differences between dose levels 1 and 2, including increased IL-7 (p <0.0004) and CD40L (p <0.046) and reduced IL-4 (p <0.0004). T cell receptor sequencing showed expansion and persistence of clones detected in infusion products. In summary, TAAT have thus far been safe and elicit immune responses in vivo. Clinical and immunologic response assessments are ongoing.
Collapse
Affiliation(s)
- Melanie Grant
- Emory University School of Medicine, Atlanta, GA, USA
| | - Maria Fortiz
- Children’s National Hospital, Washington, DC, USA
| | - Lu Wang
- Children’s National Hospital, Washington, DC, USA
| | - Haili Lang
- Children’s National Hospital, Washington, DC, USA
| | | | | | | | | | | | - Jay Tanna
- Children’s National Hospital, Washington, DC, USA
| | | | - Nan Zhang
- Children’s National Hospital, Washington, DC, USA
| | - Fahmida Hoq
- Children’s National Hospital, Washington, DC, USA
| | | | | | | | - Roger Packer
- Children’s National Hospital, Washington, DC, USA
| | - Brian Rood
- Children’s National Hospital, Washington, DC, USA
| | - Catherine Bollard
- Children’s National Hospital, Washington, DC, USA
- George Washington University, Washington, DC, USA
| |
Collapse
|
36
|
Durkee-Shock J, Lazarski C, Jensen-Wachspress M, Kankate V, Lang H, Hanley P, Bollard C, Keller M. Cytokine optimization of SARS-CoV-2 specific T-cells for therapeutic use. Cytotherapy 2021. [DOI: 10.1016/s1465324921004369] [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: 10/21/2022]
|
37
|
Lang H. Should all intrahepatic cholangiocarcinomas receive neoadjuvant chemotherapy before resection? Br J Surg 2021; 108:598-599. [PMID: 33723597 DOI: 10.1093/bjs/znab077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/08/2021] [Indexed: 12/17/2022]
Affiliation(s)
- H Lang
- Department of General, Visceral and Transplant Surgery, University Medical Centre of Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
38
|
Bouhamed A, Rajendran D, Frenzel P, Zubkova T, Al-Hamry A, Miesel D, Kamatchi V, Ramalingame R, Bautista-Quijano JR, Lang H, Baumann RR, Kanoun O. Customizing hydrothermal properties of inkjet printed sensitive films by functionalization of carbon nanotubes. Nanotechnology 2021; 32:105708. [PMID: 33217748 DOI: 10.1088/1361-6528/abcc95] [Citation(s) in RCA: 1] [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: 06/11/2023]
Abstract
Multiwalled carbon nanotubes (MWCNTs) are attractive materials for realizing sensors, owing to their high aspect ratio associated with excellent mechanical, electronic, and thermal properties. Moreover, their sensing properties can be tuned by introducing functional groups on their framework and adjusting the processing conditions. In this paper, we investigate the potential of functionalized CNTs for humidity and temperature sensing by optimization of the functionalization, the processing conditions and the printing conditions. The morphology of the differently functionalized MWCNTs is investigated by infrared spectroscopy (IR), scanning electron microscopy, thermogravimetry (TG) and TG-coupled mass-spectrometric studies. Using the functionalized MWCNTs, films were fabricated with different numbers of layers (4, 6, 8, 10 layers) via inkjet printing on a flexible polyimide substrate containing an interdigital microelectrode. The influence of hydrothermal effects was investigated. The sensitivity to humidity is higher for films prepared with MWCNTs functionalized with a high sonication amplitude and a bigger number of layers due to enhancements of hydrophilicity and water mobility. A higher sensitivity to temperature is achieved by a low sonication amplitude and a small number of layers. For the encapsulation of the temperature sensor against humidity, a Bectron layer is proposed, which reduces also the hysteresis effect. This study demonstrates the efficiency of carboxylic functionalized MWCNTs deposit by inkjet printing for realization of sensitive and cost-effective humidity and temperature sensors. It provides a real example for the interesting contribution of functionalization procedures to the sensing properties of MWCNTs films.
Collapse
Affiliation(s)
- A Bouhamed
- Technische Universität Chemnitz, Chair of Measurement and Sensor Technology, Chemnitz, Germany
| | - D Rajendran
- Technische Universität Chemnitz, Chair of Measurement and Sensor Technology, Chemnitz, Germany
| | - P Frenzel
- Technische Universität Chemnitz, Inorganic Chemistry, Chemnitz, Germany
| | - T Zubkova
- Technische Universität Chemnitz, Print and Media Technology, Chemnitz, Germany
| | - A Al-Hamry
- Technische Universität Chemnitz, Chair of Measurement and Sensor Technology, Chemnitz, Germany
| | - D Miesel
- Technische Universität Chemnitz, Inorganic Chemistry, Chemnitz, Germany
| | - V Kamatchi
- Technische Universität Chemnitz, Chair of Measurement and Sensor Technology, Chemnitz, Germany
| | - R Ramalingame
- Technische Universität Chemnitz, Chair of Measurement and Sensor Technology, Chemnitz, Germany
| | - J R Bautista-Quijano
- Technische Universität Chemnitz, Chair of Measurement and Sensor Technology, Chemnitz, Germany
| | - H Lang
- Technische Universität Chemnitz, Inorganic Chemistry, Chemnitz, Germany
| | - R R Baumann
- Technische Universität Chemnitz, Print and Media Technology, Chemnitz, Germany
| | - O Kanoun
- Technische Universität Chemnitz, Chair of Measurement and Sensor Technology, Chemnitz, Germany
| |
Collapse
|
39
|
Williams KM, Pavletic SZ, Lee SJ, Martin PJ, Lang H, Farthing DE, Hakim FT, Rose JJ, Manning-Geist B, Comis LE, Cowen EW, Justus D, Baird K, Cheng GS, Shelhamer JH, Blacklock-Schuver B, Avila D, Steinberg SM, Mitchell SA, Gress RE. Immune Correlates from a Prospective Trial Suggest Leukotriene Signaling and Alternative Macrophage Activation in Clinical Bronchiolitis Obliterans Syndrome. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00111-1] [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: 11/26/2022]
|
40
|
Tagkalos E, van der Sluis PC, Uzun E, Berlth F, Staubitz J, Gockel I, van Hillegersberg R, Lang H, Grimminger PP. The Circular Stapled Esophagogastric Anastomosis in Esophagectomy: No Differences in Anastomotic Insufficiency and Stricture Rates Between the 25 mm and 28 mm Circular Stapler. J Gastrointest Surg 2021; 25:2242-2249. [PMID: 33506342 PMCID: PMC8484169 DOI: 10.1007/s11605-020-04895-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/12/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND For patients undergoing an Ivor Lewis esophagectomy with a circular stapled anastomosis, the optimal diameter of the used circular stapler to restore continuity is unknown. The aim of this study was to compare the 25 mm stapled versus the 28 mm stapled esophagogastric anastomosis after Ivor Lewis esophagectomy, focusing on anastomotic insufficiency and postoperative anastomotic strictures. METHODS Between February 2008 and June 2019, 349 consecutive patients underwent Ivor Lewis esophagectomy with gastric conduit reconstruction and circular stapled anastomosis. Patient characteristics and postoperative results, such as anastomotic insufficiency rates, postoperative anastomotic stricture rates, time to anastomotic stricture rate, and the number of dilatations, were recorded in a prospective database and analyzed. RESULTS In 222 patients (64%), the 25 mm circular stapler was used and in 127 patients (36%) the 28 mm circular stapler was used. There were no differences in baseline characteristics. Anastomotic insufficiency rates were comparable between the 25 mm (12%) and the 28 mm groups (11%) (p = 0.751). There were no differences between postoperative anastomotic strictures in the 25 mm (14%) and the 28 mm groups (14%) (p = 0.863). Within patients with postoperative anastomotic strictures, a median number of 2 dilatations were observed in each group (p = 0.573) without differences in the time to first diagnosis (p = 0.412). CONCLUSION There were no differences in anastomotic insufficiency and postoperative anastomotic stricture rates between the 25 mm and the 28 mm circular stapled esophagogastric anastomosis after Ivor Lewis esophagectomy. Both the 25 mm and 28 mm stapler can be safely used to create a circular stapled esophagogastric anastomosis to restore continuity after esophagectomy.
Collapse
Affiliation(s)
- E. Tagkalos
- grid.410607.4Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - P. C. van der Sluis
- grid.410607.4Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - E. Uzun
- grid.410607.4Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - F. Berlth
- grid.410607.4Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - J. Staubitz
- grid.410607.4Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - I. Gockel
- grid.411339.d0000 0000 8517 9062Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - R. van Hillegersberg
- grid.7692.a0000000090126352Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H. Lang
- grid.410607.4Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peter P. Grimminger
- grid.410607.4Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| |
Collapse
|
41
|
Keller MD, Harris KM, Jensen-Wachspress MA, Kankate VV, Lang H, Lazarski CA, Durkee-Shock J, Lee PH, Chaudhry K, Webber K, Datar A, Terpilowski M, Reynolds EK, Stevenson EM, Val S, Shancer Z, Zhang N, Ulrey R, Ekanem U, Stanojevic M, Geiger A, Liang H, Hoq F, Abraham AA, Hanley PJ, Cruz CR, Ferrer K, Dropulic L, Gangler K, Burbelo PD, Jones RB, Cohen JI, Bollard CM. SARS-CoV-2-specific T cells are rapidly expanded for therapeutic use and target conserved regions of the membrane protein. Blood 2020; 136:2905-2917. [PMID: 33331927 PMCID: PMC7746091 DOI: 10.1182/blood.2020008488] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/01/2020] [Indexed: 12/25/2022] Open
Abstract
T-cell responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been described in recovered patients, and may be important for immunity following infection and vaccination as well as for the development of an adoptive immunotherapy for the treatment of immunocompromised individuals. In this report, we demonstrate that SARS-CoV-2-specific T cells can be expanded from convalescent donors and recognize immunodominant viral epitopes in conserved regions of membrane, spike, and nucleocapsid. Following in vitro expansion using a good manufacturing practice-compliant methodology (designed to allow the rapid translation of this novel SARS-CoV-2 T-cell therapy to the clinic), membrane, spike, and nucleocapsid peptides elicited interferon-γ production, in 27 (59%), 12 (26%), and 10 (22%) convalescent donors (respectively), as well as in 2 of 15 unexposed controls. We identified multiple polyfunctional CD4-restricted T-cell epitopes within a highly conserved region of membrane protein, which induced polyfunctional T-cell responses, which may be critical for the development of effective vaccine and T-cell therapies. Hence, our study shows that SARS-CoV-2 directed T-cell immunotherapy targeting structural proteins, most importantly membrane protein, should be feasible for the prevention or early treatment of SARS-CoV-2 infection in immunocompromised patients with blood disorders or after bone marrow transplantation to achieve antiviral control while mitigating uncontrolled inflammation.
Collapse
Affiliation(s)
- Michael D Keller
- Center for Cancer and Immunology Research and
- Division of Allergy and Immunology, Children's National Hospital, Washington, DC
- GW Cancer Center, George Washington University, Washington, DC
| | | | | | | | - Haili Lang
- Center for Cancer and Immunology Research and
| | | | - Jessica Durkee-Shock
- Center for Cancer and Immunology Research and
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | | | | | | | | | | | | | - Eva M Stevenson
- Division of Infectious Diseases, Weill Cornell Medicine, New York, NY
| | | | - Zoe Shancer
- Center for Cancer and Immunology Research and
| | - Nan Zhang
- Center for Cancer and Immunology Research and
| | | | | | | | | | - Hua Liang
- Department of Statistics, George Washington University, Washington, DC
| | - Fahmida Hoq
- Center for Cancer and Immunology Research and
| | - Allistair A Abraham
- Center for Cancer and Immunology Research and
- GW Cancer Center, George Washington University, Washington, DC
- Division of Blood and Marrow Transplantation and
| | - Patrick J Hanley
- Center for Cancer and Immunology Research and
- GW Cancer Center, George Washington University, Washington, DC
- Division of Blood and Marrow Transplantation and
| | - C Russell Cruz
- Center for Cancer and Immunology Research and
- GW Cancer Center, George Washington University, Washington, DC
| | - Kathleen Ferrer
- Division of Infectious Diseases, Children's National Hospital, Washington, DC
| | - Lesia Dropulic
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Krista Gangler
- Leidos Biomedical Research, Inc, Frederick National Laboratory, Frederick, MD; and
| | - Peter D Burbelo
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD
| | - R Brad Jones
- Division of Infectious Diseases, Weill Cornell Medicine, New York, NY
| | - Jeffrey I Cohen
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Catherine M Bollard
- Center for Cancer and Immunology Research and
- GW Cancer Center, George Washington University, Washington, DC
- Division of Blood and Marrow Transplantation and
| |
Collapse
|
42
|
Grant M, Fortiz MF, Wang L, Lang H, Datar A, Reynolds E, Terpilowski M, Lazarski C, Tanna J, Pitino A, Zhang N, Hoq F, Hanley P, Kilburn L, Packer R, Rood B, Bollard C, Hwang E. EPCT-15. THE REMIND TRIAL: MULTI-ANTIGEN TARGETED T CELLS FOR PEDIATRIC CNS TUMORS. Neuro Oncol 2020. [PMCID: PMC7715090 DOI: 10.1093/neuonc/noaa222.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Patients with relapsed CNS malignancies or DIPG face terrible prognoses. We hypothesized that T cells specific for 3 tumor-associated antigens (TAA), WT1, PRAME and survivin, would be safe and elicit anti-tumor immunity. METHODS Patients (n=9) have received autologous tumor antigen-associated T cells (TAAT) (up to 4x107/m2) for newly diagnosed DIPG (Group A) or recurrent CNS malignancies (Group B) on a Phase I dose-escalation study (NCT03652545) and were monitored for safety and response. RESULTS/ DISCUSSION 9/9 patients who received TAAT completed the 45-day safety monitoring phase with no dose-limiting toxicities. Infused cells were predominantly CD3+ T cells (median 96%; range: 87–99%), with CD4+ and CD8+ comprising 16% (range: 5–87%) and 40% (range: 4–67%) of the CD3+ cells, respectively. TAAT with specificity for 1–3 TAAs, at varying frequencies, was demonstrated in 8/9 TAAT by anti-IFN-γ ELISPOT. Plasma cytokine profiles demonstrated infusion-related immune cytokine responses. In summary, TAAT are safe and may elicit anti-tumor responses in vivo. To confirm TAAT-driven effects, we are evaluating plasma proteomic profiles for immune-response signatures and assessing unique T cell receptor rearrangements of infused TAAT. Response assessment and dose escalation are ongoing.
Collapse
Affiliation(s)
| | | | - Lu Wang
- Children’s National Hospital, Washington, DC, USA
| | - Haili Lang
- Children’s National Hospital, Washington, DC, USA
| | | | | | | | | | - Jay Tanna
- Children’s National Hospital, Washington, DC, USA
| | | | - Nan Zhang
- Children’s National Hospital, Washington, DC, USA
| | - Fahmida Hoq
- Children’s National Hospital, Washington, DC, USA
| | | | | | - Roger Packer
- Children’s National Hospital, Washington, DC, USA
- George Washington University, Washington, DC, USA
| | - Brian Rood
- Children’s National Hospital, Washington, DC, USA
| | - Catherine Bollard
- Children’s National Hospital, Washington, DC, USA
- George Washington University, Washington, DC, USA
| | - Eugene Hwang
- Children’s National Hospital, Washington, DC, USA
| |
Collapse
|
43
|
Watzka FM, Meyer F, Staubitz JI, Fottner C, Schad A, Lang H, Musholt TJ. Prognostic Assessment of Non-functioning Neuroendocrine Pancreatic Neoplasms as a Basis for Risk-Adapted Resection Strategies. World J Surg 2020; 44:594-603. [PMID: 31605171 DOI: 10.1007/s00268-019-05220-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND In contrast to exocrine pancreatic carcinomas, prognosis and treatment of pancreatic neuroendocrine neoplasms (PNEN) are significantly different. The variable growth pattern and associated clinical situation of functioning and non-functioning PNEN demand an individualized surgical approach. However, due to the scarce evidence associated with the rare disease, guidelines lack detailed recommendations for indication and for the required extent of surgical resection. METHODS In a retrospective single-center study from 1990 to 2018, 239 patients with PNEN were identified. Clinical data were collected in the MaDoc database of the University Medical Center Mainz. A total of 155 non-functional PNEN were selected for further analysis. RESULTS According to the classification of NET by the WHO in 2017, 28.8% (n = 40) of the tumors were G1, 61.9% (n = 86) G2, and 9.4% (n = 13) G3. In 73 patients, hepatic metastases were present. Sixty patients had lymph node metastasis. An R0 resection was achieved in 98 cases, an R1 situation in 10 cases. Five times, a tumor debulking was carried out (R2) and 5 times the operation was aborted without any resection because of the advanced tumor stage. A relapse occurred in 29 patients. Different prognostic factors (grade, tumor size, age) were analyzed. Grade-dependent 10-year overall survival rates were 79.5% (grade 1) and 60.1% (grade 2), respectively. The survival rate of grade 3 patients was limited to 66.7% after 13 months. CONCLUSION In our study, patients with non-functioning PNEN had a longer overall survival after successful R0 resection. The risk analysis confirmed a Ki-67 cutoff value of 5%, which divided a high- and low-risk group. Patients with a PNEC G3 (Ki-67 index > 50%) had a very poor prognosis.
Collapse
Affiliation(s)
- F M Watzka
- Endocrine Surgery, Clinic of General, Visceral- and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - F Meyer
- Endocrine Surgery, Clinic of General, Visceral- and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - J I Staubitz
- Endocrine Surgery, Clinic of General, Visceral- and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - C Fottner
- Endocrinology and Metabolic Diseases, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - A Schad
- Institute of Pathology, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - H Lang
- Institute of Pathology, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - T J Musholt
- Endocrine Surgery, Clinic of General, Visceral- and Transplantation Surgery, University Medical Center University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
| |
Collapse
|
44
|
Grant M, Fortiz MF, Wang J(L, Lang H, Datar A, Reynolds E, Terpilowski M, Lazarski C, Tanna J, Pitino A, Zhang N, Hoq F, Hanley P, Kilburn L, Packer R, Rood B, Bollard C, Hwang E. CTIM-33. THE REMIND TRIAL: MULTI-ANTIGEN TARGETED T CELLS FOR PEDIATRIC CNS TUMORS. Neuro Oncol 2020. [DOI: 10.1093/neuonc/noaa215.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Patients with relapsed CNS malignancies or DIPG face terrible prognoses. We hypothesized that T cells specific for 3 tumor-associated antigens (TAA), WT1, PRAME and survivin, would be safe and elicit anti-tumor immunity.
METHODS
Patients (n=15) received autologous tumor antigen-associated T cells (TAAT) (up to 4x107/m2) for newly diagnosed DIPG (Group A) or recurrent CNS malignancies (Group B) on a Phase I dose-escalation study (NCT03652545) and were monitored for safety and response.
RESULTS/DISCUSSION
15/15 patients who received TAAT completed the 45-day safety monitoring phase with no dose-limiting toxicities. Adverse events were minimal despite multiple pretreatments in Group B. Infused cells were predominantly CD3+ T cells (median 96%; range: 87–99%), with CD4+ and CD8+ comprising 16% (range: 5–87%) and 40% (range: 4–67%) respectively. Specificity for 1–3 TAAs was demonstrated in 13/15 TAAT by a-IFN-γ ELISPOT. Plasma cytokine and proteomic analyses are ongoing but have demonstrated dynamic post-infusion immune cytokine and protein responses. Increases in the inflammatory and immune-stimulatory cytokines IL-1b, IL-6, IL-2 and IL-7 were observed post-infusion in most patients evaluated. Infusion-related increases in regulatory cytokines IL-10 and IL-13 were also observed in 4/7 patients. These results are consistent with an infusion-mediated immune response in vivo. Of 9 patients who have been tested thus far, 29/92 plasma proteins showed significant differences between dose levels 1 and 2, including increased IL-7 (p < 0.0004) and CD40L (p < 0.046) and reduced IL-4 (p < 0.0004). T cell receptor sequencing data on in vivo TAAT persistence is pending. In summary, TAAT have thus far been safe and elicit immune responses in vivo. Clinical and immunologic response assessments are ongoing.
Collapse
Affiliation(s)
- Melanie Grant
- Children’s National Hospital, Silver Spring, MD, USA
| | | | | | - Haili Lang
- Children’s National Hospital, Washington, DC, USA
| | | | | | | | | | - Jay Tanna
- Children’s National Hospital, Washington, DC, USA
| | | | - Nan Zhang
- Children’s National Hospital, Washington, DC, USA
| | - Fahmida Hoq
- Children’s National Hospital, Washington, DC, USA
| | | | | | - Roger Packer
- Children’s National Hospital, Washington, DC, USA
| | - Brian Rood
- Children’s National Hospital, Washington, DC, USA
| | | | - Eugene Hwang
- Children’s National Hospital, Washington, DC, USA
| |
Collapse
|
45
|
Gaillard V, Tricard T, Garnon J, Cazzato R, Gangi A, Lang H. Thérapies ablatives itératives dans le cancer du rein héréditaire ou multifocal : résultats fonctionnels et oncologiques. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.159] [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: 10/23/2022]
|
46
|
Benichou Y, Bernhard J, Bensalah K, Roupret M, Dariane C, Paparel P, Lebacle C, Bruyere F, Nouhaud F, Soulie M, Villers A, Lang H, Durand X, Bigot P, Long J, Champy C. Étude UROCCR 54 RURANPO : néphrectomie partielle sur rein unique : comparaison des voies ouverte et laparoscopique robot-assistée. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.100] [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: 11/26/2022]
|
47
|
Harris KM, Horn SE, Grant ML, Lang H, Sani G, Jensen-Wachspress MA, Kankate VV, Datar A, Lazarski CA, Bollard CM, Keller MD. T-Cell Therapeutics Targeting Human Parainfluenza Virus 3 Are Broadly Epitope Specific and Are Cross Reactive With Human Parainfluenza Virus 1. Front Immunol 2020; 11:575977. [PMID: 33123159 PMCID: PMC7573487 DOI: 10.3389/fimmu.2020.575977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/16/2020] [Indexed: 11/13/2022] Open
Abstract
Human Parainfluenza Virus-3 (HPIV3) causes severe respiratory illness in immunocompromised patients and lacks approved anti-viral therapies. A phase I study of adoptively transferred virus-specific T-cells (VSTs) targeting HPIV3 following bone marrow transplantation is underway (NCT03180216). We sought to identify immunodominant epitopes within HPIV3 Matrix protein and their cross-reactivity against related viral proteins. VSTs were generated from peripheral blood of healthy donors by ex-vivo expansion after stimulation with a 15-mer peptide library encompassing HPIV3 matrix protein. Epitope mapping was performed using IFN-γ ELIspot with combinatorial peptide pools. Flow cytometry was used to characterize products with intracellular cytokine staining. In 10 VST products tested, we discovered 12 novel immunodominant epitopes. All products recognized an epitope at the C-terminus. On IFN-γ ELISpot, individual peptides eliciting activity demonstrated mean IFN-γ spot forming units per well (SFU)/1x105 cells of 115.5 (range 24.5-247.5). VST products were polyfunctional, releasing IFN-γ and TNF-α in response to identified epitopes, which were primarily HLA Class II restricted. Peptides from Human Parainfluenza Virus-1 corresponding to the HPIV3 epitopes showed cross-reactivity for HPIV1 in 11 of 12 tested epitopes (mean cross reactivity index: 1.19). Characterization of HPIV3 epitopes may enable development of third-party VSTs to treat immune suppressed patients with HPIV infection.
Collapse
Affiliation(s)
- Katherine M Harris
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States.,Center for Cancer and Blood Disorders, Children's National Hospital, Washington, DC, United States
| | - Sarah E Horn
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States
| | - Melanie L Grant
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States
| | - Haili Lang
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States
| | - Gelina Sani
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States
| | | | - Vaishnavi V Kankate
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States
| | - Anushree Datar
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States
| | - Christopher A Lazarski
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States
| | - Catherine M Bollard
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States.,Center for Cancer and Blood Disorders, Children's National Hospital, Washington, DC, United States.,GW Cancer Center, George Washington University, Washington, DC, United States
| | - Michael D Keller
- Center for Cancer and Immunology Research, Children's National Hospital, Washington, DC, United States.,GW Cancer Center, George Washington University, Washington, DC, United States.,Division of Allergy and Immunology, Children's National Hospital, Washington, DC, United States
| |
Collapse
|
48
|
Pignot G, Thiery-Vuillemin A, Walz J, Lang H, Werle P, Balssa L, Geoffrois L, Leblanc L, Albigès L, Di Nunno V, Bensalah K, Ladoire S, Gravis G, Barthélémy P. Nephrectomy after complete response to immune checkpoint inhibitors for metastatic Renal Cell Carcinoma (mRCC): A new surgical challenge? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33432-7] [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: 11/25/2022] Open
|
49
|
Debard C, Doumerc N, Dariane C, Bruyère F, Rizk J, Lebacle C, Bigot P, De La Taille A, Nouhaud F, Lang H, Bensalah K, Mejean A, Bernhard J. Multifocal renal tumours: A matched comparative study between robotic and open partial nephrectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32637-9] [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: 10/23/2022] Open
|
50
|
de Hauteclocque A, Dariane C, Doumerc N, Bruyère F, Champy C, Nouhaud FX, Bigot P, Jérôme R, Lang H, Lebâcle C, Pignot G, Long JA, Charles T, Tillou X, Paparel P, Boissier R, Bensalah K, Bernhard JC. Unexpected pathologic upstaging of clinically localised kidney cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33207-9] [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: 10/23/2022] Open
|