A high-yield microassembly structure for three-dimensional microelectrode arrays

This paper presents a practical microassembly process for three-dimensional (3-D) microelectrode arrays for recording and stimulation in the central nervous system (CNS). Orthogonal lead transfers between the micromachined two-dimensional probes and a cortical surface platform are formed by attaching gold beams on the probes to pads on the platform using wire-free ultrasonic bonding. The low-profile (150 microns) outrigger design of the probes allows the bonding of fully assembled high-density arrays. Micromachined assembly tools allow the formation of a full 3-D probe array within 30 min. Arrays having up to 8 x 16 shanks on 200-micron centers have been realized and used to record cortical single units successfully. Active 3-D probe arrays containing on-chip CMOS signal processing circuitry have also been created using the microassembly approach. In addition, a dynamic insertion technique has been explored to allow the implantation of high-density probe arrays into feline cortex at high-speed and with minimal traumatic injury.

Intratumoral CXCL13+CD8+T cell infiltration determines poor clinical outcomes and immunoevasive contexture in patients with clear cell renal cell carcinoma

Background

Chemokine (C-X-C motif) ligand 13 (CXCL13) was known as a selective chemotaxis for B cells, a product of follicular helper CD4⁺T cells (T_FH) and a contributor to tertiary lymphoid structures (TLS). Although secretion and function of CXCL13 produced by T_FH have been deeply explored, the immune function and prognostic significance of CXCL13 secreted by CD8⁺T cells still remain unrevealed. This study aims to investigate the clinical merit of CXCL13⁺CD8⁺T cells in clear cell renal cell carcinoma (ccRCC).

Methods

We analyzed prognostic value and immune contexture that associated with CXCL13⁺CD8⁺T cells infiltration level in a total of 755 patients from Zhongshan Hospital cohort (n=223) and The Cancer Genome Atlas cohort (n=532). In vitro analyses were conducted on 42 samples of resected tumor tissue from Zhongshan Hospital in order to detect the immune status of CXCL13⁺CD8⁺T cells and total CD8⁺T cells. Immunohistochemistry (IHC) and flow cytometry were applied to characterize immune cells and portray the tumor microenvironment (TME) in ccRCC.

Results

Intratumoral CXCL13⁺CD8⁺T cells abundance was associated with inferior overall survival and disease-free survival. CXCL13⁺CD8⁺T cells possessed higher level of immune checkpoints like programmed cell-death protein 1 (PD-1), T-cell immunoglobulin mucin 3 (Tim-3), T cell immunoreceptor with Ig and ITIM domains (TIGIT) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), higher Ki-67 expression and lower tumor necrosis factor α (TNF-α), interferon γ (IFN-γ) expression. Total CD8⁺T cells in high-level CXCL13⁺CD8⁺T cells infiltration subgroup exhibited elevated exhausted markers (PD-1, Tim-3, TIGIT) and descended activated markers (TNF-α, IFN-γ) without quantity variance. Furthermore, the abundance of intratumoral CXCL13⁺CD8⁺T cell was correlated with immunoevasive TME accompanied by increased T helper 2 cells, tumor-associated macrophages, Foxp3⁺ regulatory T cells, TLS and decreased natural killer cells, GZMB⁺ cells.

Conclusions

Intratumoral CXCL13⁺CD8⁺T cells infiltration indicated inferior clinical outcome in patients with ccRCC. CXCL13⁺CD8⁺T cells possessed increased exhausted markers, decreased effector molecules and better proliferation ability. CXCL13⁺CD8⁺T cells abundance impaired total CD8⁺T cells’ immune function. Intratumoral CXCL13⁺CD8⁺T cells abundance was associated with immunoevasive contexture. The abundance of CXCL13⁺CD8⁺T cells was an independent prognosticator and a potential immunotherapeutic target marker for ccRCC treatment.

Emission of Climate-Relevant Trace Gases and Succession of Microbial Communities during Open-Windrow Composting

Determination of different indicators of microbial biomass, community structure, and bioactivity by the fumigation extraction method, as well as determination of phospholipid fatty acids (PLFAs) and their subfractions and the measurement of trace gases, respectively, provides valuable information about microbial succession in composting processes. The emission rates of carbon dioxide (CO(inf2)), methane (CH(inf4)), and nitrous oxide (N(inf2)O) increased successively during compost maturation: initially in the presence of easily degradable nutrients, during high temperature, and after the temperature had cooled down, respectively. The emission rate patterns of these trace gases corresponded to the concentrations of PLFAs and their particular subfractions. (i) Similar to the CO(inf2) emission rates, microbial biomass estimations by fumigation extraction and by determination of the amount of total PLFAs showed a discontinuous decrease during the composting process, with a slight increase at the end of the observation period. (ii) An increase in ether lipids, indicating the enhanced presence of archaean methanogens, and an elevated CH(inf4) emission were observed at the same time. (iii) The period of enhanced N(inf2)O emission corresponded to the increase in beta and omega hydroxy fatty acids derived from the outer membrane. Additionally, the continuous increase in branched-chain fatty acids suggested an increase in gram-positive bacteria and actinomycetes, and the decrease in polyunsaturated fatty acids indicated a decrease in eukaryotic cells during the composting.

Intratumoral TIGIT+ CD8+ T-cell infiltration determines poor prognosis and immune evasion in patients with muscle-invasive bladder cancer

Background

T-cell immunoglobulin and ITIM domain (TIGIT) is identified as a novel checkpoint receptor that can facilitate immune escape via mediating T-cell exhaustion in tumors. However, the clinical significance and immune contexture correlation of intratumoral TIGIT⁺ CD8⁺ T-cells remain to be further explored in muscle-invasive bladder cancer (MIBC).

Methods

259 patients with MIBC from two clinical centers (Zhongshan Hospital, n=141; Shanghai Cancer Center, n=118) were analyzed to evaluate the prognostic value and immune contexture association of TIGIT⁺ CD8⁺ T-cells through immunohistochemistry. Fresh tumor tissue samples from 26 patients with MIBC were examined to discover the phenotype of this CD8 subpopulation by flow cytometry.

Results

High infiltration of intratumoral TIGIT⁺ CD8⁺ T-cells predicted poor overall survival (OS) and recurrence-free survival (RFS) in MIBC. For patients with stage II MIBC with low infiltration of TIGIT⁺ CD8⁺ cells, adjuvant chemotherapy (ACT) could significantly prolong their OS and RFS. Intratumoral TIGIT⁺ CD8⁺ T-cell abundance was correlated with impaired CD8⁺ T-cell cytotoxicity and exhibited production of immunosuppressive cytokine IL-10. Further analysis of tumor-infiltrating immune cell landscape revealed TIGIT⁺ CD8⁺ T-cells were associated with suppressive immune contexture, including Th2 cells, regulatory T-cells, mast cells and neutrophils.

Conclusion

Intratumoral TIGIT⁺ CD8⁺ T-cell abundance could serve as an independent prognosticator for clinical outcome and a predictive biomarker for inferior ACT responsiveness. Intratumoral TIGIT⁺ CD8⁺ T-cell abundance correlated with dampened CD8⁺ T-cell antitumor immunity and immunosuppressive contexture abundance, highlighting a tumor-promoting role of TIGIT⁺ CD8⁺ T-cells.

Single-unit neural recording with active microelectrode arrays

This paper discusses the single-unit recording characteristics of microelectrode arrays containing on-chip signal processing circuitry. Probes buffered using on-chip unity-gain operational amplifiers provide an output resistance of 200 ohm with an input-referred noise of 11-muV root-mean-square (rms) (100 Hz-10 kHz). Simultaneous in vivo recordings from single neurons using buffered and unbuffered (passive) iridium recording sites separated by less than 20 microm have shown that the use of on-chip circuitry does not significantly degrade system noise. Single-unit neural activity has also been studied using probes containing closed-loop preamplifiers having a voltage gain of 40 dB and a bandwidth of 13 kHz, and several input dc-baseline stabilization techniques have been evaluated. Low-noise in vivo recordings with a multiplexed probe have been demonstrated for the first time using an external asymmetrical clock running at 200 kHz. The multiplexed system adds less than 8-muV rms of noise to the recorded signals, suppressing the 5-V clock transitions to less than 2 ppm.

At least two genetically distinct large Babesia species infective to sheep and goats in China

A fatal disease of sheep and goats in the northern part of China has been reported to be due to Babesia ovis. However, some characteristics of the causative agent in recent reports are not in accordance with the original attributes ascribed to this parasite. Therefore, the 18S small subunit ribosomal RNA (18S rRNA) genes of a number of Babesia isolates in China were sequenced and compared with that of other Babesia and Theileria species in an attempt to clarify their taxonomic position. In the present study, seven Babesia isolates were collected from distinct areas of northern China, and the 18S rRNA genes were amplified and sequenced. The phylogenetic trees were inferred based on 18S rRNA gene sequences of the Chinese ovine Babesia isolates and some of ovine Babesia and Theileria species available in GenBank. In the phylogenetic tree, Babesia sp. isolates from Madang, Tianzhu, Lintan, Ningxian, Hebei and Liaoning all grouped with B. motasi with 88.2-99.9% identity, while Babesia sp. Xinjiang grouped in a separate clade between B. ovis and B. crassa with 79.7-81.2% identity. The results indicated that there are at least two distinct Babesia species groups-B. motasi and Babesia sp. Xinjiang, the latter was distinctly different from other ovine Babesia isolates from China with less than 86.6% identity.

Phylogenetic analysis of Theileria species transmitted by Haemaphysalis qinghaiensis

The phylogenetic relationships between six isolates of Theileria spp. infective to small ruminants, and two isolates of Theileria spp. infective to yak, all transmitted by Haemaphysalis qinghaiensis, together with the Theileria orientalis/sergenti/buffeli group and T. sinensis, were analyzed using the 18S ssrRNA gene sequence. The target DNA segment was amplified by polymerase chain reaction (PCR). The PCR product was used either for direct sequencing or was ligated to the PCR II vector for sequencing. The length of the 18S ssrRNA gene of all Theileria spp. involved in this study was around 1,740 bp. Two phylogenetic trees were inferred based on the 18S ssrRNA gene sequence of the Chinese isolates only, and Chinese isolates and other species of Theileria available in GenBank. In the first tree, the Theileria sp. infective to yaks was found to be T. sinensis. The Theileria sp. infective to small ruminants was found to be composed of two separate species of Theileria. Theileria sp. from Qinghai, Madang, Ningxian and Lintan, which was identical to the unidentified Theileria sp. described previously, is designated Theileria sp (China 1). The Theileria sp. from Longde, Zhangjiachuan and Lintan, which has not been described previously, is designated Theileria sp. (China 2) in order to avoid confusion. In the second tree, Theileria sp. (China 1) was closely related to benign Theileria, such as T. buffeli and T. sergenti, while Theileria sp. (China 2) was separated from other Theileria spp. The results indicate that H. qinghaiensis transmit at least three species of Theileria, two which are infective to sheep and goats, but not yak and one which is infective to yaks and cattle, but not to sheep and goats.

Blockade of DC-SIGN+ Tumor-Associated Macrophages Reactivates Antitumor Immunity and Improves Immunotherapy in Muscle-Invasive Bladder Cancer

Tumor-associated macrophages (TAM) play an indispensable role in the modulation of the cancer immune microenvironment. Despite the fact that TAMs may exert both antitumor and protumor activities, the molecular mechanisms involved remain poorly understood. Here, we characterized a subpopulation of TAMs expressing dendritic cell-specific C-type lectin (DC-SIGN) and investigated its relevance to the prognosis and immune microenvironment of muscle-invasive bladder cancer (MIBC). DC-SIGN⁺ TAMs were abundant in a significant proportion of human MIBC specimens. High levels of DC-SIGN⁺ TAMs were associated with dismal prognosis and unresponsiveness to adjuvant chemotherapy in MIBC. Notably, multiple anti-inflammatory cytokines were enriched in DC-SIGN⁺ TAMs. RNA-seq analysis revealed that multiple M2-like signaling pathways were significantly upregulated in DC-SIGN⁺ TAMs. High infiltration of DC-SIGN⁺ TAMs was associated with CD8⁺ T-cell tolerance in MIBC. Moreover, abrogating DC-SIGN function using a neutralizing antibody led to impaired expression of anti-inflammatory cytokines and augmented PD-1 inhibitor pembrolizumab-mediated cytotoxic effects of CD8⁺T cells toward MIBC cells. In summary, these results suggest that DC-SIGN⁺ TAM infiltration is closely linked to a protumor immune microenvironment and may serve as a promising therapeutic target in the immunotherapy of MIBC. SIGNIFICANCE: DC-SIGN⁺ TAMs have an immunosuppressive and tumor-promoting function and may serve as a prognostic indicator and therapeutic target in MIBC.

Isolation and preliminary characterization of a large Babesia sp. from sheep and goats in the eastern part of Gansu Province, China

Two species of Babesia were isolated from naturally infected sheep in the eastern part of Gansu province. One of the species was identified as B. ovis, while the another one seems as yet to be an unidentified Babesia species. The latter could be transmitted transovarially by Haemaphysalis longicornis. It was shown that larvae and nymphs transmit the organism to sheep and goats with a prepatent period of 5-28 days. As the carrier period of B. ovis is longer than that of the larger species and the prepatent period of the larger Babesia is shorter than that of B. ovis, it was possible to isolate the unidentified larger species. The larger Babesia is polymorphic, including double pyriform, single pyriform, ring-form, rod-like, three-leafed and budding forms. The size of typical paired pyriforms was 1.8-2.5 microm x 0.9-1.8 microm, with mean dimensions of 2.21 +/- 0.12 microm x 1.17 +/- 0.18 microm. The parasite causes a severe course of infection associated with a parasitaemia as high as 23.7% and with a high mortality rate in both sheep and goats, being very marked in lambs and imported small ruminants.

Efficient and intuitive method for the analysis of light scattering by a resonant nanostructure

We present a semi-analytical formalism capable of handling the coupling of electromagnetic sources, such as point dipoles or free-propagating fields, with various kinds of dissipative resonances with radiation leakage, Ohmic losses or both. Due to its analyticity, the approach is very intuitive and physically-sound. It is also very economic in computational resources, since once the resonances of a plasmonic or photonic resonator are known, their excitation coefficients are obtained analytically, independently of the polarization, frequency or location of the excitation source. To evidence that the present formalism is very general and versatile, we implement it with the commercial software COMSOL, rather than with our in-house numerical tools.

Resveratrol improves delayed r-tPA treatment outcome by reducing MMPs

OBJECTIVES

Although recombinant tissue plasminogen activator (r-tPA) is currently the most effective treatment for brain ischemic stroke, the 3-h narrow therapeutic windows severely limits its clinical efficacy. We aim to investigate the effect of resveratrol on improving treatment outcomes of delayed r-tPA administration.

MATERIALS & METHODS

Patients were randomly divided according to their onset-to-treatment time (OTT), as early OTT or delayed OTT. Then, they were either treated with r-tPA + placebo or with r-tPA + resveratrol. Twenty-four hours after the treatment, outcomes were assessed with NIH stroke scale (NIHSS), and plasma levels of MMP-2 and MMP-9 were also examined with ELISA.

RESULTS

In patients receiving delayed r-tPA treatment, co-administration of resveratrol significantly improves their treatment outcomes compared with those receiving placebo, as indicated by improved NIHSS scores. This improved outcome was be caused by resveratrol-induced reduction in plasma levels of both matrix metalloproteinase (MMP)-2 and MMP-9, as a positive correlation was observed between reductions in both MMPs and patient NIHSS scores.

CONCLUSIONS

Resveratrol could be potentially administered as an adjuvant with r-tPA treatment, which extends the clinical therapeutic window of r-tPA, therefore improving the outcome of patients receiving late stroke treatment.

Detecting and differentiating Theileria sergenti and Theileria sinensis in cattle and yaks by PCR based on major piroplasm surface protein (MPSP)

Theileria sergenti and Theileria sinensis are closely related members of benign Theileria species found in cattle and yaks in China. They are morphologically indistinguishable. A polymerase chain reaction (PCR) targeting major piroplasm surface protein of T. sergenti and T. sinensis was developed in this study. The newly developed oligonucleotide primer set was able to specifically amplify the DNA of T. sinensis and in conjunction with primers for T. sergenti and these two species could be detected and distinguished. Specificity testing also revealed that there was no cross-reaction with the other tick-borne diseases Theileria annulata, Babesia ovata, Anaplasma marginale as well as bovine white blood cells. Phylogenetic analysis based on the MPSP gene sequences confirmed the specificity of PCR assays. The sensitivity of the methods was 0.1pg DNA for the T. sergenti PCR and 1pg DNA for T. sinensis PCR. Two hundred and thirty-six field blood samples from of cattle and yaks were collected from five different geographical regions in China where benign Theileria species have been found. T. sergenti was found in all five provinces but was absent from one county in Gansu Province. T. sinensis was only found in Gansu Province. In both counties in Gansu where the parasites co-existed, mixed infections were detected. Our results indicate that the PCR methods developed in this study are suitable for the detection and differentiation of T. sergenti and T. sinensis.

A new ovine Babesia species transmitted by Hyalomma anatolicum anatolicum

The pathogenicity and morphology of a large Babesia species, Babesia sp. Xinjiang, are described here. The parasite has very low virulence for sheep, and caused no detectable clinical symptoms. Splenectomized sheep infected with the parasite showed mild fever and low parasitemia and would recover gradually. If splenectomized sheep were immuno-suppressed with dexamethasone, the parasitemia could reach 8.5%, and death occurred. A splenectomized calf could not be infected with the Babesia species. Paired parasites were the typical form of the Babesia species in erythrocytes and the average size of a pair of parasites was 2.42 (+/-0.35) microm x 1.06 (+/-0.22) microm. Merozoites were found in the gut, salivary gland, haemolymph, ovary and eggs of female Hyalomma anatolicum anatolicum engorged on sheep infected with the parasites. The results of experimental transmission showed that the larval, nymph and adult stages of H. a. anatolicum could transmit the Babesia species to sheep.

Experimental transmission of Theileria uilenbergi infective for small ruminants by Haemaphysalis longicornis and Haemaphysalis qinghaiensis

The experimental transmission of a recently designated Theileria uilenbergi pathogenic for sheep and goats in Northern China is described. Haemaphysalis qinghaiensis nymphs and adults developed from larvae and nymphs engorged on sheep infected with T. uilenbergi were able to respectively transmit the latter to sheep. However, when H. longicornis ticks picked up T. uilenbergi either at larval or nymphal, only the subsequent adult could transmit the parasites to sheep, the subsequent nymph could not transmit the parasites to sheep. This experiment suggested that the T. uilenbergi could be transmitted by at least two species of Haemaphysalis sp. ticks, H. longicornis and H. qinghaiensis, and the mode of transmission is stage to stage.

Identification and validation of dichotomous immune subtypes based on intratumoral immune cells infiltration in clear cell renal cell carcinoma patients

Background

Increasing evidence has elucidated the clinical significance of tumor infiltrating immune cells in predicting outcomes and therapeutic efficacy. In this study, we comprehensively analyze the tumor microenvironment (TME) immune cell infiltrations in clear cell renal cell carcinoma (ccRCC) and correlated the infiltration patterns with anti-tumor immunity and clinical outcomes.

Methods

We analyzed immune cell infiltrations in four independent cohorts, including the KIRC cohort of 533 patients, the Zhongshan ccRCC cohorts of 259 patients, the Zhongshan fresh tumor sample cohorts of 20 patients and the Zhongshan metastatic ccRCC cohorts of 87 patients. Intrinsic patterns of immune cell infiltrations were evaluated for associations with clinicopathological characteristics, underlying biological pathways, genetic changes, oncological outcomes and treatment responses.

Results

Unsupervised clustering of tumor infiltrating immune cells identified two microenvironment subtypes, TMEcluster-A and TMEcluster-B. Gene markers and biological pathways referring to immune evasion were upregulated in TMEcluster-B. TMEcluster-B associated with poor overall survival (p<0.001; HR 2.629) and recurrence free survival (p=0.012; HR 1.870) in ccRCC validation cohort. TMEcluster-B cases had worse treatment response (p=0.009), overall survival (p<0.001; HR 2.223) and progression free survival (p=0.015; HR 2.7762) in metastatic ccRCC cohort. The predictive accuracy of International Metastatic Database Consortium risk score was improved after incorporation of TME clusters.

Conclusions

TMEcluster-A featured increased mast cells infiltration, prolonged survival and better treatment response. TMEcluster-B was a heavily infiltrated but immunosuppressed phenotype enriched for macrophages, CD4⁺ T cells, Tregs, CD8⁺ T cells and B cells. TMEcluster-B predicted dismal survival and worse treatment response in clear cell renal cell carcinoma patients.

Accelerating Quinoline Biodegradation and Oxidation with Endogenous Electron Donors

Quinoline, a recalcitrant heterocyclic compound, is biodegraded by a series of reactions that begin with mono-oxygenations, which require an intracellular electron donor. Photolysis of quinoline can generate readily biodegradable products, such as oxalate, whose bio-oxidation can generate endogenous electron donors that ought to accelerate quinoline biodegradation and, ultimately, mineralization. To test this hypothesis, we compared three protocols for the biodegradation of quinoline: direct biodegradation (B), biodegradation after photolysis of 1 h (P1h+B) or 2 h (P2h+B), and biodegradation by adding oxalate commensurate to the amount generated from photolysis of 1 h (O1+B) or 2 h (O2+B). The experimental results show that P1h+B and P2h+B accelerated quinoline biodegradation by 19% and 50%, respectively, compared to B. Protocols O1+B and O2+B also gave 19% and 50% increases, respectively. During quinoline biodegradation, its first intermediate, 2-hydroxyquinoline, accumulated gradually in parallel to quinoline loss but declined once quinoline was depleted. Mono-oxygenation of 2-hydroxyquinoline competed with mono-oxygenation of quinoline, but the inhibition was relieved when extra electrons donors were added from oxalate, whether formed by UV photolysis or added exogenously. Rapid oxalate oxidation stimulated both mono-oxygenations, which accelerated the overall quinoline oxidation that provided the bulk of the electron donor.

Haemaphysalis qinghaiensis ticks transmit at least two different Theileria species: one is infective to yaks, one is infective to sheep

Adult Haemaphysalis qinghaiensis ticks from Gannan area, where ovine theileriosis is prevalent but bovine theileriosis has not been reported, transmitted Theileria parasites to yaks and sheep. Blood from the infected yak contained Theileria parasites that were infective to yaks, but not sheep. In contrast, blood from the infected sheep did not contain Theileria parasites infective to yaks. These results suggested that the ticks from the Gannan area were infected with two species of Theileria one which specifically parasitises yaks, one which parasitises sheep. Both infections were more aggressive in splenectomised hosts as compared to intact host. Adult H. qinghaiensis ticks from Zhanjiachuan area, where ovine theileriosis is prevalent but where no yaks are raised, transmitted Theileria parasites to ovine, but not yaks. Taken together these results indicate that H. qinghaiensis ticks may be infected with two different Theileria species. The species infective for sheep could be related to the newly recognised, but not yet named, pathogen recently reported in small ruminants in China. The species infective for yaks appears to be benign and is morphologically similar to parasites of the Theileria sergenti/orientalis/buffeli group.

Tumor infiltrating mast cells determine oncogenic HIF-2α-conferred immune evasion in clear cell renal cell carcinoma

PURPOSE

Hypoxia-inducible factor 2α (HIF-2α) overexpression leads to activation of angiogenic pathways. However, little is known about the association between HIF-2α expression and anti-tumor immunity in clear cell renal cell carcinoma (ccRCC). We aimed to explore how HIF-2α influenced the microenvironment and the underlying mechanisms.

EXPERIMENTAL DESIGN

We immunohistochemically evaluated immune cells infiltrations and prognostic value of HIF-2α expression in a retrospective Zhongshan Hospital cohort of 280 ccRCC patients. Fresh tumor samples, non-tumor tissues and autologous peripheral blood for RT-PCR, ELISA and flow cytometry analyses were collected from patients who underwent nephrectomy in Zhongshan Hospital from September 2017 to April 2018. The TCGA KIRC cohort and SATO cohort were assessed to support our findings.

RESULTS

We demonstrated that ccRCC patients with HIF-2αhigh tumors exhibited reduced overall survival (p = 0.025) and recurrence-free survival (p < 0.001). Functions of CD8+ T cells were impaired in HIF-2αhigh patients. In ccRCC patients, HIF-2α induced the expression of stem cell factor (SCF), which served as chemoattractant for mast cells. Tumor infiltrating mast cells impaired anti-tumor immunity partly by secreting IL-10 and TGF-β. HIF-2α mRNA level adversely associated with immunostimulatory genes expression in KIRC and SATO cohorts.

CONCLUSIONS

HIF-2α contributed to evasion of anti-tumor immunity via SCF secretion and subsequent recruitment of mast cells in ccRCC patients.

Prognostic Value of SETD2 Expression in Patients with Metastatic Renal Cell Carcinoma Treated with Tyrosine Kinase Inhibitors

PURPOSE

Mutations of SETD2 occur in 3% to 16% of clear cell renal cell carcinoma cases. Previous studies identified an association between SETD2 mutation and prognosis of patients with nonmetastatic clear cell renal cell carcinoma. In this study we explored the prognostic and predictive value of SETD2 expression in patients with metastatic renal cell carcinoma treated with targeted therapy.

MATERIALS AND METHODS

We retrospectively enrolled 138 patients with metastatic renal cell carcinoma treated with sunitinib or sorafenib at a single institution from 2007 to 2014. SETD2 expression was assessed by immunohistochemistry on tissue microarrays.

RESULTS

After excluding those patients with loss of followup or unavailable tissue samples, 111 were included in the study. Low SETD2 expression was associated with reduced overall survival (p <0.001) and progression-free survival (p=0.001). After adjustment for histological type, Heng risk group and drugs used for targeted therapy, SETD2 was defined as an independent prognostic marker for overall survival (HR 2.535 [95% CI 1.429-4.497], p=0.001) and progression-free survival (HR 1.755 [95% CI 1.031-2.988], p=0.038). Its prognostic value for overall survival was more predominant in patients with clear cell renal cell carcinoma (p <0.001) or patients in the intermediate risk group of Heng risk criteria (p <0.001), while its predictive value for progression-free survival was more predominant in patients treated with sorafenib (p <0.001). SETD2 could also be combined with the Heng risk model for better overall survival prediction.

CONCLUSIONS

SETD2 is a potential prognostic biomarker for overall survival and progression-free survival prediction in patients with metastatic renal cell carcinoma receiving targeted therapy. However, it remains to be seen whether this is generalizable to other ethnicities and prospective external validation is required.

CCR8 blockade primes anti-tumor immunity through intratumoral regulatory T cells destabilization in muscle-invasive bladder cancer

Regulatory T cells (Tregs) play a major role in the development of an immunosuppressive tumor microenvironment. Systemic Treg depletion is not favored because of the critical role of Tregs in maintaining immune homeostasis and preventing the autoimmunity. Recently, CCR8 has been identified as an important chemokine receptor expressed on intratumoral Tregs and is known to be critical for CCR8⁺Treg-mediated immunosuppression. However, the inherent molecular mechanisms and clinical significance of intratumoral CCR8⁺Tregs remain poorly understood. In this study, a retrospective analysis of 259 muscle-invasive bladder cancer (MIBC) patients from two independent clinic centers was conducted to explore the prognostic merit of CCR8⁺Tregs via immunohistochemistry. Eighty-three fresh MIBC samples and data from the Cancer Genome Atlas were used to evaluate the proportion and function of immune cells via flow cytometry, ex vivo intervention experiments and bioinformatics analysis. It was found that the CCR8 expression by intratumoral Tregs maintained the stability and potentiated their suppressive function by upregulating the expression of transcript factors FOXO1 and c-MAF. High level of CCR8⁺Tregs was associated with the immune tolerance and predicted poor survival and inferior therapeutic responsiveness to chemotherapy. Moreover, it was revealed that CCR8 blockade could destabilize intratumoral Tregs into a fragile phenotype accompanied with reactivation of antitumor immunity and augment of anti-PD-1 therapeutic benefits in MIBC. In summary, those results suggested that CCR8⁺Tregs represented a stable Treg subtype and a promising therapeutic target in the immunotherapy of MIBC.

Molecular phylogenetic studies on an unnamed bovine Babesia sp. based on small subunit ribosomal RNA gene sequences

The 18S small subunit ribosomal RNA (18S rRNA) gene of an unnamed Babesia species (designated B. U sp.) was sequenced and analyzed in an attempt to distinguish it from other Babesia species in China. The target DNA segment was amplified by polymerase chain reaction (PCR). The PCR product was ligated to the pGEM-T Easy vector for sequencing. It was found that the length of the 18S rRNA gene of all B. U sp. Kashi 1 and B. U sp. Kashi 2 was 1699 bp and 1689 bp. Two phylogenetic trees were, respectively, inferred based on 18S rRNA sequence of the Chinese bovine Babesia isolates and all of Babesia species available in GenBank. The first tree showed that B. U sp. was situated in the branch between B. major Yili and B. bovis Shannxian, and the second tree revealed that B. U sp. was confined to the same group as B. caballi. The percent identity of B. U sp. with other Chinese Babesia species was between 74.2 and 91.8, while the percent identity between two B. U sp. isolates was 99.7. These results demonstrated that this B. U sp. is different from other Babesia species, but that two B. U sp. isolates obtained with nymphal and adultal Hyalomma anatolicum anatolicum tick belong to the same species.

Tumor-infiltrating TNFRSF9+ CD8+ T cells define different subsets of clear cell renal cell carcinoma with prognosis and immunotherapeutic response

Objectives

Tumor necrosis receptor super family (TNFRSF) plays an important role in regulating the function of CD8+ T cells. In this study, we explored the clinical significance and immune profile of TNFRSF9+ CD8+ T cells in clear cell renal cell carcinoma (ccRCC).

Methods

The infiltration of immune cells was determined by immunohistochemistry in ZS cohort from our hospital and their prognostic value was further determined by Cox regression. Functional status of CD8+ T cells in ccRCC was determined by flow cytometry in 29 fresh tumor samples. In silico analysis on a TCGA cohort and other datasets was performed to further demonstrate our findings.

Results

High TNFRSF9+ CD8+ T cells infiltration was associated with inferior overall survival in ZS cohort (p = .0016) and TCGA-KIRC cohort (p = .018). TNFRSF9+ CD8+ T cells expressed higher exhaustion markers (PD-1, TIM-3, CTLA-4, and TIGIT), and effector markers (IFN-γ, GZMB, CD107a, and Ki-67), than their TNFRSF9 negative counterparts. In silico analysis indicated the expression of TNFRSF9 was significantly correlated with IFNG, GZMK, MKI-67, PDCD1, HAVCR2, TIGIT, and CTLA-4 in CD8+ T cells. However, higher TNFRSF9 signature was correlated with larger tumor size shrinkage (p = .003) and better progression-free survival (p = .012) in patients treated with nivolumab but not everolimus.

Conclusion

TNFRSF9+ CD8+ T cells, which possessed both exhaustion and effector phenotype, were identified as an adverse prognosticator in ccRCC. These cells enrichment was associated with better immunotherapy response which indicated these cells potentially be crucial in immunotherapy.

Effect of sedative and hypnotic doses of propofol on the EEG activity of patients with or without a history of seizure disorders

Propofol is alleged to possess both pro- and anticonvulsant properties, leading to controversy regarding its use in patients with a history of seizures. Since propofol is administered for both sedation and hypnosis, it is important to understand the effects of low (0.5-1.0 mg/kg) and high (2-2.5 mg/kg) doses of propofol on the electroencephalogram (EEG). In this study, the hemodynamic and EEG effects of cumulative doses of propofol from 0.5 to 2.5 mg/kg i.v. were studied in 30 neurosurgical patients with or without a history of seizure disorders. While continuously recording from scalp EEG electrodes (F3, F4, C3, C4, P3, P4, O1, and O2), propofol 0.5 mg/kg was infused intravenously over 20 s. The same dose of propofol was reinjected four times at 2-min intervals, until a total dose of 2.5 mg/kg had been administered. The number and average amplitude of the EEG waves were counted and measured manually, respectively, from 80 to 90 s after beginning the injection of each dose of propofol. After lower propofol doses (0.5-1 mg/kg), the number of beta-waves increased, while alpha- and theta-waves decreased significantly in all patients. However, with larger doses of propofol (total dose of 2-2.5 mg/kg), the number of beta-waves decreased and delta-waves appeared. The amplitudes of all EEG waves increased and were maintained at a higher level after administration of propofol. Spike (or sharp) waves appeared in 33% of the control patients and in 40% of the epileptic group after propofol 0.5 mg/kg and in 73% of the control and 67% of the epileptic patients after the 1.5-mg/kg dose. In the majority of patients, the spike waves disappeared when additional doses of propofol were administered. One patient in the epileptic group had an EEG-recorded and clinical grand mal seizure after propofol 1 mg/kg, but the seizure disappeared after an additional 0.5-mg/kg bolus dose was administered. The propofol-induced EEG changes appeared initially at the frontal and central EEG electrodes and subsequently at the other EEG electrodes. Overall, there were no significant differences in the spectrum of EEG changes between the two patient populations. It is concluded that propofol produces similar dose-dependent effects on EEG activity in patients with or without a history of seizure disorders. While induction of anesthesia with higher doses of propofol (> 1.5 mg/kg) in neurosurgical patients with well controlled seizure disorder is safe, smaller sedative doses should be administered with caution to epileptic patients.

Tumor-associated macrophages expressing galectin-9 identify immunoevasive subtype muscle-invasive bladder cancer with poor prognosis but favorable adjuvant chemotherapeutic response

PURPOSE

Tumor-associated macrophages (TAMs) exist as heterogeneous subsets and have dichotomous roles in cancer-immune evasion. This study aims to assess the clinical effects of Galectin-9⁺ tumor-associated macrophages (Gal-9⁺TAMs) in muscle-invasive bladder cancer (MIBC).

EXPERIMENTAL DESIGN

We identified Gal-9⁺TAMs by immunohistochemistry (IHC) analysis of a tumor microarray (TMA) (n = 141) from the Zhongshan Hospital and by flow cytometric analysis of tumor specimens (n = 20) from the Shanghai Cancer Center. The survival benefit of platinum-based chemotherapy in this subpopulation was evaluated. The effect of the tumor-immune microenvironment with different percentages of Gal-9⁺TAMs was explored.

RESULTS

The frequency of Gal-9⁺TAMs increased with tumor stage and grade. Gal-9⁺TAMs predicted poor overall survival (OS) and recurrence-free survival (RFS) and were better than Gal-9^-TAMs and TAMs to discriminate prognostic groups. In univariate and multivariate Cox regression analyses, patients with high percentages of Gal-9⁺TAMs showed the prominent survival benefit after receiving adjuvant chemotherapy (ACT). High Gal-9⁺TAM infiltration correlated with increasing numbers of regulatory T cells (Tregs) and mast cells and decreasing numbers of CD8⁺T and dendritic cells (DCs). Dense infiltration of Gal-9⁺TAMs was related to reduced cytotoxic molecules, enhanced immune checkpoints or immunosuppressive cytokines expressed by immune cells, as well as active proliferation of tumor cells. Additionally, the subpopulation accumulated was strongly associated with PD-1⁺TIM-3⁺CD8⁺T cells.

CONCLUSIONS

Gal-9⁺TAMs predicted OS and RFS and response to ACT in MIBC patients. High Gal-9⁺TAMs were associated with a pro-tumor immune contexture concomitant with T cell exhaustion.