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Pang J, Ding N, Yin N, Xiao Z. Systemic immune-inflammation index as a prognostic marker in HER2-positive breast cancer patients undergoing trastuzumab therapy. Sci Rep 2024; 14:6578. [PMID: 38503890 PMCID: PMC10951263 DOI: 10.1038/s41598-024-57343-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/18/2024] [Indexed: 03/21/2024] Open
Abstract
The prognostic value of SII (Systemic Immune-Inflammation Index) in HER-2-positive breast cancer (BC) patients, regardless of whether they receive trastuzumab treatment, and its potential value to distinguish patients who may benefit from trastuzumab therapy, warrant further investigation. Clinical data was collected from 797 HER-2-positive BC patients between July 2013 and March 2018. Baseline data differences were adjusted with propensity score matching. Univariate and multivariate analyses explored the correlation between clinical pathological factors, SII, and DFS. Four groups were established. Based on the baseline SII values of the participants, patients who did not receive trastuzumab treatment were divided into Group 1 (Low-SII) and Group 2 (High-SII), where SII had no predictive value for prognosis between groups. Participants who received trastuzumab treatment were also divided into two groups: the Low-SII group (Group 3) and the High-SII group (Group 4). The 5-year DFS was significantly higher in Group 3 than in Group 4 (91.76% vs. 82.76%, P = 0.017). Furthermore, multivariate analysis demonstrated a significant association between high SII and shorter DFS (HR = 3.430, 95% CI = 1.830-6.420, P < 0.001). In HER-2-positive BC patients treated with trastuzumab, those with lower SII showed a longer DFS, suggesting that SII may help in identifying patients who benefit from trastuzumab therapy.
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Affiliation(s)
- Jian Pang
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Nianhua Ding
- Department of Clinical Laboratory, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Nana Yin
- Department of Operating Room, First People's Hospital of Changde, Changde, China
| | - Zhi Xiao
- Department of Breast Surgery, Xiangya Hospital, Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, China.
- Clinical Research Center for Breast Cancer in Hunan Province, Changsha, China.
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2
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Graf J, Trautmann-Rodriguez M, Sabnis S, Kloxin AM, Fromen CA. On the path to predicting immune responses in the lung: Modeling the pulmonary innate immune system at the air-liquid interface (ALI). Eur J Pharm Sci 2023; 191:106596. [PMID: 37770004 PMCID: PMC10658361 DOI: 10.1016/j.ejps.2023.106596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/01/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
Chronic respiratory diseases and infections are among the largest contributors to death globally, many of which still have no cure, including chronic obstructive pulmonary disorder, idiopathic pulmonary fibrosis, and respiratory syncytial virus among others. Pulmonary therapeutics afford untapped potential for treating lung infection and disease through direct delivery to the site of action. However, the ability to innovate new therapeutic paradigms for respiratory diseases will rely on modeling the human lung microenvironment and including key cellular interactions that drive disease. One key feature of the lung microenvironment is the air-liquid interface (ALI). ALI interface modeling techniques, using cell-culture inserts, organoids, microfluidics, and precision lung slices (PCLS), are rapidly developing; however, one major component of these models is lacking-innate immune cell populations. Macrophages, neutrophils, and dendritic cells, among others, represent key lung cell populations, acting as the first responders during lung infection or injury. Innate immune cells respond to and modulate stromal cells and bridge the gap between the innate and adaptive immune system, controlling the bodies response to foreign pathogens and debris. In this article, we review the current state of ALI culture systems with a focus on innate immune cells and suggest ways to build on current models to add complexity and relevant immune cell populations.
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Affiliation(s)
- Jodi Graf
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE 19716, USA
| | | | - Simone Sabnis
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA
| | - April M Kloxin
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE 19716, USA; Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA.
| | - Catherine A Fromen
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, DE 19716, USA.
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3
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Isono T, Hirayama S, Domon H, Maekawa T, Tamura H, Hiyoshi T, Sirisereephap K, Takenaka S, Noiri Y, Terao Y. Degradation of EGFR on lung epithelial cells by neutrophil elastase contributes to the aggravation of pneumococcal pneumonia. J Biol Chem 2023; 299:104760. [PMID: 37119853 DOI: 10.1016/j.jbc.2023.104760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/01/2023] Open
Abstract
Streptococcus pneumoniae is the main cause of bacterial pneumonia. S. pneumoniae infection has been shown to cause elastase, an intracellular host defense factor, to leak from neutrophils. However, when neutrophil elastase (NE) leaks into the extracellular environment, it can degrade host cell surface proteins such as epidermal growth factor receptor (EGFR) and potentially disrupt the alveolar epithelial barrier. In this study, we hypothesized that NE degrades the extracellular domain of EGFR in alveolar epithelial cells and inhibits alveolar epithelial repair. Using SDS-PAGE, we showed that NE degraded the recombinant EGFR extracellular domain and its ligand EGF, and that the degradation of these proteins was counteracted by NE inhibitors. Furthermore, we confirmed the degradation by NE of EGFR expressed in alveolar epithelial cells in vitro. We show intracellular uptake of EGF and EGFR signaling were downregulated in alveolar epithelial cells exposed to NE, and found cell proliferation was inhibited in these cells These negative effects of NE on cell proliferation were abolished by NE inhibitors. Finally, we confirmed the degradation of EGFR by NE in vivo. Fragments of the extracellular domain of EGFR were detected in bronchoalveolar lavage fluid from pneumococcal pneumonia mice, and the percentage of cells positive for a cell proliferation marker Ki67 in lung tissue was reduced. In contrast, administration of an NE inhibitor decreased EGFR fragments in bronchoalveolar lavage fluid and increased the percentage of Ki67-positive cells. These findings suggest that degradation of EGFR by NE could inhibit the repair of alveolar epithelium and cause severe pneumonia.
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Affiliation(s)
- Toshihito Isono
- Division of Microbiology and Infectious Diseases, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoru Hirayama
- Division of Microbiology and Infectious Diseases, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hisanori Domon
- Division of Microbiology and Infectious Diseases, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Center for Advanced Oral Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tomoki Maekawa
- Center for Advanced Oral Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hikaru Tamura
- Division of Microbiology and Infectious Diseases, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Division of Periodontology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takumi Hiyoshi
- Division of Microbiology and Infectious Diseases, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Center for Advanced Oral Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Division of Periodontology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kridtapat Sirisereephap
- Center for Advanced Oral Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Division of Periodontology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Shoji Takenaka
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuichiro Noiri
- Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Terao
- Division of Microbiology and Infectious Diseases, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan; Center for Advanced Oral Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
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4
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Keir HR, Long MB, Abo-Leyah H, Giam YH, Vadiveloo T, Pembridge T, Hull RC, Delgado L, Band M, McLaren-Neil F, Adamson S, Lahnsteiner E, Gilmour A, Hughes C, New BJ, Connell D, Dowey R, Turton H, Richardson H, Cassidy D, Cooper J, Suntharalingam J, Diwakar L, Russell P, Underwood J, Hicks A, Dosanjh DP, Sage B, Dhasmana D, Spears M, Thompson AR, Brightling C, Smith A, Patel M, George J, Condliffe AM, Shoemark A, MacLennan G, Chalmers JD. Dipeptidyl peptidase-1 inhibition in patients hospitalised with COVID-19: a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial. THE LANCET. RESPIRATORY MEDICINE 2022; 10:1119-1128. [PMID: 36075243 PMCID: PMC9442496 DOI: 10.1016/s2213-2600(22)00261-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Neutrophil serine proteases are involved in the pathogenesis of COVID-19 and increased serine protease activity has been reported in severe and fatal infection. We investigated whether brensocatib, an inhibitor of dipeptidyl peptidase-1 (DPP-1; an enzyme responsible for the activation of neutrophil serine proteases), would improve outcomes in patients hospitalised with COVID-19. METHODS In a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial, across 14 hospitals in the UK, patients aged 16 years and older who were hospitalised with COVID-19 and had at least one risk factor for severe disease were randomly assigned 1:1, within 96 h of hospital admission, to once-daily brensocatib 25 mg or placebo orally for 28 days. Patients were randomly assigned via a central web-based randomisation system (TruST). Randomisation was stratified by site and age (65 years or ≥65 years), and within each stratum, blocks were of random sizes of two, four, or six patients. Participants in both groups continued to receive other therapies required to manage their condition. Participants, study staff, and investigators were masked to the study assignment. The primary outcome was the 7-point WHO ordinal scale for clinical status at day 29 after random assignment. The intention-to-treat population included all patients who were randomly assigned and met the enrolment criteria. The safety population included all participants who received at least one dose of study medication. This study was registered with the ISRCTN registry, ISRCTN30564012. FINDINGS Between June 5, 2020, and Jan 25, 2021, 406 patients were randomly assigned to brensocatib or placebo; 192 (47·3%) to the brensocatib group and 214 (52·7%) to the placebo group. Two participants were excluded after being randomly assigned in the brensocatib group (214 patients included in the placebo group and 190 included in the brensocatib group in the intention-to-treat population). Primary outcome data was unavailable for six patients (three in the brensocatib group and three in the placebo group). Patients in the brensocatib group had worse clinical status at day 29 after being randomly assigned than those in the placebo group (adjusted odds ratio 0·72 [95% CI 0·57-0·92]). Prespecified subgroup analyses of the primary outcome supported the primary results. 185 participants reported at least one adverse event; 99 (46%) in the placebo group and 86 (45%) in the brensocatib group. The most common adverse events were gastrointestinal disorders and infections. One death in the placebo group was judged as possibly related to study drug. INTERPRETATION Brensocatib treatment did not improve clinical status at day 29 in patients hospitalised with COVID-19. FUNDING Sponsored by the University of Dundee and supported through an Investigator Initiated Research award from Insmed, Bridgewater, NJ; STOP-COVID19 trial.
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Affiliation(s)
- Holly R Keir
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Merete B Long
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Hani Abo-Leyah
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Yan Hui Giam
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | | | - Thomas Pembridge
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Rebecca C Hull
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Lilia Delgado
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Margaret Band
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | | | - Simon Adamson
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Eva Lahnsteiner
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Amy Gilmour
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Chloe Hughes
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Benjamin Jm New
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - David Connell
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Rebecca Dowey
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Helena Turton
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | | | - Diane Cassidy
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | | | | | | | | | | | | | | | | | | | - Mark Spears
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Aa Roger Thompson
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | | | | | | | - Jacob George
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Alison M Condliffe
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Amelia Shoemark
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - James D Chalmers
- Molecular and Clinical Medicine, University of Dundee, Dundee, UK.
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5
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Peyneau M, Granger V, Wicky PH, Khelifi-Touhami D, Timsit JF, Lescure FX, Yazdanpanah Y, Tran-Dinh A, Montravers P, Monteiro RC, Chollet-Martin S, Hurtado-Nedelec M, de Chaisemartin L. Innate immune deficiencies are associated with severity and poor prognosis in patients with COVID-19. Sci Rep 2022. [PMID: 35022495 DOI: 10.1101/2021.03.29.21254560:2021.03.29.21254560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
COVID-19 can cause acute respiratory distress syndrome, leading to death in many individuals. Evidence of a deleterious role of the innate immune system is accumulating, but the precise mechanisms involved remain unclear. In this study, we investigated the links between circulating innate phagocytes and severity in COVID-19 patients. We performed in-depth phenotyping of neutrophil and monocyte subpopulations and measured soluble activation markers in plasma. Additionally, anti-microbial functions (phagocytosis, oxidative burst, and NETosis) were evaluated on fresh cells from patients. Neutrophils and monocytes had a strikingly disturbed phenotype, and elevated concentrations of activation markers (calprotectin, myeloperoxidase, and neutrophil extracellular traps) were measured in plasma. Critical patients had increased CD13low immature neutrophils, LOX-1 + and CCR5 + immunosuppressive neutrophils, and HLA-DRlow downregulated monocytes. Markers of immature and immunosuppressive neutrophils were strongly associated with severity. Moreover, neutrophils and monocytes of critical patients had impaired antimicrobial functions, which correlated with organ dysfunction, severe infections, and mortality. Together, our results strongly argue in favor of a pivotal role of innate immunity in COVID-19 severe infections and pleads for targeted therapeutic options.
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Affiliation(s)
- Marine Peyneau
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France
- INSERM UMR 996, "Inflammation, Microbiome and Immunosurveillance", Faculty of Pharmacy, Université Paris-Saclay, 92290, Châtenay-Malabry, France
| | - Vanessa Granger
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France
- INSERM UMR 996, "Inflammation, Microbiome and Immunosurveillance", Faculty of Pharmacy, Université Paris-Saclay, 92290, Châtenay-Malabry, France
| | - Paul-Henri Wicky
- AP-HP, Bichat Hospital Medical and Infectious Diseases ICU (MI2), Paris, France
- IAME Université de Paris, Inserm U 1137, Paris, France
| | - Dounia Khelifi-Touhami
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France
| | - Jean-François Timsit
- AP-HP, Bichat Hospital Medical and Infectious Diseases ICU (MI2), Paris, France
- IAME Université de Paris, Inserm U 1137, Paris, France
| | - François-Xavier Lescure
- IAME Université de Paris, Inserm U 1137, Paris, France
- Infectious Diseases Department, AP-HP, Hôpital Bichat, Paris, France
| | - Yazdan Yazdanpanah
- IAME Université de Paris, Inserm U 1137, Paris, France
- Infectious Diseases Department, AP-HP, Hôpital Bichat, Paris, France
| | - Alexy Tran-Dinh
- Département d'Anesthésie-Réanimation, DMU PARABOL, Université de Paris, AP-HP, Bichat Hospital, Paris, France
- INSERM UMR 1152 - ANR10-LABX-17, Paris, France
| | - Philippe Montravers
- Département d'Anesthésie-Réanimation, DMU PARABOL, Université de Paris, AP-HP, Bichat Hospital, Paris, France
- INSERM UMR 1152 - ANR10-LABX-17, Paris, France
| | - Renato C Monteiro
- Center for Research On Inflammation (CRI), Inflamex Laboratory of Excellence, U1149, CNRS ERL8252, Paris, France
- Immunological Dysfunction Laboratory, APHP, Bichat Hospital, Paris, France
| | - Sylvie Chollet-Martin
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France
- INSERM UMR 996, "Inflammation, Microbiome and Immunosurveillance", Faculty of Pharmacy, Université Paris-Saclay, 92290, Châtenay-Malabry, France
| | - Margarita Hurtado-Nedelec
- Center for Research On Inflammation (CRI), Inflamex Laboratory of Excellence, U1149, CNRS ERL8252, Paris, France
- Immunological Dysfunction Laboratory, APHP, Bichat Hospital, Paris, France
| | - Luc de Chaisemartin
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France.
- INSERM UMR 996, "Inflammation, Microbiome and Immunosurveillance", Faculty of Pharmacy, Université Paris-Saclay, 92290, Châtenay-Malabry, France.
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6
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Peyneau M, Granger V, Wicky PH, Khelifi-Touhami D, Timsit JF, Lescure FX, Yazdanpanah Y, Tran-Dinh A, Montravers P, Monteiro RC, Chollet-Martin S, Hurtado-Nedelec M, de Chaisemartin L. Innate immune deficiencies are associated with severity and poor prognosis in patients with COVID-19. Sci Rep 2022; 12:638. [PMID: 35022495 PMCID: PMC8755788 DOI: 10.1038/s41598-021-04705-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 12/17/2021] [Indexed: 02/06/2023] Open
Abstract
COVID-19 can cause acute respiratory distress syndrome, leading to death in many individuals. Evidence of a deleterious role of the innate immune system is accumulating, but the precise mechanisms involved remain unclear. In this study, we investigated the links between circulating innate phagocytes and severity in COVID-19 patients. We performed in-depth phenotyping of neutrophil and monocyte subpopulations and measured soluble activation markers in plasma. Additionally, anti-microbial functions (phagocytosis, oxidative burst, and NETosis) were evaluated on fresh cells from patients. Neutrophils and monocytes had a strikingly disturbed phenotype, and elevated concentrations of activation markers (calprotectin, myeloperoxidase, and neutrophil extracellular traps) were measured in plasma. Critical patients had increased CD13low immature neutrophils, LOX-1 + and CCR5 + immunosuppressive neutrophils, and HLA-DRlow downregulated monocytes. Markers of immature and immunosuppressive neutrophils were strongly associated with severity. Moreover, neutrophils and monocytes of critical patients had impaired antimicrobial functions, which correlated with organ dysfunction, severe infections, and mortality. Together, our results strongly argue in favor of a pivotal role of innate immunity in COVID-19 severe infections and pleads for targeted therapeutic options.
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Affiliation(s)
- Marine Peyneau
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France.,INSERM UMR 996, "Inflammation, Microbiome and Immunosurveillance", Faculty of Pharmacy, Université Paris-Saclay, 92290, Châtenay-Malabry, France
| | - Vanessa Granger
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France.,INSERM UMR 996, "Inflammation, Microbiome and Immunosurveillance", Faculty of Pharmacy, Université Paris-Saclay, 92290, Châtenay-Malabry, France
| | - Paul-Henri Wicky
- AP-HP, Bichat Hospital Medical and Infectious Diseases ICU (MI2), Paris, France.,IAME Université de Paris, Inserm U 1137, Paris, France
| | - Dounia Khelifi-Touhami
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France
| | - Jean-François Timsit
- AP-HP, Bichat Hospital Medical and Infectious Diseases ICU (MI2), Paris, France.,IAME Université de Paris, Inserm U 1137, Paris, France
| | - François-Xavier Lescure
- IAME Université de Paris, Inserm U 1137, Paris, France.,Infectious Diseases Department, AP-HP, Hôpital Bichat, Paris, France
| | - Yazdan Yazdanpanah
- IAME Université de Paris, Inserm U 1137, Paris, France.,Infectious Diseases Department, AP-HP, Hôpital Bichat, Paris, France
| | - Alexy Tran-Dinh
- Département d'Anesthésie-Réanimation, DMU PARABOL, Université de Paris, AP-HP, Bichat Hospital, Paris, France.,INSERM UMR 1152 - ANR10-LABX-17, Paris, France
| | - Philippe Montravers
- Département d'Anesthésie-Réanimation, DMU PARABOL, Université de Paris, AP-HP, Bichat Hospital, Paris, France.,INSERM UMR 1152 - ANR10-LABX-17, Paris, France
| | - Renato C Monteiro
- Center for Research On Inflammation (CRI), Inflamex Laboratory of Excellence, U1149, CNRS ERL8252, Paris, France.,Immunological Dysfunction Laboratory, APHP, Bichat Hospital, Paris, France
| | - Sylvie Chollet-Martin
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France.,INSERM UMR 996, "Inflammation, Microbiome and Immunosurveillance", Faculty of Pharmacy, Université Paris-Saclay, 92290, Châtenay-Malabry, France
| | - Margarita Hurtado-Nedelec
- Center for Research On Inflammation (CRI), Inflamex Laboratory of Excellence, U1149, CNRS ERL8252, Paris, France.,Immunological Dysfunction Laboratory, APHP, Bichat Hospital, Paris, France
| | - Luc de Chaisemartin
- Autoimmunity and Hypersensitivity Laboratory, AP-HP, Bichat Hospital, 46 Rue Henri Huchard, 75018, Paris, France. .,INSERM UMR 996, "Inflammation, Microbiome and Immunosurveillance", Faculty of Pharmacy, Université Paris-Saclay, 92290, Châtenay-Malabry, France.
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7
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Gao Y, Li X, Zhang N, Zhao P, Li S, Tai L, Li X, Li L, Li J, Zhang X, Sun M, Cao L, Gong P. Trichomonas vaginalis induces extracellular trap release in mouse neutrophils in vitro. Acta Biochim Biophys Sin (Shanghai) 2021; 53:1736-1738. [PMID: 34585245 DOI: 10.1093/abbs/gmab139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Yuhang Gao
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
- College of Animal Science and Technology, Inner Mongolia University for Nationalities, Tongliao 028000, China
| | - Xin Li
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Nan Zhang
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Panpan Zhao
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Shan Li
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Lixin Tai
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
- Faculty of Health Science, University of Macau, Macao 999078, China
| | - Xinyu Li
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
- Jilin Animal Health Inspection Institute, Changchun 130062, China
| | - Ling Li
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Jianhua Li
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Xichen Zhang
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Min Sun
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Lili Cao
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
- Department of Parasite, Jilin Academy of Animal Husbandry and Veterinary Medicine, Changchun 130062, China
| | - Pengtao Gong
- Key Laboratory of Zoonosis Research, Ministry of Education, College of Veterinary Medicine, Jilin University, Changchun 130062, China
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8
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Clarithromycin Inhibits Pneumolysin Production via Downregulation of ply Gene Transcription despite Autolysis Activation. Microbiol Spectr 2021; 9:e0031821. [PMID: 34468195 PMCID: PMC8557819 DOI: 10.1128/spectrum.00318-21] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Streptococcus pneumoniae, the most common cause of community-acquired pneumonia, causes severe invasive infections, including meningitis and bacteremia. The widespread use of macrolides has been reported to increase the prevalence of macrolide-resistant S. pneumoniae (MRSP), thereby leading to treatment failure in patients with pneumococcal pneumonia. However, previous studies have demonstrated that several macrolides and lincosamides have beneficial effects on MRSP infection since they inhibit the production and release of pneumolysin, a pneumococcal pore-forming toxin released during autolysis. In this regard, we previously demonstrated that the mechanisms underlying the inhibition of pneumolysin release by erythromycin involved both the transcriptional downregulation of the gene encoding pneumolysin and the impairment of autolysis in MRSP. Here, using a cell supernatant of the culture, we have shown that clarithromycin inhibits pneumolysin release in MRSP. However, contrary to previous observations in erythromycin-treated MRSP, clarithromycin upregulated the transcription of the pneumococcal autolysis-related lytA gene and enhanced autolysis, leading to the leakage of pneumococcal DNA. On the other hand, compared to erythromycin, clarithromycin significantly downregulated the gene encoding pneumolysin. In a mouse model of MRSP pneumonia, the administration of both clarithromycin and erythromycin significantly decreased the pneumolysin protein level in bronchoalveolar lavage fluid and improved lung injury and arterial oxygen saturation without affecting bacterial load. Collectively, these in vitro and in vivo data reinforce the benefits of macrolides on the clinical outcomes of patients with pneumococcal pneumonia. IMPORTANCE Pneumolysin is a potent intracellular toxin possessing multiple functions that augment pneumococcal virulence. For over 10 years, sub-MICs of macrolides, including clarithromycin, have been recognized to decrease pneumolysin production and release from pneumococcal cells. However, this study indicates that macrolides significantly slowed pneumococcal growth, which may be related to decreased pneumolysin release recorded by previous studies. In this study, we demonstrated that clarithromycin decreases pneumolysin production through downregulation of ply gene transcription, regardless of its inhibitory activity against bacterial growth. Additionally, administration of clarithromycin resulted in the amelioration of lung injury in a mouse model of pneumonia induced by macrolide-resistant pneumococci. Therefore, therapeutic targeting of pneumolysin offers a good strategy to treat pneumococcal pneumonia.
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Bonnet B, Cosme J, Dupuis C, Coupez E, Adda M, Calvet L, Fabre L, Saint-Sardos P, Bereiziat M, Vidal M, Laurichesse H, Souweine B, Evrard B. Severe COVID-19 is characterized by the co-occurrence of moderate cytokine inflammation and severe monocyte dysregulation. EBioMedicine 2021; 73:103622. [PMID: 34678611 PMCID: PMC8526358 DOI: 10.1016/j.ebiom.2021.103622] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/10/2021] [Accepted: 09/28/2021] [Indexed: 02/07/2023] Open
Abstract
Background SARS-CoV-2 has been responsible for considerable mortality worldwide, owing in particular to pulmonary failures such as ARDS, but also to other visceral failures and secondary infections. Recent progress in the characterization of the immunological mechanisms that result in severe organ injury led to the emergence of two successive hypotheses simultaneously tested here: hyperinflammation with cytokine storm syndrome or dysregulation of protective immunity resulting in immunosuppression and unrestrained viral dissemination. Methods In a prospective observational monocentric study of 134 patients, we analysed a panel of plasma inflammatory and anti-inflammatory cytokines and measured monocyte dysregulation via their membrane expression of HLA-DR. We first compared the results of patients with moderate forms hospitalized in an infectious disease unit with those of patients with severe forms hospitalized in an intensive care unit. In the latter group of patients, we then analysed the differences between the surviving and non-surviving groups and between the groups with or without secondary infections. Findings Higher blood IL-6 levels, lower quantitative expression of HLA-DR on blood monocytes and higher IL-6/mHLA-DR ratios were statistically associated with the risk of severe forms of the disease and among the latter with death and the early onset of secondary infections. Interpretation The unique immunological profile in patients with severe COVID-19 corresponds to a moderate cytokine inflammation associated with severe monocyte dysregulation. Individuals with major CSS were rare in our cohort of hospitalized patients, especially since the use of corticosteroids, but formed a very severe subgroup of the disease. Funding None.
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Affiliation(s)
- Benjamin Bonnet
- Service d'Immunologie, CHU Gabriel-Montpied, Clermont-Ferrand, France; Laboratoire d'Immunologie, ECREIN, UMR1019 UNH, UFR Médecine de Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Justine Cosme
- Service d'Immunologie, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Claire Dupuis
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Elisabeth Coupez
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Mireille Adda
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Laure Calvet
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Laurie Fabre
- Service d'Immunologie, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Pierre Saint-Sardos
- Laboratoire de Bactériologie, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Marine Bereiziat
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Magali Vidal
- Service de Maladies Infectieuses et Tropicales, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Henri Laurichesse
- Service de Maladies Infectieuses et Tropicales, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Bertrand Souweine
- Service de Médecine Intensive et Réanimation, CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - Bertrand Evrard
- Service d'Immunologie, CHU Gabriel-Montpied, Clermont-Ferrand, France; Laboratoire d'Immunologie, ECREIN, UMR1019 UNH, UFR Médecine de Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France.
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A Fragile Balance: Does Neutrophil Extracellular Trap Formation Drive Pulmonary Disease Progression? Cells 2021; 10:cells10081932. [PMID: 34440701 PMCID: PMC8394734 DOI: 10.3390/cells10081932] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/22/2021] [Accepted: 07/28/2021] [Indexed: 12/13/2022] Open
Abstract
Neutrophils act as the first line of defense during infection and inflammation. Once activated, they are able to fulfil numerous tasks to fight inflammatory insults while keeping a balanced immune response. Besides well-known functions, such as phagocytosis and degranulation, neutrophils are also able to release "neutrophil extracellular traps" (NETs). In response to most stimuli, the neutrophils release decondensed chromatin in a NADPH oxidase-dependent manner decorated with histones and granule proteins, such as neutrophil elastase, myeloperoxidase, and cathelicidins. Although primarily supposed to prevent microbial dissemination and fight infections, there is increasing evidence that an overwhelming NET response correlates with poor outcome in many diseases. Lung-related diseases especially, such as bacterial pneumonia, cystic fibrosis, chronic obstructive pulmonary disease, aspergillosis, influenza, and COVID-19, are often affected by massive NET formation. Highly vascularized areas as in the lung are susceptible to immunothrombotic events promoted by chromatin fibers. Keeping this fragile equilibrium seems to be the key for an appropriate immune response. Therapies targeting dysregulated NET formation might positively influence many disease progressions. This review highlights recent findings on the pathophysiological influence of NET formation in different bacterial, viral, and non-infectious lung diseases and summarizes medical treatment strategies.
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Domon H, Terao Y. The Role of Neutrophils and Neutrophil Elastase in Pneumococcal Pneumonia. Front Cell Infect Microbiol 2021; 11:615959. [PMID: 33796475 PMCID: PMC8008068 DOI: 10.3389/fcimb.2021.615959] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 03/01/2021] [Indexed: 12/11/2022] Open
Abstract
Streptococcus pneumoniae, also known as pneumococcus, is a Gram-positive diplococcus and a major human pathogen. This bacterium is a leading cause of bacterial pneumonia, otitis media, meningitis, and septicemia, and is a major cause of morbidity and mortality worldwide. To date, studies on S. pneumoniae have mainly focused on the role of its virulence factors including toxins, cell surface proteins, and capsules. However, accumulating evidence indicates that in addition to these studies, knowledge of host factors and host-pathogen interactions is essential for understanding the pathogenesis of pneumococcal diseases. Recent studies have demonstrated that neutrophil accumulation, which is generally considered to play a critical role in host defense during bacterial infections, can significantly contribute to lung injury and immune subversion, leading to pneumococcal invasion of the bloodstream. Here, we review bacterial and host factors, focusing on the role of neutrophils and their elastase, which contribute to the progression of pneumococcal pneumonia.
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Affiliation(s)
- Hisanori Domon
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yutaka Terao
- Division of Microbiology and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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