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Palanivel J, Sounderrajan V, Thangam T, Rao SS, Harshavardhan S, Parthasarathy K. Latent Tuberculosis: Challenges in Diagnosis and Treatment, Perspectives, and the Crucial Role of Biomarkers. Curr Microbiol 2023; 80:392. [PMID: 37884822 DOI: 10.1007/s00284-023-03491-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023]
Abstract
Tuberculosis (TB) is the major cause of morbidity and mortality globally, which is caused by a single infectious agent Mycobacterium tuberculosis. For years, many TB control programmes are established for effective diagnosis and treatment of active TB cases, but these approaches alone are insufficient for TB eradication. This review aims to discourse on the crucial management of latent tuberculosis infection. This review will first summarize the current status, and methods for diagnosing latent tuberculosis then describes the challenges involved in the diagnosis and treatment of latent tuberculosis, and finally encounters the purpose of biomarkers as predicting tool in latent tuberculosis.
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Affiliation(s)
- Jayanthi Palanivel
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India
| | - Vignesh Sounderrajan
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India
| | - T Thangam
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India
| | - Sudhanarayani S Rao
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India
| | - Shakila Harshavardhan
- Department of Molecular Microbiology, School of Biotechnology, Madurai Kamaraj University, Madurai, India
| | - Krupakar Parthasarathy
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, India.
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2
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Drennan PG, Karponis D, Richards D, Coles M, Fullerton JN. In vivo human keyhole limpet hemocyanin challenge in early phase drug development: A systematic review. Clin Transl Sci 2023; 16:357-382. [PMID: 36420645 PMCID: PMC10014697 DOI: 10.1111/cts.13457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/18/2022] [Accepted: 11/02/2022] [Indexed: 11/25/2022] Open
Abstract
Experimental exposure of healthy volunteers to the T-cell dependent neoantigen keyhole limpet hemocyanin (KLH) permits the evaluation of immunomodulatory investigational medicinal product (IMP) pharmacology prior to the recruitment of patient populations. Despite widespread use, no standardized approach to the design and conduct of such studies has been agreed. The objective of this systematic review was to survey the published literature where KLH was used as a challenge agent, describing methodology, therapeutic targets addressed, and pharmacodynamic outcome measures. We searched MEDLINE, EMBASE, clinicaltrials.gov, and Cochrane CENTRAL for studies using KLH challenge in humans between January 1, 1994, and April 1, 2022. We described key study features, including KLH formulation, dose, use of adjuvants, route of administration, co-administered IMPs, and end points. Of 2421 titles and abstracts screened, 46 met the inclusion criteria, including 14 (31%) early phase trials of IMP, of which 10 (71%) targeted T-cell co-stimulation. IMPs with diverse mechanisms demonstrated modulation of the humoral response to KLH, suggesting limited specificity of this end point. Two early phase IMP studies (14%) described the response to intradermal re-challenge (delayed type hypersensitivity). Challenge regimens for IMP assessment were often incompletely described, and exhibited marked heterogeneity, including primary KLH dose (25-fold variation: 100-2500 mcg), KLH formulation, and co-administration with adjuvants. Methodological heterogeneity and failure to exploit the access to tissue-level mechanism-relevant end points afforded by KLH challenge has impaired the translational utility of this paradigm to date. Future standardization, characterization, and methodological development is required to permit tailored, appropriately powered, mechanism-dependent study design to optimize drug development decisions.
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Affiliation(s)
- Philip G Drennan
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Medicine, University of Oxford, Oxford, UK.,Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Duncan Richards
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Medicine, University of Oxford, Oxford, UK
| | - Mark Coles
- Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Medicine, University of Oxford, Oxford, UK
| | - James N Fullerton
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Medicine, University of Oxford, Oxford, UK
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3
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Caruso C, Ligotti ME, Accardi G, Aiello A, Candore G. An immunologist's guide to immunosenescence and its treatment. Expert Rev Clin Immunol 2022; 18:961-981. [PMID: 35876758 DOI: 10.1080/1744666x.2022.2106217] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION : The ageing process causes several changes in the immune system, although immune ageing is strongly influenced by individual immunological history, as well as genetic and environmental factors leading to inter-individual variability. AREAS COVERED : Here, we focused on the biological and clinical meaning of immunosenescence. Data on SARS-CoV-2 and Yellow Fever vaccine have demonstrated the clinical relevance of immunosenescence, while inconsistent results, obtained from longitudinal studies aimed at looking for immune risk phenotypes, have revealed that the immunosenescence process is highly context-dependent. Large projects have allowed the delineation of the drivers of immune system variance, including genetic and environmental factors, sex, smoking, and co-habitation. Therefore, it is difficult to identify the interventions that can be envisaged to maintain or improve immune function in older people. That suggests that drug treatment of immunosenescence should require personalized intervention. Regarding this, we discussed the role of changes in lifestyle as a potential therapeutic approach. EXPERT OPINION : Our review points out that age is only part of the problem of immunosenescence. Everyone ages differently because he/she is unique in genetics and experience of life and this applies even more to the immune system (immunobiography). Finally, the present review shows how appreciable results in the modification of immunosenescence biomarkers can be achieved with lifestyle modification.
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Affiliation(s)
- Calogero Caruso
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Mattia Emanuela Ligotti
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Giulia Accardi
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Anna Aiello
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
| | - Giuseppina Candore
- Laboratorio di Immunopatologia e Immunosenescenza, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
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4
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Egbuniwe IU, Harris RJ, Nakamura M, Nestle FO, Akbar AN, Karagiannis SN, Lacy KE. B Lymphocytes Accumulate and Proliferate in Human Skin at Sites of Cutaneous Antigen Challenge. J Invest Dermatol 2021; 142:726-731.e4. [PMID: 34450137 PMCID: PMC8880055 DOI: 10.1016/j.jid.2021.06.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/21/2021] [Accepted: 06/30/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Isioma U Egbuniwe
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, United Kingdom; Translational Medical Sciences Unit, School of Medicine, University of Nottingham Biodiscovery Institute, Nottingham, United Kingdom
| | - Robert J Harris
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, United Kingdom
| | - Mano Nakamura
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, United Kingdom
| | - Frank O Nestle
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, United Kingdom; Sanofi Immunology and Inflammation Research Therapeutic Area, Cambridge, Massachusetts, USA
| | - Arne N Akbar
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Sophia N Karagiannis
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, United Kingdom; Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Cancer Centre, London, United Kingdom
| | - Katie E Lacy
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences, King's College London, London, United Kingdom.
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Chambers ES, Akbar AN. Can blocking inflammation enhance immunity during aging? J Allergy Clin Immunol 2021; 145:1323-1331. [PMID: 32386656 DOI: 10.1016/j.jaci.2020.03.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 02/09/2023]
Abstract
Aging is a global burden, and the increase in life span does not increase in parallel with health span. Therefore, older adults are currently living longer with chronic diseases, increased infections, and cancer. A characteristic of aging is the presence of chronic low-grade inflammation that is characterized by elevated concentrations of IL-6, TNF-α, and C-reactive protein, which has been termed inflammaging. Previous studies have demonstrated that chronic inflammation interferes with T-cell response and macrophage function and is also detrimental for vaccine responses. This raises the question of whether therapeutic strategies that reduce inflammation may be useful for improving immunity in older adults. In this review we discuss the potential causes of inflammaging, the cellular source of the inflammatory mediators, and the mechanisms by which inflammation may inhibit immunity. Finally, we describe existing interventions that target inflammation that have been used to enhance immunity during aging.
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Affiliation(s)
- Emma S Chambers
- Division of Infection and Immunity, University College London, London, United Kingdom; Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, United Kingdom.
| | - Arne N Akbar
- Division of Infection and Immunity, University College London, London, United Kingdom
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Recruitment of inflammatory monocytes by senescent fibroblasts inhibits antigen-specific tissue immunity during human aging. ACTA ACUST UNITED AC 2021; 1:101-113. [PMID: 37118005 DOI: 10.1038/s43587-020-00010-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/25/2020] [Indexed: 12/13/2022]
Abstract
We have previously shown that healthy older adults exhibit reduced cutaneous immune responses during a varicella zoster virus (VZV) antigen challenge that correlated with a nonspecific inflammatory response to the injection itself. Here we found that needle damage during intradermal injections in older adults led to an increase in the number of cutaneous senescent fibroblasts expressing CCL2, resulting in the local recruitment of inflammatory monocytes. These infiltrating monocytes secreted prostaglandin E2, which inhibited resident memory T cell activation and proliferation. Pretreatment of older participants with a p38 mitogen-activated protein kinase inhibitor in vivo decreased CCL2 expression and inhibited monocyte recruitment and secretion of prostaglandin E2. This coincided with an increased response to VZV antigen challenge in the skin. Our results point to a series of molecular and cellular mechanisms that link cellular senescence, tissue damage, excessive inflammation and reduced immune responsiveness in human skin and demonstrate that tissue-specific immunity can be restored in older adults by short-term inhibition of inflammatory responses.
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Farsida, Shabariah R, Hatta M, Patellongi I, Prihantono, Nasrum Massi M, Asadul Islam A, Natzir R, Dwi Bahagia Febriani A, Hamid F, Fatimah, Akaputra R, Aprilia Savitri P. Relationship between expression mRNA gene Treg, Treg, CD4 +, and CD8 + protein levels with TST in tuberculosis children: A nested case-control. Ann Med Surg (Lond) 2021; 61:44-47. [PMID: 33384873 PMCID: PMC7770507 DOI: 10.1016/j.amsu.2020.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background The ability of Mycobacterium tuberculosis to survive intracellularly, provides a cellular adaptive immune response played by specific T cells to defend against tuberculosis. The adaptive immune response to Bacillus of Calmette and Guerin (BCG) immunization is responded to by B cells, T Follicular B helper, T regulatory, restriction CD1, CD8+, CD4+, Th1, Th2, and Th17. BCG immunization can cause a tuberculin test reaction to being positive. The tuberculin test is a method for diagnosing TB infection and for screening individuals for latent infection and assessing the rate of TB infection in a given population. Methods a nested case-control survey was conducted on patients with a diagnosis of TB and parents 0–18 years of age from 3 hospitals in Indonesia during September–November 2019 with a total sample of 69 people undergoing clinical examinations, supporting and diagnosing subjects, blood sampling 1–2 cc for examination mRNA gene Treg, Treg, CD 4+, and CD 8+, then centrifuged at 3000 rpm for 10 min to support blood cells and serum. Results There was a significant relationship between expression of mRNA gene Treg with TST (p = 0,000), Treg with TST (p = 0,000), and CD4+ with TST (p = 0,000). Meanwhile, CD8 + was not significantly associated with TST (p = 0.118). Conclusions It is necessary to check the expression of mRNA gene Treg, Treg, CD4+, and CD8+ with more samples to find the mean value that shows the protective value of further TB. The Mantoux tuberculin skin test (TST) is one of the criteria to determine whether a person is infected with Mycobacterium tuberculosis. It is often used to screen individuals for latent infection and assess rates of TB infection in a given population. tuberculin test results with induration diameter> 10 mm were positive regardless of the cause. Patients in this study were children who had been vaccinated against BCG and diagnosed with TB in their early toddler years. It was necessary to see the adaptive immune response that existed when the child was infected with TB. The main immune response that acts as protection against TB is played by cellular immunity, namely CD4 and CD8 T cells. We thought that if we could find between TST and adaptive immune response, TST could be a prior test to determine prognosis or disease progression. We found a strong correlation between immune activation and Treg cell frequency in TST positive persons. A higher Treg consentration was found in TST positive subjects. Nevertheless, local immune responses may differ from those in peripheral blood and exploring this interaction in the site of active infection will give important clues about their involvement in protection or pathogenesis . According to our studies the increased Treg cell frequency observed in the blood of people with active tuberculosis is likely a response to inflammation and bacterial burden.
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Affiliation(s)
- Farsida
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia
| | - Rahmini Shabariah
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia
| | - Mochammad Hatta
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | - Prihantono
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | | | - Rosdiana Natzir
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | | | - Firdaus Hamid
- Faculty of Medicine, Universitas Hasanuddin Makassar, Indonesia
| | - Fatimah
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia
| | - Risky Akaputra
- Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia
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8
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Chambers ES, Vukmanovic-Stejic M, Turner CT, Shih BB, Trahair H, Pollara G, Tsaliki E, Rustin M, Freeman TC, Mabbott NA, Noursadeghi M, Martineau AR, Akbar AN. Vitamin D 3 replacement enhances antigen-specific immunity in older adults. IMMUNOTHERAPY ADVANCES 2020; 1:ltaa008. [PMID: 36284901 PMCID: PMC9585673 DOI: 10.1093/immadv/ltaa008] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/12/2020] [Accepted: 11/19/2020] [Indexed: 12/27/2022] Open
Abstract
Introduction Ageing is associated with increased number of infections, decreased vaccine efficacy and increased systemic inflammation termed inflammageing. These changes are reflected by reduced recall responses to varicella zoster virus (VZV) challenge in the skin of older adults. Vitamin D deficiency is more common in the old and has been associated with frailty and increased inflammation. In addition, vitamin D increases immunoregulatory mechanisms and therefore has the potential to inhibit inflammageing. Objectives We investigated the use of vitamin D3 replacement to enhance cutaneous antigen-specific immunity in older adults (≥65 years). Methods Vitamin D insufficient older adults (n = 18) were administered 6400IU of vitamin D3/day orally for 14 weeks. Antigen-specific immunity to VZV was assessed by clinical score assessment of the injection site and transcriptional analysis of skin biopsies collected from challenged injection sites pre- and post-vitamin D3 replacement. Results We showed that older adults had reduced VZV-specific cutaneous immune response and increased non-specific inflammation as compared to young. Increased non-specific inflammation observed in the skin of older adults negatively correlated with vitamin D sufficiency. We showed that vitamin D3 supplementation significantly increased the response to cutaneous VZV antigen challenge in older adults. This enhancement was associated with a reduction in inflammatory monocyte infiltration with a concomitant enhancement of T cell recruitment to the site of antigen challenge in the skin. Conclusion Vitamin D3 replacement can boost antigen-specific immunity in older adults with sub-optimal vitamin D status.
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Affiliation(s)
- Emma S Chambers
- Correspondence: Emma S. Chambers, Centre for Immunobiology, Blizard Institute, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK.
| | | | - Carolin T Turner
- Division of Infection and Immunity, University College London, London, UK
| | - Barbara B Shih
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Hugh Trahair
- Division of Medicine, University College London, London, UK
| | - Gabriele Pollara
- Division of Infection and Immunity, University College London, London, UK
| | - Evdokia Tsaliki
- Division of Infection and Immunity, University College London, London, UK
| | - Malcolm Rustin
- Department of Dermatology, Royal Free Hospital, London, UK
| | - Tom C Freeman
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Neil A Mabbott
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, UK
| | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, UK
| | - Adrian R Martineau
- Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, UK
| | - Arne N Akbar
- Division of Medicine, University College London, London, UK
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The conundrum of human immune system "senescence". Mech Ageing Dev 2020; 192:111357. [PMID: 32949594 PMCID: PMC7494491 DOI: 10.1016/j.mad.2020.111357] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 12/15/2022]
Abstract
Biomarkers of human immunosenescence are discussed. Longitudinal studies are essential. Associations of immune markers in older adults with clinical outcome are context-dependent. There are no universal biomarkers of human immunosenescence. There are common age-associated changes to peripheral immune markers in humans.
There is a great deal of debate on the question of whether or not we know what ageing is (Ref. Cohen et al., 2020). Here, we consider what we believe to be the especially confused and confusing case of the ageing of the human immune system, commonly referred to as “immunosenescence”. But what exactly is meant by this term? It has been used loosely in the literature, resulting in a certain degree of confusion as to its definition and implications. Here, we argue that only those differences in immune parameters between younger and older adults that are associated in some definitive manner with detrimental health outcomes and/or impaired survival prospects should be classed as indicators of immunosenescence in the strictest sense of the word, and that in humans we know remarkably little about their identity. Such biomarkers of immunosenescence may nonetheless indicate beneficial effects in other contexts, consistent with the notion of antagonistic pleiotropy. Identifying what could be true immunosenescence in this respect requires examining: (1) what appears to correlate with age, though generality across human populations is not yet confirmed; (2) what clearly is part of a suite of canonical changes in the immune system that happen with age; (3) which subset of those changes accelerates rather than slows aging; and (4) all changes, potentially population-specific, that accelerate agig. This remains an immense challenge. These questions acquire an added urgency in the current SARS-CoV-2 pandemic, given the clearly greater susceptibility of older adults to COVID-19.
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10
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Carranza C, Pedraza-Sanchez S, de Oyarzabal-Mendez E, Torres M. Diagnosis for Latent Tuberculosis Infection: New Alternatives. Front Immunol 2020; 11:2006. [PMID: 33013856 PMCID: PMC7511583 DOI: 10.3389/fimmu.2020.02006] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/24/2020] [Indexed: 12/29/2022] Open
Abstract
Latent tuberculosis infection (LTBI) is a subclinical mycobacterial infection defined on the basis of cellular immune response to mycobacterial antigens. The tuberculin skin test (TST) and the interferon gamma release assay (IGRA) are currently used to establish the diagnosis of LTB. However, neither TST nor IGRA is useful to discriminate between active and latent tuberculosis. Moreover, these tests cannot be used to predict whether an individual with LTBI will develop active tuberculosis (TB) or whether therapy for LTBI could be effective to decrease the risk of developing active TB. Therefore, in this article, we review current approaches and some efforts to identify an immunological marker that could be useful in distinguishing LTBI from TB and in evaluating the effectiveness of treatment of LTB on the risk of progression to active TB.
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Affiliation(s)
- Claudia Carranza
- Departamento de Microbiología, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Sigifredo Pedraza-Sanchez
- Unidad de Bioquímica Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
| | | | - Martha Torres
- Departamento de Microbiología, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.,Subdirección de Investigación Biomédica, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
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Di Domizio J, Belkhodja C, Chenuet P, Fries A, Murray T, Mondéjar PM, Demaria O, Conrad C, Homey B, Werner S, Speiser DE, Ryffel B, Gilliet M. The commensal skin microbiota triggers type I IFN-dependent innate repair responses in injured skin. Nat Immunol 2020; 21:1034-1045. [PMID: 32661363 DOI: 10.1038/s41590-020-0721-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 05/27/2020] [Indexed: 01/25/2023]
Abstract
Skin wounds heal by coordinated induction of inflammation and tissue repair, but the initiating events are poorly defined. Here we uncover a fundamental role of commensal skin microbiota in this process and show that it is mediated by the recruitment and the activation of type I interferon (IFN)-producing plasmacytoid DC (pDC). Commensal bacteria colonizing skin wounds trigger activation of neutrophils to express the chemokine CXCL10, which recruits pDC and acts as an antimicrobial protein to kill exposed microbiota, leading to the formation of CXCL10-bacterial DNA complexes. These complexes and not complexes with host-derived DNA activate pDC to produce type I IFNs, which accelerate wound closure by triggering skin inflammation and early T cell-independent wound repair responses, mediated by macrophages and fibroblasts that produce major growth factors required for healing. These findings identify a key function of commensal microbiota in driving a central innate wound healing response of the skin.
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Affiliation(s)
- Jeremy Di Domizio
- Department of Dermatology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Cyrine Belkhodja
- Department of Dermatology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Pauline Chenuet
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orleans, France
| | - Anissa Fries
- Department of Dermatology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Timothy Murray
- Department of Oncology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Paula Marcos Mondéjar
- Department of Oncology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Olivier Demaria
- Department of Dermatology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Curdin Conrad
- Department of Dermatology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Bernhard Homey
- Department of Dermatology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Sabine Werner
- ETH Zurich, Institute of Molecular Health Sciences, Zurich, Switzerland
| | - Daniel E Speiser
- Department of Oncology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Bernhard Ryffel
- Laboratory of Experimental and Molecular Immunology and Neurogenetics, UMR 7355 CNRS-University of Orleans, Orleans, France.,Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Health Sciences Faculty, University of Cape Town, and South Africa Medical Research Council, Cape Town, South Africa
| | - Michel Gilliet
- Department of Dermatology, CHUV University Hospital, University of Lausanne, Lausanne, Switzerland.
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12
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Nikzad R, Angelo LS, Aviles-Padilla K, Le DT, Singh VK, Bimler L, Vukmanovic-Stejic M, Vendrame E, Ranganath T, Simpson L, Haigwood NL, Blish CA, Akbar AN, Paust S. Human natural killer cells mediate adaptive immunity to viral antigens. Sci Immunol 2020; 4:4/35/eaat8116. [PMID: 31076527 DOI: 10.1126/sciimmunol.aat8116] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 04/10/2019] [Indexed: 12/13/2022]
Abstract
Adaptive immune responses are defined as antigen sensitization-dependent and antigen-specific responses leading to establishment of long-lived immunological memory. Although natural killer (NK) cells have traditionally been considered cells of the innate immune system, mounting evidence in mice and nonhuman primates warrants reconsideration of the existing paradigm that B and T cells are the sole mediators of adaptive immunity. However, it is currently unknown whether human NK cells can exhibit adaptive immune responses. We therefore tested whether human NK cells mediate adaptive immunity to virally encoded antigens using humanized mice and human volunteers. We found that human NK cells displayed vaccination-dependent, antigen-specific recall responses in vitro, when isolated from livers of humanized mice previously vaccinated with HIV-encoded envelope protein. Furthermore, we discovered that large numbers of cytotoxic NK cells with a tissue-resident phenotype were recruited to sites of varicella-zoster virus (VZV) skin test antigen challenge in VZV-experienced human volunteers. These NK-mediated recall responses in humans occurred decades after initial VZV exposure, demonstrating that NK memory in humans is long-lived. Our data demonstrate that human NK cells exhibit adaptive immune responses upon vaccination or infection. The existence of human memory NK cells may allow for the development of vaccination-based approaches capable of establishing potent NK-mediated memory functions contributing to host protection.
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Affiliation(s)
- Rana Nikzad
- Center for Human Immunobiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.,Translational Biology and Molecular Medicine Graduate Program at Baylor College of Medicine, Houston, TX, USA.,Department of Immunology and Microbiology, Scripps Research Institute, La Jolla, CA, USA
| | - Laura S Angelo
- Center for Human Immunobiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
| | - Kevin Aviles-Padilla
- Center for Human Immunobiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.,Integrative Molecular and Biomedical Sciences Graduate Program at Baylor College of Medicine, Houston, TX, USA
| | - Duy T Le
- Center for Human Immunobiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.,Graduate Program in Immunology at Baylor College of Medicine, Houston, TX, USA
| | - Vipul K Singh
- Center for Human Immunobiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
| | - Lynn Bimler
- Center for Human Immunobiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA.,Graduate Program in Immunology at Baylor College of Medicine, Houston, TX, USA
| | | | - Elena Vendrame
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Thanmayi Ranganath
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Laura Simpson
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nancy L Haigwood
- Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, USA
| | - Catherine A Blish
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.,Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Arne N Akbar
- Division of Infection and Immunity, University College London, UK
| | - Silke Paust
- Center for Human Immunobiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA. .,Translational Biology and Molecular Medicine Graduate Program at Baylor College of Medicine, Houston, TX, USA.,Department of Immunology and Microbiology, Scripps Research Institute, La Jolla, CA, USA.,Integrative Molecular and Biomedical Sciences Graduate Program at Baylor College of Medicine, Houston, TX, USA.,Graduate Program in Immunology at Baylor College of Medicine, Houston, TX, USA
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13
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Rakita A, Nikolić N, Mildner M, Matiasek J, Elbe-Bürger A. Re-epithelialization and immune cell behaviour in an ex vivo human skin model. Sci Rep 2020. [PMID: 31913322 DOI: 10.1038/s41598020-77127-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A large body of literature is available on wound healing in humans. Nonetheless, a standardized ex vivo wound model without disruption of the dermal compartment has not been put forward with compelling justification. Here, we present a novel wound model based on application of negative pressure and its effects for epidermal regeneration and immune cell behaviour. Importantly, the basement membrane remained intact after blister roof removal and keratinocytes were absent in the wounded area. Upon six days of culture, the wound was covered with one to three-cell thick K14+Ki67+ keratinocyte layers, indicating that proliferation and migration were involved in wound closure. After eight to twelve days, a multi-layered epidermis was formed expressing epidermal differentiation markers (K10, filaggrin, DSG-1, CDSN). Investigations about immune cell-specific manners revealed more T cells in the blister roof epidermis compared to normal epidermis. We identified several cell populations in blister roof epidermis and suction blister fluid that are absent in normal epidermis which correlated with their decrease in the dermis, indicating a dermal efflux upon negative pressure. Together, our model recapitulates the main features of epithelial wound regeneration, and can be applied for testing wound healing therapies and investigating underlying mechanisms.
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Affiliation(s)
- Ana Rakita
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Nenad Nikolić
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Michael Mildner
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Johannes Matiasek
- Department of Plastic, Aesthetic and Reconstructive Surgery, St. Josef Hospital, Vienna, Austria
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14
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Rakita A, Nikolić N, Mildner M, Matiasek J, Elbe-Bürger A. Re-epithelialization and immune cell behaviour in an ex vivo human skin model. Sci Rep 2020; 10:1. [PMID: 31913322 PMCID: PMC6959339 DOI: 10.1038/s41598-019-56847-4] [Citation(s) in RCA: 5052] [Impact Index Per Article: 1263.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/10/2019] [Indexed: 02/06/2023] Open
Abstract
A large body of literature is available on wound healing in humans. Nonetheless, a standardized ex vivo wound model without disruption of the dermal compartment has not been put forward with compelling justification. Here, we present a novel wound model based on application of negative pressure and its effects for epidermal regeneration and immune cell behaviour. Importantly, the basement membrane remained intact after blister roof removal and keratinocytes were absent in the wounded area. Upon six days of culture, the wound was covered with one to three-cell thick K14+Ki67+ keratinocyte layers, indicating that proliferation and migration were involved in wound closure. After eight to twelve days, a multi-layered epidermis was formed expressing epidermal differentiation markers (K10, filaggrin, DSG-1, CDSN). Investigations about immune cell-specific manners revealed more T cells in the blister roof epidermis compared to normal epidermis. We identified several cell populations in blister roof epidermis and suction blister fluid that are absent in normal epidermis which correlated with their decrease in the dermis, indicating a dermal efflux upon negative pressure. Together, our model recapitulates the main features of epithelial wound regeneration, and can be applied for testing wound healing therapies and investigating underlying mechanisms.
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Affiliation(s)
- Ana Rakita
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Nenad Nikolić
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Michael Mildner
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Johannes Matiasek
- Department of Plastic, Aesthetic and Reconstructive Surgery, St. Josef Hospital, Vienna, Austria
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15
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Patel NP, Vukmanovic-Stejic M, Suarez-Farinas M, Chambers ES, Sandhu D, Fuentes-Duculan J, Mabbott NA, Rustin MHA, Krueger J, Akbar AN. Impact of Zostavax Vaccination on T-Cell Accumulation and Cutaneous Gene Expression in the Skin of Older Humans After Varicella Zoster Virus Antigen-Specific Challenge. J Infect Dis 2019; 218:S88-S98. [PMID: 30247603 PMCID: PMC6151076 DOI: 10.1093/infdis/jiy420] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background The live attenuated vaccine Zostavax was developed to prevent varicella zoster virus (VZV) reactivation that causes herpes zoster (shingles) in older humans. However, the impact of vaccination on the cutaneous response to VZV is not known. Methods We investigated the response to intradermal VZV antigen challenge before and after Zostavax vaccination in participants >70 years of age by immunohistological and transcriptomic analyses of skin biopsy specimens collected from the challenge site. Results Vaccination increased the proportion of VZV-specific CD4+ T cells in the blood and promoted the accumulation of both CD4+ and CD8+ T cells in the skin after VZV antigen challenge. However, Zostavax did not alter the proportion of resident memory T cells (CD4+ and CD8+) or CD4+Foxp3+ regulatory T cells in unchallenged skin. After vaccination, there was increased cutaneous T-cell proliferation at the challenge site and also increased recruitment of T cells from the blood, as indicated by an elevated T-cell migratory gene signature. CD8+ T-cell–associated functional genes were also highly induced in the skin after vaccination. Conclusion Zostavax vaccination does not alter the abundance of cutaneous resident memory T cells but instead increases the recruitment of VZV-specific T cells from the blood and enhances T-cell activation, particularly cells of the CD8+ subset, in the skin after VZV antigen challenge.
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Affiliation(s)
- Neil P Patel
- Division of Infection and Immunity, University College London.,Department of Dermatology, Royal Free Hospital, London
| | | | - Mayte Suarez-Farinas
- Laboratory for Investigative Dermatology, Rockefeller University, New York, New York
| | - Emma S Chambers
- Division of Infection and Immunity, University College London
| | - Daisy Sandhu
- Division of Infection and Immunity, University College London.,Department of Dermatology, Royal Free Hospital, London
| | | | - Neil A Mabbott
- Roslin Institute, University of Edinburgh, Midlothian, United Kingdom.,Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian, United Kingdom
| | | | - James Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, New York
| | - Arne N Akbar
- Division of Infection and Immunity, University College London
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16
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Zimmer CL, Cornillet M, Solà-Riera C, Cheung KW, Ivarsson MA, Lim MQ, Marquardt N, Leo YS, Lye DC, Klingström J, MacAry PA, Ljunggren HG, Rivino L, Björkström NK. NK cells are activated and primed for skin-homing during acute dengue virus infection in humans. Nat Commun 2019; 10:3897. [PMID: 31467285 PMCID: PMC6715742 DOI: 10.1038/s41467-019-11878-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/08/2019] [Indexed: 01/25/2023] Open
Abstract
Despite animal models showing that natural killer (NK) cells are important players in the early defense against many viral infections, the NK cell response is poorly understood in humans. Here we analyze the phenotype, temporal dynamics, regulation and trafficking of NK cells in a patient cohort with acute dengue virus infection. NK cells are robustly activated and proliferate during the first week after symptom debut. Increased IL-18 levels in plasma and in induced skin blisters of DENV-infected patients, as well as concomitant signaling downstream of the IL-18R, suggests an IL-18-dependent mechanism in driving the proliferative NK cell response. Responding NK cells have a less mature phenotype and a distinct chemokine-receptor imprint indicative of skin-homing. A corresponding NK cell subset can be localized to skin early during acute infection. These data provide evidence of an IL-18-driven NK cell proliferation and priming for skin-homing during an acute viral infection in humans. Here, Zimmer et al. analyze the natural killer (NK) cell response in a patient cohort with acute dengue virus infection showing early NK cell activation and proliferation, and the data suggest that NK cell proliferation depends on IL-18 signaling, and that responding NK cells have a skin-homing phenotype.
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Affiliation(s)
- Christine L Zimmer
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Martin Cornillet
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Carles Solà-Riera
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ka-Wai Cheung
- Programme in Emerging Infectious Diseases, DUKE-NUS Medical School, Singapore, Singapore
| | - Martin A Ivarsson
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Mei Qiu Lim
- Programme in Emerging Infectious Diseases, DUKE-NUS Medical School, Singapore, Singapore
| | - Nicole Marquardt
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Yee-Sin Leo
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - David Chien Lye
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Jonas Klingström
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Paul A MacAry
- Immunology Programme, Life Science Institute and Department of Microbiology and Immunology, National University of Singapore, Singapore, Singapore
| | - Hans-Gustaf Ljunggren
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Laura Rivino
- Programme in Emerging Infectious Diseases, DUKE-NUS Medical School, Singapore, Singapore.,School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
| | - Niklas K Björkström
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
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17
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Reid J, Zamuner S, Edwards K, Rumley S, Nevin K, Feeney M, Zecchin C, Fernando D, Wisniacki N. In vivo affinity and target engagement in skin and blood in a first-time-in-human study of an anti-oncostatin M monoclonal antibody. Br J Clin Pharmacol 2018; 84:2280-2291. [PMID: 29900565 PMCID: PMC6138480 DOI: 10.1111/bcp.13669] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 05/04/2018] [Accepted: 05/28/2018] [Indexed: 01/30/2023] Open
Abstract
AIMS The oncostatin M (OSM) pathway drives fibrosis, inflammation and vasculopathy, and is a potential therapeutic target for inflammatory and fibrotic diseases. The aim of this first-time-in-human experimental medicine study was to assess the safety, tolerability, pharmacokinetics and target engagement of single subcutaneous doses of GSK2330811, an anti-OSM monoclonal antibody, in healthy subjects. METHODS This was a phase I, randomized, double-blind, placebo-controlled, single-dose escalation, first-time-in-human study of subcutaneously administered GSK2330811 in healthy adults (NCT02386436). Safety and tolerability, GSK2330811 pharmacokinetic profile, OSM levels in blood and skin, and the potential for antidrug antibody formation were assessed. The in vivo affinity of GSK2330811 for OSM and target engagement in serum and skin blister fluid (obtained via a skin suction blister model) were estimated using target-mediated drug disposition (TMDD) models in combination with compartmental and physiology-based pharmacokinetic (PBPK) models. RESULTS Thirty subjects were randomized to receive GSK2330811 and 10 to placebo in this completed study. GSK2330811 demonstrated a favourable safety profile in healthy subjects; no adverse events were serious or led to withdrawal. There were no clinically relevant trends in change from baseline in laboratory values, with the exception of a reversible dose-dependent reduction in platelet count. GSK2330811 exhibited linear pharmacokinetics over the dose range 0.1-6 mg kg-1 . The estimated in vivo affinity (nM) of GSK2330811 for OSM was 0.568 [95% confidence interval (CI) 0.455, 0.710] in the compartmental with TMDD model and 0.629 (95% CI 0.494, 0.802) using the minimal PBPK with TMDD model. CONCLUSIONS Single subcutaneous doses of GSK2330811 were well tolerated in healthy subjects. GSK2330811 demonstrated sufficient affinity to achieve target engagement in systemic circulation and target skin tissue, supporting the progression of GSK2330811 clinical development.
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Affiliation(s)
- Juliet Reid
- ImmunoInflammationGlaxoSmithKlineStevenageUK
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18
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Seidel JA, Vukmanovic‐Stejic M, Muller‐Durovic B, Patel N, Fuentes‐Duculan J, Henson SM, Krueger JG, Rustin MHA, Nestle FO, Lacy KE, Akbar AN. Skin resident memory CD8 + T cells are phenotypically and functionally distinct from circulating populations and lack immediate cytotoxic function. Clin Exp Immunol 2018; 194:79-92. [PMID: 30030847 PMCID: PMC6156810 DOI: 10.1111/cei.13189] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2018] [Indexed: 02/06/2023] Open
Abstract
The in-depth understanding of skin resident memory CD8+ T lymphocytes (TRM ) may help to uncover strategies for their manipulation during disease. We investigated isolated TRM from healthy human skin, which expressed the residence marker CD69, and compared them to circulating CD8+ T cell populations from the same donors. There were significantly increased proportions of CD8+ CD45RA- CD27- T cells in the skin that expressed low levels of killer cell lectin-like receptor G1 (KLRG1), CD57, perforin and granzyme B. The CD8+ TRM in skin were therefore phenotypically distinct from circulating CD8+ CD45RA- CD27- T cells that expressed high levels of all these molecules. Nevertheless, the activation of CD8+ TRM with T cell receptor (TCR)/CD28 or interleukin (IL)-2 or IL-15 in vitro induced the expression of granzyme B. Blocking signalling through the inhibitory receptor programmed cell death 1 (PD)-1 further boosted granzyme B expression. A unique feature of some CD8+ TRM cells was their ability to secrete high levels of tumour necrosis factor (TNF)-α and IL-2, a cytokine combination that was not seen frequently in circulating CD8+ T cells. The cutaneous CD8+ TRM are therefore diverse, and appear to be phenotypically and functionally distinct from circulating cells. Indeed, the surface receptors used to distinguish differentiation stages of blood T cells cannot be applied to T cells in the skin. Furthermore, the function of cutaneous TRM appears to be stringently controlled by environmental signals in situ.
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Affiliation(s)
- J. A. Seidel
- Division of Infection and ImmunityUniversity College LondonUK
| | | | - B. Muller‐Durovic
- Division of Infection and ImmunityUniversity College LondonUK
- Department of BiomedicineUniversity of BaselBaselSwitzerland
| | - N. Patel
- Division of Infection and ImmunityUniversity College LondonUK
| | - J. Fuentes‐Duculan
- Laboratory for Investigative DermatologyThe Rockefeller UniversityNew YorkUSA
| | - S. M. Henson
- Division of Infection and ImmunityUniversity College LondonUK
- Present address:
William Harvey Research Institute Queen Mary University of LondonCharterhouse SquareLondon EC1M 6BQ
| | - J. G. Krueger
- Laboratory for Investigative DermatologyThe Rockefeller UniversityNew YorkUSA
| | | | - F. O. Nestle
- NIHR Biomedical Research Centre, Cutaneous Medicine and ImmunotherapySt John’s Institute of Dermatology, Division of Genetics and Molecular Medicine, Guy’s Hospital, King’s College LondonLondonUK
| | - K. E. Lacy
- NIHR Biomedical Research Centre, Cutaneous Medicine and ImmunotherapySt John’s Institute of Dermatology, Division of Genetics and Molecular Medicine, Guy’s Hospital, King’s College LondonLondonUK
| | - A. N. Akbar
- Division of Infection and ImmunityUniversity College LondonUK
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19
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Arya S, Kumar SK, Nath A, Kapoor P, Aggarwal A, Misra R, Sinha S. Synergy between tuberculin skin test and proliferative T cell responses to PPD or cell-membrane antigens of Mycobacterium tuberculosis for detection of latent TB infection in a high disease-burden setting. PLoS One 2018; 13:e0204429. [PMID: 30248144 PMCID: PMC6152960 DOI: 10.1371/journal.pone.0204429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 09/09/2018] [Indexed: 12/02/2022] Open
Abstract
Tuberculin skin test (TST) is used most widely for the detection of latent tuberculosis infection (LTBI), even though evidences suggest that it could be underreporting the prevalence of LTBI particularly in high disease-burden settings. We have explored whether in vivo (TST) and in vitro (cell-proliferative) T cell responses to PPD can serve as complementary measures. In addition, we also probed whether in vitro T cell response to cell-membrane antigens (Mem) of Mycobacterium tuberculosis (MTB) can serve as a biomarker for LTBI. Study subjects comprised 43 healthcare workers (HCWs), and 9 smear-positive TB patients served as ‘disease control’. To measure proliferative T cell responses, 0.1 ml blood (diluted 1:10) was incubated (5 days) with test or control antigen. Cells were stained with fluorescent antibodies to T cell (CD3+/CD4+/CD8+) surface markers and, after fixation and permeabilization, to nuclear proliferation marker Ki67. Data was acquired on a flow cytometer. HCWs who had an intimate exposure to MTB showed significantly higher TST positivity (85%) than the rest (43%), notwithstanding their BCG vaccination status. The proliferative responses of CD4+ and CD8+ subsets of T cells were comparable. Sixty seven and 100% TST-negative HCWs, respectively, were positive for proliferative T cell response to PPD and MTBMem. Cumulative positivity (TST or in vitro) was 86% with PPD and 100% with MTBMem indicating complementarity of the two responses. As standalone in vitro assay, MTBMem provided a significantly higher positivity (95%) than PPD (67%). T cell responses of TB patients were ‘generally’ depressed, having implications for the development of immunological assays for ‘progressive’ LTBI. Altogether, these results demonstrate that in vivo and in vitro T cell responses to PPD are complementary and in vitro response to MTBMem can be developed as a highly sensitive biomarker for LTBI.
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Affiliation(s)
- Suvrat Arya
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Shashi Kant Kumar
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Alok Nath
- Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Prerna Kapoor
- DOT Centre, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amita Aggarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Ramnath Misra
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Sudhir Sinha
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
- * E-mail:
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20
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Holm LL, Vukmanovic-Stejic M, Blauenfeldt T, Benfield T, Andersen P, Akbar AN, Ruhwald M. A Suction Blister Protocol to Study Human T-cell Recall Responses In Vivo. J Vis Exp 2018. [PMID: 30148487 PMCID: PMC6126709 DOI: 10.3791/57554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cutaneous antigen-recall models allow for studies of human memory responses in vivo. When combined with skin suction blister (SB) induction, this model offers accessibility to rare populations of antigen-specific T-cells representative of the cellular memory response as well as the cytokine microenvironment in situ. This report describes the practical procedure of a cutaneous recall, an SB induction, and a harvest of antigen-specific T-cells. To exemplify the method, the tuberculin skin test is used for antigenic recall in individuals who, prior to this study, underwent a Bacillus Calmette-Guérin vaccination against an infection with Mycobacterium tuberculosis. Finally, examples of multiplex and flow cytometric analyses of SB specimens are provided, illustrating high fractions of antigen-specific polyfunctional CD4+ T-cells available by this sampling method compared with cells isolated from the blood. The method described here is safe and minimally invasive, provides a unique opportunity to study both innate and adaptive immune responses in vivo, and may be beneficial to a broad community of researchers working with cell-mediated immunity and human memory responses, in the context of vaccine development.
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Affiliation(s)
- Line L Holm
- Department of Infectious Disease Immunology, Center for Vaccine Research, Statens Serum Institut; Department of Infectious Diseases, Hvidovre Hospital; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen;
| | | | - Thomas Blauenfeldt
- Department of Infectious Disease Immunology, Center for Vaccine Research, Statens Serum Institut
| | - Thomas Benfield
- Department of Infectious Diseases, Hvidovre Hospital; Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen
| | - Peter Andersen
- Department of Infectious Disease Immunology, Center for Vaccine Research, Statens Serum Institut
| | - Arne N Akbar
- Division of Infection and Immunity, University College London
| | - Morten Ruhwald
- Department of Infectious Disease Immunology, Center for Vaccine Research, Statens Serum Institut
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21
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Polak D, Hafner C, Briza P, Kitzmüller C, Elbe-Bürger A, Samadi N, Gschwandtner M, Pfützner W, Zlabinger GJ, Jahn-Schmid B, Bohle B. A novel role for neutrophils in IgE-mediated allergy: Evidence for antigen presentation in late-phase reactions. J Allergy Clin Immunol 2018; 143:1143-1152.e4. [PMID: 29920351 DOI: 10.1016/j.jaci.2018.06.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/18/2018] [Accepted: 06/01/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Neutrophils and allergen-specific T cells accumulate in patients with allergic late-phase reactions (LPRs). Their presence is associated with severe inflammation. Cytokines, such as GM-CSF, IFN-γ, and IL-3, which are typically found in patients with allergic LPRs, have been proposed to convert neutrophils into antigen-presenting cells (APCs). OBJECTIVE We sought to assess the antigen-processing and antigen-presenting capacities of neutrophils from allergic patients. METHODS Neutrophils were isolated from peripheral blood of donors with birch pollen allergy and stimulated with GM-CSF, IFN-γ, and IL-3. The viability and expression of HLA-DR, CD80, and CD86 were assessed by using flow cytometry. HLA-DM expression was analyzed by means of immunoblotting. Allergen uptake was studied after fluorescence labeling of the major birch pollen allergen Bet v 1. Bet v 1 was digested with neutrophilic endolysosomal extracts, and the resulting fragments were sequenced by using mass spectrometry. Neutrophils were used as APCs in coculture experiments with autologous HLA-DR-restricted and Bet v 1-specific T-cell clones reactive with epitopes in different regions of the allergen. In all experiments monocytes were used for comparison. Fluids from suction blisters formed on top of LPRs induced by using intradermal allergen injection were assessed for HLA-DR+ neutrophils by using flow cytometry. RESULTS The cytokines significantly enhanced the survival, allergen uptake, and expression of HLA-DM and HLA-DR on neutrophils. Neutrophils rapidly degraded Bet v 1 into fragments containing all relevant T-cell epitopes. Cytokine-activated, allergen-pulsed neutrophils induced proliferative and cytokine responses of Bet v 1-specific T cells irrespective of epitope specificity, confirming that they fully processed and presented the allergen. HLA-DR+ neutrophils were detected in patients with cutaneous allergic LPRs. CONCLUSION Neutrophils can serve as APCs for local allergen-specific effector T cells in patients with allergic LPRs.
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Affiliation(s)
- Dominika Polak
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Christine Hafner
- Department of Dermatology, University Hospital St Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Peter Briza
- Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - Claudia Kitzmüller
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | - Nazanin Samadi
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Maria Gschwandtner
- Department of Dermatology, Research Division of Biology and Pathobiology of the Skin, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Pfützner
- Department of Dermatology and Allergology, Philipps University Marburg, Marburg, Germany
| | | | - Beatrice Jahn-Schmid
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Barbara Bohle
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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22
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Aspinall R, Lang PO. Interventions to restore appropriate immune function in the elderly. IMMUNITY & AGEING 2018; 15:5. [PMID: 29416551 PMCID: PMC5785902 DOI: 10.1186/s12979-017-0111-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 12/28/2017] [Indexed: 01/03/2023]
Abstract
Advanced age is one indicator of likely immune dysfunction. As worldwide, the global population contains progressively more and more older individuals there is likelihood of an increased prevalence and incidence of infectious diseases due to common and emergent pathogens. The resultant increase in mortality and morbidity would be matched by the risk of functional decline and disability. Maintaining immune function at a plateau throughout life may therefore be associated with considerable cost savings. The aim of improving immune function in older individuals may be achieved through considering a therapeutic approach to rejuvenate, stimulate or support the indigenous immune system to perform in a more optimal manner. In terms of cost effectiveness a therapeutic approach may prove difficult because of issues associated with; identifying those who would benefit the most from this treatment, identifying the type of treatment which would suit them and identifying whether the treatment was successful. The alternative of supporting or providing a stronger stimulus through vaccination, whilst more cost effective, may be a more valuable option in the short term. Both approaches will be addressed in this review.
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Affiliation(s)
- Richard Aspinall
- Rivock Ltd, Bury St Edmunds, UK.,3Anglia Ruskin University, Cambridge, UK
| | - Pierre Olivier Lang
- 2Geriatric and Geriatric Rehabilitation Division, Department of Medicine, University Hospital of Lausanne, Lausanne, Switzerland.,3Anglia Ruskin University, Cambridge, UK
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Vukmanovic-Stejic M, Chambers ES, Suárez-Fariñas M, Sandhu D, Fuentes-Duculan J, Patel N, Agius E, Lacy KE, Turner CT, Larbi A, Birault V, Noursadeghi M, Mabbott NA, Rustin MHA, Krueger JG, Akbar AN. Enhancement of cutaneous immunity during aging by blocking p38 mitogen-activated protein (MAP) kinase-induced inflammation. J Allergy Clin Immunol 2017; 142:844-856. [PMID: 29155150 PMCID: PMC6127037 DOI: 10.1016/j.jaci.2017.10.032] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/13/2017] [Accepted: 10/23/2017] [Indexed: 01/09/2023]
Abstract
Background Immunity decreases with age, which leads to reactivation of varicella zoster virus (VZV). In human subjects age-associated immune changes are usually measured in blood leukocytes; however, this might not reflect alterations in tissue-specific immunity. Objectives We used a VZV antigen challenge system in the skin to investigate changes in tissue-specific mechanisms involved in the decreased response to this virus during aging. Methods We assessed cutaneous immunity based on the extent of erythema and induration after intradermal VZV antigen injection. We also performed immune histology and transcriptomic analyses on skin biopsy specimens taken from the challenge site in young (<40 years) and old (>65 years) subjects. Results Old human subjects exhibited decreased erythema and induration, CD4+ and CD8+ T-cell infiltration, and attenuated global gene activation at the site of cutaneous VZV antigen challenge compared with young subjects. This was associated with increased sterile inflammation in the skin in the same subjects related to p38 mitogen-activated protein kinase–related proinflammatory cytokine production (P < .0007). We inhibited systemic inflammation in old subjects by means of pretreatment with an oral small-molecule p38 mitogen-activated protein kinase inhibitor (Losmapimod; GlaxoSmithKline, Brentford, United Kingdom), which reduced both serum C-reactive protein levels and peripheral blood monocyte secretion of IL-6 and TNF-α. In contrast, cutaneous responses to VZV antigen challenge were increased significantly in the same subjects (P < .0003). Conclusion Excessive inflammation in the skin early after antigen challenge retards antigen-specific immunity. However, this can be reversed by inhibition of inflammatory cytokine production that can be used to promote vaccine efficacy and the treatment of infections and malignancy during aging.
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Affiliation(s)
| | - Emma S Chambers
- Division of Infection and Immunity, University College London, London, United Kingdom
| | | | - Daisy Sandhu
- Division of Infection and Immunity, University College London, London, United Kingdom; Department of Dermatology, Royal Free Hospital, London, United Kingdom
| | | | - Neil Patel
- Division of Infection and Immunity, University College London, London, United Kingdom; Department of Dermatology, Royal Free Hospital, London, United Kingdom
| | - Elaine Agius
- Division of Infection and Immunity, University College London, London, United Kingdom; Department of Dermatology, Royal Free Hospital, London, United Kingdom
| | - Katie E Lacy
- Division of Infection and Immunity, University College London, London, United Kingdom; Department of Dermatology, Royal Free Hospital, London, United Kingdom; NIHR Biomedical Research Centre at Guy's and St Thomas's Hospitals and King's College London, Cutaneous Medicine and Immunotherapy, St John's Institute of Dermatology, Division of Genetics and Molecular Medicine, King's College London School of Medicine, Guy's Hospital, King's College London, London, United Kingdom
| | - Carolin T Turner
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Anis Larbi
- Biomedical Sciences Institutes: Agency for Science, Technology and Research (A*STAR), Singapore
| | | | - Mahdad Noursadeghi
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Neil A Mabbott
- Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | | | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - Arne N Akbar
- Division of Infection and Immunity, University College London, London, United Kingdom.
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Padovan E. Modulation of CD4+ T Helper Cell Memory Responses in the Human Skin. Int Arch Allergy Immunol 2017; 173:121-137. [PMID: 28787717 DOI: 10.1159/000477728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Immunological memory is defined as the capacity to mount faster and more effective immune responses against antigenic challenges that have been previously encountered by the host. CD4+ T helper (Th) cells play central roles in the establishment of immunological memory as they assist the functions of other leukocytes. Th cells express polarized cytokine profiles and distinct migratory and seeding capacities, but also retain a certain functional plasticity that allows them to modulate their proliferation, activity, and homing behaviour upon need. Thus, in healthy individuals, T cell immunomodulation fulfils the task of eliciting protective immune responses where they are needed. At times, however, Th plasticity can lead to collateral tissue damage and progression to autoimmune diseases or, conversely, incapacity to reject malignant tissues and clear chronic infections. Furthermore, common immune players and molecular pathways of diseases can lead to different outcomes in different individuals. A mechanistic understanding of those pathways is therefore crucial for developing precise and curative medical interventions. Here, I focus on the skin microenvironment and comprehensively describe some of the cellular and molecular determinants of CD4+ T cell memory responses in homeostatic and pathological conditions. In discussing the cellular network orchestrating cutaneous immunity, I comprehensively describe the bidirectional interaction of skin antigen-presenting cells and mononuclear phagocytes with Th17 lymphocytes, and examine how the outcome of this interaction is influenced by endogenous skin molecules, including sodium salts and neuropeptides.
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Affiliation(s)
- Elisabetta Padovan
- Department of Biomedicine, University Hospital, University of Basel, Basel, Switzerland
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Bouma G, Zamuner S, Hicks K, Want A, Oliveira J, Choudhury A, Brett S, Robertson D, Felton L, Norris V, Fernando D, Herdman M, Tarzi R. CCL20 neutralization by a monoclonal antibody in healthy subjects selectively inhibits recruitment of CCR6 + cells in an experimental suction blister. Br J Clin Pharmacol 2017; 83:1976-1990. [PMID: 28295451 DOI: 10.1111/bcp.13286] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 02/21/2017] [Accepted: 03/06/2017] [Indexed: 01/10/2023] Open
Abstract
AIMS GSK3050002, a humanized IgG1κ antibody with high binding affinity to human CCL20, was administered in a first-in-human study to evaluate safety, pharmacokinetics (PK) and pharmacodynamics (PD). An experimental skin suction blister model was employed to assess target engagement and the ability of the compound to inhibit recruitment of inflammatory CCR6 expressing cells. METHODS This study was a randomized, double-blind (sponsor open), placebo-controlled, single-centre, single ascending intravenous dose escalation trial in 48 healthy male volunteers. RESULTS GSK3050002 (0.1-20 mg kg-1 ) was well tolerated and no safety concerns were identified. The PK was linear over the dose range, with a half-life of approximately 2 weeks. Complex of GSK3050002/CCL20 increased in serum and blister fluid with increasing doses of GSK3050002. There were dose-dependent decreases in CCR6+ cell recruitment to skin blisters with maximal effects at doses of 5 mg kg-1 and higher, doses at which GSK3050002/CCL20 complex in serum and blister fluid also appeared to reach maximum levels. CONCLUSIONS These results indicate a relationship between PK, target engagement and PD, suggesting a selective inhibition of recruitment of CCR6+ cells by GSK3050002 and support further development of GSK3050002 in autoimmune and inflammatory diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Virginia Norris
- GlaxoSmithKline, Hertfordshire, UK.,GN Clinical Consulting Ltd, London, UK
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Belson A, Schmidt T, Fernando D, Hardes K, Scott N, Brett S, Clark D, Oliveira JJ, Davis B, McHugh S, Stone J. Characterisation of the clinical and activated T cell response to repeat delayed-type hypersensitivity skin challenges in human subjects, with KLH and PPD, as a potential model to test T cell-targeted therapies. Inflamm Res 2016; 65:389-404. [PMID: 26969026 DOI: 10.1007/s00011-016-0923-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 12/21/2015] [Accepted: 02/03/2016] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To characterise the delayed-type hypersensitivity (DTH) skin reaction to repeated challenges of keyhole limpet hemocyanin (KLH) and tuberculin purified protein derivative (PPD) in healthy volunteers, as a potential model to test T cell-targeted investigational agents. SUBJECTS, TREATMENT AND METHODS Forty-nine subjects received either KLH, PPD, or PBS repeat skin challenges, and clinical assessments including induration, erythema and Laser Doppler Imaging. Skin biopsies or suction blisters were taken after challenge to investigate the cellular infiltrate of the challenge site, the T cell activation status, as determined by LAG-3 expression, and, specifically for the blister, the concentrations of inflammatory cytokines. Point estimates, estimates of variation and corresponding 95% confidence intervals were constructed for each type of challenge and timepoint. RESULTS The DTH response could be measured at 48 and 120 h post-KLH and PPD challenge with induration, erythema and Laser Doppler Imaging, with 48 h post-challenge demonstrating the peak of the response. PPD was well tolerated in subjects after multiple challenges, however, a significant number of KLH-treated subjects demonstrated an injection site reaction 6-7 days following the SC injection. PPD demonstrated a boost effect on the second challenge as measured by increased induration, where as this was not noted consistently for KLH. Compared to unchallenged and PBS control-injected skin, increased T cell numbers were detected in the challenge site by both the skin suction blister and biopsy technique, at either time point following KLH or PPD challenge. Use of the T cell activation marker LAG-3 demonstrated the activated phenotype of these cells. In skin blisters, higher numbers of LAG-3+ T cells were detected at 48 h post-challenge, whereas in the biopsies, similar numbers of LAG-3+ cells were observed at both 48 and 120 h. Analysis of blister T cell subpopulations revealed some differences in phenotypes between the time points and between the CD4 and CD8 T cells. Blister cytokine analysis revealed a pro-inflammatory dominated signature in PPD-challenged skin. CONCLUSIONS In summary, our data support the use of a repeat KLH and PPD DTH challenge in clinical trials and that the clinical measures of induration and to a lesser extent erythema are appropriate to monitor the clinical DTH response. Both the blister and biopsy can be utilised to assess and quantify activated T cells and at the dose used, PPD was better tolerated than KLH and hence may be optimal for future studies.
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Affiliation(s)
- Alexandra Belson
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, SG1 2NY, UK.
| | - Tim Schmidt
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, SG1 2NY, UK
| | - Disala Fernando
- Clinical Unit Cambridge, Addenbrooke's Centre for Clinical Investigation, GlaxoSmithKline, Hills Road, Cambridge, CB2 0QQ, UK
| | - Kelly Hardes
- GlaxoSmithKline, Stockley Park West, 1-3 Iron Bridge Road, Uxbridge, Middlesex, UB11 1BT, UK
| | - Nicola Scott
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, SG1 2NY, UK
| | - Sara Brett
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, SG1 2NY, UK
| | - Deborah Clark
- Clinical Unit Cambridge, Addenbrooke's Centre for Clinical Investigation, GlaxoSmithKline, Hills Road, Cambridge, CB2 0QQ, UK
| | - João Joaquim Oliveira
- Clinical Unit Cambridge, Addenbrooke's Centre for Clinical Investigation, GlaxoSmithKline, Hills Road, Cambridge, CB2 0QQ, UK
| | - Bill Davis
- Clinical Unit Cambridge, Addenbrooke's Centre for Clinical Investigation, GlaxoSmithKline, Hills Road, Cambridge, CB2 0QQ, UK
| | - Simon McHugh
- Clinical Unit Cambridge, Addenbrooke's Centre for Clinical Investigation, GlaxoSmithKline, Hills Road, Cambridge, CB2 0QQ, UK
| | - John Stone
- GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, SG1 2NY, UK.
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27
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Rivino L, Kumaran EA, Thein TL, Too CT, Gan VCH, Hanson BJ, Wilder-Smith A, Bertoletti A, Gascoigne NRJ, Lye DC, Leo YS, Akbar AN, Kemeny DM, MacAry PA. Virus-specific T lymphocytes home to the skin during natural dengue infection. Sci Transl Med 2015; 7:278ra35. [PMID: 25761891 DOI: 10.1126/scitranslmed.aaa0526] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Dengue, which is the most prevalent mosquito-borne viral disease afflicting human populations, causes a spectrum of clinical symptoms that include fever, muscle and joint pain, maculopapular skin rash, and hemorrhagic manifestations. Patients infected with dengue develop a broad antigen-specific T lymphocyte response, but the phenotype and functional properties of these cells are only partially understood. We show that natural infection induces dengue-specific CD8(+) T lymphocytes that are highly activated and proliferating, exhibit antiviral effector functions, and express CXCR3, CCR5, and the skin-homing marker cutaneous lymphocyte-associated antigen (CLA). In the same patients, bystander human cytomegalovirus -specific CD8(+) T cells are also activated during acute dengue infection but do not express the same tissue-homing phenotype. We show that CLA expression by circulating dengue-specific CD4(+) and CD8(+) T cells correlates with their in vivo ability to traffic to the skin during dengue infection. The juxtaposition of dengue-specific T cells with virus-permissive cell types at sites of possible dengue exposure represents a previously uncharacterized form of immune surveillance for this virus. These findings suggest that vaccination strategies may need to induce dengue-specific T cells with similar homing properties to provide durable protection against dengue viruses.
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Affiliation(s)
- Laura Rivino
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore. Programme in Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore 169857, Singapore.
| | - Emmanuelle A Kumaran
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
| | - Tun-Linn Thein
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Chien Tei Too
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
| | - Victor Chih Hao Gan
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Brendon J Hanson
- Defense Medical and Environmental Research Institute, National Laboratories, Singapore 118230, Singapore
| | - Annelies Wilder-Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Antonio Bertoletti
- Programme in Emerging Infectious Diseases, Duke-NUS Graduate Medical School, Singapore 169857, Singapore. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore
| | - Nicholas R J Gascoigne
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
| | - David Chien Lye
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Yee Sin Leo
- Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, Singapore 308433, Singapore. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Arne N Akbar
- Division of Infection and Immunity, University College of London, London WC1E 6BT, UK
| | - David M Kemeny
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
| | - Paul A MacAry
- Immunology Programme, Life Sciences Institute and Department of Microbiology, National University of Singapore, Singapore 117456, Singapore
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DIMENT BETHANYC, FORTES MATTHEWB, EDWARDS JASONP, HANSTOCK HELENG, WARD MARKD, DUNSTALL HUWM, FRIEDMANN PETERS, WALSH NEILP. Exercise Intensity and Duration Effects on In Vivo Immunity. Med Sci Sports Exerc 2015; 47:1390-8. [DOI: 10.1249/mss.0000000000000562] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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29
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Tatovic D, Young P, Kochba E, Levin Y, Wong FS, Dayan CM. Fine-Needle Aspiration Biopsy of the Lymph Node: A Novel Tool for the Monitoring of Immune Responses after Skin Antigen Delivery. THE JOURNAL OF IMMUNOLOGY 2015; 195:386-92. [PMID: 26026065 DOI: 10.4049/jimmunol.1500364] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/02/2015] [Indexed: 11/19/2022]
Abstract
Assessment of immune responses in lymph nodes (LNs) is routine in animals, but rarely done in humans. We have applied minimally invasive ultrasound-guided fine-needle aspiration of the LN to a before-and-after study of the immune response to intradermally delivered Ag in healthy volunteers (n = 25). By comparison with PBMCs from the same individual, LN cells (LNCs) were characterized by reduced numbers of effector memory cells, especially CD8(+) TEMRA cells (3.37 ± 1.93 in LNCs versus 22.53 ± 7.65 in PBMCs; p = 0.01) and a marked increased in CD69 expression (27.67 ± 7.49 versus 3.49 ± 2.62%, LNCs and PBMCs, respectively; p < 0.0001). At baseline, there was a striking absence of IFN-γ ELISPOT responses to recall Ags (purified protein derivative, Tetanus toxoid, or flu/EBV/CMV viral mix) in LN, despite strong responses in the peripheral blood. However, 48 h after tuberculin purified protein derivative administration in the ipsilateral forearm resulting in a positive skin reaction, a clear increase in IFN-γ ELISPOT counts was seen in the draining LN but not in PBMCs. This response was lost by 5 d. These data suggest that the low levels of effector memory cells in the LN may explain the low background of baseline ELISPOT responses in LNs as compared with PBMCs, and the appearance of a response after 48 h is likely to represent migration of effector memory cells from the skin to the LN. Hence, it appears that the combination of intradermal Ag administration and draining LN sampling can be used as a sensitive method to probe the effector memory T cell repertoire in the skin.
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Affiliation(s)
- Danijela Tatovic
- Diabetes Research Group, Institute for Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff CF14 4XN, Wales, United Kingdom;
| | - Philippa Young
- Radiology Department, University Hospital of Wales, Cardiff CF14 4XN, Wales, United Kingdom; and
| | | | - Yotam Levin
- NanoPass Technologies, Nes Ziona 74036, Israel
| | - F Susan Wong
- Diabetes Research Group, Institute for Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff CF14 4XN, Wales, United Kingdom
| | - Colin M Dayan
- Diabetes Research Group, Institute for Molecular and Experimental Medicine, Cardiff University School of Medicine, Cardiff CF14 4XN, Wales, United Kingdom
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30
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Egbuniwe IU, Karagiannis SN, Nestle FO, Lacy KE. Revisiting the role of B cells in skin immune surveillance. Trends Immunol 2015; 36:102-11. [PMID: 25616715 DOI: 10.1016/j.it.2014.12.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/18/2014] [Accepted: 12/18/2014] [Indexed: 12/18/2022]
Abstract
Whereas our understanding of the skin immune system has increased exponentially in recent years, the role of B cells in cutaneous immunity remains poorly defined. Recent studies have revealed the presence of B cells within lymphocytic infiltrates in chronic inflammatory skin diseases and cutaneous malignancies including melanoma, and have examined their functional significance in these settings. We review these findings and discuss them in the context of the current understanding of the role of B cells in normal skin physiology, as well as in both animal and human models of skin pathology. We integrate these findings into a model of cutaneous immunity wherein crosstalk between B cells and other skin-resident immune cells plays a central role in skin immune homeostasis.
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Affiliation(s)
- Isioma U Egbuniwe
- Cutaneous Medicine and Immunotherapy Unit, St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Hospitals and King's College London, London SE1 9RT, UK
| | - Sophia N Karagiannis
- Cutaneous Medicine and Immunotherapy Unit, St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Hospitals and King's College London, London SE1 9RT, UK
| | - Frank O Nestle
- Cutaneous Medicine and Immunotherapy Unit, St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Hospitals and King's College London, London SE1 9RT, UK.
| | - Katie E Lacy
- Cutaneous Medicine and Immunotherapy Unit, St. John's Institute of Dermatology, Division of Genetics and Molecular Medicine, and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' Hospitals and King's College London, London SE1 9RT, UK.
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31
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Lost in translation: mice, men and cutaneous immunity in old age. Biogerontology 2014; 16:203-8. [DOI: 10.1007/s10522-014-9517-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/02/2014] [Indexed: 01/24/2023]
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32
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Terrazzini N, Bajwa M, Vita S, Thomas D, Smith H, Vescovini R, Sansoni P, Kern F. Cytomegalovirus infection modulates the phenotype and functional profile of the T-cell immune response to mycobacterial antigens in older life. Exp Gerontol 2013; 54:94-100. [PMID: 24370373 PMCID: PMC4003347 DOI: 10.1016/j.exger.2013.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/13/2013] [Accepted: 12/18/2013] [Indexed: 01/10/2023]
Abstract
Infection with Cytomegalovirus is associated with accelerated immunosenescence. Expansions of CMV-specific T cell responses have previously been demonstrated to affect the ability of T cells to respond to other infections. Most people above 60 years of age display M. tuberculosis-specific immunity because of vaccination, exposure, or both. T-cell responses can be assessed by measuring intracellular IFN-γ in vitro after tuberculin stimulation. Here we investigated tuberculin-specific CD4 T-cell responses in independently living healthy older people in the South of England using flow-cytometry. Individuals were investigated for tuberculin and CMV-specific T-cell immunity using in vitro antigen stimulation followed by intracellular staining for IFN-γ, TNF-α, IL2, as well as degranulation and CD154 upregulation. We also examined a control group of younger individuals (20–35 years of age). There was no significant difference between older and young people in regards to tuberculin responsiveness of CD4 T-cells; however, older people seemed to show more outliers. Increased responsiveness to tuberculin was significantly correlated to CMV responsiveness but not age. In older donors, the memory phenotype of tuberculin-induced T-cells was significantly skewed towards a more terminal differentiation phenotype in CMV-infected compared to uninfected individuals and the degree of skewing correlated quantitatively with the size of the CMV-specific CD4 T-cell response. This is a fundamental advance over previous reports of changes of the tuberculin-specific CD4 T-cell response with CMV serostatus. Our results show that how the immune system responds to CMV has a fundamental impact on the phenotype and function of the immune response to mycobacterial antigens in older life. We examine the CD4 T-cell response to tuberculosis antigens in older people. The CD4 T-cell response to Cytomegalovirus is explored in parallel. CMV infection changes the profile of the tuberculin-specific-response. The size of the CMV T-cell response is linked to these changes in a quantitative way. The way we respond to CMV (‘mode’) affects our T-cell immunity to other pathogens.
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Affiliation(s)
- Nadia Terrazzini
- Division of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom; School of Health, Sport and Bioscience, University of East London, London, United Kingdom
| | - Martha Bajwa
- Division of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Serena Vita
- Institute Pasteur, Cenci-Bolognetti Foundation, Department of Public Health and Infectious Diseases, University Sapienza of Rome, Rome, Italy
| | - David Thomas
- Division of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Helen Smith
- Division of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Rosanna Vescovini
- Dipartimento di Medicina Interna e Scienze Biomediche, Università di Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Paolo Sansoni
- Dipartimento di Medicina Interna e Scienze Biomediche, Università di Parma, Via Gramsci 14, 43100 Parma, Italy
| | - Florian Kern
- Division of Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom.
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