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In-Press Preview

Articles in this category appear as authors submitted them for publication, prior to copyediting and publication layout.
LXRs regulate features of age-related macular degeneration and may be a potential therapeutic target
Effective treatments and animal models for the most prevalent neurodegenerative form of blindness in the elderly, called age-related macular degeneration (AMD), are lacking. Genome-wide association...
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Research In-Press Preview Ophthalmology Therapeutics

LXRs regulate features of age-related macular degeneration and may be a potential therapeutic target

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Abstract

Effective treatments and animal models for the most prevalent neurodegenerative form of blindness in the elderly, called age-related macular degeneration (AMD), are lacking. Genome-wide association studies have identified lipid metabolism and inflammation as AMD-associated pathogenic pathways. Given liver x receptors, encoded by NR1H3 and NR1H2, are master regulators of these pathways, herein we investigated the role of LXR in human and mouse eyes as a function of age and disease, and tested the therapeutic potential of targeting LXR. We identified immunopositive LXR fragments in human extracellular early dry AMD lesions and a decrease in LXR expression within the retinal pigment epithelium (RPE) as a function of age. Aged mice, lacking LXR presented with isoform dependent ocular pathologies. Specifically, loss of the Nr1h3 isoform results in pathobiologies aligned with AMD, supported by compromised visual function, accumulation of native and oxidized lipids in the outer retina, and upregulation of ocular inflammatory cytokines, while absence of Nr1h2 is associated with ocular lipoidal degeneration. Therapeutically, LXR activation, ameliorated lipid accumulation and oxidant-induced injury in RPE cells in vitro, and decreased ocular inflammatory markers and lipid deposition in a mouse model, in vivo, providing translational support for pursuing LXR-active pharmaceuticals as potential therapies for dry AMD.

Authors

Mayur Choudhary, Ebraheim N. Ismail, Pei-Li Yao, Faryan Tayyari, Roxana A. Radu, Steven Nusinowitz, Michael E. Boulton, Rajendra S. Apte, Jeffrey W. Ruberti, James T. Handa, Peter Tontonoz, Goldis Malek

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Structure–function relationships of HDL in diabetes and coronary heart disease
High-density lipoproteins (HDL) contain hundreds of lipid species and proteins and exert many potentially vasoprotective and anti-diabetogenic activities on cells. To resolve...
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Research In-Press Preview Cardiology Metabolism

Structure–function relationships of HDL in diabetes and coronary heart disease

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Abstract

High-density lipoproteins (HDL) contain hundreds of lipid species and proteins and exert many potentially vasoprotective and anti-diabetogenic activities on cells. To resolve structure-function-disease relationships of HDL we characterized HDL of 51 healthy subjects and 98 patients with diabetes (T2DM), coronary heart disease (CHD), or both for protein and lipid composition as well as functionality in five cell types. The integration of 40 clinical characteristics, 34 NMR features, 182 proteins, 227 lipid species, and 12 functional read-outs by high-dimensional statistical modelling revealed first that CHD and T2DM are associated with different changes of HDL in size distribution, protein and lipid composition as well as function. Second, different cellular functions of HDL are weakly correlated with each other and determined by different structural components. Cholesterol efflux capacity was no proxy of other functions. Third, three novel determinants of HDL function were identified and validated by the use of artificially reconstituted HDL, namely the sphingadienine-based sphingomyelin SM 42:3 and glycosylphosphatidylinositol-phospholipase D1 for the ability of HDL to inhibit starvation induced apoptosis of human aortic endothelial cells and apolipoprotein F for the ability of HDL to promote maximal respiration of brown adipocytes.

Authors

Mathias Cardner, Mustafa Yalcinkaya, Sandra Goetze, Edlira Luca, Miroslav Balaz, Monika Hunjadi, Johannes Hartung, Andrej Shemet, Nicolle Kraenkel, Silvija Radosavljevic, Michaela Keel, Alaa Othman, Gergely Karsai, Thorsten Hornemann, Manfred Claassen, Gerhard Liebisch, Erick Carreira, Andreas Ritsch, Ulf Landmesser, Jan Krützfeldt, Christian Wolfrum, Bernd Wollscheid, Niko Beerenwinkel, Lucia Rohrer, Arnold von Eckardstein

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Immunologic alterations in the pancreatic cancer microenvironment of patients treated with neoadjuvant chemo- and radiotherapy
Pancreatic ductal adenocarcinoma (PDAC) has dismal five-year survival (<9%). We hypothesize that exposure of tumors to conventional therapies may preferentially modulate immune biomarkers in the...
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Research In-Press Preview Immunology Oncology

Immunologic alterations in the pancreatic cancer microenvironment of patients treated with neoadjuvant chemo- and radiotherapy

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Pancreatic ductal adenocarcinoma (PDAC) has dismal five-year survival (<9%). We hypothesize that exposure of tumors to conventional therapies may preferentially modulate immune biomarkers in the tumor microenvironment in PDAC. PDAC patients who underwent upfront surgical resection or who received neoadjuvant FOLFIRINOX with or without neoadjuvant radiotherapy followed by surgical resection were selected for study. Total expression of immunologically relevant transcripts and spatially resolved expression of immunologically relevant proteins was quantitated using multiplexed methods (Nanostring nCounter and GeoMX platforms). This analysis identified numerous differentially expressed transcripts associated with the type of neoadjuvant therapy received. Moreover, we identified significant alterations in the expression and/or spatial distribution of immunologically relevant proteins in different regions (tumor cell rich, immune cell rich, stromal cell rich) of the TME. These data provide insight into the immunological effects of clinically relevant neoadjuvant therapy for resectable/borderline-resectable PDAC, by describing significant differences in the expression of key immunologic biomarkers within the PDAC microenvironment that were associated with the type of treatment patients received prior to surgical resection. This represents a comprehensive analysis of numerous biomarkers conducted on the PDAC microenvironment. This work may guide strategic new combination therapies for pancreatic cancer.

Authors

Matthew R. Farren, Layal Sayegh, Michael Brandon Ware, Hsiao-Rong Chen, Jingjing Gong, Yan Liang, Alyssa Krasinskas, Shishir K. Maithel, Mohammad Zaidi, Juan M. Sarmiento, David Kooby, Pretesh Patel, Bassel El-Rayes, Walid Shaib, Gregory B. Lesinski

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Gut permeability, inflammation, and bone density across the menopause transition
Background: Inflammation is implicated in many aging-related disorders. In animal models, menopause leads to increased gut permeability and inflammation. Our primary objective was to determine if...
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Clinical Research and Public Health In-Press Preview Bone biology Endocrinology

Gut permeability, inflammation, and bone density across the menopause transition

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Background: Inflammation is implicated in many aging-related disorders. In animal models, menopause leads to increased gut permeability and inflammation. Our primary objective was to determine if gut permeability increases during the menopause transition (MT) in women. Our exploratory objectives were to examine whether greater gut permeability is associated with more inflammation and lower bone mineral density (BMD).Methods: We included 65 women from the Study of Women’s Health Across the Nation. Key measures were markers of gut permeability (gut barrier dysfunction [fatty acid binding protein 2 [FABP2]) and immune activation secondary to gut microbial translocation (lipopolysaccharide binding protein [LBP], soluble CD14 [sCD14]); inflammation (high-sensitivity CRP); and lumbar spine (LS) or total hip (TH) BMD. Results: In our primary analysis, FABP2, LBP, and sCD14 increased by 22.8% (P = 0.001), 3.7% (P = 0.05), and 8.9% (P = 0.0002), respectively from pre- to postmenopause. In exploratory, repeated measures, mixed-effects linear regression (adjusted for age at the premenopausal visit, body mass index, race/ethnicity, and study site), greater gut permeability was associated with greater inflammation, and lower LS and TH BMD. Conclusions: Gut permeability increases during the MT. Greater gut permeability is associated with more inflammation and lower BMD. Future studies should examine the longitudinal associations of gut permeability, inflammation, and BMD.Funding: NIH, Department of Health and Human Services, through the National Institute on Aging, National Institute of Nursing Research, and NIH Office of Research on Women’s Health (U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495).

Authors

Albert Shieh, Marta Epeldegui, Arun S Karlamangla, Gail A. Greendale

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Pharmacologic and genetic approaches define human pancreatic beta cell mitogenic targets of DYRK1A inhibitors
Small molecule inhibitors of Dual Specificity, Tyrosine Phosphorylation-Regulated Kinase 1A (DYRK1A), including harmine and others, are able to drive human beta cell regeneration. While DYRK1A is...
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Research In-Press Preview Endocrinology Metabolism

Pharmacologic and genetic approaches define human pancreatic beta cell mitogenic targets of DYRK1A inhibitors

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Small molecule inhibitors of Dual Specificity, Tyrosine Phosphorylation-Regulated Kinase 1A (DYRK1A), including harmine and others, are able to drive human beta cell regeneration. While DYRK1A is certainly a target of this class, whether it is the only, or the most important target, is uncertain. Here, we employ a combined pharmacologic and genetic approach to refine the potential mitogenic targets of the DYRK1A inhibitor family in human islets. A combination of human beta cell RNAseq, DYRK1A inhibitor kinome screens, pharmacologic inhibitors, and targeted silencing of candidate genes confirms that DYRK1A is a central target. Surprisingly, however, DYRK1B also proves to be an important target: silencing DYRK1A results in an increase in DYRK1B; simultaneous silencing of both DYRK1A and DYRK1B yields greater beta cell proliferation than silencing either individually. Importantly, other potential kinases, such as the CLK and the GSK3 families, are excluded as important harmine targets. Finally, we describe adenoviruses that are able to silence up to seven targets simultaneously. Collectively, we report that inhibition of both DYRK1A and DYRK1B is required for induction of maximal rates of human beta cell proliferation, and provide clarity for future efforts at structure-based drug design for human beta cell regenerative drugs.

Authors

Courtney Ackeifi, Ethan Swartz, Kunal Kumar, Hongtao Liu, Suebsuwong Chalada, Esra Karakose, Donald K. Scott, Adolfo Garcia-Ocaña, Roberto Sanchez, Robert J. DeVita, Andrew F. Stewart, Peng Wang

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Siponimod therapy implicates Th17 cells in a preclinical model of subpial cortical injury
Subpial demyelination is a specific hallmark of multiple sclerosis (MS) and a correlate of disease progression. Although the mechanism(s) that mediate pathogenesis in the subpial compartment remain...
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Research In-Press Preview Immunology

Siponimod therapy implicates Th17 cells in a preclinical model of subpial cortical injury

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Subpial demyelination is a specific hallmark of multiple sclerosis (MS) and a correlate of disease progression. Although the mechanism(s) that mediate pathogenesis in the subpial compartment remain unclear, it has been speculated that inflammation in the overlying meninges may be associated with subpial injury. Here we show that adoptive transfer of proteolipid protein-primed Th17 cells into SJL/J recipient mice induces subpial demyelination associated with microglial/macrophage activation, disruption of the glial limitans and evidence of an oxidative stress response. This pathology was topologically associated with foci of immune cells in the meninges and occurred in the absence of measurable anti-MOG IgM or IgG antibodies. To test the role of brain-infiltrating leukocytes on subpial injury, we modulated sphingosine 1-phosphate (S1P) receptor1,5 activity with BAF312 (siponimod) treatment. Administration of BAF312, even after adoptively transferred T cells had entered the brain, significantly ameliorated clinical EAE and diminished subpial pathology, concomitant with a selective reduction in the capacity of transferred T cells to make Th17 cytokines. We conclude that sustained subpial cortical injury is associated with the capacity for brain-resident T cells to produce Th17 cytokines, and this pathological process occurs in an S1P receptor1,5-dependent manner.

Authors

Lesley A. Ward, Dennis S.W. Lee, Anshu Sharma, Angela Wang, Ikbel Naouar, Xianjie I. Ma, Natalia Pikor, Barbara Nuesslein-Hildesheim, Valeria Ramaglia, Jennifer L. Gommerman

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Vitamin E sequestration by liver fat in humans
BACKGROUND We hypothesized that obesity-associated hepato-steatosis served as a pathophysiologic chemical depot for fat-soluble vitamins and altered normal physiology. Using α-tocopherol (vitamin...
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Clinical Research and Public Health In-Press Preview Hepatology Metabolism

Vitamin E sequestration by liver fat in humans

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BACKGROUND We hypothesized that obesity-associated hepato-steatosis served as a pathophysiologic chemical depot for fat-soluble vitamins and altered normal physiology. Using α-tocopherol (vitamin E) as a model vitamin, pharmacokinetics and kinetics principles were utilized to determine whether excess liver fat sequestered α-tocopherol in women with obesity-associated hepato-steatosis vs healthy controls. METHODS Custom-synthesized deuterated α-tocopherols (d3- and d6-α-tocopherols) were administered to hospitalized healthy women and women with hepato-steatosis under IND guidelines. Serial samples obtained over 72 hours were analyzed by LC/MS. Fluorescent-labelled α-tocopherol was custom-synthesized for cell studies. RESULTS In healthy subjects, 85% of intravenous d6-α-tocopherol disappeared from the circulation within 20 minutes but reappeared within minutes and peaked at 6-8 hours. d3- and d6-α-Tocopherols localized to lipoproteins. Lipoprotein redistribution occurred only in vivo within 1h, indicating a key role of liver in rapid uptake and re-release into the circulation. Compared to healthy subjects, subjects with hepato-steatosis had similar d6-α-tocopherol entry rates into liver, but reduced initial release rates (p<0.001). Similarly, pharmacokinetics parameters of AUC and Maximum Concentration (Cmax) were reduced (AUC0-8 ,p<0.01;Cmax p<0.02) in hepato-steatosis subjects, indicating reduced hepatic d6-α-tocopherol output. Reduced kinetics and pharmacokinetics parameters (AUC and Cmax) in hepato-steatosis subjects who received 2 mg were mirrored by similar reductions in healthy subjects when comparing 5 and 2 mg doses. In vitro, fluorescent-labelled α-tocopherol localized specifically to lipid in fat-loaded hepatocytes, indicating sequestration. CONCLUSIONS The unique role of the liver in vitamin E physiology is dysregulated by excess liver fat. Obesity-associated hepato-steatosis may produce unrecognized hepatic vitamin E sequestration, which might subsequently drive liver disease. Our findings raise the possibility that hepato-steatosis may similarly alter hepatic physiology of other fat-soluble vitamins.

Authors

Pierre-Christian Violet, Ifechukwude C. Ebenuwa, Yu Wang, Mahtab Niyyati, Sebastian J. Padayatty, Brian Head, Kenneth Wilkins, Stacey Chung, Varsha Thakur, Lynn Ulatowski, Jeffrey Atkinson, Mikel Ghelfi, Sheila Smith, Hongbin Tu, Gerd Bobe, Chia-Ying Liu, David W. Herion, Robert D. Shamburek, Danny Manor, Maret G. Traber, Mark Levine

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Lupus-associated endogenous retroviral LTR polymorphism and epigenetic imprinting promote HRES-1/Rab4 expression and mTOR activation
Overexpression and long terminal repeat (LTR) polymorphism of the HRES-1/Rab4 human endogenous retrovirus locus have been associated with T-cell activation and disease manifestations in systemic...
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Research In-Press Preview Immunology

Lupus-associated endogenous retroviral LTR polymorphism and epigenetic imprinting promote HRES-1/Rab4 expression and mTOR activation

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Overexpression and long terminal repeat (LTR) polymorphism of the HRES-1/Rab4 human endogenous retrovirus locus have been associated with T-cell activation and disease manifestations in systemic lupus erythematosus (SLE). Although genomic DNA methylation is overall diminished in SLE, its role in HRES-1/Rab4 expression is unknown. Therefore, we determined how lupus-associated polymorphic rs451401 alleles of the LTR regulate transcription from the HRES-1/Rab4 promoter and thus impact T-cell activation. The results show that cytosine-119 is hypermethylated while cytosine-51 of the promoter and the LTR-enhancer are hypomethylated in SLE. Pharmacological or genetic inactivation of DNA-methyltransferase-1 augmented the expression of HRES-1/Rab4. The minimal promoter was selectively recognized by metabolic stress sensor NRF1 when cytosine-119 but not cytosine-51 was methylated, and NRF1 stimulated HRES-1/Rab4 expression in human T cells. In turn, IRF2 and PSIP1 bound to the LTR-enhancer and exerted control over HRES-1/Rab4 expression in rs451401-genotype and methylation-dependent manners. The LTR-enhancer conferred markedly greater expression of HRES-1/Rab4 in subjects with rs451401CC over rs451401GG alleles that in turn promoted mechanistic target of rapamycin (mTOR) activation upon T-cell receptor stimulation. HRES-1/Rab4 alone robustly activated mTOR in human T cells. These findings identify HRES-1/Rab4 as a methylation and rs451401 allele-dependent transducer of environmental stress and controller of T-cell activation.

Authors

Aparna Godavarthy, Ryan Kelly, John Jimah, Miguel Beckford, Tiffany Caza, David Fernandez, Nick Huang, Manuel Duarte, Joshua Lewis, Hind J. Fadel, Eric M. Poeschla, Katalin Banki, Andras Perl

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Null mutations of NEUROG3 are associated with delayed onset diabetes mellitus
Biallelic mutations of the gene encoding the transcription factor NEUROG3 are associated with a rare disorder that presents in neonates as generalized malabsorption – due to a complete absence of...
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Research In-Press Preview Endocrinology Gastroenterology

Null mutations of NEUROG3 are associated with delayed onset diabetes mellitus

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Biallelic mutations of the gene encoding the transcription factor NEUROG3 are associated with a rare disorder that presents in neonates as generalized malabsorption – due to a complete absence of enteroendocrine cells – followed, in early childhood or beyond, by insulin-dependent diabetes mellitus (IDDM). The commonly delayed onset of IDDM suggests a differential requirement for NEUROG3 in endocrine cell generation in the human pancreas versus the intestine. However, previously identified human mutations were hypomorphic, and hence may have had residual function in pancreas. We report two patients with biallelic functionally null variants of the NEUROG3 gene who nonetheless did not present with IDDM during infancy, but instead developed permanent IDDM during middle childhood ages. The variants show no evidence of function in traditional promoter-based assays of NEUROG3 function and also fail to exhibit function in a variety of novel in vitro and in vivo molecular assays designed to discern residual NEUROG3 function. These findings imply that unlike in mice, pancreatic endocrine cell generation in humans is not entirely dependent on NEUROG3 expression, and hence suggests the presence of unidentified redundant in vivo pathways in human pancreas capable of yielding beta-cell mass sufficient to maintain euglycemia until early childhood.

Authors

R. Sergio Solorzano-Vargas, Matthew Bjerknes, Jiafang Wang, S. Vincent Wu, Manuel G. Garcia-Careaga, Duke Pisit, Hazel Cheng, Michael S. German, Senta Georgia, Martin G. Martín

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Pre-existing subtype immunodominance shapes memory B cell recall response to influenza vaccination
Influenza is a highly contagious viral pathogen with more than 200,000 cases reported in the U.S. during the 2017-2018 season. Annual vaccination is recommended by the World Health Organization...
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Research In-Press Preview Infectious disease Virology

Pre-existing subtype immunodominance shapes memory B cell recall response to influenza vaccination

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Influenza is a highly contagious viral pathogen with more than 200,000 cases reported in the U.S. during the 2017-2018 season. Annual vaccination is recommended by the World Health Organization with the goal to reduce influenza severity and transmission. Currently available vaccines are ~60% effective and vaccine effectiveness varies from season to season, as well as between different influenza subtypes within a single season. Immunological imprinting from early life influenza infection can prominently shape the immune response to subsequent infections. Here, the impact of pre-existing B cell memory in the response to quadrivalent influenza vaccine was assessed using blood samples collected from healthy subjects (18 to 85 years old) prior to and 21-28 days following influenza vaccination. Influenza vaccination increased both HA-specific antibodies and memory B cells frequency. Despite no apparent differences in antigenicity between vaccine components, most individuals were biased towards one of the vaccine strains. Specifically, responses to H3N2 were reduced in magnitude relative to the other vaccine components. Overall, this study unveils a new mechanism underlying differential vaccine effectiveness against distinct influenza subtypes.

Authors

Rodrigo B. Abreu, Greg A. Kirchenbaum, Emily F. Clutter, Giuseppe A. Sautto, Ted M. Ross

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Anti-MSP-10 IgG indicates recent exposure to Plasmodium vivax infection in the Peruvian Amazon
Background: Serological tools for the accurate detection of recent malaria exposure are needed to guide and monitor malaria control efforts. IgG responses against P. vivax and P. falciparum...
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Clinical Research and Public Health In-Press Preview Immunology Infectious disease

Anti-MSP-10 IgG indicates recent exposure to Plasmodium vivax infection in the Peruvian Amazon

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Background: Serological tools for the accurate detection of recent malaria exposure are needed to guide and monitor malaria control efforts. IgG responses against P. vivax and P. falciparum merozoite surface protein-10 (MSP10) were measured as a potential way to identify recent malaria exposure in the Peruvian Amazon. Methods: A field-based study included 470 participants in a longitudinal cohort who completed a comprehensive evaluation: light microscopy and PCR on enrollment; at least one monthly follow-up by light microscopy; a second PCR; and serum and dried blood spots for serological analysis at the end of the follow-up. IgG titers against novel mammalian cell-produced recombinant PvMSP10 and PfMSP10 were determined by ELISA. Results: During the follow-up period, 205 participants were infected, including 171 with P. vivax, 26 with P. falciparum, 6 with infections by both species but at different times, and 2 with mixed infections. Exposure to P. vivax was more accurately identified when serological responses to PvMSP10 were obtained from serum (sensitivity, 58.1%; specificity, 81.8%; AUC: 0.76) than from dried blood spots (sensitivity, 35.2; specificity, 83.5%; AUC: 0.64) (PAUC < 0.001). Sensitivity was highest (serum, 82.9%; dried blood spot, 45.7%) with confirmed P. vivax infections occurring 7-30 days before sample collection; sensitivity decreased significantly in relation to time since last documented infection. PvMSP10 serological data did not show evidence of inter-species cross-reactivity. Anti-PfMSP10 responses poorly discriminated between P. falciparum exposed- and non-exposed individuals (AUC = 0.59, P > 0.05). Conclusions: Anti-PvMSP10 IgG indicates recent exposure to P. vivax at the population level in the Amazon region. Serum, not dried blood spots, should be used for such serological tests.

Authors

Angel Rosas-Aguirre, Kailash P. Patra, Maritza Calderón, Katherine Torres, Dionicia Gamboa, Edith Arocutipa, Edith Málaga, Katherine Garro, Carlos Fernández, Grace Trompeter, Yossef Alnasser, Alejandro Llanos-Cuentas, Robert H. Gilman, Joseph M. Vinetz

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Gigaxonin glycosylation regulates intermediate filament turnover and may impact giant axonal neuropathy etiology or treatment
Gigaxonin (also known as KLHL16) is an E3 ligase adaptor protein that promotes the ubiquitination and degradation of intermediate filament (IF) proteins. Mutations in human gigaxonin cause the...
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Research In-Press Preview Cell biology

Gigaxonin glycosylation regulates intermediate filament turnover and may impact giant axonal neuropathy etiology or treatment

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Gigaxonin (also known as KLHL16) is an E3 ligase adaptor protein that promotes the ubiquitination and degradation of intermediate filament (IF) proteins. Mutations in human gigaxonin cause the fatal neurodegenerative disease giant axonal neuropathy (GAN), in which IF proteins accumulate and aggregate in axons throughout the nervous system, impairing neuronal function and viability. Despite this pathophysiological significance, the upstream regulation and downstream effects of normal and aberrant gigaxonin function remain incompletely understood. Here, we report that gigaxonin is modified by O-linked β-N-acetylglucosamine (O-GlcNAc), a prevalent form of intracellular glycosylation, in a nutrient- and growth factor-dependent manner. Mass spectrometry analyses of human gigaxonin revealed nine candidate sites of O-GlcNAcylation, two of which – serine 272 and threonine 277 – are required for its ability to mediate IF turnover in novel gigaxonin-deficient human cell models that we created. Taken together, these results suggest that nutrient-responsive gigaxonin O-GlcNAcylation forms a regulatory link between metabolism and IF proteostasis. Our work may have significant implications for understanding the non-genetic modifiers of GAN phenotypes and for the optimization of gene therapy for this disease.

Authors

Po-Han Chen, Jimin Hu, Jianli Wu, Duc T. Huynh, Timothy J. Smith, Samuel Pan, Brittany J. Bisnett, Alexander B. Smith, Annie Lu, Brett M. Condon, Jen-Tsan Chi, Michael Boyce

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Microbial Functional Change is Linked with Clinical Outcomes after Capsular Fecal Transplant in Cirrhosis
Background: Hepatic encephalopathy (HE) is associated with poor outcomes. A prior randomized, pilot trial demonstrated safety after oral capsular FMT in HE with favorable changes in microbial...
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Clinical Research and Public Health In-Press Preview Hepatology

Microbial Functional Change is Linked with Clinical Outcomes after Capsular Fecal Transplant in Cirrhosis

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Background: Hepatic encephalopathy (HE) is associated with poor outcomes. A prior randomized, pilot trial demonstrated safety after oral capsular FMT in HE with favorable changes in microbial composition and cognition. However, microbial functional changes are unclear. Aim: Determine impact of FMT on gut-brain axis compared to placebo using microbial function based on bile acids (BA), inflammation (serum IL-6, lipopolysaccharide-binding protein,LBP), and EncephalApp. Methods: 20 cirrhotic patients were randomized 1:1 into receiving one-time FMT capsules from a donor enriched in Lachnospiraceae and Ruminococcaceae, or placebo capsules with 5-month follow-up for safety outcomes. Stool microbiota and BA, serum IL-6, BA and LBP, and EncephalApp were analyzed at baseline and 4-weeks post-FMT/placebo. Correlation networks between microbiota, BAs, EncephalApp, IL-6 and LBP were performed pre/post-FMT. Results: FMT-assigned participants had one HE recurrence and 2 unrelated infections. Six placebo-assigned participants developed negative outcomes. FMT, but not placebo, was associated with reduced serum IL-6 and LBP and improved EncephalApp. FMT-assigned participants demonstrated higher deconjugation and secondary BA formation in feces and serum compared to baseline. No change was seen in placebo. Correlation networks showed greater complexity post-FMT compared to baseline. Beneficial taxa such as Ruminococcaceae, Verrucomicrobiaceae and Lachnospiraceae were correlated with cognitive improvement and decrease in inflammation post-FMT. Fecal/serum secondary/primary ratios and PiCRUST secondary BA pathways did not increase in participants who developed poor outcomes. Conclusions: Gut microbial function in cirrhosis is beneficially affected by capsular FMT with improved inflammation and cognition. Lower secondary BAs in FMT recipients could select for participants who develop negative outcomes.

Authors

Jasmohan S. Bajaj, Nita Salzman, Chathur Acharya, Hajime Takei, Genta Kakiyama, Andrew Fagan, Melanie B. White, Edith A. Gavis, Mary L. Holtz, Michael Hayward, Hiroshi Nittono, Philip B. Hylemon, I. Jane Cox, Roger Williams, Simon D. Taylor-Robinson, Richard K. Sterling, Scott C. Matherly, Michael Fuchs, Hannah Lee, Puneet Puri, R. Todd Stravitz, Arun J. Sanyal, Lola Ajayi, Adrien Le Guennec, R. Andrew Atkinson, Mohammad S. Siddiqui, Velimir A. Luketic, William M. Pandak, Masoumeh Sikaroodi, Patrick M. Gillevet

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Mitochondrial Arginase-2 is a cell autonomous regulator of CD8+ T cell function and anti-tumor efficacy
As sufficient extracellular arginine is crucial for T cell function, depletion of extracellular arginine by elevated Arginase 1 (Arg1) activity has emerged as a hallmark immunosuppressive...
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Research In-Press Preview Immunology Oncology

Mitochondrial Arginase-2 is a cell autonomous regulator of CD8+ T cell function and anti-tumor efficacy

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As sufficient extracellular arginine is crucial for T cell function, depletion of extracellular arginine by elevated Arginase 1 (Arg1) activity has emerged as a hallmark immunosuppressive mechanism. However, the potential cell-autonomous roles of arginases in T cells have remained unexplored. Here we show that the arginase isoform expressed by T cells, the mitochondrial Arginase 2 (Arg2), is a cell-intrinsic regulator of CD8+ T cell activity. Both germ-line Arg2 deletion and adoptive transfer of Arg2-/- CD8+ T cells significantly reduced tumor growth in preclinical cancer models by enhancing CD8+ T cell activation, effector function and persistence. Transcriptomic, proteomic and high-dimensional flow cytometry characterization revealed a CD8+ T cell-intrinsic role of Arg2 in modulating T cell activation, anti-tumor cytoxicity and memory formation, independently of extracellular arginine availability. Furthermore, specific deletion of Arg2 in CD8+ T cells strongly synergized with PD-1 blockade for the control of tumor growth and animal survival. These observations coupled with the finding that pharmacologic arginase inhibition accelerates activation of ex vivo human T cells unveil Arg2 as a new therapeutic target for T cell-based cancer therapies.

Authors

Adrià-Arnau Martí i Líndez, Isabelle Dunand-Sauthier, Mark Conti, Florian Gobet, Nicolás Núñez, J. Thomas Hannich, Howard Riezman, Geiger Roger, Alessandra Piersigilli, Kerstin Hahn, Sylvain Lemeille, Burkhard Becher, Thibaut De Smedt, Stéphanie Hugues, Walter Reith

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Tubular injury triggers podocyte dysfunction by β-catenin-driven release of MMP7
Proteinuric chronic kidney disease (CKD) remains a major health problem worldwide. While the progression of primary glomerular disease to induce tubulointerstitial lesions is well established, the...
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Research In-Press Preview Nephrology

Tubular injury triggers podocyte dysfunction by β-catenin-driven release of MMP7

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Abstract

Proteinuric chronic kidney disease (CKD) remains a major health problem worldwide. While the progression of primary glomerular disease to induce tubulointerstitial lesions is well established, the effect of tubular injury to trigger glomerular damage is poorly understood. We hypothesized that injured tubules secrete mediators that adversely affect glomerular health. To test this, we utilized conditional knockout mice with tubule-specific ablation of β-catenin (Ksp-β-cat-/-), and subjected them to chronic angiotensin II (Ang II) infusion or adriamycin. Compared to control mice, Ksp-β-cat-/- mice were dramatically protected from proteinuria and glomerular damage. Matrix metalloproteinase-7 (MMP-7), a downstream target of β-catenin, was upregulated in treated control mice, but this induction was blunted in the Ksp-β-cat-/- littermates. Incubation of isolated glomeruli with MMP-7 ex vivo led to nephrin depletion and impaired glomerular permeability. Furthermore, MMP-7 specifically and directly degraded nephrin in cultured glomeruli or cell-free systems, and this effect was dependent on its proteolytic activity. In vivo, expression or infusion of exogenous MMP-7 caused proteinuria, and genetic ablation of MMP-7 protected mice from Ang II-induced proteinuria and glomerular injury. Collectively, these results demonstrate that beta-catenin-driven MMP-7 release from renal tubules promotes glomerular injury via direct degradation of the key slit diaphragm protein nephrin.

Authors

Roderick J. Tan, Yingjian Li, Brittney M. Rush, Débora Malta Cerqueira, Dong Zhou, Haiyan Fu, Jacqueline Ho, Donna Beer Stolz, Youhua Liu

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BCG revaccination boosts adaptive polyfunctional Th1/Th17 and innate effectors in IGRA+ and IGRA- Indian adults
Background: Bacille Calmette-Guérin (BCG) vaccine is protective in children but its efficacy wanes with age. Consequently, determining if BCG revaccination augments anti-TB immunity in young adults...
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Clinical Research and Public Health In-Press Preview Immunology Infectious disease

BCG revaccination boosts adaptive polyfunctional Th1/Th17 and innate effectors in IGRA+ and IGRA- Indian adults

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Abstract

Background: Bacille Calmette-Guérin (BCG) vaccine is protective in children but its efficacy wanes with age. Consequently, determining if BCG revaccination augments anti-TB immunity in young adults in TB endemic regions is vital. Methods: 200 healthy adults, BCG vaccinated at birth were tested for their IGRA status. Of these, 28 IGRA+ and 30 IGRA- were BCG revaccinated and 24 IGRA+ and 23 IGRA- subjects served as unvaccinated controls. T and innate cell responses to mycobacterial antigens were analyzed by 14-colour flow cytometry over 34 weeks. Results: IFN-γ and/or IL-2 Ag85A and BCG-specific CD4+ and CD8+ T-cell responses were boosted by revacciantion at 4 and 34 weeks respectively and were >2-fold higher in IGRA+ compared to IGRA- vaccinees. Polyfunctional Ag85A, BCG and Mtb latency Ag (LTAg)-specific CD4+ T-cells expressing up to 8 cytokines were also significantly enhanced in both IGRA+ and IGRA- vaccinees relative to unvaccinated controls, most markedly in IGRA+ vaccinees. A focussed analysis of Th17 responses revealed expansion of Ag85A, BCG and LTAg-specific total IL-17A+IL-17F+IL-22+ and IL-10+ CD4+ T-cell effectors in both IGRA+ and IGRA- subjects. Also, innate IFN-γ+ NK/γδ/NKT responses were higher in both IGRA+ and IGRA- vaccinees compared to controls. This is the first evidence that BCG revaccination significantly boosts anti-mycobacterial Th1/Th17 responses in IGRA+ and IGRA- subjects. Summary: These data show that BCG revaccination is immunogenic in IGRA- and IGRA+ subjects implying that Mtb pre-infection in IGRA+ subjects does not impact immunogenicity. This has implications for public health and vaccine development strategies. Funding: This work was funded principally by DBT-NIH (BT/MB/Indo-US/HIPC/2013).

Authors

Srabanti Rakshit, Asma Ahmed, Vasista Adiga, Bharath K. Sundararaj, Pravat Nalini Sahoo, John Kenneth, George D'Souza, Wesley Bonam, Christina Johnson, Kees L.M.C. Franken, Tom H.M. Ottenhoff, Greg Finak, Raphael Gottardo, Kenneth D. Stuart, Stephen C. De Rosa, M. Juliana McElrath, Annapurna Vyakarnam

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L-citrulline as add-on therapy to increase nitric oxide, and to improve asthma control in obese asthmatics
Introduction: The airways of obese asthmatics have been shown to be nitric oxide (NO) deficient, which contributes to airway dysfunction and reduced response to inhaled corticosteroids (ICS). In...
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Clinical Research and Public Health In-Press Preview Pulmonology

L-citrulline as add-on therapy to increase nitric oxide, and to improve asthma control in obese asthmatics

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Abstract

Introduction: The airways of obese asthmatics have been shown to be nitric oxide (NO) deficient, which contributes to airway dysfunction and reduced response to inhaled corticosteroids (ICS). In cultured airway epithelial cells, L-citrulline, a precursor of L-arginine recycling and NO formation, has been shown to prevent asymmetric di-methyl arginine (ADMA)-mediated NO synthase (NOS2) uncoupling, restoring NO and reducing oxidative stress. Methods: In a proof of concept, pre – post open label pilot study, we hypothesized that 15g/day of L-citrulline for two weeks would: a) increase the fractional excretion of NO (FeNO); b) improve asthma control and c) improve lung function. To do this, we recruited obese (body mass index [BMI] >30) asthmatics on controller therapy with a baseline fractional exhaled nitric oxide (FeNO) ≤ 30 ppb from the University of Colorado Medical Center and Duke University Health System. Results: A total of 41 subjects with an average FeNO of 17 ppb (95% 19 - 20) and poorly controlled asthma (average asthma control questionnaire [ACQ] 1.5 [95% 1.2 – 1.8) completed the study. Compared to baseline, L-citrulline increased (values represent the mean delta and 95%CI): plasma L-citrulline (190uM, 84 – 297), plasma L-arginine (67uM, 38 – 95), plasma L-arginine/ADMA (117, 67 - 167), but not ADMA or arginase concentration. FeNO increased by 4.2ppb (1.7 – 6.7); ACQ decreased by -0.46 (-0.67 – -0.27); the forced vital capacity (FVC) and forced exhalation volume in one second (FEV1) respectively changed by 86 ml (10 – 161), and 52 ml (-11 – 132). In a secondary analysis, the greatest FEV1 increments occurred in those subjects with late onset asthma (>12 years) (63 ml [95%CI 1 – 137]), in females (80 ml [95%CI 5 – 154]), with a greater change seen in late onset females (100ml, [95%CI 2 – 177]). The changes in lung function or asthma control were not significantly associated with the pre-post changes in L-arginine/ADMA or FeNO. Conclusion: Short-term L-citrulline treatment improved asthma control and FeNO levels in obese asthmatics with low or normal FeNO. Larger FEV1 increments were observed in those with late onset asthma and in females.

Authors

Fernando Holguin, Hartmut Grasemann, Sunita Sharma, Daniel Winnica, Karen Wasil, Vong Smithphone, Margaret H. Cruse, Nancy Perez, Erika Coleman, Timothy J. Scialla, Loretta Que

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S-nitrosylation of Connexin43 hemichannels elicits cardiac stress induced arrhythmias in Duchenne Muscular Dystrophy mice
Patients with Duchene Muscular Dystrophy (DMD) commonly present severe ventricular arrhythmias that contribute to heart failure. Arrhythmias and lethality are also consistently observed in adult...
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Research In-Press Preview Muscle biology

S-nitrosylation of Connexin43 hemichannels elicits cardiac stress induced arrhythmias in Duchenne Muscular Dystrophy mice

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Abstract

Patients with Duchene Muscular Dystrophy (DMD) commonly present severe ventricular arrhythmias that contribute to heart failure. Arrhythmias and lethality are also consistently observed in adult Dmdmdx mice, a mouse model of DMD, after acute β-adrenergic stimulation. These pathological features were previously linked to aberrant expression and remodeling of the cardiac gap junction protein connexin 43 (Cx43). Here, we report that remodeled Cx43 protein forms Cx43 hemichannels in the lateral membrane of Dmdmdx cardiomyocytes and that the β -adrenergic agonist isoproterenol (Iso) aberrantly activates these hemichannels. Block of Cx43 hemichannels or a reduction in Cx43 levels (using Dmdmdx:Cx43+/- mice) prevents the abnormal increase in membrane permeability, plasma membrane depolarization and Iso-evoked electrical activity in these cells. Additionally, Iso treatment promotes nitric oxide (NO) production and S-nitrosylation of Cx43 hemichannels in Dmdmdx heart. Importantly, inhibition of NO production prevents arrhythmias evoked by Iso. We found that NO directly activates Cx43 hemichannels by S-nitrosylation of cysteine at the position 271. Our results demonstrate that opening of remodeled and S-nitrosylated Cx43 hemichannels play a key role in the development of arrhythmias in DMD mice and may serve as therapeutic targets to prevent fatal arrhythmias in DMD patients.

Authors

Mauricio A. Lillo, Eric Himelman, Natalia Shirokova, Lai-Hua Xie, Diego Fraidenraich, Jorge E. Contreras

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Cytomegalovirus infection is a risk factor for TB disease in Infants
Immune activation is associated with increased risk of tuberculosis (TB) disease in infants. We performed a case control analysis to identify drivers of immune activation and disease risk. Among 49...
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Research In-Press Preview Inflammation Vaccines

Cytomegalovirus infection is a risk factor for TB disease in Infants

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Abstract

Immune activation is associated with increased risk of tuberculosis (TB) disease in infants. We performed a case control analysis to identify drivers of immune activation and disease risk. Among 49 infants who developed TB disease over the first two years of life, and 129 matched controls who remained healthy, we found the cytomegalovirus (CMV) stimulated IFNγ response at age 4-6 months to be associated with CD8+ T cell activation (Spearmans rho, P = 6 x 10-8). A CMV specific IFNγ response was also associated with increased risk of developing TB disease (Conditional Logistic Regression, P = 0.043, OR 2.2, 95% CI 1.02-4.83), and shorter time to TB diagnosis (Log Rank Mantel-Cox P = 0.037). CMV positive infants who developed TB disease had lower expression of natural killer cell associated gene signatures and a lower frequency of CD3−CD4−CD8− lymphocytes. We identified transcriptional signatures predictive of risk of TB disease among CMV ELISpot positive (AUROC 0.98, accuracy 92.57%) and negative (AUROC 0.9, accuracy 79.3%) infants; the CMV negative signature validated in an independent infant study (AUROC 0.71, accuracy 63.9%). Understanding and controlling the microbial drivers of T cell activation, such as CMV, could guide new strategies for prevention of TB disease in infants.

Authors

Julius Müller, Rachel Tanner, Magali Matsumiya, Margaret A. Snowden, Bernard Landry, Iman Satti, Stephanie A. Harris, Matthew K. O'Shea, Lisa Stockdale, Leanne Marsay, Agnieszka Chomka, Rachel Harrington-Kandt, Zita-Rose Manjaly Thomas, Elena Stylianou, Vivek Naranbhai, Stanley Kimbung Mbandi, Mark Hatherill, Gregory Hussey, Hassan Mahomed, Michele Tameris, J. Bruce McClain, Willem A. Hanekom, Thomas G. Evans, Thomas J. Scriba, Helen McShane, Helen A. Fletcher

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Low-level Cxcr4-haploinsufficient HSC engraftment is sufficient to correct leukopenia in WHIM syndrome mice
WHIM syndrome immunodeficiency is caused by autosomal dominant gain-of-function mutations in chemokine receptor CXCR4. Patient WHIM-09 was spontaneously cured by chromothriptic deletion of one copy...
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Research In-Press Preview Immunology Stem cells

Low-level Cxcr4-haploinsufficient HSC engraftment is sufficient to correct leukopenia in WHIM syndrome mice

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Abstract

WHIM syndrome immunodeficiency is caused by autosomal dominant gain-of-function mutations in chemokine receptor CXCR4. Patient WHIM-09 was spontaneously cured by chromothriptic deletion of one copy of 164 genes, including the CXCR4WHIM allele, presumably in a single hematopoietic stem cell (HSC) that repopulated HSCs and the myeloid lineage. Testing the specific contribution of CXCR4 hemizygosity to her cure, we previously demonstrated enhanced engraftment of Cxcr4+/o HSCs after transplantation in WHIM (Cxcr4+/w) model mice, but the potency was not quantitated. We now report graded-dose competitive transplantation experiments using lethally irradiated Cxcr4+/+ recipients in which mixed BM cells containing ~5 Cxcr4+/o HSCs and a 100-fold excess of Cxcr4+/w HSCs achieved durable 50% Cxcr4+/o myeloid and B cell chimerism in blood and ~20% Cxcr4+/o HSC chimerism in BM. In Cxcr4+/o/Cxcr4+/w parabiotic mice, we observed 80-100% Cxcr4+/o myeloid and lymphoid chimerism in the blood and 15% Cxcr4+/o HSC chimerism in BM from the Cxcr4+/w parabiont, which was durable after separation from the Cxcr4+/o parabiont. Thus, CXCR4 haploinsufficiency likely significantly contributed to the selective repopulation of HSCs and the myeloid lineage from a single chromothriptic HSC in WHIM-09. Moreover, the results suggest that WHIM allele silencing of patient HSCs is a viable gene therapy strategy.

Authors

Ji-Liang Gao, Albert Owusu-Ansah, Andrea Paun, Kimberly Beacht, Erin Yim, Marie Siwicki, Alexander Yang, Qian Liu, David H. McDermott, Philip M. Murphy

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