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Issue published May 21, 2020

  • Volume 5, Issue 10
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  • Research Articles
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Mycobacterium tuberculosis cords within lymphatic endothelial cells to evade host immunity

In this issue of JCI Insight, Thomas Lerner and colleagues demonstrate that clinical M. tuberculosis isolates form cords within the cytoplasm of lymphatic endothelial cells and that these cords are present in lymph node samples of patients with extra-pulmonary tuberculosis. Moreover, cytosolic immune sensors did not recognize these cords, indicating that cord formation may allow immune evasion. The cover image shows human lymphatic endothelial cells infected with M. tuberculosis (green). Actin cytoskeleton is shown in white, ubiquitin is shown in red, and nuclei are shown in blue.

Viewpoint
COVID-19 in older adults: clinical, psychosocial, and public health considerations
John P. Mills, … , Keith S. Kaye, Lona Mody
John P. Mills, … , Keith S. Kaye, Lona Mody
Published April 17, 2020
Citation Information: JCI Insight. 2020;5(10):e139292. https://doi.org/10.1172/jci.insight.139292.
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COVID-19 in older adults: clinical, psychosocial, and public health considerations

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Abstract

Authors

John P. Mills, Keith S. Kaye, Lona Mody

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Review
Genetic and environmental factors underlying keratinocyte carcinoma risk
Hélène Choquet, … , Maryam M. Asgari, Eric Jorgenson
Hélène Choquet, … , Maryam M. Asgari, Eric Jorgenson
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e134783. https://doi.org/10.1172/jci.insight.134783.
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Genetic and environmental factors underlying keratinocyte carcinoma risk

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Recent large-scale GWAS and large epidemiologic studies have accelerated the discovery of genes and environmental factors that contribute to the risk of keratinocyte carcinoma (KC), which includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). This Review summarizes the genomic regions associated with SCC and BCC risk, examines the genetic overlap between SCC and BCC, and discusses biological pathways involved in SCC and BCC development. Next, we review environmental factors that are associated with KC risk, including those that are shared between SCC and BCC as well as others that associated with only one type of KC. We conclude with a critical appraisal of current research and potential directions for future research.

Authors

Hélène Choquet, Sepideh Ashrafzadeh, Yuhree Kim, Maryam M. Asgari, Eric Jorgenson

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Research Articles
Loss of Wasl improves pancreatic cancer outcome
Ana Hidalgo-Sastre, … , Roland M. Schmid, Clara Lubeseder-Martellato
Ana Hidalgo-Sastre, … , Roland M. Schmid, Clara Lubeseder-Martellato
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e127275. https://doi.org/10.1172/jci.insight.127275.
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Loss of Wasl improves pancreatic cancer outcome

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Several studies have suggested an oncogenic role for the neural Wiskott-Aldrich syndrome protein (N-WASP, encoded by the Wasl gene), but thus far, little is known about its function in pancreatic ductal adenocarcinoma (PDAC). In this study, we performed in silico analysis of WASL expression in PDAC patients and found a correlation between low WASL expression and prolonged survival. To clarify the role of Wasl in pancreatic carcinogenesis, we used 2 oncogenic Kras–based PDAC mouse models with pancreas-specific Wasl deletion. In line with human data, both mouse models had an increased survival benefit due to either impaired tumor development in the presence of the tumor suppressor Trp53 or the delayed tumor progression and senescent phenotype upon genetic ablation of Trp53. Mechanistically, loss of Wasl resulted in cell-autonomous senescence through displacement of the N-WASP binding partners WASP-interacting protein (WIP) and p120ctn; vesicular accumulation of GSK3β, as well as YAP1 and phosphorylated β-catenin, which are components of the destruction complex; and upregulation of Cdkn1a(p21), a master regulator of senescence. Our findings, thus, indicate that Wasl functions in an oncogenic manner in PDAC by promoting the deregulation of the p120-catenin/β-catenin/p21 pathway. Therefore, strategies to reduce N-WASP activity might improve the survival outcomes of PDAC patients.

Authors

Ana Hidalgo-Sastre, Judit Desztics, Zahra Dantes, Katharina Schulte, Hilal Kabadayi Ensarioglu, Blessing Bassey-Archibong, Rupert Öllinger, Thomas Engleiter, Lyndsay Rayner, Henrik Einwächter, Juliet M. Daniel, Ali Sameer Abdulghani Altaee, Katia Steiger, Marina Lesina, Roland Rad, Maximilian Reichert, Guido von Figura, Jens T. Siveke, Roland M. Schmid, Clara Lubeseder-Martellato

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Maternal erythrocyte ENT1–mediated AMPK activation counteracts placental hypoxia and supports fetal growth
Seisuke Sayama, … , Angelo D’Alessandro, Yang Xia
Seisuke Sayama, … , Angelo D’Alessandro, Yang Xia
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e130205. https://doi.org/10.1172/jci.insight.130205.
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Maternal erythrocyte ENT1–mediated AMPK activation counteracts placental hypoxia and supports fetal growth

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Insufficient O2 supply is frequently associated with fetal growth restriction (FGR), a leading cause of perinatal mortality and morbidity. Although the erythrocyte is the most abundant and only cell type to deliver O2 in our body, its function and regulatory mechanism in FGR remain unknown. Here, we report that genetic ablation of mouse erythrocyte equilibrative nucleoside transporter 1 (eENT1) in dams, but not placentas or fetuses, results in FGR. Unbiased high-throughput metabolic profiling coupled with in vitro and in vivo flux analyses with isotopically labeled tracers led us to discover that maternal eENT1–dependent adenosine uptake is critical in activating AMPK by controlling the AMP/ATP ratio and its downstream target, bisphosphoglycerate mutase (BPGM); in turn, BPGM mediates 2,3-BPG production, which enhances O2 delivery to maintain placental oxygenation. Mechanistically and functionally, we revealed that genetic ablation of maternal eENT1 increases placental HIF-1α; preferentially reduces placental large neutral aa transporter 1 (LAT1) expression, activity, and aa supply; and induces FGR. Translationally, we revealed that elevated HIF-1α directly reduces LAT1 gene expression in cultured human trophoblasts. We demonstrate the importance and molecular insight of maternal eENT1 in fetal growth and open up potentially new diagnostic and therapeutic possibilities for FGR.

Authors

Seisuke Sayama, Anren Song, Benjamin C. Brown, Jacob Couturier, Xiaoli Cai, Ping Xu, Changhan Chen, Yangxi Zheng, Takayuki Iriyama, Baha Sibai, Monica Longo, Rodney E. Kellems, Angelo D’Alessandro, Yang Xia

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In utero exposure to transient ischemia-hypoxemia promotes long-term neurodevelopmental abnormalities in male rat offspring
Arvind Palanisamy, … , Joel R. Garbow, David F. Wozniak
Arvind Palanisamy, … , Joel R. Garbow, David F. Wozniak
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e133172. https://doi.org/10.1172/jci.insight.133172.
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In utero exposure to transient ischemia-hypoxemia promotes long-term neurodevelopmental abnormalities in male rat offspring

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The impact of transient ischemic-hypoxemic insults on the developing fetal brain is poorly understood despite evidence suggesting an association with neurodevelopmental disorders such as schizophrenia and autism. To address this, we designed an aberrant uterine hypercontractility paradigm with oxytocin to better assess the consequences of acute, but transient, placental ischemia-hypoxemia in term pregnant rats. Using MRI, we confirmed that oxytocin-induced aberrant uterine hypercontractility substantially compromised uteroplacental perfusion. This was supported by the observation of oxidative stress and increased lactate concentration in the fetal brain. Genes related to oxidative stress pathways were significantly upregulated in male, but not female, offspring 1 hour after oxytocin-induced placental ischemia-hypoxemia. Persistent upregulation of select mitochondrial electron transport chain complex proteins in the anterior cingulate cortex of adolescent male offspring suggested that this sex-specific effect was enduring. Functionally, offspring exposed to oxytocin-induced uterine hypercontractility showed male-specific abnormalities in social behavior with associated region-specific changes in gene expression and functional cortical connectivity. Our findings, therefore, indicate that even transient but severe placental ischemia-hypoxemia could be detrimental to the developing brain and point to a possible mitochondrial link between intrauterine asphyxia and neurodevelopmental disorders.

Authors

Arvind Palanisamy, Tusar Giri, Jia Jiang, Annie Bice, James D. Quirk, Sara B. Conyers, Susan E. Maloney, Nandini Raghuraman, Adam Q. Bauer, Joel R. Garbow, David F. Wozniak

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Persistent DNA damage–induced NLRP12 improves hematopoietic stem cell function
Qiqi Lin, … , Habibul Hasan Mazumder, Wei Du
Qiqi Lin, … , Habibul Hasan Mazumder, Wei Du
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e133365. https://doi.org/10.1172/jci.insight.133365.
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Persistent DNA damage–induced NLRP12 improves hematopoietic stem cell function

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NOD-like receptor 12 (NLRP12) is a member of the nucleotide-binding domain and leucine-rich repeat containing receptor inflammasome family that plays a central role in innate immunity. We previously showed that DNA damage upregulated NLRP12 in hematopoietic stem cells (HSCs) of mice deficient in the DNA repair gene Fanca. However, the role of NLRP12 in HSC maintenance is not known. Here, we show that persistent DNA damage–induced NLRP12 improves HSC function in both mouse and human models of DNA repair deficiency and aging. Specifically, treatment of Fanca–/– mice with the DNA cross-linker mitomycin C or ionizing radiation induces NLRP12 upregulation in phenotypic HSCs. NLRP12 expression is specifically induced by persistent DNA damage. Functionally, knockdown of NLRP12 exacerbates the repopulation defect of Fanca–/– HSCs. Persistent DNA damage–induced NLRP12 was also observed in the HSCs from aged mice, and depletion of NLRP12 in these aged HSCs compromised their self-renewal and hematopoietic recovery. Consistently, overexpression of NLRP12 substantially improved the long-term repopulating function of Fanca–/– and aged HSCs. Finally, persistent DNA damage–induced NLRP12 maintains the function of HSCs from patients with FA or aged donors. These results reveal a potentially novel role of NLRP12 in HSC maintenance and suggest that NLRP12 targeting has therapeutic potential in DNA repair disorders and aging.

Authors

Qiqi Lin, Limei Wu, Zhilin Ma, Fabliha Ahmed Chowdhury,1, Habibul Hasan Mazumder, Wei Du

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Bone marrow is the preferred site of memory CD4+ T cell proliferation during recovery from sepsis
Tomasz Skirecki, … , Dominika Nowis, Ewa Kozłowska
Tomasz Skirecki, … , Dominika Nowis, Ewa Kozłowska
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e134475. https://doi.org/10.1172/jci.insight.134475.
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Bone marrow is the preferred site of memory CD4+ T cell proliferation during recovery from sepsis

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Sepsis survivors suffer from increased vulnerability to infections, and lymphopenia presumably contributes to this problem. The mechanisms of the recovery of memory CD4+ T cells after sepsis remain elusive. We used the cecal ligation and puncture mouse model of sepsis to study the restoration of the memory CD4+ T cells during recovery from sepsis. Then, adoptive transfer of antigen-specific naive CD4+ T cells followed by immunization and BrdU labeling were performed to trace the proliferation and migration of memory CD4+ T cells. We revealed that the bone marrow (BM) is the primary site of CD4+ memory T cell homing and proliferation after sepsis-induced lymphopenia. Of interest, BM CD4+ T cells had a higher basal proliferation rate in comparison with splenic T cells. These cells also show features of resident memory T cells yet have the capacity to migrate outside the BM niche and engraft secondary lymphoid organs. The BM niche also sustains viability and functionality of CD4+ T cells. We also identified IL-7 as the major inducer of proliferation of the BM memory CD4+ T cells and showed that recombinant IL-7 improves the recovery of these cells. Taken together, we provide data on the mechanism and location of memory CD4+ T cell proliferation during recovery from septic lymphopenia, which are of relevance in studying immunostimulatory therapies in sepsis.

Authors

Tomasz Skirecki, Patrycja Swacha, Grażyna Hoser, Jakub Golab, Dominika Nowis, Ewa Kozłowska

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Monounsaturated fat rapidly induces hepatic gluconeogenesis and whole-body insulin resistance
Theresia Sarabhai, … , John Griffith Jones, Michael Roden
Theresia Sarabhai, … , John Griffith Jones, Michael Roden
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e134520. https://doi.org/10.1172/jci.insight.134520.
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Monounsaturated fat rapidly induces hepatic gluconeogenesis and whole-body insulin resistance

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BACKGROUND While saturated fat intake leads to insulin resistance and nonalcoholic fatty liver, Mediterranean-like diets enriched in monounsaturated fatty acids (MUFA) may have beneficial effects. This study examined effects of MUFA on tissue-specific insulin sensitivity and energy metabolism.METHODS A randomized placebo-controlled cross-over study enrolled 16 glucose-tolerant volunteers to receive either oil (OIL, ~1.18 g/kg), rich in MUFA, or vehicle (VCL, water) on 2 occasions. Insulin sensitivity was assessed during preclamp and hyperinsulinemic-euglycemic clamp conditions. Ingestion of 2H2O/acetaminophen was combined with [6,6-2H2]glucose infusion and in vivo 13C/31P/1H/ex vivo 2H-magnet resonance spectroscopy to quantify hepatic glucose and energy fluxes.RESULTS OIL increased plasma triglycerides and oleic acid concentrations by 44% and 66% compared with VCL. Upon OIL intervention, preclamp hepatic and whole-body insulin sensitivity markedly decreased by 28% and 27%, respectively, along with 61% higher rates of hepatic gluconeogenesis and 32% lower rates of net glycogenolysis, while hepatic triglyceride and ATP concentrations did not differ from VCL. During insulin stimulation hepatic and whole-body insulin sensitivity were reduced by 21% and 25%, respectively, after OIL ingestion compared with that in controls.CONCLUSION A single MUFA-load suffices to induce insulin resistance but affects neither hepatic triglycerides nor energy-rich phosphates. These data indicate that amount of ingested fat, rather than its composition, primarily determines the development of acute insulin resistance.TRIAL REGISTRATION ClinicalTrials.gov NCT01736202.FUNDING German Diabetes Center, German Federal Ministry of Health, Ministry of Culture and Science of the state of North Rhine-Westphalia, German Federal Ministry of Education and Research, German Diabetes Association, German Center for Diabetes Research, Portugal Foundation for Science and Technology, European Regional Development Fund, and Rede Nacional de Ressonancia Magnética Nuclear.

Authors

Theresia Sarabhai, Sabine Kahl, Julia Szendroedi, Daniel F. Markgraf, Oana-Patricia Zaharia, Cristina Barosa, Christian Herder, Frithjof Wickrath, Pavel Bobrov, Jong-Hee Hwang, John Griffith Jones, Michael Roden

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In vivo–directed evolution of adeno-associated virus in the primate retina
Leah C. Byrne, … , David V. Schaffer, John G. Flannery
Leah C. Byrne, … , David V. Schaffer, John G. Flannery
Published April 9, 2020
Citation Information: JCI Insight. 2020;5(10):e135112. https://doi.org/10.1172/jci.insight.135112.
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In vivo–directed evolution of adeno-associated virus in the primate retina

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Efficient adeno-associated virus–mediated (AAV-mediated) gene delivery remains a significant obstacle to effective retinal gene therapies. Here, we apply directed evolution — guided by deep sequencing and followed by direct in vivo secondary selection of high-performing vectors with a GFP-barcoded library — to create AAV viral capsids with the capability to deliver genes to the outer retina in primates. A replication-incompetent library, produced via providing rep in trans, was created to mitigate risk of AAV propagation. Six rounds of in vivo selection with this library in primates — involving intravitreal library administration, recovery of genomes from outer retina, and extensive next-generation sequencing of each round — resulted in vectors with redirected tropism to the outer retina and increased gene delivery efficiency to retinal cells. These viral vectors expand the toolbox of vectors available for primate retina, and they may enable less invasive delivery of therapeutic genes to patients, potentially offering retina-wide infection at a similar dosage to vectors currently in clinical use.

Authors

Leah C. Byrne, Timothy P. Day, Meike Visel, Jennifer A. Strazzeri, Cécile Fortuny, Deniz Dalkara, William H. Merigan, David V. Schaffer, John G. Flannery

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IL-12 from endogenous cDC1, and not vaccine DC, is required for Th1 induction
DiyaaElDin Ashour, … , Florian Erhard, Manfred B. Lutz
DiyaaElDin Ashour, … , Florian Erhard, Manfred B. Lutz
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e135143. https://doi.org/10.1172/jci.insight.135143.
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IL-12 from endogenous cDC1, and not vaccine DC, is required for Th1 induction

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Success of DC vaccines relies on the quality of antigen presentation, costimulation, lymph node migration, and the release of IL-12, in case of Th1 priming. Here, we provide evidence for interaction between the injected vaccine DCs with endogenous lymph node–resident DCs for Th1 induction. While migration of the injected DCs was essential for antigen delivery to the lymph node, the injected DCs contributed only partially to Th0 priming and were unable to instruct Th1 generation. Instead, we provide evidence that the lymph node–resident XCR1+ DCs are activated by the injected DCs to present the cognate antigen and release IL-12 for Th1 polarization. The timing of interactions in the draining lymph nodes appeared step-wise as (a) injected DCs with cognate T cells, (b) injected DCs with bystander DCs, and (c) bystander DCs with T cells. The transcriptome of the bystander DCs showed a downregulation of Treg- and Th2/Th9-inducing genes and self-antigen presentation, as well as upregulation of MHC class II and genes required for Th1 instruction. Together, these data show that injected mature lymph node migratory DCs direct T cell priming and bystander DC activation, but not Th1 polarization, which is mediated by endogenous IL-12p70+XCR1+ resident bystander DCs. Our results are of importance for clinical DC-based vaccinations against tumors where endogenous DCs may be functionally impaired by chemotherapy.

Authors

DiyaaElDin Ashour, Panagiota Arampatzi, Vladimir Pavlovic, Konrad U. Förstner, Tsuneyasu Kaisho, Andreas Beilhack, Florian Erhard, Manfred B. Lutz

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Tubular β-catenin and FoxO3 interactions protect in chronic kidney disease
Stellor Nlandu-Khodo, … , Ethan Lee, Leslie S. Gewin
Stellor Nlandu-Khodo, … , Ethan Lee, Leslie S. Gewin
Published May 5, 2020
Citation Information: JCI Insight. 2020;5(10):e135454. https://doi.org/10.1172/jci.insight.135454.
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Tubular β-catenin and FoxO3 interactions protect in chronic kidney disease

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The Wnt/β-catenin signaling pathway plays an important role in renal development and is reexpressed in the injured kidney and other organs. β-Catenin signaling is protective in acute kidney injury (AKI) through actions on the proximal tubule, but the current dogma is that Wnt/β-catenin signaling promotes fibrosis and development of chronic kidney disease (CKD). As the role of proximal tubular β-catenin signaling in CKD remains unclear, we genetically stabilized (i.e., activated) β-catenin specifically in murine proximal tubules. Mice with increased tubular β-catenin signaling were protected in 2 murine models of AKI to CKD progression. Oxidative stress, a common feature of CKD, reduced the conventional T cell factor/lymphoid enhancer factor–dependent β-catenin signaling and augmented FoxO3-dependent activity in proximal tubule cells in vitro and in vivo. The protective effect of proximal tubular β-catenin in renal injury required the presence of FoxO3 in vivo. Furthermore, we identified cystathionine γ-lyase as a potentially novel transcriptional target of β-catenin/FoxO3 interactions in the proximal tubule. Thus, our studies overturned the conventional dogma about β-catenin signaling and CKD by showing a protective effect of proximal tubule β-catenin in CKD and identified a potentially new transcriptional target of β-catenin/FoxO3 signaling that has therapeutic potential for CKD.

Authors

Stellor Nlandu-Khodo, Yosuke Osaki, Lauren Scarfe, Haichun Yang, Melanie Phillips-Mignemi, Jane Tonello, Kenyi Saito-Diaz, Surekha Neelisetty, Alla Ivanova, Tessa Huffstater, Robert McMahon, M. Mark Taketo, Mark deCaestecker, Balakuntalam Kasinath, Raymond C. Harris, Ethan Lee, Leslie S. Gewin

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Gut microbial metabolites alter IgA immunity in type 1 diabetes
Juan Huang, … , Zhiguang Zhou, Li Wen
Juan Huang, … , Zhiguang Zhou, Li Wen
Published April 16, 2020
Citation Information: JCI Insight. 2020;5(10):e135718. https://doi.org/10.1172/jci.insight.135718.
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Gut microbial metabolites alter IgA immunity in type 1 diabetes

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The incidence of type 1 diabetes (T1D) has been increasing among children and adolescents, in which environmental factors, including gut microbiota, play an important role. However, the underlying mechanisms are yet to be determined. Here, we show that patients with newly diagnosed T1D displayed not only a distinct profile of gut microbiota associated with decreased short-chain fatty acids (SCFAs) production, but also an altered IgA-mediated immunity compared with healthy control subjects. Using germ-free NOD mice, we demonstrate that gut microbiota from patients with T1D promoted different IgA-mediated immune responses compared with healthy control gut microbiota. Treatment with the SCFA, acetate, reduced gut bacteria–induced IgA response accompanied by decreased severity of insulitis in NOD mice. We believe our study provides new insights into the functional effects of gut microbiota on inducing IgA immune response in T1D, suggesting that SCFAs might be potential therapeutic agents in T1D prevention and/or treatment.

Authors

Juan Huang, James A. Pearson, Jian Peng, Youjia Hu, Sha Sha, Yanpeng Xing, Gan Huang, Xia Li, Fang Hu, Zhiguo Xie, Yang Xiao, Shuoming Luo, Chen Chao, F. Susan Wong, Zhiguang Zhou, Li Wen

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Allograft inflammatory factor-1 in myeloid cells drives autoimmunity in type 1 diabetes
Diana M. Elizondo, … , Tatiana R. de Moura, Michael W. Lipscomb
Diana M. Elizondo, … , Tatiana R. de Moura, Michael W. Lipscomb
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e136092. https://doi.org/10.1172/jci.insight.136092.
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Allograft inflammatory factor-1 in myeloid cells drives autoimmunity in type 1 diabetes

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Allograft inflammatory factor-1 (AIF1) is a calcium-responsive cytoplasmic scaffold protein that directs hematopoiesis and immune responses within dendritic cells (DC) and macrophages. Although the role of AIF1 in transplant rejection and rheumatoid arthritis has been explored, little is known about its role in type 1 diabetes. Here, we show that in vivo silencing of AIF1 in NOD mice restrained infiltration of immune cells into the pancreas and inhibited diabetes incidence. Analyses of FACS-sorted CD45neg nonleukocyte populations from resected pancreatic islets showed markedly higher expression of insulin in the AIF1-silenced groups. Evaluation of CD45+ leukocytes revealed diminished infiltration of effector T cells and DC in the absence of AIF1. Transcriptional profiling further revealed a marked decrease in cDC1 DC-associated genes CD103, BATF3, and IRF8, which are required for orchestrating polarized type 1 immunity. Reduced T cell numbers within the islets were observed, with concomitant lower levels of IFN-γ and T-bet in AIF1-silenced cohorts. In turn, there was a reciprocal increase in functionally suppressive pancreas-resident CD25+Foxp3+CD4+ Tregs. Taken together, results show that AIF1 expression in myeloid cells plays a pivotal role in promoting type 1 diabetes and that its suppression restrains insulitis by shifting the immune microenvironment toward tolerance.

Authors

Diana M. Elizondo, Nailah Z.D. Brandy, Ricardo L. da Silva, Tatiana R. de Moura, Michael W. Lipscomb

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Effects of B cell–activating factor on tumor immunity
Mark Yarchoan, … , Todd D. Armstrong, Elizabeth M. Jaffee
Mark Yarchoan, … , Todd D. Armstrong, Elizabeth M. Jaffee
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e136417. https://doi.org/10.1172/jci.insight.136417.
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Effects of B cell–activating factor on tumor immunity

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Immunotherapies that modulate T cell function have been firmly established as a pillar of cancer therapy, whereas the potential for B cells in the antitumor immune response is less established. B cell–activating factor (BAFF) is a B cell–activating cytokine belonging to the TNF ligand family that has been associated with autoimmunity, but little is known about its effects on cancer immunity. We find that BAFF upregulates multiple B cell costimulatory molecules; augments IL-12a expression, consistent with Be-1 lineage commitment; and enhances B cell antigen-presentation to CD4+ Th cells in vitro. In a syngeneic mouse model of melanoma, BAFF upregulates B cell CD40 and PD-L1 expression; it also modulates T cell function through increased T cell activation and TH1 polarization, enhanced expression of the proinflammatory leukocyte trafficking chemokine CCR6, and promotion of a memory phenotype, leading to enhanced antitumor immunity. Similarly, adjuvant BAFF promotes a memory phenotype of T cells in vaccine-draining lymph nodes and augments the antitumor efficacy of whole cell vaccines. BAFF also has distinct immunoregulatory functions, promoting the expansion of CD4+Foxp3+ Tregs in the spleen and tumor microenvironment (TME). Human melanoma data from The Cancer Genome Atlas (TCGA) demonstrate that BAFF expression is positively associated with overall survival and a TH1/IFN-γ gene signature. These data support a potential role for BAFF signaling as a cancer immunotherapy.

Authors

Mark Yarchoan, Won Jin Ho, Aditya Mohan, Yajas Shah, Teena Vithayathil, James Leatherman, Lauren Dennison, Neeha Zaidi, Sudipto Ganguly, Skylar Woolman, Kayla Cruz, Todd D. Armstrong, Elizabeth M. Jaffee

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Self-assembling influenza nanoparticle vaccines drive extended germinal center activity and memory B cell maturation
Hannah G. Kelly, … , Stephen J. Kent, Adam K. Wheatley
Hannah G. Kelly, … , Stephen J. Kent, Adam K. Wheatley
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e136653. https://doi.org/10.1172/jci.insight.136653.
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Self-assembling influenza nanoparticle vaccines drive extended germinal center activity and memory B cell maturation

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Protein-based, self-assembling nanoparticles elicit superior immunity compared with soluble protein vaccines, but the immune mechanisms underpinning this effect remain poorly defined. Here, we investigated the immunogenicity of a prototypic ferritin-based nanoparticle displaying influenza hemagglutinin (HA) in mice and macaques. Vaccination of mice with HA-ferritin nanoparticles elicited higher serum antibody titers and greater protection against experimental influenza challenge compared with soluble HA protein. Germinal centers in the draining lymph nodes were expanded and persistent following HA-ferritin vaccination, with greater deposition of antigen that colocalized with follicular dendritic cells. Our findings suggest that a highly ordered and repetitive antigen array may directly drive germinal centers through a B cell–intrinsic mechanism that does not rely on ferritin-specific T follicular helper cells. In contrast to mice, enhanced immunogenicity of HA-ferritin was not observed in pigtail macaques, where antibody titers and lymph node immunity were comparable to soluble vaccination. An improved understanding of factors that drive nanoparticle vaccine immunogenicity in small and large animal models will facilitate the clinical development of nanoparticle vaccines for broad and durable protection against diverse pathogens.

Authors

Hannah G. Kelly, Hyon-Xhi Tan, Jennifer A. Juno, Robyn Esterbauer, Yi Ju, Wenbo Jiang, Verena C. Wimmer, Brigette C. Duckworth, Joanna R. Groom, Frank Caruso, Masaru Kanekiyo, Stephen J. Kent, Adam K. Wheatley

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Upregulation of BDNF and hippocampal functions by a hippocampal ligand of PPARα
Dhruv Patel, … , Frank J. Gonzalez, Kalipada Pahan
Dhruv Patel, … , Frank J. Gonzalez, Kalipada Pahan
Published April 21, 2020
Citation Information: JCI Insight. 2020;5(10):e136654. https://doi.org/10.1172/jci.insight.136654.
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Upregulation of BDNF and hippocampal functions by a hippocampal ligand of PPARα

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Discovery strategies commonly focus on the identification of chemical libraries or natural products, but the modulation of endogenous ligands offers a much better therapeutic strategy due to their low adverse potential. Recently, we found that hexadecanamide (Hex) is present in hippocampal nuclei of normal mice as an endogenous ligand of PPARα. This study underlines the importance of Hex in inducing the expression of brain-derived neurotrophic factor (BDNF) from hippocampal neurons via PPARα. The level of Hex was lower in the hippocampi of 5XFAD mice as compared with that in non-Tg mice. Oral administration of Hex increased the level of this molecule in the hippocampus to stimulate BDNF and its downstream plasticity-associated molecules, promote synaptic functions in the hippocampus, and improve memory and learning in 5XFAD mice. However, oral Hex remained unable to stimulate hippocampal plasticity and improve cognitive behaviors in 5XFADPparα-null and 5XFADPparα-ΔHippo mice, indicating an essential role of hippocampal PPARα in Hex-mediated improvement in hippocampal functions. This is the first demonstration to our knowledge of protection of hippocampal functions by oral administration of a hippocampus-based drug, suggesting that Hex may be explored for therapeutic intervention in AD.

Authors

Dhruv Patel, Avik Roy, Sumita Raha, Madhuchhanda Kundu, Frank J. Gonzalez, Kalipada Pahan

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Mycobacterium tuberculosis cords within lymphatic endothelial cells to evade host immunity
Thomas R. Lerner, … , Robert J. Wilkinson, Maximiliano G. Gutierrez
Thomas R. Lerner, … , Robert J. Wilkinson, Maximiliano G. Gutierrez
Published May 5, 2020
Citation Information: JCI Insight. 2020;5(10):e136937. https://doi.org/10.1172/jci.insight.136937.
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Mycobacterium tuberculosis cords within lymphatic endothelial cells to evade host immunity

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Abstract

The ability of Mycobacterium tuberculosis to form serpentine cords is intrinsically related to its virulence, but specifically how M. tuberculosis cording contributes to pathogenesis remains obscure. Here, we show that several M. tuberculosis clinical isolates form intracellular cords in primary human lymphatic endothelial cells (hLECs) in vitro and in the lymph nodes of patients with tuberculosis. We identified via RNA-Seq a transcriptional program that activated, in infected-hLECs, cell survival and cytosolic surveillance of pathogens pathways. Consistent with this, cytosolic access was required for intracellular M. tuberculosis cording. Mycobacteria lacking ESX-1 type VII secretion system or phthiocerol dimycocerosates expression, which failed to access the cytosol, were indeed unable to form cords within hLECs. Finally, we show that M. tuberculosis cording is a size-dependent mechanism used by the pathogen to avoid its recognition by cytosolic sensors and evade either resting or IFN-γ–induced hLEC immunity. These results explain the long-standing association between M. tuberculosis cording and virulence and how virulent mycobacteria use intracellular cording as strategy to successfully adapt and persist in the lymphatic tracts.

Authors

Thomas R. Lerner, Christophe J. Queval, Rachel P. Lai, Matthew R.G. Russell, Antony Fearns, Daniel J. Greenwood, Lucy Collinson, Robert J. Wilkinson, Maximiliano G. Gutierrez

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Photoacoustic imaging of kidney fibrosis for assessing pretransplant organ quality
Eno Hysi, … , Michael C. Kolios, Darren A. Yuen
Eno Hysi, … , Michael C. Kolios, Darren A. Yuen
Published April 16, 2020
Citation Information: JCI Insight. 2020;5(10):e136995. https://doi.org/10.1172/jci.insight.136995.
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Photoacoustic imaging of kidney fibrosis for assessing pretransplant organ quality

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Abstract

Roughly 10% of the world’s population has chronic kidney disease (CKD). In its advanced stages, CKD greatly increases the risk of hospitalization and death. Although kidney transplantation has revolutionized the care of advanced CKD, clinicians have limited ways of assessing donor kidney quality. Thus, optimal donor kidney–recipient matching cannot be performed, meaning that some patients receive damaged kidneys that function poorly. Fibrosis is a form of chronic damage often present in donor kidneys, and it is an important predictor of future renal function. Currently, no safe, easy-to-perform technique exists that accurately quantifies renal fibrosis. We describe a potentially novel photoacoustic (PA) imaging technique that directly images collagen, the principal component of fibrotic tissue. PA imaging noninvasively quantifies whole kidney fibrotic burden in mice, and cortical fibrosis in pig and human kidneys, with outstanding accuracy and speed. Remarkably, 3-dimensional PA imaging exhibited sufficiently high resolution to capture intrarenal variations in collagen content. We further show that PA imaging can be performed in a setting that mimics human kidney transplantation, suggesting the potential for rapid clinical translation. Taken together, our data suggest that PA collagen imaging is a major advance in fibrosis quantification that could have widespread preclinical and clinical impact.

Authors

Eno Hysi, Xiaolin He, Muhannad N. Fadhel, Tianzhou Zhang, Adriana Krizova, Michael Ordon, Monica Farcas, Kenneth T. Pace, Victoria Mintsopoulos, Warren L. Lee, Michael C. Kolios, Darren A. Yuen

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Integrated human pseudoislet system and microfluidic platform demonstrate differences in GPCR signaling in islet cells
John T. Walker, … , Alvin C. Powers, Marcela Brissova
John T. Walker, … , Alvin C. Powers, Marcela Brissova
Published April 30, 2020
Citation Information: JCI Insight. 2020;5(10):e137017. https://doi.org/10.1172/jci.insight.137017.
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Integrated human pseudoislet system and microfluidic platform demonstrate differences in GPCR signaling in islet cells

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Abstract

Pancreatic islets secrete insulin from β cells and glucagon from α cells, and dysregulated secretion of these hormones is a central component of diabetes. Thus, an improved understanding of the pathways governing coordinated β and α cell hormone secretion will provide insight into islet dysfunction in diabetes. However, the 3D multicellular islet architecture, essential for coordinated islet function, presents experimental challenges for mechanistic studies of intracellular signaling pathways in primary islet cells. Here, we developed an integrated approach to study the function of primary human islet cells using genetically modified pseudoislets that resemble native islets across multiple parameters. Further, we developed a microperifusion system that allowed synchronous acquisition of GCaMP6f biosensor signal and hormone secretory profiles. We demonstrate the utility of this experimental approach by studying the effects of Gi and Gq GPCR pathways on insulin and glucagon secretion by expressing the designer receptors exclusively activated by designer drugs (DREADDs) hM4Di or hM3Dq. Activation of Gi signaling reduced insulin and glucagon secretion, while activation of Gq signaling stimulated glucagon secretion but had both stimulatory and inhibitory effects on insulin secretion, which occur through changes in intracellular Ca2+. The experimental approach of combining pseudoislets with a microfluidic system allowed the coregistration of intracellular signaling dynamics and hormone secretion and demonstrated differences in GPCR signaling pathways between human β and α cells.

Authors

John T. Walker, Rachana Haliyur, Heather A. Nelson, Matthew Ishahak, Gregory Poffenberger, Radhika Aramandla, Conrad Reihsmann, Joseph R. Luchsinger, Diane C. Saunders, Peng Wang, Adolfo Garcia-Ocaña, Rita Bottino, Ashutosh Agarwal, Alvin C. Powers, Marcela Brissova

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Tryptophan catabolism reflects disease activity in human tuberculosis
Jeffrey M. Collins, … , Henry M. Blumberg, Thomas R. Ziegler
Jeffrey M. Collins, … , Henry M. Blumberg, Thomas R. Ziegler
Published May 5, 2020
Citation Information: JCI Insight. 2020;5(10):e137131. https://doi.org/10.1172/jci.insight.137131.
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Tryptophan catabolism reflects disease activity in human tuberculosis

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Abstract

There is limited understanding of the role of host metabolism in the pathophysiology of human tuberculosis (TB). Using high-resolution metabolomics with an unbiased approach to metabolic pathway analysis, we discovered that the tryptophan pathway is highly regulated throughout the spectrum of TB infection and disease. This regulation is characterized by increased catabolism of tryptophan to kynurenine, which was evident not only in active TB disease but also in latent TB infection (LTBI). Further, we found that tryptophan catabolism is reversed with effective treatment of both active TB disease and LTBI in a manner commensurate with bacterial clearance. Persons with active TB and LTBI also exhibited increased expression of indoleamine 2,3-dioxygenase-1 (IDO-1), suggesting IDO-1 mediates observed increases in tryptophan catabolism. Together, these data indicate IDO-1–mediated tryptophan catabolism is highly preserved in the human response to Mycobacterium tuberculosis and could be a target for biomarker development as well as host-directed therapies.

Authors

Jeffrey M. Collins, Amnah Siddiqa, Dean P. Jones, Ken Liu, Russell R. Kempker, Azhar Nizam, N. Sarita Shah, Nazir Ismail, Samuel G. Ouma, Nestani Tukvadze, Shuzhao Li, Cheryl L. Day, Jyothi Rengarajan, James C.M. Brust, Neel R. Gandhi, Joel D. Ernst, Henry M. Blumberg, Thomas R. Ziegler

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Immunologic timeline of Ebola virus disease and recovery in humans
Anita K. McElroy, … , Stuart T. Nichol, Christina F. Spiropoulou
Anita K. McElroy, … , Stuart T. Nichol, Christina F. Spiropoulou
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e137260. https://doi.org/10.1172/jci.insight.137260.
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Immunologic timeline of Ebola virus disease and recovery in humans

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Abstract

A complete understanding of human immune responses to Ebola virus infection is limited by the availability of specimens and the requirement for biosafety level 4 (BSL-4) containment. In an effort to bridge this gap, we evaluated cryopreserved PBMCs from 4 patients who survived Ebola virus disease (EVD) using an established mass cytometry antibody panel to characterize various cell populations during both the acute and convalescent phases. Acute loss of nonclassical monocytes and myeloid DCs, especially CD1c+ DCs, was noted. Classical monocyte proliferation and CD38 upregulation on plasmacytoid DCs coincided with declining viral load. Unsupervised analysis of cell abundance demonstrated acute declines in monocytic, NK, and T cell populations, but some populations, many of myeloid origin, increased in abundance during the acute phase, suggesting emergency hematopoiesis. Despite cell losses during the acute phase, upregulation of Ki-67 correlated with recovery of cell populations over time. These data provide insights into the human immune response during EVD.

Authors

Anita K. McElroy, Rama S. Akondy, David R. Mcllwain, Han Chen, Zach Bjornson-Hooper, Nilanjan Mukherjee, Aneesh K. Mehta, Garry Nolan, Stuart T. Nichol, Christina F. Spiropoulou

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CCL5 mediates CD40-driven CD4+ T cell tumor infiltration and immunity
Austin P. Huffman, … , Katelyn T. Byrne, Robert H. Vonderheide
Austin P. Huffman, … , Katelyn T. Byrne, Robert H. Vonderheide
Published April 23, 2020
Citation Information: JCI Insight. 2020;5(10):e137263. https://doi.org/10.1172/jci.insight.137263.
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CCL5 mediates CD40-driven CD4+ T cell tumor infiltration and immunity

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The role CD4+ T cells play in tumor immunity is less well appreciated than the cytotoxic role of CD8+ T cells. Despite clear evidence for CD4+ T cell dependency across multiple immunotherapies, the mechanisms by which CD4+ T cells infiltrate tumors remain poorly understood. Prior studies by our group have shown in a mouse model of pancreatic cancer that systemic activation of the cell surface TNF superfamily member CD40 drives T cell infiltration into tumors and, in combination with immune checkpoint blockade, leads to durable tumor regressions and cures that depend on both CD8+ and CD4+ T cells. Here, we used single-cell transcriptomics to examine the tumor microenvironment following treatment with agonist CD40 antibody with or without immune checkpoint blockade. We show that intratumor myeloid cells produce the chemokine CCL5 in response to CD40 agonist and that CCL5 mediates an influx of CD4+ T cells into the tumor microenvironment. Disruption of CCL5 genetically or pharmacologically mitigates the influx of CD4+ but not CD8+ T cells into tumors and blunts the therapeutic efficacy of immunotherapy. These findings highlight a previously unappreciated role for CCL5 in selectively mediating CD4+ T cell tumor infiltration in response to effective immunotherapy.

Authors

Austin P. Huffman, Jeffrey H. Lin, Samuel I. Kim, Katelyn T. Byrne, Robert H. Vonderheide

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Age-dependent regulation of cell-mediated collagen turnover
Michael J. Podolsky, … , Claude Jourdan Le Saux, Kamran Atabai
Michael J. Podolsky, … , Claude Jourdan Le Saux, Kamran Atabai
Published April 21, 2020
Citation Information: JCI Insight. 2020;5(10):e137519. https://doi.org/10.1172/jci.insight.137519.
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Age-dependent regulation of cell-mediated collagen turnover

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Abstract

Although aging represents the most important epidemiologic risk factor for fibrotic disease, the reasons for this are incompletely understood. Excess collagen deposition in tissues is the sine qua non of tissue fibrosis and can be viewed as an imbalance between collagen production and collagen degradation. Yet we still lack a detailed understanding of the changes that take place during development, maturation, and aging in extracellular matrix (ECM) dynamics. Resolution of fibrosis is impaired in aging, and this impairment may explain why age is the most important risk factor for fibrotic diseases, such as idiopathic pulmonary fibrosis. However, ECM dynamics and impaired resolution of fibrosis in aging remain understudied. Here we show that cell-mediated collagen uptake and degradation are diminished in aged animals and this finding correlates with downregulation of the collagen endocytic receptor mannose receptor, C-type 2 (Mrc2). We identify myeloid zinc finger-1 as a potentially novel transcriptional regulator of Mrc2, and both this transcription factor and Mrc2 are downregulated in multiple tissues and organisms in an age-dependent manner. Thus, cell-mediated degradation of collagen is an essential process that promotes resolution of fibrosis, and impairment in this process contributes to age-related fibrosis.

Authors

Michael J. Podolsky, Christopher D. Yang, Carlos Lizama Valenzuela, Ritwik Datta, Steven K. Huang, Stephen L. Nishimura, Sarah L. Dallas, Paul J. Wolters, Claude Jourdan Le Saux, Kamran Atabai

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Characteristics and diagnosis rate of 5630 subjects receiving SARS-CoV-2 nucleic acid tests from Wuhan, China
Na Shen, … , Liming Cheng, Ziyong Sun
Na Shen, … , Liming Cheng, Ziyong Sun
Published April 30, 2020
Citation Information: JCI Insight. 2020;5(10):e137662. https://doi.org/10.1172/jci.insight.137662.
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Characteristics and diagnosis rate of 5630 subjects receiving SARS-CoV-2 nucleic acid tests from Wuhan, China

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BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a novel viral pneumonia (COVID-19), which is rapidly spreading throughout the world. The positive result of nucleic acid test is a golden criterion to confirm SARS-CoV-2 infection, but the detection features remain unclear.METHODS We performed a retrospective analysis in 5630 high-risk individuals receiving SARS-CoV-2 nucleic acid tests in Wuhan, China, and investigated their characteristics and diagnosis rates.RESULTS The overall diagnosis rate was 34.7% (1952/5630). Male (P = 0.025) and older populations (P = 2.525 × 10–39) were at significantly higher risk of SARS-CoV-2 infection. People were generally susceptible, and most cases concentrated in people of 30–79 years. Furthermore, we investigated the association between diagnosis rate and the amount of testing in 501 subjects. Results revealed a 1.27-fold improvement (from 27.9% to 35.5%) of diagnosis rate from testing once to twice (P = 5.847 × 10–9) and a 1.43-fold improvement (from 27.9% to 39.9%) from testing once to 3 times (P = 7.797 × 10–14). More than 3 testing administrations was not helpful for further improvement. However, this improvement was not observed in subjects with pneumonia (P = 0.097).CONCLUSION All populations are susceptible to SARS-CoV-2 infection, and male and older-aged populations are at significantly higher risk. Increasing the amount of testing could significantly improve diagnosis rates, except for subjects with pneumonia. It is recommended to test twice in those high-risk individuals whose results are negative the first time, and performing 3 tests is better, if possible.FUNDING This work was supported by National Mega Project on Major Infectious Disease Prevention (no. 2017ZX10103005-007) and National Key Research and Development Program of China (no. 2018YFE0204500).

Authors

Na Shen, Yaowu Zhu, Xiong Wang, Jing Peng, Weiyong Liu, Feng Wang, Yanjun Lu, Liming Cheng, Ziyong Sun

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The laboratory tests and host immunity of COVID-19 patients with different severity of illness
Feng Wang, … , Huilan Zhang, Ziyong Sun
Feng Wang, … , Huilan Zhang, Ziyong Sun
Published April 23, 2020
Citation Information: JCI Insight. 2020;5(10):e137799. https://doi.org/10.1172/jci.insight.137799.
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The laboratory tests and host immunity of COVID-19 patients with different severity of illness

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BACKGROUND The coronavirus disease 2019 (COVID-19), infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a severe outbreak throughout the world. The host immunity of COVID-19 patients is unknown.METHODS The routine laboratory tests and host immunity in COVID-19 patients with different severity of illness were compared after patient admission.RESULTS A total of 65 SARS-CoV-2–positive patients were classified as having mild (n = 30), severe (n = 20), and extremely severe (n = 15) illness. Many routine laboratory tests, such as ferritin, lactate dehydrogenase, and D-dimer, were increased in severe and extremely severe patients. The absolute numbers of CD4+ T cells, CD8+ T cells, and B cells were gradually decreased with increased severity of illness. The activation markers such as HLA-DR and CD45RO expressed on CD4+ and CD8+ T cells were increased in severe and extremely severe patients compared with mild patients. The costimulatory molecule CD28 had opposite results. The percentage of natural Tregs was decreased in extremely severe patients. The percentage of IFN-γ–producing CD8+ T cells was increased in both severe and extremely severe patients compared with mild patients. The percentage of IFN-γ–producing CD4+ T cells was increased in extremely severe patients. IL-2R, IL-6, and IL-10 were all increased in extremely severe patients. The activation of DC and B cells was decreased in extremely severe patients.CONCLUSION The number and function of T cells are inconsistent in COVID-19 patients. The hyperfunction of CD4+ and CD8+ T cells is associated with the pathogenesis of extremely severe SARS-CoV-2 infection.FUNDING This work was funded by the National Mega Project on Major Infectious Disease Prevention (2017ZX10103005-007) and the Fundamental Research Funds for the Central Universities (2019kfyRCPY098).

Authors

Feng Wang, Hongyan Hou, Ying Luo, Guoxing Tang, Shiji Wu, Min Huang, Weiyong Liu, Yaowu Zhu, Qun Lin, Liyan Mao, Minghao Fang, Huilan Zhang, Ziyong Sun

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