Engineered T cells secreting anti-BCMA T cell engagers control multiple myeloma and promote immune memory in vivo

Multiple myeloma is the second most common hematological malignancy in adults and remains an incurable disease. B cell maturation antigen (BCMA)-directed immunotherapy, including T cells bearing chimeric antigen receptors (CARs) and systemically injected bispecific T cell engagers (TCEs), has shown remarkable clinical activity, and several products have received market approval. However, despite promising results, most patients eventually become refractory and relapse, highlighting the need for alternative strategies. Engineered T cells secreting TCE antibodies (STAb) represent a promising strategy that combines the advantages of adoptive cell therapies and bispecific antibodies. Here, we undertook a comprehensive preclinical study comparing the therapeutic potential of T cells either expressing second-generation anti-BCMA CARs (CAR-T) or secreting BCMAxCD3 TCEs (STAb-T) in a T cell-limiting experimental setting mimicking the conditions found in patients with relapsed/refractory multiple myeloma. STAb-T cells recruited T cell activity at extremely low effector-to-target ratios and were resistant to inhibition mediated by soluble BCMA released from the cell surface, resulting in enhanced cytotoxic responses and prevention of immune escape of multiple myeloma cells in vitro. These advantages led to robust expansion and persistence of STAb-T cells in vivo, generating long-lived memory BCMA-specific responses that could control multiple myeloma progression in xenograft models, outperforming traditional CAR-T cells. These promising preclinical results encourage clinical testing of the BCMA-STAb-T cell approach in relapsed/refractory multiple myeloma.

Wave-particle duality in tripartite systems

Quantum objects, sometimes called quantons, often display a characteristic feature referred to as wave-particle duality (WPD). Lately, this and other quantum traits have been subjected to intensive research, mainly motivated by the development of quantum information science. As a consequence, the scopes of some concepts have been extended, and it has been realized that they are not in the exclusive domain of quantum physics. This is particularly clear in optics, where qubits may show up as Jones vectors and WPD has its counterpart as wave-ray duality. WPD was originally addressed by focusing on a single qubit, which was afterwards supplemented with a second one playing the role of a path-marker in an interferometer setup. Fringe contrast, a sign of wave-like behavior, was proved to be diminished in connection with the effectiveness of the marker, the inducer of particle-like behavior. Going from bipartite to tripartite states is a natural and necessary step towards better understanding of WPD. This step is what we have accomplished in this work. We report some constraints ruling WPD for tripartite systems, as well as their experimental display with single photons.

Experimental display of generalized wave-particle duality

The quantification of wave-particle duality (WPD) by means of measurable features associated to it, such as fringe visibility ($\mathcal {V}$) and path distinguishability ($\mathcal {D}$), led to the establishment of the constraint $\mathcal {V}^{2}+\mathcal {D}^{2} \leq \,1$. The two involved quantities refer to so-called "quantons", physical objects that are capable of generating an interferometric pattern, while being at least partially localizable. Any quanton's internal degree of freedom (DOF) can in principle be used as a path-marker. When the quanton and its internal DOF are simultaneously engaged, new constraints can be derived and experimentally tested. Generalized constraints show how $\mathcal {V}$ and $\mathcal {D}$ relate to other quantifiers and bring to light coherences that might remain otherwise hidden in both quantum and classical light. We submitted two-qubit constraints to experimental tests, using optical light beams. This shows that, despite the rather contrived nature of the constraints, linear optics setups are appropriate to test them. Our experimental results are in very good agreement with theoretical predictions related to the tested constraints. Our results also show that quantifiers such as $\mathcal {V}$ and $\mathcal {D}$ help not only to quantify, but also to generalize the concept of WPD.

Randomized clinical trial comparing liver resection with and without perioperative assessment of liver function

Background

Liver function tests may help to predict outcomes after liver surgery. The aim of this study was to evaluate the clinical impact on postoperative outcome and patient management of perioperative liver function testing using the LiMAx^® test.

Methods

A multicentre RCT was conducted in six academic liver centres. Patients with intrahepatic tumours scheduled for open liver resection of at least one segment were eligible. Patients were randomized to undergo additional perioperative liver function tests (LiMAx^® group) or standard care (control group). Patients in the intervention arm received two perioperative LiMAx^® tests, one before the operation for surgical planning and another after surgery for postoperative management. The primary endpoint was the proportion of patients transferred directly to a general ward. Secondary endpoints were severe complications, length of hospital stay (LOS) and length of intermediate care/ICU (LOI) stay.

Results

Some 148 patients were randomized. Thirty‐six of 58 patients (62 per cent) in the LiMAx^® group were transferred directly to a general ward, compared with one of 60 (2 per cent) in the control group (P < 0·001). The rate of severe complications was significantly lower in the LiMAx^® group (14 per cent versus 28 per cent in the control group; P = 0·022). LOS and LOI were significantly shorter in the LiMAx^® group (LOS: 10·6 versus 13·3 days respectively, P = 0·012; LOI: 0·8 versus 3·0 days, P < 0·001).

Conclusion

Perioperative use of the LiMAx^® test improves postoperative management and reduces the incidence of severe complications after liver surgery. Registration number: NCT01785082 ( https://clinicaltrials.gov).

Limit theorems for some continuous-time random walks

In this paper we consider the scaled limit of a continuous-time random walk (CTRW) based on a Markov chain {Xn,n≥ 0} and two observables, τ(∙) andV(∙), corresponding to the renewal times and jump sizes. Assuming that these observables belong to the domains of attraction of some stable laws, we give sufficient conditions on the chain that guarantee the existence of the scaled limits for CTRWs. An application of the results to a process that arises in quantum transport theory is provided. The results obtained in this paper generalize earlier results contained in Becker-Kern, Meerschaert and Scheffler (2004) and Meerschaert and Scheffler (2008), and the recent results of Henry and Straka (2011) and Jurlewicz, Kern, Meerschaert and Scheffler (2010), where {Xn,n≥ 0} is a sequence of independent and identically distributed random variables.

Genetic stability of human embryonic stem cells: A first-step toward the development of potential hESC-based systems for modeling childhood leukemia

Human ESCs provide an opportunity for modeling human-specific strategies to study the earliest events leading to normal hematopoietic specification versus leukemic transformation. Of interest, are the human childhood acute leukemias harboring specific fusion oncogenes such as MLL-AF4, TEL-AML1 or BCR-ABL wherein clinically significant manifestations arise in utero. The mechanisms of transformation are not amenable to analysis with patient samples and, many mouse models for pediatric leukemias have fallen short in illuminating the human disease because they do not recapitulate key aspects of the actual disease, suggesting that the mouse models are missing essential components of oncogenesis present in the human embryo. Prior to using hESCs as a tentative system for modeling leukemia, robust studies aimed at demonstrating their genetic stability are required; otherwise, cooperating mutations already present could prime hESCs susceptible to transformation. We performed an extensive molecular cytogenetic and cellular in vitro and in vivo analysis which reveals an overall genomic stability of HS181 and HS293 hESCs maintained long-term by mechanical dissociation in human feeders. Importantly, we show for the first time that the genetically stable HS181 hESC line differentiates into CD45+ hematopoietic cells and clonogenic hematopoietic progenitors. This data should encourage stem cell researchers to implement robust cytogenetic tools when assessing hESC genetic stability, in order to detect tiny but relevant biological functional or structural chromosome abnormalities and, paves the way for generating fusion oncogene-expressing transgenic hESCs as a human-specific system for studying the early in utero events leading to normal hematopoietic specification versus childhood leukemic transformation.

Age-induced apoptosis in the male genital tract of the mouse

We have examined the effects of ageing on the increase in apoptotic cells numbers in the male genital tract of the house mouse (Mus musculus). We have found that not all organs have the same response. There is an induction of apoptosis in both the epididymis and ventral prostate. However, seminal vesicles and other prostatic lobes remain unaffected. Apoptosis was assessed by several methods: TUNEL, detection of the active fragment of caspase-3 and the pattern of DNA fragmentation on agarose gels. This increase in apoptosis is related to the fall in testosterone levels, although there is only a partial decrease in androgen receptor (AR). AR is still present in all tissues and only moderately reduced in the epididymis and ventral prostate. A more intense increase of lipofuscin granules, which may be indicative of oxidative stress, occurred in these tissues. Finally, testosterone supplementation reverses the changes (both in apoptosis and lipofuscin content in the tissue), suggesting a role of androgens in these processes.

Epidemiology of congenital toxoplasmosis identified by population-based newborn screening in Massachusetts

BACKGROUND

Fourteen years of newborn screening in Massachusetts for congenital toxoplasmosis infection identified subpopulations that appeared to have higher rates of infection. Elaborating an epidemiologic profile and risk correlates might aid implementing targeted prenatal education and newborn screening strategies with the goal of early postnatal treatment to prevent morbidity.

OBJECTIVE

To describe the epidemiology of congenital toxoplasmosis in Massachusetts and risk correlates of infection using birth certificate data.

METHODS

A case-control study was conducted based on Massachusetts birth certificate data. Cases were all infants with congenital toxoplasmosis identified by statewide universal newborn screening from 1988 to 1999. Controls were all children born on the same day as those infants in Massachusetts.

RESULTS

Factors that strongly predicted congenital toxoplasmosis infection were mother's country of birth outside the US (especially the southeast Asian refugee origin countries of Cambodia and Laos), mother's educational level and higher gravidity.

CONCLUSIONS

More extensive, culturally and linguistically appropriate, prenatal education is needed for pregnant women, regardless of a mother's educational level, especially for non-US-born mothers, and not focused only on primiparous women. Other states may be able to use their state-specific birth certificate data to compare risk profiles with those of Massachusetts to guide a toxoplasmosis screening policy on the basis of population similarities and differences.

A newborn with nodular ulcerated lesion on a giant congenital nevus

The proliferative nodule is a lesion that develops within a congenital nevus. It is usually small (less than 5 mm), sometimes multiple, with a slow growth rate, and has a black or dark brown, smooth, shiny surface. It usually involutes spontaneously. We report a newborn infant who, at birth, had a giant congenital nevus with a nodular, ulcerative, hemorrhagic lesion within it. Physical and neurologic examinations were normal. Radiologic studies at birth and subsequently were normal. A fragment of the lesion was biopsied and histologic findings were compatible with a diagnosis of proliferative nodule in a giant congenital nevus. The rest of the nodule regressed spontaneously after 4 months.

Dermatomyositis and flagellate erythema

Flagellate erythema, described by Moulin in 1970 as reminiscent of the lesions produced by flogging and by other authors as zebra-like lesions, was noted first in association with bleomycin treatment, but later occasionally reported in relationship with dermatomyositis, mostly from Japan. It is characterized by linear, erythematous, cutaneous streaks, pruriginous or painful, arising on an oedematous background and disappearing spontaneously over several weeks. So far, fewer than five cases have been reported in association with dermatomyositis, but we now present a further one.