Oxidized Mitochondrial DNA Engages TLR9 to Activate the NLRP3 Inflammasome in Myelodysplastic Syndromes

Myelodysplastic Syndromes (MDSs) are bone marrow (BM) failure malignancies characterized by constitutive innate immune activation, including NLRP3 inflammasome driven pyroptotic cell death. We recently reported that the danger-associated molecular pattern (DAMP) oxidized mitochondrial DNA (ox-mtDNA) is diagnostically increased in MDS plasma although the functional consequences remain poorly defined. We hypothesized that ox-mtDNA is released into the cytosol, upon NLRP3 inflammasome pyroptotic lysis, where it propagates and further enhances the inflammatory cell death feed-forward loop onto healthy tissues. This activation can be mediated via ox-mtDNA engagement of Toll-like receptor 9 (TLR9), an endosomal DNA sensing pattern recognition receptor known to prime and activate the inflammasome propagating the IFN-induced inflammatory response in neighboring healthy hematopoietic stem and progenitor cells (HSPCs), which presents a potentially targetable axis for the reduction in inflammasome activation in MDS. We found that extracellular ox-mtDNA activates the TLR9-MyD88-inflammasome pathway, demonstrated by increased lysosome formation, IRF7 translocation, and interferon-stimulated gene (ISG) production. Extracellular ox-mtDNA also induces TLR9 redistribution in MDS HSPCs to the cell surface. The effects on NLRP3 inflammasome activation were validated by blocking TLR9 activation via chemical inhibition and CRISPR knockout, demonstrating that TLR9 was necessary for ox-mtDNA-mediated inflammasome activation. Conversely, lentiviral overexpression of TLR9 sensitized cells to ox-mtDNA. Lastly, inhibiting TLR9 restored hematopoietic colony formation in MDS BM. We conclude that MDS HSPCs are primed for inflammasome activation via ox-mtDNA released by pyroptotic cells. Blocking the TLR9/ox-mtDNA axis may prove to be a novel therapeutic strategy for MDS.

The anisotropic propagation of ultrasonic guided waves in composite materials and implications for practical applications

Ultrasonic guided wave propagation in anisotropic attenuative materials like CFRP (carbon fibre reinforced polymer) is much more complicated than in isotropic materials. Propagation phenomena need to be understood and quantified before reliable NDE (Non-destructive Evaluation)/SHM (Structural Health Monitoring) inspection systems can be realized. The propagation characteristics: energy velocity, dispersion, mode coupling, energy focusing factor and attenuation are considered in this paper. Concepts of minimum resolvable distance and sensitivity maps are extended to anisotropic attenuative materials in order to provide the means for comparison of different guided wave modes in composite materials. The paper is intended to serve as a framework for evaluating and comparing different modes and choosing the optimum operating conditions (frequency, sensor layout) for possible NDE/SHM applications on composite materials. Fundamental guided wave modes in the low frequency regime for highly anisotropic CFRP plates are investigated experimentally and theoretically and the implications for NDE/SHM are discussed.

The influence of temperature variations on ultrasonic guided waves in anisotropic CFRP plates

Carbon Fibre Reinforced Polymer (CFRP) materials are lightweight and corrosion-resistant and therefore are increasingly used in aerospace, automotive and construction industries. In Structural Health Monitoring (SHM) applications of CFRP materials, ultrasonic guided waves potentially offer large area inspection or inspection from a remote location. This paper addresses the effect of temperature variation on guided wave propagation in highly anisotropic CFRP materials. Temperature variations cause changes in guided wave velocity that can in turn compromise the baseline subtraction procedures employed by many SHM systems for damage detection. A simple model that describes the dependence of elastic properties of the CFRP plates on temperature is presented in this paper. The model can be used to predict anisotropic velocity changes and baseline subtraction performance under varying thermal conditions. The results produced by the model for unidirectional and 0/90 CFRP plates are compared with experimental measurements.

Penetrating cardiac trauma: management strategy based on 129 surgical emergencies over 2 years

Between 1986 and 1988, 129 patients with stab wounds to the heart were referred from the emergency room of our institution for a thoracic surgical procedure. Multiple entrance wounds of the heart were present in 12 patients, and through-and-through stab wounds were encountered in another 10. The overall hospital mortality rate was 8.5% (11/129), which includes a 54% mortality rate for the 13 patients undergoing emergency room thoracotomy. These patients were pulseless and unconscious either on arrival (n = 8) or soon thereafter (n = 5). Cardiopulmonary bypass was not used during the primary operation, although 7 patients underwent subsequent intracardiac repair with bypass without hospital mortality. Important aspects of our preoperative management strategy include: (1) aggressive transfusion to improve the central venous pressure/intrapericardial pressure gradient; (2) rapid drainage of the pleural and pericardial spaces to reduce intrapericardial pressure; (3) empirical partial correction of metabolic acidosis with sodium bicarbonate; and (4) emergency operation without unnecessary cardiac imaging. Patients suspected of having penetrating cardiac trauma and cardiac tamponade are best managed by aggressive primary intervention and immediate operation.