1
|
Xu X, Andersson E, Rahbar A, Söderberg-Nauclér C, Nowak P. Cytomegalovirus infection among people living with HIV in Sweden: Case profiles, treatment strategies and patient outcomes at Karolinska University Hospital 2010-2020. HIV Med 2024. [PMID: 38350653 DOI: 10.1111/hiv.13618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/24/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVES In countries with access to early antiretroviral treatment (ART), opportunistic infections caused by cytomegalovirus (CMV) in people living with HIV (PLWH) are becoming increasingly rare. As potential complications are severe, it is critical to remain aware of this important diagnosis. However, clinical characteristics and prognosis of CMV infection in PLWH in the era of modern ART have not been well described. METHODS Here, we compiled the clinical presentation, management and outcome of CMV infection in PLWH treated at the infectious diseases clinic of Karolinska University Hospital during 2010-2020. RESULTS We identified 51 cases of active CMV infection, based on detection of CMV-DNA, mainly diagnosed in patients with CD4 T-cell count <200 cells/μL (86%). Median time from HIV diagnosis to detection of CMV infection was 16 days. In 20 cases (39%), CMV infection was symptomatic with retinitis identified as a manifestation in 70% of cases. Symptomatic CMV infection was treated for 73 (20-313) days upon diagnosis, mostly using valganciclovir. One-year mortality was 22% and was associated with longer time to ART initiation from HIV diagnosis and with comorbidities, but not with CMV-DNA levels or CD4 count. Immune reconstitution was not significantly compromised in patients with symptomatic CMV, although CD4/8 ratio tended to be lower in patients with systemic CMV infection. CONCLUSIONS Retinitis remains the most common manifestation of symptomatic CMV infection in PLWH. Recognizing CMV infection is important, especially in the management of 'late presenters'. Adequate duration of antiviral therapy and appropriate follow-up must be ensured to avoid complications.
Collapse
Affiliation(s)
- Xinling Xu
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institute, Stockholm, Sweden
| | - Emmi Andersson
- Department of Laboratory medicine, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Laboratory, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institute, Stockholm, Sweden
- Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institute, Stockholm, Sweden
- Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
- Institute of BioMedicine, Unit of Infection and Immunology, MediCity Research Laboratory, Flagship InFLAMES, Turku University, Turku, Finland
| | - Piotr Nowak
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Infectious Diseases, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
2
|
Almazán NM, Rahbar A, Carlsson M, Hoffman T, Kolstad L, Rönnberg B, Pantalone MR, Fuchs IL, Nauclér A, Ohlin M, Sacharczuk M, Religa P, Amér S, Molnár C, Lundkvist Å, Susrud A, Sörensen B, Söderberg-Nauclér C. Influenza-A mediated pre-existing immunity levels to SARS-CoV-2 could predict early COVID-19 outbreak dynamics. iScience 2023; 26:108441. [PMID: 38144451 PMCID: PMC10746369 DOI: 10.1016/j.isci.2023.108441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/14/2023] [Accepted: 11/09/2023] [Indexed: 12/26/2023] Open
Abstract
Susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is highly variable and could be mediated by a cross-protective pre-immunity. We identified 14 cross-reactive peptides between SARS-CoV-2 and influenza A H1N1, H3N2, and human herpesvirus (HHV)-6A/B with potential relevance. The H1N1 peptide NGVEGF was identical to a peptide in the most critical receptor binding motif in SARS-CoV-2 spike protein that interacts with the angiotensin converting enzyme 2 receptor. About 62%-73% of COVID-19-negative blood donors in Stockholm had antibodies to this peptide in the early pre-vaccination phase of the pandemic. Seasonal flu vaccination enhanced neutralizing capacity to SARS-CoV-2 and T cell immunity to this peptide. Mathematical modeling taking the estimated pre-immunity levels to flu into account could fully predict pre-Omicron SARS-CoV-2 outbreaks in Stockholm and India. This cross-immunity provides mechanistic explanations to the epidemiological observation that influenza vaccination protected people against early SARS-CoV-2 infections and implies that flu-mediated cross-protective immunity significantly dampened the first SARS-CoV-2 outbreaks.
Collapse
Affiliation(s)
- Nerea Martín Almazán
- Department of Medicine, Unit for Microbial Pathogenesis, Karolinska Institutet, 17164 Solna, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, 171 76 Solna Stockholm, Sweden
- Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, 141 86 Huddinge Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Unit for Microbial Pathogenesis, Karolinska Institutet, 17164 Solna, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, 171 76 Solna Stockholm, Sweden
| | - Marcus Carlsson
- Centre for the Mathematical Sciences, Lund University, 223 62 Lund, Sweden
| | - Tove Hoffman
- Zoonosis Science Center (ZSC), Department of Medical Biochemistry and Microbiology (IMBIM), Uppsala University, 1477 Uppsala, Sweden
| | - Linda Kolstad
- Zoonosis Science Center (ZSC), Department of Medical Biochemistry and Microbiology (IMBIM), Uppsala University, 1477 Uppsala, Sweden
| | - Bengt Rönnberg
- Zoonosis Science Center (ZSC), Department of Medical Biochemistry and Microbiology (IMBIM), Uppsala University, 1477 Uppsala, Sweden
| | - Mattia Russel Pantalone
- Department of Medicine, Unit for Microbial Pathogenesis, Karolinska Institutet, 17164 Solna, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, 171 76 Solna Stockholm, Sweden
| | - Ilona Lewensohn Fuchs
- Department of Labortory Medicine, Division of Clinical Microbiology, Karolinska Institutet, 141 86 Huddinge Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, 141 86 Huddinge Stockholm, Sweden
| | - Anna Nauclér
- Department of Medicine, Unit for Microbial Pathogenesis, Karolinska Institutet, 17164 Solna, Stockholm, Sweden
| | - Mats Ohlin
- Department of Immunotechnology and SciLifeLab Human Antibody Therapeutics Infrastructure Unit, Lund University, 223 62 Lund, Sweden
| | - Mariusz Sacharczuk
- Faculty of Pharmacy with the Laboratory Medicine Division, Department of Pharmacodynamics, Medical University of Warsaw, Centre for Preclinical Research and Technology, Banacha 1B, 02-091 Warsaw, Poland
- Department of Experimental Genomics, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, Postępu 36A, 05-552 Magdalenka, Poland
| | - Piotr Religa
- Department of Medicine, Unit for Microbial Pathogenesis, Karolinska Institutet, 17164 Solna, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, 171 76 Solna Stockholm, Sweden
- Department of Experimental Genomics, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, Postępu 36A, 05-552 Magdalenka, Poland
| | - Stefan Amér
- Familjeläkarna Saltsjöbaden, 133 34 Saltsjöbaden, Sweden
| | - Christian Molnár
- Familjeläkarna Saltsjöbaden, 133 34 Saltsjöbaden, Sweden
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Åke Lundkvist
- Zoonosis Science Center (ZSC), Department of Medical Biochemistry and Microbiology (IMBIM), Uppsala University, 1477 Uppsala, Sweden
| | | | | | - Cecilia Söderberg-Nauclér
- Department of Medicine, Unit for Microbial Pathogenesis, Karolinska Institutet, 17164 Solna, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, 171 76 Solna Stockholm, Sweden
- Institute of Biomedicine, Unit for Infection and Immunology, MediCity Research Laboratory, University of Turku, FI-20014 Turku, Finland
| |
Collapse
|
3
|
Pantalone MR, Almazan NM, Lattanzio R, Taher C, De Fabritiis S, Valentinuzzi S, Bishehsari F, Mahdavinia M, Verginelli F, Rahbar A, Mariani-Costantini R, Söderberg-Naucler C. Human cytomegalovirus infection enhances 5‑lipoxygenase and cycloxygenase‑2 expression in colorectal cancer. Int J Oncol 2023; 63:116. [PMID: 37654195 PMCID: PMC10546380 DOI: 10.3892/ijo.2023.5564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/07/2023] [Indexed: 09/02/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common and fatal types of cancer. Inflammation promotes CRC development, however, the underlying etiological factors are unknown. Human cytomegalovirus (HCMV), a virus that induces inflammation and other cancer hallmarks, has been detected in several types of malignancy, including CRC. The present study investigated whether HCMV infection was associated with expression of the pro‑inflammatory enzymes 5‑lipoxygenase (5‑LO) and cyclooxygenase‑2 (COX‑2) and other molecular, genetic and clinicopathological CRC features. The present study assessed 146 individual paraffin‑embedded CRC tissue microarray (TMA) cores already characterized for TP53 and KRAS mutations, microsatellite instability (MSI) status, Ki‑67 index and EGFR by immunohistochemistry (IHC). The cores were further analyzed by IHC for the expression of two HCMV proteins (Immediate Early, IE and pp65) and the inflammatory markers 5‑LO and COX‑2. The CRC cell lines Caco‑2 and LS‑174T were infected with HCMV strain VR1814, treated with antiviral drug ganciclovir (GCV) and/or anti‑inflammatory drug celecoxib (CCX) and analyzed by reverse transcription‑quantitative PCR and immunofluorescence for 5‑LO, COX‑2, IE and pp65 transcripts and proteins. HCMV IE and pp65 proteins were detected in ~90% of the CRC cases tested; this was correlated with COX‑2, 5‑LO and KI‑67 expression, but not with EGFR immunostaining, TP53 and KRAS mutations or MSI status. In vitro, HCMV infection upregulated 5‑LO and COX‑2 transcript and proteins in both Caco‑2 and LS‑174T cells and enhanced cell proliferation as determined by MTT assay. Treatment with GCV and CCX significantly decreased the transcript levels of COX‑2, 5‑LO, HCMV IE and pp65 in infected cells. HCMV was widely expressed in CRC and may promote inflammation and serve as a potential new target for CRC therapy.
Collapse
Affiliation(s)
- Mattia Russel Pantalone
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, 17164 Stockholm, Sweden
- Center for Advanced Studies and Technology, G. d'Annunzio University, I-66100 Chieti, Italy
| | - Nerea Martin Almazan
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Stockholm, Sweden
- Department of Laboratory Medicine, Unit of Microbial Pathogenesis, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Rossano Lattanzio
- Center for Advanced Studies and Technology, G. d'Annunzio University, I-66100 Chieti, Italy
- Department of Innovative Technologies in Medicine & Dentistry, G. d'Annunzio University, I-66100 Chieti, Italy
| | - Chato Taher
- Department of Basic Sciences, Hawler Medical University, Erbil 44001, Iraq
| | - Simone De Fabritiis
- Center for Advanced Studies and Technology, G. d'Annunzio University, I-66100 Chieti, Italy
- Department of Innovative Technologies in Medicine & Dentistry, G. d'Annunzio University, I-66100 Chieti, Italy
| | - Silvia Valentinuzzi
- Center for Advanced Studies and Technology, G. d'Annunzio University, I-66100 Chieti, Italy
- Department of Pharmacy, G. d'Annunzio University of Chieti-Pescara, I-66100 Chieti, Italy
| | - Faraz Bishehsari
- Division of Digestive Diseases, Rush Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, IL 60612, USA
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 14114, Iran
| | - Mahboobeh Mahdavinia
- Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran 14114, Iran
- Department of Internal Medicine, Division of Allergy and Immunology, Rush University Medical Center, Chicago, IL 60612, USA
| | - Fabio Verginelli
- Center for Advanced Studies and Technology, G. d'Annunzio University, I-66100 Chieti, Italy
- Department of Pharmacy, G. d'Annunzio University of Chieti-Pescara, I-66100 Chieti, Italy
| | - Afsar Rahbar
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, 17164 Stockholm, Sweden
| | | | - Cecilia Söderberg-Naucler
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, 17164 Stockholm, Sweden
- MediCity Research Laboratory, University of Turku, FI-20014 Turku, Finland
- Institute of Biomedicine, University of Turku, FI-20014 Turku, Finland
| |
Collapse
|
4
|
Peredo-Harvey I, Bartek J, Ericsson C, Yaiw KC, Nistér M, Rahbar A, Söderberg-Naucler C. Higher Human Cytomegalovirus (HCMV) Specific IgG Antibody Levels in Plasma Samples from Patients with Metastatic Brain Tumors Are Associated with Longer Survival. Medicina (Kaunas) 2023; 59:1248. [PMID: 37512060 PMCID: PMC10384986 DOI: 10.3390/medicina59071248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/04/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023]
Abstract
Background: Human cytomegalovirus (HCMV) has been detected in tissue samples from patients with glioblastoma but little is known about the systemic immunological response to HCMV in these patients. Objectives: To investigate the presence and clinical significance of HCMV antibodies levels in plasma samples obtained from patients with brain tumors. Materials and Methods: HCMV-specific IgG and IgM antibody levels were determined in 59 plasma samples collected from brain tumor patients included in a prospective study and in 114 healthy individuals. We examined if the levels of HCMV specific antibodies varied in patients with different brain tumor diagnoses compared to healthy individuals, and if antibody levels were predictive for survival time. Results: HCMV specific IgG antibodies were detected by ELISA in 80% and 89% of patients with GBM and astrocytoma grades II-III, respectively, in all samples (100%) from patients with secondary GBM and brain metastases, as well as in 80% of healthy donors (n = 114). All plasma samples were negative for HCMV-IgM. Patients with brain metastases who had higher plasma HCMV-IgG titers had longer survival times (p = 0.03). Conclusions: HCMV specific IgG titers were higher among all brain tumor patient groups compared with healthy donors, except for patients with secondary GBM. Higher HCMV specific IgG levels in patients with brain metastases but not in patients with primary brain tumors were associated with prolonged survival time.
Collapse
Affiliation(s)
- Inti Peredo-Harvey
- Department of Neurosurgery, Karolinska University Hospital, SE-17176 Stockholm, Sweden
- Department of Medicine Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, SE-17164 Solna, Sweden
| | - Jiri Bartek
- Department of Neurosurgery, Karolinska University Hospital, SE-17176 Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Department of Neurosurgery, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | | | - Koon-Chu Yaiw
- Department of Medicine Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, SE-17164 Solna, Sweden
- Division of Neurology, Karolinska University Hospital, SE-17176 Stockholm, Sweden
| | - Monica Nistér
- Department of Oncology-Pathology, BioClinicum, Karolinska Institutet, SE-17164 Solna, Sweden
| | - Afsar Rahbar
- Department of Medicine Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, SE-17164 Solna, Sweden
- Division of Neurology, Karolinska University Hospital, SE-17176 Stockholm, Sweden
| | - Cecilia Söderberg-Naucler
- Department of Medicine Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, SE-17164 Solna, Sweden
- Division of Neurology, Karolinska University Hospital, SE-17176 Stockholm, Sweden
- Institute of Biomedicine, Infection and Immunology Unit, MediCity Research Laboratory, Turku University, FI-20014 Turku, Finland
| |
Collapse
|
5
|
Touma J, Pantalone MR, Rahbar A, Liu Y, Vetvik K, Sauer T, Söderberg-Naucler C, Geisler J. Human Cytomegalovirus Protein Expression Is Correlated with Shorter Overall Survival in Breast Cancer Patients: A Cohort Study. Viruses 2023; 15:v15030732. [PMID: 36992442 PMCID: PMC10054688 DOI: 10.3390/v15030732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/04/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
Background: Human cytomegalovirus (HCMV) is increasingly suggested to be involved in human carcinogenesis and onco-modulation due to its ability to contribute to all hallmarks of cancer. Growing evidence demonstrates a link between HCMV infection and various malignancies, including breast cancer, which incidence and mortality are still on the rise. The etiology of breast cancer remains mostly unclear, leaving 80% of breast cancer cases considered to be sporadic. Identifying novel risk- and prognostic factors for improved breast cancer treatment and increased survival rates, were the objectives of this study. Methods: Automated immunohistochemical staining results for HCMV proteins in 109 breast tumors and lymph node metastasis were correlated with clinical follow-up data (>10 years). Statistical analyses for median Overall Survival (OS) were performed. Results: Survival analyses revealed shorter median OS for patients with HCMV-IE positive tumors of 118.4 months compared to 202.4 months for HCMV-IE negative tumors. A higher number of HCMV-LA positive cells in the tumors was also associated with a shorter OS in patients (146.2 months vs. 151.5 months). Conclusions: Our findings suggest a link between HCMV-infections and breast cancer prognosis, which paves the way for potential novel clinical intervention and targeted therapy that may prolong the overall survival of selected patients with breast cancer.
Collapse
Affiliation(s)
- Joel Touma
- Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
- Department of Oncology, Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
| | - Mattia Russel Pantalone
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Solna, Sweden
- Department of Neurology, Karolinska University Hospital, 17177 Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Solna, Sweden
- Department of Neurology, Karolinska University Hospital, 17177 Stockholm, Sweden
| | - Yan Liu
- Department of Clinical Molecular Biology, University of Oslo, 0315 Oslo, Norway
- Department of Clinical Molecular Biology (EpiGen), Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
| | - Katja Vetvik
- Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
- Department of Breast and Endocrine Surgery, Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
| | - Torill Sauer
- Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
- Department of Pathology, Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
| | - Cecilia Söderberg-Naucler
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Solna, Sweden
- Department of Neurology, Karolinska University Hospital, 17177 Stockholm, Sweden
- Institute of Biomedicine, Unit for Infection and Immunology, MediCity Research Laboratory, Turku University, 20520 Turku, Finland
- Correspondence: (C.S.-N.); (J.G.); Tel.: +46-8-5177-9816 (C.S.-N.); +47-9118-7447 (J.G.)
| | - Jürgen Geisler
- Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
- Department of Oncology, Akershus University Hospital (AHUS), 1478 Nordbyhagen, Norway
- Correspondence: (C.S.-N.); (J.G.); Tel.: +46-8-5177-9816 (C.S.-N.); +47-9118-7447 (J.G.)
| |
Collapse
|
6
|
Salehi H, Moienian E, Rahbar A, Salehi S, Momeni M. Prevalence of Thrombocytopenia in the First Week After Burn Injury and Its Relationship With Burn Severity in Shahid Motahari Hospital Over a Period of 6 Months in 2017. Ann Burns Fire Disasters 2023; 36:29-39. [PMID: 38680903 PMCID: PMC11044712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/06/2021] [Indexed: 05/01/2024]
Abstract
A platelet count of less than 150,000 per microliter of blood is called thrombocytopenia. Platelet count monitoring is essential in the care of burn patients. The aim of this study was to evaluate platelet count in groups of patients with different percentage of burns on the body surface and its relationship with the severity of burns and mortality. This retrospective descriptive cross-sectional study was performed on patients admitted to Shahid Motahari Hospital over a period of six months. The study was conducted on burn patients who were admitted to the hospital on the first day after injury. Patients were divided into two groups of with or without thrombocytopenia in the first week. Demographic information and treatment information about the patients were recorded. SPSS V.26 software was used for the statistical analysis of data. In this study, the prevalence of thrombocytopenia in the first week after burns was 36%. The variables of age, sex, duration of hospitalization, burn agent, percentage of burns and use of silver sulfadiazine ointment were significantly different in the two groups of patients. The group without thrombocytopenia had a mortality rate of 5.1%, while the group with thrombocytopenia had a rate of 32.2%. Based on the results of this study, thrombocytopenia is significantly associated with mortality in burn patients. Furthermore, the results of this study indicate that age, sex, burn agent, percentage of burns, and the use of silver sulfadiazine ointment have a clear impact on the thrombocytopenic status of patients.
Collapse
Affiliation(s)
- H. Salehi
- Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - E. Moienian
- Iran University of Medical Sciences, Tehran, Iran
| | - A. Rahbar
- International Baccalaureate Student, Ontario, Canada
| | - S.A.H. Salehi
- Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M. Momeni
- Shahid Motahari Burns Hospital, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Bagheri T, Fatemi M, Abdollahi Far S, Rahbar A, Asgari M, Hoveidamanesh S, Momeni M. Investigation Of Common Burn Mechanisms, And Training And Safety Conditions In The Workplace. Ann Burns Fire Disasters 2022; 35:179-185. [PMID: 37016594 PMCID: PMC10067145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 08/15/2021] [Indexed: 06/19/2023]
Abstract
Workplace burn injuries are associated with significant physical, psychological, and social challenges. This study was designed and conducted to investigate the common burn mechanisms, and training and safety conditions in the workplace. The study is a cross-sectional study that was performed on patients admitted to Shahid Motahari University Hospital in Tehran from August 2016 to October 2017. Samples consisted of patients who suffered burns at work and were able to answer research questions. Data were recorded in tablets by electronic patient registration forms.Of the total burn patients under study, 14.28% were injured in the workplace. The burns were mainly thermal, followed by electrical, chemical, and inhalation burns. 38.2% of patients were not trained for safety measures at work and 27.8% of patients were not given personal protective equipment. 39.0% of workspaces were not safe against the risk of burns. Failure of devices and equipment was the cause of 28.8% of the accidents. Electrical damage, the ignition of flammable materials, gas explosions and contact with molten materials were the most common mechanisms in the occurrence of workplace burns. The lack of awareness by workers, lack of attention to the use of safety equipment at work, and the presence of damaged equipment are the main causes of burn accidents in the workplace. Therefore, the implementation of codified safety training and monitoring the observance of safety measures by workers and employers are recommended.
Collapse
Affiliation(s)
- T. Bagheri
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - M.J. Fatemi
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - S. Abdollahi Far
- Disaster Medicine Management, Iranian Red Crescent Society, Tehran, Iran
| | - A. Rahbar
- International Baccalaureate Student, Ontario, Canada
| | - M. Asgari
- School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S. Hoveidamanesh
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - M. Momeni
- Shahid Motahari Hospital, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Landázuri N, Gorwood J, Terelius Y, Öberg F, Yaiw KC, Rahbar A, Söderberg-Nauclér C. The Endothelin Receptor Antagonist Macitentan Inhibits Human Cytomegalovirus Infection. Cells 2021; 10:cells10113072. [PMID: 34831300 PMCID: PMC8619441 DOI: 10.3390/cells10113072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/15/2021] [Accepted: 10/23/2021] [Indexed: 12/27/2022] Open
Abstract
Human cytomegalovirus (HCMV) infection is an important cause of morbidity and mortality in immunocompromised patients and a major etiological factor for congenital birth defects in newborns. Ganciclovir and its pro-drug valganciclovir are the preferred drugs in use today for prophylaxis and treatment of viremic patients. Due to long treatment times, patients are at risk for developing viral resistance to ganciclovir and to other drugs with a similar mechanism of action. We earlier found that the endothelin receptor B (ETBR) is upregulated during HCMV infection and that it plays an important role in the life cycle of this virus. Here, we tested the hypothesis that ETBR blockade could be used in the treatment of HCMV infection. As HCMV infection is specific to humans, we tested our hypothesis in human cell types that are relevant for HCMV pathogenesis; i.e., endothelial cells, epithelial cells and fibroblasts. We infected these cells with HCMV and treated them with the ETBR specific antagonist BQ788 or ETR antagonists that are approved by the FDA for treatment of pulmonary hypertension; macitentan, its metabolite ACT-132577, bosentan and ambrisentan, and as an anti-viral control, we used ganciclovir or letermovir. At concentrations expected to be relevant in vivo, macitentan, ACT-132577 and BQ788 effectively inhibited productive infection of HCMV. Of importance, macitentan also inhibited productive infection of a ganciclovir-resistant HCMV isolate. Our results suggest that binding or signaling through ETBR is crucial for viral replication, and that selected ETBR blockers inhibit HCMV infection.
Collapse
Affiliation(s)
- Natalia Landázuri
- Microbial Pathogenesis Unit, Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; (N.L.); (J.G.); (K.C.Y.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Jennifer Gorwood
- Microbial Pathogenesis Unit, Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; (N.L.); (J.G.); (K.C.Y.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Ylva Terelius
- Medivir AB, SE-141 22 Huddinge, Sweden; (Y.T.); (F.Ö.)
| | - Fredrik Öberg
- Medivir AB, SE-141 22 Huddinge, Sweden; (Y.T.); (F.Ö.)
| | - Koon Chu Yaiw
- Microbial Pathogenesis Unit, Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; (N.L.); (J.G.); (K.C.Y.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Afsar Rahbar
- Microbial Pathogenesis Unit, Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; (N.L.); (J.G.); (K.C.Y.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Microbial Pathogenesis Unit, Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; (N.L.); (J.G.); (K.C.Y.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
- Correspondence:
| |
Collapse
|
9
|
Peredo-Harvey I, Rahbar A, Söderberg-Nauclér C. Presence of the Human Cytomegalovirus in Glioblastomas-A Systematic Review. Cancers (Basel) 2021; 13:cancers13205051. [PMID: 34680198 PMCID: PMC8533734 DOI: 10.3390/cancers13205051] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 12/29/2022] Open
Abstract
Simple Summary Whether the human cytomegalovirus (HCMV) is present in samples obtained from patients with glioblastoma (GBM) has been a matter under debate during the last two decades. Many investigators have demonstrated the presence of HCMV proteins and nucleic acids in GBM tumors, while some have not been able to detect it. It is important to evaluate current data and resolve these issues to clarify the possible role of the HCMV in GBM tumorigenesis and if this virus can serve as a potential target of therapy for these patients. In the present systematic review, we aim to review published research studies with a focus to identify differences and similarities in methods used for the detection of the HCMV in GBM samples found to be positive or negative for HCMV. Our data suggest that the HCMV is highly prevalent in glioblastomas and that optimized immunohistochemistry techniques are required to detect it. Abstract Glioblastoma is a malignant brain tumor with a dismal prognosis. The standard treatment has not changed in the past 15 years as clinical trials of new treatment protocols have failed. A high prevalence of the human cytomegalovirus (HCMV) in glioblastomas was first reported in 2002. The virus was found only in the tumor and not in the surrounding healthy brain tissue. Many groups have confirmed the presence of the HCMV in glioblastomas, but others could not. To resolve this discrepancy, we systematically reviewed 645 articles identified in different databases. Of these, 81 studies included results from 247 analyses of 9444 clinical samples (7024 tumor samples and 2420 blood samples) by different techniques, and 81 articles included 191 studies that identified the HCMV in 2529 tumor samples (36% of all tumor samples). HCMV proteins were often detected, whereas HCMV nucleic acids were not reliably detected by PCR methods. Optimized immunohistochemical techniques identified the virus in 1391 (84,2%) of 1653 samples. These data suggest that the HCMV is highly prevalent in glioblastomas and that optimized immunohistochemistry techniques are required to detect it.
Collapse
Affiliation(s)
- Inti Peredo-Harvey
- Department of Neurosurgery, Karolinska University Hospital, 171 76 Stockholm, Sweden;
- Department of Medicine, Solna, BioClinicum, Karolinska Institutet, 171 64 Stockholm, Sweden;
| | - Afsar Rahbar
- Department of Medicine, Solna, BioClinicum, Karolinska Institutet, 171 64 Stockholm, Sweden;
- Department of Neurology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Solna, BioClinicum, Karolinska Institutet, 171 64 Stockholm, Sweden;
- Department of Neurology, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Correspondence:
| |
Collapse
|
10
|
Rahbar A, David J, Promlap J, Hara J, Zitek T, Lee P. 178 Safety Comparison of Antibiotics Administered via Intravenous Push versus Intravenous Piggyback to Adult Patients in the Emergency Department. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
11
|
Rahbar A, Pantalone MR, Religa P, Rådestad AF, Söderberg-Naucler C. Evidence of human cytomegalovirus infection and expression of 5-lipoxygenase in borderline ovarian tumors. J Med Virol 2021; 93:4023-4027. [PMID: 33174621 DOI: 10.1002/jmv.26664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/05/2020] [Accepted: 11/07/2020] [Indexed: 11/10/2022]
Abstract
Borderline ovarian tumors (BOTs) belong to a group of tumors that are distinctly different from ovarian carcinomas. There is an increased risk of BOTs in patients with pelvic inflammatory disease. Human cytomegalovirus (HCMV) has been detected in ovarian cancer tissue specimens. This virus favors the inflammatory milieu by inducing expression of the potent inflammatory factor 5-lipoxygenase (5LO), which stimulates cellular viability, cellular proliferation and activates antiapoptotic signaling pathways. Here, we aimed to examine presence of HCMV and 5LO in BOTs. Expression levels of HCMV proteins (IE and pp65) and 5LO were examined in paraffin embedded BOT tissue sections by immunohistochemistry staining and HCMV immunoglobulin M and immunoglobulin G (IgG) levels were determined by serology in blood samples obtained from 15 patients with BOTs identified in a prospective study at Karolinska University Hospital. Extensive expression of HCMV-IE, pp65, and 5LO were detected in 87%, 40%, and 90% of examined BOT tissue sections, respectively. HCMV-IgG prevalence and antibody levels were significantly higher in patients with BOT compared to age matched healthy women (83.3% vs. 65,6%, respectively, p = .01). Whether HCMV can induce inflammation and affect the pathogenesis of BOTs should therefore be further investigated.
Collapse
Affiliation(s)
- Afsar Rahbar
- Microbial Pathogens Unit, Department of Medicine Solna, BioClinicum, Karolinska Institute, Stockholm, Sweden
- Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Mattia Russel Pantalone
- Microbial Pathogens Unit, Department of Medicine Solna, BioClinicum, Karolinska Institute, Stockholm, Sweden
- Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Piotr Religa
- Microbial Pathogens Unit, Department of Medicine Solna, BioClinicum, Karolinska Institute, Stockholm, Sweden
- Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
- Polish Academy of Sciences, Magdalenka, Poland
| | - Angelique Flöter Rådestad
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Hereditary Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Cecilia Söderberg-Naucler
- Microbial Pathogens Unit, Department of Medicine Solna, BioClinicum, Karolinska Institute, Stockholm, Sweden
- Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
12
|
Yaiw KC, Mohammad AA, Taher C, Cui HL, Costa H, Kostopoulou ON, Jung M, Assinger A, Wilhelmi V, Yang J, Strååt K, Rahbar A, Pernow J, Söderberg-Nauclér C. Human Cytomegalovirus Reduces Endothelin-1 Expression in Both Endothelial and Vascular Smooth Muscle Cells. Microorganisms 2021; 9:microorganisms9061137. [PMID: 34070407 PMCID: PMC8229579 DOI: 10.3390/microorganisms9061137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022] Open
Abstract
Human cytomegalovirus (HCMV) is an opportunistic pathogen that has been implicated in the pathogenesis of atherosclerosis. Endothelin-1 (ET-1), a potent vasoconstrictive peptide, is overexpressed and strongly associated with many vasculopathies. The main objective of this study was to investigate whether HCMV could affect ET-1 production. As such, both endothelial and smooth muscle cells, two primary cell types involved in the pathogenesis of atherosclerosis, were infected with HCMV in vitro and ET-1 mRNA and proteins were assessed by quantitative PCR assay, immunofluorescence staining and ELISA. HCMV infection significantly decreased ET-1 mRNA and secreted bioactive ET-1 levels from both cell types and promoted accumulation of the ET-1 precursor protein in infected endothelial cells. This was associated with inhibition of expression of the endothelin converting enzyme-1 (ECE-1), which cleaves the ET-1 precursor protein to mature ET-1. Ganciclovir treatment did not prevent the virus suppressive effects on ET-1 expression. Consistent with this observation we identified that the IE2-p86 protein predominantly modulated ET-1 expression. Whether the pronounced effects of HCMV in reducing ET-1 expression in vitro may lead to consequences for regulation of the vascular tone in vivo remains to be proven.
Collapse
Affiliation(s)
- Koon-Chu Yaiw
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
- Correspondence: (K.-C.Y.); (C.S.-N.)
| | - Abdul-Aleem Mohammad
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
| | - Chato Taher
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
| | - Huanhuan Leah Cui
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
| | - Helena Costa
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
| | - Ourania N. Kostopoulou
- Department of Oncology and Pathology, Karolinska Institutet, SE 171 64 Stockholm, Sweden;
| | - Masany Jung
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
| | - Alice Assinger
- Institute of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, A-1090 Vienna, Austria;
| | - Vanessa Wilhelmi
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
| | - Jiangning Yang
- Department of Molecular Medicine and Surgery, Karolinska Institutet and University Hospital Solna, SE 171 64 Stockholm, Sweden; (J.Y.); (J.P.)
| | - Klas Strååt
- Department of Medicine, Division of Hematology, BioClinicum and Centre for Molecular Medicine, Karolinska University, Hospital Solna and Karolinska Institutet, SE 171 64 Stockholm, Sweden;
| | - Afsar Rahbar
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
| | - John Pernow
- Department of Molecular Medicine and Surgery, Karolinska Institutet and University Hospital Solna, SE 171 64 Stockholm, Sweden; (J.Y.); (J.P.)
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, SE 171 64 Stockholm, Sweden; (A.-A.M.); (C.T.); (H.L.C.); (H.C.); (M.J.); (V.W.); (A.R.)
- Division of Neurology, Karolinska University Hospital, SE 171 64 Stockholm, Sweden
- Correspondence: (K.-C.Y.); (C.S.-N.)
| |
Collapse
|
13
|
Wahlin B, Fasth AE, Karp K, Lejon K, Malmström V, Rahbar A, Wållberg-Jonsson S, Södergren A. Atherosclerosis in rheumatoid arthritis: associations between anti-cytomegalovirus IgG antibodies, CD4+CD28null T-cells, CD8+CD28null T-cells and intima-media thickness. Clin Exp Rheumatol 2021. [DOI: 10.55563/clinexprheumatol/gs3o43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Bengt Wahlin
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Sweden.
| | - Andreas E.R. Fasth
- Rheumatology Division, Department of Medicine at Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Kjell Karp
- Department of Surgical and Perioperative Sciences/Clinical physiology, Umeå University, Sweden
| | - Kristina Lejon
- Department of Clinical Microbiology, Infection and Immunology, Umeå University, Sweden
| | - Vivianne Malmström
- Rheumatology Division, Department of Medicine at Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Afsar Rahbar
- Division of Microbial Pathogens, BioClinicum, Department of Medicine at Solna, Karolinska Universtity Hospital, Karolinska Institutet, Stockholm, Sweden
| | | | - Anna Södergren
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, and Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Sweden
| |
Collapse
|
14
|
Teng J, Elwin A, Omarsdottir S, Aquilano G, Vanpee M, Nemeth A, Rahbar A, Bohlin K, Fischler B, Söderberg-Nauclér C. High Rate of Cytomegalovirus Detection in Cholestatic Preterm Infants. Front Pediatr 2021; 9:754941. [PMID: 34900864 PMCID: PMC8652112 DOI: 10.3389/fped.2021.754941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: To evaluate the prevalence of cytomegalovirus (CMV) infection in preterm infants with cholestasis. Study design: Preterm infants (<37 weeks gestational age) with cholestasis were tested for CMV DNA using Taqman PCR in blood cells from sedimented whole blood, plasma, and urine. Infants were regarded as positive for CMV if any sample was tested positive. Their mothers were tested for CMV serostatus simultaneously. A control group of non-cholestatic preterm infants, and their mothers, were tested at a similar age. Results: A total of 69 preterm infants with a median gestational age of 26 weeks and 5 days were included, 45 cholestatic and 24 non-cholestatic. Of the cholestatic infants, 31/45 (69%) were CMV positive vs. 3/24 (13%) of the non-cholestatic infants (p < 0.001). Cholestatic infants were equally preterm as the non-cholestatic ones, but were more severely ill. After adjusting for the risk factors necrotizing enterocolitis, prolonged parenteral nutrition, and gestational age, being CMV positive remained significantly associated with cholestasis in a multivariable logistic regression model. Characteristics of CMV-positive and -negative cholestatic infants showed differences only for necrotizing enterocolitis, occurring in 55% (17/31) of CMV positive vs. 21% (3/14) of CMV negative (p = 0.054), and mortality. Eight cholestatic CMV-positive infants died (26%) vs. none of the CMV-negative infants (p = 0.044). Conclusions: CMV DNA was detected in two out of three cholestatic preterm infants, by far more often than in the non-cholestatic control group. Cholestasis with simultaneous detection of CMV DNA may be associated with increased mortality.
Collapse
Affiliation(s)
- Jonas Teng
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Södertälje Hospital, Stockholm, Sweden
| | - Anne Elwin
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| | - Soley Omarsdottir
- Department of Medicine, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Aquilano
- Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| | - Mireille Vanpee
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Karolinska University Hospital, Stockholm, Sweden
| | - Antal Nemeth
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Kajsa Bohlin
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden
| | - Björn Fischler
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Karolinska University Hospital, Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
15
|
Xu X, Estekizadeh A, Davoudi B, Varani S, Malmström V, Rahbar A, Söderberg-Nauclér C. Detection of human cytomegalovirus in synovial neutrophils obtained from patients with rheumatoid arthritis. Scand J Rheumatol 2020; 50:183-188. [PMID: 33243069 DOI: 10.1080/03009742.2020.1825798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: To examine whether signs of an active human cytomegalovirus (HCMV) infection are present in affected joints of patients with rheumatoid arthritis (RA).Method: Polymorphonuclear leucocytes (PMNLs) were obtained from synovial fluid (SF) of 17 RA patients and were analysed for HCMV-pp65 and HCMV-immediate early (IE) proteins using the antigenemia assay. Peripheral blood (PB) and SF obtained from these 17 patients and from 17 additional RA patients (n = 34) were tested for HCMV-IE and pp150 DNA with Taqman polymerase chain reaction. Plasma samples from the patients were analysed for HCMV-immunoglobulin M (IgM) and immunoglobulin G (IgG) by enzyme-linked immunosorbent assay and compared to 71 healthy gender-matched blood donors.Results: HCMV-pp65 protein was detected in 65% of synovial PMNL samples, but in only 18% of PMNLs from PB. In contrast, HCMV IE protein was not found in any of the analysed PMNL samples. On the DNA level, HCMV-IE and pp150 DNA was detected in SF of 13/32 (41%) and 14/23 (61%) of RA patients, respectively. HCMV-IE and pp150 DNA was also found in 24/33 (73%) and in 16/24 (67%) of PB samples obtained from RA patients, respectively. HCMV IgG seroprevalence was 76% in RA patients as well as in healthy controls, while only one RA patient was positive for specific IgM.Conclusions: HCMV pp65 antigen was found in PMNLs from SF of RA patients, indicating an active infection in the affected joint. Future studies are needed to determine whether HCMV infection can aggravate the inflammatory process in these patients.
Collapse
Affiliation(s)
- X Xu
- Department of Medicine, Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, Stockholm, Sweden.,Division of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.,Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - A Estekizadeh
- Department of Laboratory Medicine, Virology Division, University of Washington, Seattle, USA
| | - B Davoudi
- Department of Medicine, Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - S Varani
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - V Malmström
- Division of Rheumatology, Department of Medicine, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden
| | - A Rahbar
- Department of Medicine, Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - C Söderberg-Nauclér
- Department of Medicine, Solna, Microbial Pathogenesis Unit, BioClinicum, Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
16
|
Stragliotto G, Pantalone MR, Rahbar A, Söderberg-Nauclér C. Valganciclovir as Add-On to Standard Therapy in Secondary Glioblastoma. Microorganisms 2020; 8:microorganisms8101471. [PMID: 32987955 PMCID: PMC7599902 DOI: 10.3390/microorganisms8101471] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/28/2022] Open
Abstract
Patients with glioblastoma have a very poor prognosis despite aggressive therapeutic strategies. Cytomegalovirus has been detected in >90% of glioblastoma tumors. This virus can affect tumor progression and may represent a novel glioblastoma therapy target. We report, here, a retrospective survival analysis of patients with secondary glioblastoma who were treated with the anti-viral drug valganciclovir at Karolinska University Hospital in Stockholm. We performed survival analyses of eight patients with secondary glioblastoma who were treated with a standard dose of valganciclovir as an add-on to second-line therapy after their disease progression to glioblastoma. Thirty-six patients with secondary glioblastoma admitted during the same time period who received similar treatment and care served as contemporary controls. The patients treated with valganciclovir showed an increased median overall survival after progression to glioblastoma compared with controls (19.1 versus 12.7 months, p = 0.0072). This result indicates a potential positive effect of valganciclovir in secondary glioblastoma, which is in agreement with our previous observation that valganciclovir treatment improves the outcomes of patients with newly diagnosed glioblastoma. Larger randomized studies are warranted to prove this hypothesis.
Collapse
Affiliation(s)
- Giuseppe Stragliotto
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Stockholm, Sweden; (G.S.); (A.R.)
- Division of Neurology, Karolinska University Hospital, 17177 Stockholm, Sweden
| | - Mattia Russel Pantalone
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Stockholm, Sweden; (G.S.); (A.R.)
- Division of Neurology, Karolinska University Hospital, 17177 Stockholm, Sweden
- Correspondence: (M.R.P.); (C.S.-N.)
| | - Afsar Rahbar
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Stockholm, Sweden; (G.S.); (A.R.)
- Division of Neurology, Karolinska University Hospital, 17177 Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, 17164 Stockholm, Sweden; (G.S.); (A.R.)
- Division of Neurology, Karolinska University Hospital, 17177 Stockholm, Sweden
- Correspondence: (M.R.P.); (C.S.-N.)
| |
Collapse
|
17
|
Stragliotto G, Pantalone MR, Rahbar A, Bartek J, Söderberg-Naucler C. Valganciclovir as Add-on to Standard Therapy in Glioblastoma Patients. Clin Cancer Res 2020; 26:4031-4039. [PMID: 32423968 DOI: 10.1158/1078-0432.ccr-20-0369] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/31/2020] [Accepted: 05/14/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Several groups have reported a prevalence of human cytomegalovirus (CMV) in glioblastoma close to 100%. Previously, we reported that treatment with the antiviral drug valganciclovir as an add-on to standard therapy significantly prolonged survival in 50 patients with glioblastoma. Here, we present an updated retrospective analysis that includes an additional 52 patients. EXPERIMENTAL DESIGN From December 2006 to November 2019, 102 patients with newly diagnosed glioblastoma received valganciclovir as an add-on to standard therapy. No additional toxicity was observed. Contemporary controls were 231 patients with glioblastoma who received similar baseline therapy. RESULTS Patients with newly diagnosed glioblastoma receiving valganciclovir had longer median overall survival (OS 24.1 vs. 13.3 months, P < 0.0001) and a 2-year survival rate (49.8% vs. 17.3%) than controls. Median time-to-tumor progression was also longer than in controls; 9.9 (0.7-67.5 months) versus 7.3 (1.2-49 months), P = 0.0003. Valganciclovir improved survival in patients with radical or partial resection and an unmethylated or methylated MGMT promoter gene. CONCLUSIONS Valganciclovir prolonged median OS of patients with newly diagnosed glioblastoma (with methylated or unmethylated MGMT promoter gene) and was safe to use.
Collapse
Affiliation(s)
- Giuseppe Stragliotto
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Mattia Russel Pantalone
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, Stockholm, Sweden.,Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Jiri Bartek
- Genome Integrity Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Medical Biochemistry and Biophysics, Division of Genome Biology, Science for Life Laboratory, Karolinska Institute, Stockholm, Sweden
| | - Cecilia Söderberg-Naucler
- Department of Medicine, Solna, Microbial Pathogenesis Unit, Karolinska Institutet, Stockholm, Sweden. .,Division of Neurology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
18
|
Rahbar A, AlKharusi A, Costa H, Pantalone MR, Kostopoulou ON, Cui HL, Carlsson J, Rådestad AF, Söderberg-Naucler C, Norstedt G. Human Cytomegalovirus Infection Induces High Expression of Prolactin and Prolactin Receptors in Ovarian Cancer. Biology (Basel) 2020; 9:biology9030044. [PMID: 32121009 PMCID: PMC7150842 DOI: 10.3390/biology9030044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/07/2020] [Accepted: 02/09/2020] [Indexed: 11/30/2022]
Abstract
One of the potential biomarkers for ovarian cancer patients is high serum level of prolactin (PRL), which is a growth factor that may promote tumor cell growth. The prolactin receptor (PRLR) and human cytomegalovirus (HCMV) proteins are frequently detected in ovarian tumor tissue specimens, but the potential impact of HCMV infection on the PRL system have so far not been investigated. In this study, HCMV’s effects on PRL and PRLR expression were assessed in infected ovarian cancer cells (SKOV3) by PCR and Western blot techniques. The levels of both PRL and PRLR transcripts as well as the corresponding proteins were highly increased in HCMV-infected SKOV3 cells. Tissue specimens obtained from 10 patients with ovarian cancer demonstrated high expression of PRLR, HCMV-IE, and pp65 proteins. Extensive expression of PRLR was detected in all examined ovarian tumor tissue specimens except for one from a patient who had focal expression of PRLR and this patient was HCMV-negative in her tumor. In conclusion, PRL and PRLR were induced to high levels in HCMV-infected ovarian cancer cells and PRLR expression was extensively detected in HCMV-infected ovarian tissue specimens. Highly induced PRL and PRLR by HCMV infection may be of relevance for the oncomodulatory role of this virus in ovarian cancer.
Collapse
Affiliation(s)
- Afsar Rahbar
- Department of Medicine, Solna, Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 171 64 Solna, Sweden; (H.C.); (M.R.P.); (O.N.K.); (H.L.C.); (C.S.-N.)
- Division of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Correspondence: (A.R.); (A.K.)
| | - Amira AlKharusi
- Department of Physiology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 135, Oman
- Correspondence: (A.R.); (A.K.)
| | - Helena Costa
- Department of Medicine, Solna, Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 171 64 Solna, Sweden; (H.C.); (M.R.P.); (O.N.K.); (H.L.C.); (C.S.-N.)
- Division of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
| | - Mattia Russel Pantalone
- Department of Medicine, Solna, Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 171 64 Solna, Sweden; (H.C.); (M.R.P.); (O.N.K.); (H.L.C.); (C.S.-N.)
- Division of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
| | - Ourania N. Kostopoulou
- Department of Medicine, Solna, Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 171 64 Solna, Sweden; (H.C.); (M.R.P.); (O.N.K.); (H.L.C.); (C.S.-N.)
- Division of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
| | - Huanhuan L. Cui
- Department of Medicine, Solna, Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 171 64 Solna, Sweden; (H.C.); (M.R.P.); (O.N.K.); (H.L.C.); (C.S.-N.)
- Division of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
| | - Joseph Carlsson
- Division of Pathology and Cytology, Karolinska University Hospital, 171 77 Stockholm, Sweden;
- Department of Oncology and Pathology, BioClinicum, Karolinska Institutet, 171 64 Solna, Sweden
| | - Angelique Flöter Rådestad
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden;
- Division of Obstetrics and Gynecology, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Cecilia Söderberg-Naucler
- Department of Medicine, Solna, Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 171 64 Solna, Sweden; (H.C.); (M.R.P.); (O.N.K.); (H.L.C.); (C.S.-N.)
- Division of Neurosurgery, Karolinska University Hospital, 171 64 Stockholm, Sweden
| | - Gunnar Norstedt
- Department of Biochemistry, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 135, Oman;
| |
Collapse
|
19
|
Bartek J, Merchut-Maya JM, Maya-Mendoza A, Fornara O, Rahbar A, Bröchner CB, Sehested A, Söderberg-Nauclér C, Bartek J, Bartkova J. Cancer cell stemness, responses to experimental genotoxic treatments, cytomegalovirus protein expression and DNA replication stress in pediatric medulloblastomas. Cell Cycle 2020; 19:727-741. [PMID: 32054408 DOI: 10.1080/15384101.2020.1728025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Despite recent progress in research on brain tumors, including identification of cancer stem-like cells (CSCs), little is known about the interplay of stemness with the commonly observed infection by the human cytomegalovirus (HCMV) and the widespread features of replication stress in these malignancies. To shed more light on these outstanding issues, here we combine immunohistochemical analysis of archival clinical specimens from a cohort of 25 human pediatric medulloblastomas, complemented by functional experiments and analytical approaches to examine three medulloblastoma cell lines. In the clinical samples, we find consistent, yet individually variable subsets of CSCs expressing the stem-cell markers CD133 and CD15, and a candidate marker VEGFR2, across the spectrum of endogenous DNA damage (γH2AX), expression of HCMV immediate early and late proteins, proliferation rate (Ki67) or molecular class of MB. Contrary to MB cell lines DAOY and D324, the D283 cells showed pronounced phenotypic features of stemness, associated with enhanced endogenous DNA damage, exceptionally high susceptibility to infection with HCMV, unorthodox signaling pathway response to ionizing radiation and hyperactive response to hydroxyurea-induced replication stress. Notably, single-molecule DNA fiber analysis revealed aberrantly slow replication fork progression, pronounced fork asymmetry and inability to timely recover from drug-induced fork stalling in stem-like D283 cells, all hallmarks of pronounced chronic replication stress and propensity to genomic instability. These findings provide insights into human medulloblastoma stemness phenotypes, with various susceptibilities to infection by HCMV and impact on replication fork (mal)function, with implications for better understanding pathogenesis and responses to treatment in pediatric brain malignancies.Abbreviations: CSC: cancer stem-like cells; FBS: fetal bovine serum; HCMV: human cytomegalovirus; MB: medulloblastoma; MBSC: medulloblastoma stem cells; MOI: multiplicity of infection; PBS: phosphate-buffered saline; RPA: replication protein A; RS: replication stress; SHH: sonic hedgehog; VEGFR2: vascular endothelia growth factor receptor 2.
Collapse
Affiliation(s)
- Jiri Bartek
- Department of Medicine, Unit of Microbial Pathogenesis, Karolinska Institutet, Stockholm, Sweden.,Genome Integrity Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | | | - Olesja Fornara
- Department of Medicine, Unit of Microbial Pathogenesis, Karolinska Institutet, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Unit of Microbial Pathogenesis, Karolinska Institutet, Stockholm, Sweden
| | | | - Astrid Sehested
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Unit of Microbial Pathogenesis, Karolinska Institutet, Stockholm, Sweden.,Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| | - Jiri Bartek
- Genome Integrity Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Medical Biochemistry and Biophysics, Division of Genome Biology, Science for Life Laboratory, Karolinska Institute, Stockholm, Sweden
| | - Jirina Bartkova
- Genome Integrity Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Medical Biochemistry and Biophysics, Division of Genome Biology, Science for Life Laboratory, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
20
|
Geisler J, Touma J, Rahbar A, Söderberg-Nauclér C, Vetvik K. A Review of the Potential Role of Human Cytomegalovirus (HCMV) Infections in Breast Cancer Carcinogenesis and Abnormal Immunity. Cancers (Basel) 2019; 11:cancers11121842. [PMID: 31766600 PMCID: PMC6966479 DOI: 10.3390/cancers11121842] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 12/13/2022] Open
Abstract
Previously recognized classical human onco-viruses can regulate complex neoplastic events, and are estimated to play a role during carcinogenesis in 15-20% of cancer cases. Although the DNA and gene products of several viruses have been found in breast tumors, none of the classical onco-viruses have definitely been linked to the initiation of breast cancer. However, recent evidence shows that human cytomegalovirus (HCMV) gene products are found in >90% of tumors and metastases of breast cancers, and their increased expression can be correlated to a more aggressive breast cancer phenotype. Supporting the active role of HCMV in breast cancer, a specific HCMV strain, HCMV-DB, was recently shown to exert oncogenic transformational activity in breast epithelial cells in vitro, and to give rise to fast-growing, triple-negative breast tumors when injected into immune deficient mice. The same observation holds true for clinical studies implying increased HCMV protein expression in triple negative breast cancer biopsies. In addition to functionally being able to hijack tumor-promoting cellular events, HCMV is known to exhibit a wide range of immunosuppressive effects, which can have radical impact on the tumor microenvironment. HCMV infected cells can avoid recognition and elimination by the immune system by orchestrating polarization of immunosuppressive type II macrophages, preventing antigen presentation, by expressing T cell inhibitory molecules, and possibly, by the induction of regulatory T (Treg) cell responses. These actions would be especially deleterious for the antigenic activation and proliferation of tumor specific CD8+ cytotoxic T lymphocytes (CTLs), whose effector functions have recently been targeted by successful, experimental immunotherapy protocols. The recognition of alternative causes and drivers of breast cancer is a pivotal research topic for the development of diagnostics and novel, effective preventive and therapeutic strategies targeting both tumor cells and their microenvironments.
Collapse
Affiliation(s)
- Jürgen Geisler
- Department of Oncology, Akershus University Hospital (AHUS), 1478 Lørenskog, Norway; (J.G.); (J.T.)
- Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital (AHUS), 1478 Lørenskog, Norway
| | - Joel Touma
- Department of Oncology, Akershus University Hospital (AHUS), 1478 Lørenskog, Norway; (J.G.); (J.T.)
- Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital (AHUS), 1478 Lørenskog, Norway
- Department of Breast and Endocrine Surgery at Akershus University Hospital (AHUS), 1478 Lørenskog, Norway
| | - Afsar Rahbar
- Department of Medicine, Division of Microbial Pathogenesis, Bioclinicum, Karolinska Institutet, 17176 Stockholm, Sweden; (A.R.); (C.S.-N.)
- Department of Neurosurgery, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Division of Microbial Pathogenesis, Bioclinicum, Karolinska Institutet, 17176 Stockholm, Sweden; (A.R.); (C.S.-N.)
- Department of Neurosurgery, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Katja Vetvik
- Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital (AHUS), 1478 Lørenskog, Norway
- Department of Breast and Endocrine Surgery at Akershus University Hospital (AHUS), 1478 Lørenskog, Norway
- Correspondence: ; Tel.: +47-95796638
| |
Collapse
|
21
|
van Senten JR, Bebelman MP, Fan TS, Heukers R, Bergkamp ND, van Gasselt P, Langemeijer EV, Slinger E, Lagerweij T, Rahbar A, Stigter-van Walsum M, Maussang D, Leurs R, Musters RJP, van Dongen GAMS, Söderberg-Nauclér C, Würdinger T, Siderius M, Smit MJ. The human cytomegalovirus-encoded G protein-coupled receptor UL33 exhibits oncomodulatory properties. J Biol Chem 2019; 294:16297-16308. [PMID: 31519750 DOI: 10.1074/jbc.ra119.007796] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 09/09/2019] [Indexed: 12/14/2022] Open
Abstract
Herpesviruses can rewire cellular signaling in host cells by expressing viral G protein-coupled receptors (GPCRs). These viral receptors exhibit homology to human chemokine receptors, but some display constitutive activity and promiscuous G protein coupling. Human cytomegalovirus (HCMV) has been detected in multiple cancers, including glioblastoma, and its genome encodes four GPCRs. One of these receptors, US28, is expressed in glioblastoma and possesses constitutive activity and oncomodulatory properties. UL33, another HCMV-encoded GPCR, also displays constitutive signaling via Gαq, Gαi, and Gαs proteins. However, little is known about the nature and functional effects of UL33-driven signaling. Here, we assessed UL33's signaling repertoire and oncomodulatory potential. UL33 activated multiple proliferative, angiogenic, and inflammatory signaling pathways in HEK293T and U251 glioblastoma cells. Notably, upon infection, UL33 contributed to HCMV-mediated STAT3 activation. Moreover, UL33 increased spheroid growth in vitro and accelerated tumor growth in different in vivo tumor models, including an orthotopic glioblastoma xenograft model. UL33-mediated signaling was similar to that stimulated by US28; however, UL33-induced tumor growth was delayed. Additionally, the spatiotemporal expression of the two receptors only partially overlapped in HCMV-infected glioblastoma cells. In conclusion, our results unveil that UL33 has broad signaling capacity and provide mechanistic insight into its functional effects. UL33, like US28, exhibits oncomodulatory properties, elicited via constitutive activation of multiple signaling pathways. UL33 and US28 might contribute to HCMV's oncomodulatory effects through complementing and converging cellular signaling, and hence UL33 may represent a promising drug target in HCMV-associated malignancies.
Collapse
Affiliation(s)
- Jeffrey R van Senten
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Maarten P Bebelman
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Tian Shu Fan
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Raimond Heukers
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Nick D Bergkamp
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Puck van Gasselt
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Ellen V Langemeijer
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Erik Slinger
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Tonny Lagerweij
- Neuro-oncology Research Group, Cancer Center Amsterdam, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Afsar Rahbar
- Department of Medicine Solna, Microbial Pathogenesis Research Unit and Department of Neurology, Center for Molecular Medicine, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Marijke Stigter-van Walsum
- Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - David Maussang
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Rob Leurs
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - René J P Musters
- Department of Physiology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Guus A M S van Dongen
- Department of Radiology and Nuclear Medicine, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Cecilia Söderberg-Nauclér
- Department of Medicine Solna, Microbial Pathogenesis Research Unit and Department of Neurology, Center for Molecular Medicine, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Thomas Würdinger
- Neuro-oncology Research Group, Cancer Center Amsterdam, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Marco Siderius
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| | - Martine J Smit
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, 1081 HZ Amsterdam, The Netherlands
| |
Collapse
|
22
|
Estekizadeh A, Landázuri N, Pantalone MR, Davoudi B, Hu LF, Nawaz I, Stragliotto G, Ekström TJ, Rahbar A. 5‑Azacytidine treatment results in nuclear exclusion of DNA methyltransferase‑1, as well as reduced proliferation and invasion in human cytomegalovirus‑infected glioblastoma cells. Oncol Rep 2019; 41:2927-2936. [PMID: 30896862 DOI: 10.3892/or.2019.7074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 02/07/2019] [Indexed: 11/06/2022] Open
Abstract
Glioblastoma (GBM) is the most aggressive form of brain tumor in adults, with a devastating outcome. Emerging evidence shows that human cytomegalovirus (HCMV) proteins and nucleic acids are present in GBM tissues. DNA methylation is important for the initiation and progression of cancer and is an established host response against invading nucleic acids. The expression and localization of DNA methyltransferase 1 (DNMT‑1) was assessed, and the effects of DNA methylation inhibitor 5‑azacytidine (5AZA) were analyzed in the context of the viral replication, proliferation and invasion capacities of HCMV‑infected GBM U343MG cells. In addition, the expression of various HCMV proteins and DNMT‑1 was examined in GBM tissue specimens obtained from five patients. DNMT‑1 was localized in the nucleus of cells expressing HCMV‑immediate early, whereas in cells expressing HCMV‑glycoprotein gB (gB), extranuclear/cytoplasmic localization was observed. This was also observed in vitro in U343MG cells. In addition, DNMT‑1 was localized to the extranuclear/cytoplasmic space of cells lining blood vessel walls within the GBM tumors. Treatment of infected U343MG cells with 5AZA did not affect viral replication, but reduced cell invasion and proliferation (P=0.05 and P<0.0001, respectively). However, 5AZA treatment of uninfected cells did not affect cell invasion (P=0.09), but proliferation was significantly reduced (P<0.0001). These findings may be of importance in further investigations aimed at using DNA methylation and viral inhibitors in GBM therapy.
Collapse
Affiliation(s)
- Atosa Estekizadeh
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Natalia Landázuri
- Department of Medicine (Solna), Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Mattia Russel Pantalone
- Department of Medicine (Solna), Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Belghis Davoudi
- Department of Medicine (Solna), Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Li-Fu Hu
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Imran Nawaz
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Giuseppe Stragliotto
- Department of Medicine (Solna), Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Tomas J Ekström
- Department of Clinical Neuroscience, Center for Molecular Medicine, Karolinska Institutet, 17165 Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine (Solna), Division of Microbial Pathogenesis, BioClinicum, Karolinska Institutet, 17165 Stockholm, Sweden
| |
Collapse
|
23
|
Rådestad AF, Estekizadeh A, Cui HL, Kostopoulou ON, Davoudi B, Hirschberg AL, Carlson J, Rahbar A, Söderberg-Naucler C. Impact of Human Cytomegalovirus Infection and its Immune Response on Survival of Patients with Ovarian Cancer. Transl Oncol 2018; 11:1292-1300. [PMID: 30172882 PMCID: PMC6121833 DOI: 10.1016/j.tranon.2018.08.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/03/2018] [Accepted: 08/07/2018] [Indexed: 12/12/2022] Open
Abstract
Human cytomegalovirus (HCMV) has been detected in various types of tumors. We studied the prevalence of HCMV in ovarian cancer and its relation to clinical outcome. Paraffin-embedded tissues obtained prospectively from 45 patients with ovarian cancer and 30 patients with benign ovarian cystadenoma were analyzed for expression of HCMV immediate-early protein (IE) and HCMV tegument protein (pp65) by immunohistochemistry. Plasma was analyzed for HCMV serology. HCMV-IgG levels were higher in patients with ovarian cancer or benign cystadenoma than in age-matched controls (P = .002, P < .0001, respectively). HCMV IgM was detected in 12% of ovarian cancer patients and 3% of patients with benign tumors but was absent in controls. In patients with ovarian cancer, higher IgG levels were associated with better outcomes (P = .04). Extensive HCMV-IE protein expression was detected in 75% of ovarian cancers and 26% of benign tumors; pp65 was detected in 67% of ovarian cancers and 14% of benign tumors. A higher grade of HCMV infection was associated with higher stage of disease. Extensive HCMV-pp65 expression was associated with shorter median overall survival than focal expression (39 versus 42.5 months, P = .03). At study closure, 58% of ovarian cancer patients with focal pp65 expression were alive versus 27% of patients with extensive pp65 expression (P = .03). Thus, HCMV proteins are detected at different levels in ovarian tumors and benign cystadenomas. Ovarian cancer patients with focal HCMV-pp65 expression in their tumors and high IgG levels against HCMV lived longer, highlighting a need for in-depth studies of the oncomodulatory role of HCMV in ovarian cancer.
Collapse
Affiliation(s)
- Angelique Flöter Rådestad
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
| | - Atosa Estekizadeh
- Department of Medicine Solna, Microbial Pathogens Unit and Department of Neurology, Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Huanhuan L Cui
- Department of Medicine Solna, Microbial Pathogens Unit and Department of Neurology, Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ourania N Kostopoulou
- Department of Medicine Solna, Microbial Pathogens Unit and Department of Neurology, Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Belghis Davoudi
- Department of Medicine Solna, Microbial Pathogens Unit and Department of Neurology, Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Division of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden; Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Joseph Carlson
- Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine Solna, Microbial Pathogens Unit and Department of Neurology, Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden.
| | - Cecilia Söderberg-Naucler
- Department of Medicine Solna, Microbial Pathogens Unit and Department of Neurology, Centre for Molecular Medicine, Karolinska Institute, Stockholm, Sweden.
| |
Collapse
|
24
|
Touma J, Rahbar A, Davoudi B, Lindstrom JC, Sauer T, Bukholm IR, Vetvik K, Soderberg-Naucler C, Geisler J. Abstract 4222: The prognostic impact of human cytomegalovirus infection in breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-4222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Emerging evidence demonstrates a frequent presence of Human Cytomegalovirus (HCMV) proteins and nucleic acids in several primary malignant tumours including breast cancer (BC). HCMV maintains latency in monocytes and reactivates in an inflammatory or immune-suppressive state. The virus infection expresses more than 750 proteins, many has revealed both oncogenic and onco-modulatory properties which fulfil all the criteria for the hallmarks of cancer. HCMV is not believed to transform the host cell itself, but HCMV-encoded proteins are involved in cell cycle progression, interact with key proteins in the extrinsic and intrinsic apoptotic signalling cascade, and can induce drug resistance to chemotherapeutic agents. Earlier studies from our lab detected HCMV-IE (immediate early) and HCMV-LA (late antigen) proteins in >90% of analysed primary breast cancer tumours, sentinel lymph node and brain metastasis, and that their prevalence is higher in advanced breast cancer. We have reported a significant correlation between HCMV and hormone receptor expression in a certain subgroup of breast cancer patients. The purpose of this study is to retrospectively investigate the prognosis and overall survival of 120 patients diagnosed and treated for breast cancer at the Akershus University Hospital, Norway, between 1996 and 2010. Material/methods: Formalin-fixed, paraffin-embedded, consecutively collected breast tumour samples and metastases, from clinically well-characterized patients were examined for HCMV-IE and HCMV-LA, using immuno-histochemical techniques. HCMV values was then correlated with BC subtypes: HER-2 positive, luminal A (LUM-A), luminal B (LUM-B) and triple negative breast cancer (TNBC). As well as time to: distant metastasis, loco-regional relapse and overall relapse. All data were defined in Kaplan-Meier curves for survival and a Cox regression model was fitted to each subgroup. Results: Both HCMV-IE and HCMV-LA was present in >99% of the tissue samples analysed. We found a significant association between HCMV-LA and overall survival in TNBC patients (Hazard ratio 2.502; P-value 0.025). In addition, HCMV-LA was significantly correlated to the risk of local relapses in TNBC patients (Hazard ratio 4.149; P-value: 0.026). Finally, we also found the risk for local relapses and distant metastasis to be significantly tied to HCMV-LA levels in TNBC patients (Hazard ratio 4.126; P-value: 0.032). HCMV-LA and HCMV-IE levels were not found to be associated with either survival or risk for relapses in any other BC subtype. Conclusion: Our findings reveal a significant correlation between HCMV-LA expression and TNBC subtype concerning both risk of recurrence and overall survival. While no other BC subtype was found to be significantly influenced by the presence of HCMV-related proteins, the presence of HCMV-LA that imply an active HCMV infection seems to indicate a more aggressive disease when detected in TNBC patients.
Citation Format: Joel Touma, Afsar Rahbar, Belghis Davoudi, Jonas Christoffer Lindstrom, Torill Sauer, Ida Rashida Bukholm, Katja Vetvik, Cecilia Soderberg-Naucler, Jurgen Geisler. The prognostic impact of human cytomegalovirus infection in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4222.
Collapse
Affiliation(s)
- Joel Touma
- 1Akershus University Hospital, Oslo, Norway
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Heukers R, Fan TS, de Wit RH, van Senten JR, De Groof TWM, Bebelman MP, Lagerweij T, Vieira J, de Munnik SM, Smits-de Vries L, van Offenbeek J, Rahbar A, van Hoorick D, Söderberg-Naucler C, Würdinger T, Leurs R, Siderius M, Vischer HF, Smit MJ. The constitutive activity of the virally encoded chemokine receptor US28 accelerates glioblastoma growth. Oncogene 2018; 37:4110-4121. [PMID: 29706656 PMCID: PMC6062493 DOI: 10.1038/s41388-018-0255-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/04/2018] [Accepted: 03/14/2018] [Indexed: 01/10/2023]
Abstract
Glioblastoma (GBM) is the most aggressive and an incurable type of brain cancer. Human cytomegalovirus (HCMV) DNA and encoded proteins, including the chemokine receptor US28, have been detected in GBM tumors. US28 displays constitutive activity and is able to bind several human chemokines, leading to the activation of various proliferative and inflammatory signaling pathways. Here we show that HCMV, through the expression of US28, significantly enhanced the growth of 3D spheroids of U251− and neurospheres of primary glioblastoma cells. Moreover, US28 expression accelerated the growth of glioblastoma cells in an orthotopic intracranial GBM-model in mice. We developed highly potent and selective US28-targeting nanobodies, which bind to the extracellular domain of US28 and detect US28 in GBM tissue. The nanobodies inhibited chemokine binding and reduced the constitutive US28-mediated signaling with nanomolar potencies and significantly impaired HCMV/US28-mediated tumor growth in vitro and in vivo. This study emphasizes the oncomodulatory role of HCMV-encoded US28 and provides a potential therapeutic approach for HCMV-positive tumors using the nanobody technology.
Collapse
Affiliation(s)
- Raimond Heukers
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Tian Shu Fan
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Raymond H de Wit
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Jeffrey R van Senten
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Timo W M De Groof
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Maarten P Bebelman
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Tonny Lagerweij
- Neuro-oncology Research Group, Cancer Center Amsterdam, VU University Medical Center, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - Joao Vieira
- Ablynx N.V., Technologiepark 21, Zwijnaarde, 9052, Belgium
| | - Sabrina M de Munnik
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Laura Smits-de Vries
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Jody van Offenbeek
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Afsar Rahbar
- Department of Medicine Solna, Experimental Cardiovascular Research Unit and Department of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, 171 77, Sweden
| | | | - Cecilia Söderberg-Naucler
- Department of Medicine Solna, Experimental Cardiovascular Research Unit and Department of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, 171 77, Sweden
| | - Thomas Würdinger
- Neuro-oncology Research Group, Cancer Center Amsterdam, VU University Medical Center, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - Rob Leurs
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Marco Siderius
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Henry F Vischer
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands
| | - Martine J Smit
- Amsterdam Institute for Molecules, Medicines and Systems (AIMMS), Division of Medicinal Chemistry, Faculty of Sciences, Vrije Universiteit, De Boelelaan 1108, Amsterdam, 1081 HZ, The Netherlands.
| |
Collapse
|
26
|
Estekizadeh A, Landázur N, Bartek J, Beltoft Brøchner C, Davoudi B, Broholm H, Karimi M, Ekström TJ, Rahbar A. Increased cytomegalovirus replication by 5-Azacytidine and viral-induced cytoplasmic expression of DNMT‑1 in medulloblastoma and endothelial cells. Int J Oncol 2018; 52:1317-1327. [PMID: 29484388 DOI: 10.3892/ijo.2018.4286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/24/2018] [Indexed: 11/06/2022] Open
Abstract
Among all brain tumors diagnosed in children, medulloblastomas (MBs) are associated with a poor prognosis. The etiology of MB is not fully understood, yet the impact of epigenetic alterations of oncogenes has previously been established. During the past decade, the human cytomegalovirus (HCMV) has been detected in several types of cancer, including MB. Since DNA methylation occurs in the cell nucleus and this is considered a host defence response, we studied the impact of HCMV infection on DNA methyltransferase (DNMT‑1) in MB (D324) cells, human umbilical vein endothelial cells (HUVECs) as well as in MB tissue sections. We hypothesized that infection and DNMT‑1 intracellular localization are linked. Uninfected and HCMV‑infected D324 cells and HUVECs were analyzed for HCMV immediate early (HCMV‑IE) protein, HCMV‑glycoprotein B (HCMV‑gB) and DNMT‑1 using immunofluorescence staining and quantitative ELISA. DNMT‑1 localized to the nucleus of uninfected and HCMV‑IE- expressing D324 cells and HUVECs, but accumulated in the extra nuclear space in all HCMV‑gB-positive cells. Inhibition of HCMV late protein expression by Cymevene® (ganciclovir) prevented the cytoplasmic localization of DNMT‑1. Treatment of HCMV‑ infected D324 cells and HUVECs with the methylation inhibitor 5-Azacytidine (5AZA), significantly increased HCMV‑IE and HCMV‑gB gene transcription and protein expression. Immunohistochemical staining of DNMT‑1 and HCMV proteins in MB cancer tissue sections revealed both nuclear and cytoplasmic DNMT‑1 localization. In conclusion, DNMT‑1 resides in the cytoplasm of HCMV‑gB-expressing HUVECs and D324 cells. Increased viral protein synthesis in 5AZA-treated cells suggests that HCMV replication may benefit from a DNA methyltransferase-free cellular environment. Our findings emphasize the importance of assessing potential viral activation in the treatment of MB patients with epigenetic drugs.
Collapse
Affiliation(s)
- Atosa Estekizadeh
- Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet, SE_17176 Stockholm, Sweden
| | - Natalia Landázur
- Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet, SE_17176 Stockholm, Sweden
| | - Jiri Bartek
- Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, SE_17176 Stockholm, Sweden
| | | | - Belghis Davoudi
- Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, SE_17176 Stockholm, Sweden
| | - Helle Broholm
- Department of Pathology, Copenhagen University Hospital Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Mohsen Karimi
- Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, SE_17176 Stockholm, Sweden
| | - Tomas J Ekström
- Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet, SE_17176 Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Solna and Center for Molecular Medicine, Karolinska Institutet, SE_17176 Stockholm, Sweden
| |
Collapse
|
27
|
Vasaikar S, Tsipras G, Landázuri N, Costa H, Wilhelmi V, Scicluna P, Cui HL, Mohammad AA, Davoudi B, Shang M, Ananthaseshan S, Strååt K, Stragliotto G, Rahbar A, Wong KT, Tegner J, Yaiw KC, Söderberg-Naucler C. Overexpression of endothelin B receptor in glioblastoma: a prognostic marker and therapeutic target? BMC Cancer 2018; 18:154. [PMID: 29409474 PMCID: PMC5801893 DOI: 10.1186/s12885-018-4012-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 01/22/2018] [Indexed: 01/07/2023] Open
Abstract
Background Glioblastoma (GBM) is the most common malignant brain tumor with median survival of 12-15 months. Owing to uncertainty in clinical outcome, additional prognostic marker(s) apart from existing markers are needed. Since overexpression of endothelin B receptor (ETBR) has been demonstrated in gliomas, we aimed to test whether ETBR is a useful prognostic marker in GBM and examine if the clinically available endothelin receptor antagonists (ERA) could be useful in the disease treatment. Methods Data from The Cancer Genome Atlas and the Gene Expression Omnibus database were analyzed to assess ETBR expression. For survival analysis, glioblastoma samples from 25 Swedish patients were immunostained for ETBR, and the findings were correlated with clinical history. The druggability of ETBR was assessed by protein-protein interaction network analysis. ERAs were analyzed for toxicity in in vitro assays with GBM and breast cancer cells. Results By bioinformatics analysis, ETBR was found to be upregulated in glioblastoma patients, and its expression levels were correlated with reduced survival. ETBR interacts with key proteins involved in cancer pathogenesis, suggesting it as a druggable target. In vitro viability assays showed that ERAs may hold promise to treat glioblastoma and breast cancer. Conclusions ETBR is overexpressed in glioblastoma and other cancers and may be a prognostic marker in glioblastoma. ERAs may be useful for treating cancer patients. Electronic supplementary material The online version of this article (10.1186/s12885-018-4012-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Suhas Vasaikar
- Unit of Computational Medicine, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Giorgos Tsipras
- Unit of Computational Medicine, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Natalia Landázuri
- Unit of Computational Medicine, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Costa
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Vanessa Wilhelmi
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Patrick Scicluna
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Huanhuan L Cui
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Abdul-Aleem Mohammad
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Belghis Davoudi
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Mingmei Shang
- Unit of Computational Medicine, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sharan Ananthaseshan
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Klas Strååt
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden
| | | | - Afsar Rahbar
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Kum Thong Wong
- Department of Pathology, University of Malaya, Kuala Lumpur, Malaysia
| | - Jesper Tegner
- Unit of Computational Medicine, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Biological and Environmental Sciences and Engineering Division (BESE), Computer, Electrical and Mathematical Sciences and Engineering Division (CEMSE), King Abdullah University of Science and Technology (KAUST), Thuwal, 23955-6900, Kingdom of Saudi Arabia
| | - Koon-Chu Yaiw
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden.
| | - Cecilia Söderberg-Naucler
- Cell and Molecular Immunology, Experimental Cardiovascular Unit, Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institutet, SE-171 76, Stockholm, Sweden.
| |
Collapse
|
28
|
Abstract
Patients diagnosed with high grade serous ovarian adenocarcinoma have a poor prognosis. Recently human cytomegalovirus (HCMV) has been detected in several tumors. Here, we evaluated HCMV in ovarian cancer tissue specimens obtained at pre- and postchemotherapy tumor resection.Available paraffin embedded ovarian cancer tissues from matched pre- and postchemotherapy tumor resection specimens (i.e., diagnostic excisional biopsy prechemotherapy; DEBPC) and neoadjuvant chemotherapy followed by interval debulking surgery (NACT + IDS) from 10 patients with stage IIIC-IV high grade serous ovarian carcinoma (HGS) diagnosed between years 2007 and 2008 at Karolinska University Hospital were examined for HCMV immediate-early protein (HCMV-IE), tegument protein pp65, and nucleic acid (β2.7) by immunohistochemistry and in situ hybridization.HCMV-IE and pp65 were detected in 8/10 (80%), 4/9 (44%) and in 4/10 (40%), 5/8 in ovarian cancer tissue specimens from DEBPC and NACT + IDS, respectively. HCMV-β2.7 was detected in all available tissue sections obtained from DEBPC and NACT + IDS. Patients with HCMV-IE or pp65 positive cells in their ovarian tumors at IDS after NACT had a median overall survival of 23.4 and 18.2 months, respectively, compared to 29.6 and 54 months, respectively, in those who did not express HCMV proteins in their tumors.In conclusion, HCMV proteins and nucleic acids are frequently detected at different levels in HGS ovarian carcinoma. Despite the limitation of our study, shorter median overall survival of patients with HCMV-IE and pp65 in their tumor highlights the need to further investigate the role of HCMV in ovarian cancer patients.
Collapse
Affiliation(s)
- Joseph W. Carlson
- Department of Pathology and Cytology, Institute for Oncology-Pathology
| | - Angelique Flöter Rådestad
- Department of Women's and Children's Health, Karolinska Institutet and Division of Obstetrics and Gynecology, Karolinska University Hospital
| | - Cecilia Söderberg-Naucler
- Department of Medicine Solna, Unit of Microbial Pathogenesis and Department of Neurology, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine Solna, Unit of Microbial Pathogenesis and Department of Neurology, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
29
|
Skaggs Z, Zitek T, Rahbar A, Patel J, Khan M. 59 Does Intravenous Lactated Ringer's Solution Raise Serum Lactate? Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
30
|
Zitek T, Gates M, Pitotti C, Bartlett A, Patel J, Rahbar A, Forred W, Sontgerath J, Clark J. 269 The CHECK Trial: A Comparison of Headache Treatment in the Emergency Department: ProChlorperazine Versus Ketamine. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
31
|
Mohammad AA, Costa H, Landázuri N, Lui WO, Hultenby K, Rahbar A, Yaiw KC, Söderberg-Nauclér C. Human cytomegalovirus microRNAs are carried by virions and dense bodies and are delivered to target cells. J Gen Virol 2017; 98:1058-1072. [PMID: 28589873 PMCID: PMC5656795 DOI: 10.1099/jgv.0.000736] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Human cytomegalovirus (HCMV) infection results in the production of virions, dense bodies (DBs) and non-infectious enveloped particles, all of which incorporate proteins and RNAs that can be transferred to host cells. Here, we investigated whether virions and DBs also carry microRNAs (miRNAs) and assessed their delivery and functionality in cells. Human lung fibroblasts (MRC-5) were infected with the HCMV strain AD169, and conditioned cell culture medium was collected and centrifuged. The pellets were treated with RNase-ONE, and the virions and DBs were purified with a potassium tartrate–glycerol gradient and dialysed. The virions and DBs were incubated with micrococcal nuclease, DNA and RNA were extracted and then analysed with TaqMan PCR assays, while the proteins were examined with Western blots. To assess the delivery of miRNAs to cells and their functionality, virions and DBs were irradiated with UV light. The purity of the virions and DBs was confirmed by typical morphology, the presence of the structural protein pp65 and the HCMV genome, the ability to infect MRC-5 cells and the absence of the host genome. RNA analysis revealed the presence of 14 HCMV-encoded miRNAs (UL22A-5p, US25-1-5p, UL22A-3p, US5-2-3p, UL112-3p, US25-2-3p, US25-2-5p, US33-3p, US5-1, UL36-5p, US4-5p, UL36-3p, UL70-5p and US25-1-3p), HCMV immediate-early mRNA and long non-coding RNA2.7, moreover, two host-encoded miRNAs (hsa-miR-218-5p and hsa-miR-21-5p) and beta-2-microglobulin RNA. UV-irradiated virions and DBs delivered viral miRNAs (US25-1-5p and UL112-3p) to the host cells, and miR-US25-1-5p was functional in a luciferase reporter assay. We conclude that virions and DBs carry miRNAs that are biologically functional and can be delivered to cells, which may affect cellular processes.
Collapse
Affiliation(s)
- Abdul-Aleem Mohammad
- Department of Medicine, Solna, Experimental Cardiovascular Unit, Department of Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Helena Costa
- Department of Medicine, Solna, Experimental Cardiovascular Unit, Department of Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Natalia Landázuri
- Department of Medicine, Solna, Experimental Cardiovascular Unit, Department of Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Weng-Onn Lui
- Department of Oncology-Pathology, Karolinska Institutet, Cancer Center Karolinska, Karolinska University Hospital, Stockholm, Sweden
| | - Kjell Hultenby
- Department of Laboratory Medicine, Karolinska Institute, Huddinge, Sweden
| | - Afsar Rahbar
- Department of Medicine, Solna, Experimental Cardiovascular Unit, Department of Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Koon-Chu Yaiw
- Department of Medicine, Solna, Experimental Cardiovascular Unit, Department of Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Solna, Experimental Cardiovascular Unit, Department of Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
32
|
Omarsdottir S, Agnarsdottir M, Casper C, Orrego A, Vanpée M, Rahbar A, Söderberg-Nauclér C. High prevalence of cytomegalovirus infection in surgical intestinal specimens from infants with necrotizing enterocolitis and spontaneous intestinal perforation: A retrospective observational study. J Clin Virol 2017. [PMID: 28633098 DOI: 10.1016/j.jcv.2017.05.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Necrotizing enterocolitis (NEC) is a severe, often fatal gastrointestinal emergency that predominantly affects preterm infants, and there is evidence that neonatal cytomegalovirus (CMV) infection may in some cases contribute to its pathogenesis. OBJECTIVES This study aimed to evaluate the prevalence of CMV in infants with NEC. STUDY DESIGN Seventy intestinal specimens from 61 infants with NEC, spontaneous intestinal perforation (SIP), or related surgical complications were collected at Karolinska University Hospital and Uppsala University Hospital, Sweden. Ten specimens from autopsied infants without bowel disease served as controls. Samples were analyzed for CMV immediate-early antigen (IEA), CMV late antigen (LA), 5-lipoxigenase (5LO) and CMV-DNA by immunohistochemistry (IHC) and in situ hybridization (ISH), respectively. In 10 index samples, CMV DNA was analyzed with Taqman PCR after laser capture microdissection (LCM) of cells positive for CMV IEA by IHC. RESULTS CMV IEA was detected by IHC in 57 (81%) and CMV LA in 45 (64%) of 70 intestinal specimens from index cases; 2 (20%) of 10 control specimens were positive for both antigens. 5LO was detected in intestinal tissue section obtained from all examined index and controls. CMV DNA was detected in 4 of 10 samples (40%) after LCM. By ISH, all 13 IHC-IEA-positive samples were positive for CMV DNA; however, 3 of 5 IHC-IEA-negative samples (60%) were also positive. CONCLUSIONS CMV-specific antigens and CMV DNA were highly prevalent in intestinal specimens from infants with NEC, SIP, and related surgical complications. Our findings provide further evidence that neonatal CMV infection contributes to the pathogenesis of these diseases and may affect patient outcome.
Collapse
Affiliation(s)
- Soley Omarsdottir
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Margret Agnarsdottir
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Charlotte Casper
- Unit of Neonatology, Children's Hospital, Paul Sabatier University, Toulouse, France
| | - Abiel Orrego
- Departments of Clinical Pathology and Cytology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Mireille Vanpée
- Women's and Children's Health, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden.
| |
Collapse
|
33
|
Lollinga WT, de Wit RH, Rahbar A, Vasse GF, Davoudi B, Diepstra A, Riezebos-Brilman A, Harmsen MC, Hillebrands JL, Söderberg-Naucler C, van Son WJ, Smit MJ, Sanders JS, van den Born J. Human Cytomegalovirus-Encoded Receptor US28 Is Expressed in Renal Allografts and Facilitates Viral Spreading In Vitro. Transplantation 2017; 101:531-540. [PMID: 27362315 DOI: 10.1097/tp.0000000000001289] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Renal transplantation is the preferred treatment for patients with end-stage renal disease. Human cytomegalovirus (HCMV) activation is associated with decreased renal graft function and survival. Human cytomegalovirus encodes several immune modulatory proteins, including the G protein-coupled receptor US28, which scavenges human chemokines and modulates intracellular signaling. METHODS Our aim was to identify the expression and localization of US28 in renal allograft biopsies by immunohistochemistry and determine its role in viral spreading in vitro. RESULTS Immunohistochemistry revealed US28 in 31 of 34 renal transplant biopsies from HCMV-seropositive donors. Expression was independent of HCMV viremia or IgG serostatus. US28 was predominantly expressed in the cytoplasm of vascular smooth muscle cells (VSMCs) and tubular epithelial cells, with a median positivity of 20% and 40%, respectively. Also, US28-positive cells were present within arterial neointima. In contrast to US28, HCMV-encoded immediate early antigen was detected in less than 5% of VSMCs, tubular epithelial cells, interstitial endothelium, interstitial inflammatory infiltrates, and glomerular cells.Primary VSMCs were infected with green fluorescent protein-tagged wild type or US28-deficient HCMV. The viral spreading of US28-deficient HCMV, via culture medium or cell-to-cell transmission, was significantly impeded as shown by green fluorescent protein (ie, infected) cell quantification and quantitative real-time polymerase chain reaction. Additionally, the number and size of foci was smaller. CONCLUSIONS In summary, HCMV-encoded US28 was detected in renal allografts from HCMV-positive donors independent of viremia and serostatus. Also, US28 facilitates HCMV spreading in VSMCs in vitro. Because the vasculature is affected in chronic renal transplant dysfunction, US28 may provide a potential target for therapeutic intervention.
Collapse
Affiliation(s)
- Wouter T Lollinga
- 1 Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 2 Department of Chemistry and Pharmaceutical Sciences, Division of Medicinal Chemistry, Vrije Universiteit, Amsterdam, the Netherlands. 3 Department of Medicine, Center for Molecular Medicine, Unit for Microbial Pathogenesis, Karolinska Institutet, Solna, Stockholm, Sweden. 4 Division of Pathology, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 5 Division of Clinical Virology, Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 6 Division of Medical Biology, Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Rahbar A, Touma J, Costa H, Davoudi B, Bukholm IR, Sauer T, Vetvik K, Geisler J, Söderberg-Naucler C. Low Expression of Estrogen Receptor-α and Progesterone Receptor in Human Breast Cancer Tissues Is Associated With High-Grade Human Cytomegalovirus Protein Expression. Clin Breast Cancer 2017; 17:526-535.e1. [PMID: 28595965 DOI: 10.1016/j.clbc.2017.04.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/21/2017] [Accepted: 04/29/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The underlying mechanisms for breast cancer (BC) are largely unknown. We investigated possible correlations between the expression levels of human cytomegalovirus (HCMV) proteins and established histopathological markers of BC, including expression of estrogen receptor (ER)-α, the progesterone receptor (PgR), and HER2. MATERIALS AND METHODS We retrospectively examined paraffin-embedded biopsy specimens of BC (n = 62), ductal carcinoma in situ (n = 19), and adjacent normal breast tissue (n = 42) for HCMV immediate-early protein (IE), HCMV late antigen, HCMV DNA and RNA, and investigated possible correlations between them and expression of ER-α, PgR, and HER2. RESULTS HCMV DNA and RNA were detected in all examined infiltrating BCs. High-grade positivity for HCMV-IE was detected in 77% of infiltrating BCs, 39% of ductal carcinomas in situ, and 7% of tumor-free breast tissue samples. HCMV expression correlated inversely with ER-α (P = .02) and PgR (P = .003) expression. HER2 expression was also reduced in HCMV-positive samples without reaching a level of statistical significance (P = .09). CONCLUSION The negative correlation between high-grade expression HCMV-IE and hormone receptor expression suggests a role for HCMV in hormone receptor-negative BC tumors, possibly by forcing BC cells into a more aggressive phenotype.
Collapse
Affiliation(s)
- Afsar Rahbar
- Department of Medicine Solna, Experimental Cardiovascular Research Unit and Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden.
| | - Joel Touma
- Department of Breast and Endocrine Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Helena Costa
- Department of Medicine Solna, Experimental Cardiovascular Research Unit and Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Belghis Davoudi
- Department of Medicine Solna, Experimental Cardiovascular Research Unit and Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Ida Rashid Bukholm
- Norwegian System of Compensation for Patient Claimes, Oslo, Norway; Norwegian University of Life Sciences, Oslo, Norway
| | - Torill Sauer
- Department of Pathology, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital, Lørenskog, Oslo, Norway
| | - Katja Vetvik
- Department of Breast and Endocrine Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Jürgen Geisler
- Institute of Clinical Medicine, University of Oslo, Campus Akershus University Hospital, Lørenskog, Oslo, Norway; Department of Oncology, Akershus University Hospital, Lørenskog, Norway
| | - Cecilia Söderberg-Naucler
- Department of Medicine Solna, Experimental Cardiovascular Research Unit and Departments of Medicine and Neurology, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
35
|
Rahbar A, Touma J, Costa H, Davoudi B, Vetvik K, Geisler J, Söderberg Naucler C. Abstract P6-06-02: Low expression levels of hormone receptors (ER-α and PGR) in human breast cancer samples is significantly associated with high-grade human cytomegalovirus-IEA. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-06-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer (BC) is the most common type of malignancy and second leading cause of cancer deaths in women worldwide. While contemporary breast cancer therapy allows many patients with localized breast cancer to be cured for their disease, subgroups experience non-curable distant metastasis. In addition, majority of BC cases are considered to be "sporadic", with unknown underlying mechanisms. Thus, it is of major importance to investigate alternative factors that may initiate or promote human breast cancer. Recently, human cytomegalovirus (HCMV) has been detected in samples from primary BC, sentinel lymph nodes and brain metastases obtained from breast cancer patients. However, the oncomodulatory role of HCMV in BC is unknown. Accordingly, the purpose of this study was to elucidate possible correlations between expression of HCMV proteins and established histopathological markers (ER-α, PgR, HER2 etc.) in human breast cancer tissues. Material and Methods: Paraffin embedded breast cancer biopsies (n=62), ductal carcinoma in-situ (DCIS, n=18) and adjacent, benign breast tissue samples (n=42) were retrospectively examined for HCMV-immediate early (IE) and late (LA) proteins by using immunohistochemical techniques. Clinical data were available from the patients´ hospital files provided from the departments of oncology and pathology at Akershus University Hospital, Norway. All patients underwent direct surgery in 2011. The median age at time of surgery was 55 years. All patients received standard adjuvant treatment according to the Norwegian guidelines. Results: HCMV-IE was detected at different levels in all BC cases, DCIS and benign breast tissue samples. Interestingly, high grade HCMV-IE (defined as >50% positive cells in the tumor tissues) was detected in 77% of infiltrating BC and in 39% of DCIS and merely in 7% benign breast tissue samples. High grade HCMV-IE was detected in 40%, 76% and 83% of BC patients with >50-90%, >10-50% and <10% tumor cells expressing PgR in their tumors, respectively (p=0.003). All BC samples with negative or low (0-10%) positive staining for estrogen receptors (ER-α) showed high-grade HCMV-IE staining. In subgroups of patients with increasingly positive staining for ER-α between 10-50% and >50-90% of tumor cells, high HCMV-IE was found in 86% and 74%, respectively (p=0.02). A trend but no significant correlation was found between high-grade HCMV-IE and HER2 negativity (p=0.09). In contrast, High grade HCMV-LA proteins were detected in 5%, 11% and 3% of adjacent benign breast samples, DCIS and infiltrating BC, only. Conclusion: Our findings demonstrate that HCMV- IE but not HCMV-LA proteins are frequently detected in samples obtained from infiltrating BC and DCIS. Although the role of HCMV in carcinogenesis of BC is not defined, our findings suggest a negative correlation between high grade HCMV-IE and hormone receptors in general. All in all, our findings may indicate a possible oncomodulatory role of HCMV-IE in human BC, hampering the expression of hormone receptors and forcing the BC cells to a more aggressive phenotype. The effects of HCMV-induced proteins in human breast cancer cells should be investigated further.Background: Breast cancer (BC) is the most common type of malignancy and second leading cause of cancer deaths in women worldwide. While contemporary breast cancer therapy allows many patients with localized breast cancer to be cured for their disease, subgroups experience non-curable distant metastasis. In addition, majority of BC cases are considered to be "sporadic", with unknown underlying mechanisms. Thus, it is of major importance to investigate alternative factors that may initiate or promote human breast cancer. Recently, human cytomegalovirus (HCMV) has been detected in samples from primary BC, sentinel lymph nodes and brain metastases obtained from breast cancer patients. However, the oncomodulatory role of HCMV in BC is unknown. Accordingly, the purpose of this study was to elucidate possible correlations between expression of HCMV proteins and established histopathological markers (ER-α, PgR, HER2 etc.) in human breast cancer tissues. Material and Methods: Paraffin embedded breast cancer biopsies (n=62), ductal carcinoma in-situ (DCIS, n=18) and adjacent, benign breast tissue samples (n=42) were retrospectively examined for HCMV-immediate early (IE) and late (LA) proteins by using immunohistochemical techniques. Clinical data were available from the patients´ hospital files provided from the departments of oncology and pathology at Akershus University Hospital, Norway. All patients underwent direct surgery in 2011. The median age at time of surgery was 55 years. All patients received standard adjuvant treatment according to the Norwegian guidelines. Results: HCMV-IE was detected at different levels in all BC cases, DCIS and benign breast tissue samples. Interestingly, high grade HCMV-IE (defined as >50% positive cells in the tumor tissues) was detected in 77% of infiltrating BC and in 39% of DCIS and merely in 7% benign breast tissue samples. High grade HCMV-IE was detected in 40%, 76% and 83% of BC patients with >50-90%, >10-50% and <10% tumor cells expressing PgR in their tumors, respectively (p=0.003). All BC samples with negative or low (0-10%) positive staining for estrogen receptors (ER-α) showed high-grade HCMV-IE staining. In subgroups of patients with increasingly positive staining for ER-α between 10-50% and >50-90% of tumor cells, high HCMV-IE was found in 86% and 74%, respectively (p=0.02). A trend but no significant correlation was found between high-grade HCMV-IE and HER2 negativity (p=0.09). In contrast, High grade HCMV-LA proteins were detected in 5%, 11% and 3% of adjacent benign breast samples, DCIS and infiltrating BC, only. Conclusion: Our findings demonstrate that HCMV- IE but not HCMV-LA proteins are frequently detected in samples obtained from infiltrating BC and DCIS. Although the role of HCMV in carcinogenesis of BC is not defined, our findings suggest a negative correlation between high grade HCMV-IE and hormone receptors in general. All in all, our findings may indicate a possible oncomodulatory role of HCMV-IE in human BC, hampering the expression of hormone receptors and forcing the BC cells to a more aggressive phenotype. The effects of HCMV-induced proteins in human breast cancer cells should be investigated further.
Citation Format: Rahbar A, Touma J, Costa H, Davoudi B, Vetvik K, Geisler J, Söderberg Naucler C. Low expression levels of hormone receptors (ER-α and PGR) in human breast cancer samples is significantly associated with high-grade human cytomegalovirus-IEA [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-06-02.
Collapse
Affiliation(s)
| | - J Touma
- Karolinska Institute, Sweden
| | - H Costa
- Karolinska Institute, Sweden
| | | | | | | | | |
Collapse
|
36
|
Costa H, Touma J, Davoudi B, Geisler J, Vetvik K, Söderberg Naucler C, Rahbar A. Abstract P6-06-01: High-grade human cytomegalovirus IEA is associated with expression of COX-2 and 5-LO in human breast cancer samples. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-06-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The role of cyclooxygenase-2 (COX-2) in breast cancer development and progression has been supported by an increasing number of studies that show the overexpression of COX-2 in all the stages of the disease but in particular, in the metastatic phase. Besides COX-2 and its derived metabolites, 5-lipoxygenase (5-LO) and leukotrienes have also been associated with cancer progression. Human Cytomegalovirus (HCMV) detection in samples from primary BC, sentinel lymph nodes and brain metastases obtained from breast cancer patients' suggests that viral infection may also have a critical role in the development of breast cancer metastasis. Interestingly, in vitro studies showed that HCMV infections induce COX-2 in human fibroblasts, which augments viral replication through a prostaglandin dependent pathway. Thus, our main objective was to investigate whether there is a correlation between HCMV infection and overexpression of COX-2 and 5-LO in breast cancer. If so, HCMV could be an important additional target for breast cancer treatment.
Material and Methods: Paraffin embedded breast cancer biopsies (n=48), ductal carcinoma in-situ (DCIS, n=14) and adjacent, benign breast tissue samples (n=29) were retrospectively examined for HCMV-immediate early (IE), HCMV-Late (LA) proteins, COX2 and 5LO by using immunohistochemical techniques established in our laboratory. Clinical data were available from the patients´ hospital files provided from the departments of oncology and pathology at Akershus University Hospital, Norway. All patients underwent direct surgery in 2011. All patients received standard adjuvant treatment according to the Norwegian guidelines. For in vitro studies, breast cancer cell lines (MCF-7, MB-MDA-231 and SKBR3) were infected with HCMV VR1814 strain and levels of COX-2 and 5-LO were determined by qPCR and western blot and immunofluorescence.
Results: High levels of COX-2, 5-LO and HCMV-IE were detected mainly in breast cancer samples. High grade HCMV-IE (defined as >50% positive cells in the tumor tissues) was detected in 72% of infiltrating BC and in 28% of DCIS, but it was detected only in 7% of benign, adjacent breast tissue samples. Similarly, high grade COX-2 and 5-LO were detected in 58% and 53% of BC, in 21% and 8% of DCIS, and in 4% and 7% of benign, adjacent breast tissue samples, respectively. We found a statistically significant positive correlation for the levels of HCMV-IE and COX-2 (p=0.001) as well as for HCMV-IE and5-LO (p=0.0002) in infiltrating breast cancer. Furthermore, induction of COX-2 and 5-LO was confirmed in breast cancer cell lines following infection with HCMV was shown at both mRNA and protein level.
Conclusion: Our findings confirm a positive correlation of HCMV-IE protein synthesis and overexpression of COX-2 and 5-LO in infiltrating breast cancer, DCIS and benign, adjacent breast tissue samples, which is consistent with the up-regulation of these enzymes in breast cancer cells infected with HCMV. These results suggest that the inflammation driven by COX-2 and 5-LO in human breast cancer might be induced by HCMV infections and lead to tumor progression. Thus, anti-viral therapy should be considered as an additional experimental treatment in selected breast cancer patients.
Citation Format: Costa H, Touma J, Davoudi B, Geisler J, Vetvik K, Söderberg Naucler C, Rahbar A. High-grade human cytomegalovirus IEA is associated with expression of COX-2 and 5-LO in human breast cancer samples [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-06-01.
Collapse
Affiliation(s)
- H Costa
- Karolinska Institute, Sweden
| | - J Touma
- Karolinska Institute, Sweden
| | | | | | | | | | | |
Collapse
|
37
|
Alkharusi A, Yu S, Landázuri N, Zadjali F, Davodi B, Nyström T, Gräslund T, Rahbar A, Norstedt G. Stimulation of prolactin receptor induces STAT-5 phosphorylation and cellular invasion in glioblastoma multiforme. Oncotarget 2016; 7:79572-79583. [PMID: 27788487 PMCID: PMC5346736 DOI: 10.18632/oncotarget.12840] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 10/10/2016] [Indexed: 02/07/2023] Open
Abstract
Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in humans and is characterized with poor outcome. In this study, we investigated components of prolactin (Prl) system in cell models of GBM and in histological tissue sections obtained from GBM patients. Expression of Prolactin receptor (PrlR) was detected at high levels in U251-MG, at low levels in U87-MG and barely detectable in U373 cell lines and in 66% of brain tumor tissues from 32 GBM patients by immunohistochemical technique. In addition, stimulation of U251-MG and U87-MG cells but not U373 with Prl resulted in increased STAT5 phosphorylation and only in U251-MG cells with increased cellular invasion. Furthermore, STAT5 phosphorylation and cellular invasion induced in Prl stimulated cells were significantly reduced by using a Prl receptor antagonist that consists of Prl with four amino acid replacements. We conclude that Prl receptor is expressed at different levels in the majority of GBM tumors and that blocking of PrlR in U251-MG cells significantly reduce cellular invasion.
Collapse
Affiliation(s)
- Amira Alkharusi
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sultan Qaboos University, College of Medicine and Health Sciences, Muscat, Oman
| | - Shengze Yu
- School of Biotechnology, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Natalia Landázuri
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Fahad Zadjali
- Sultan Qaboos University, College of Medicine and Health Sciences, Muscat, Oman
| | - Belghis Davodi
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Nyström
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Torbjörn Gräslund
- School of Biotechnology, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Norstedt
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
38
|
Stragliotto G, Rahbar A. P08.75 Update of valganciclovir add-on therapy in glioblastoma. Effect in new ly diagnosed and in recurrent patients. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now188.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
39
|
Gustafsson RKL, Jeffery HC, Yaiw KC, Wilhelmi V, Kostopoulou ON, Davoudi B, Rahbar A, Benard M, Renné T, Söderberg-Nauclér C, Butler LM. Direct infection of primary endothelial cells with human cytomegalovirus prevents angiogenesis and migration. J Gen Virol 2016; 96:3598-3612. [PMID: 26416316 DOI: 10.1099/jgv.0.000301] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Human cytomegalovirus (hCMV) is a beta herpesvirus that establishes lifelong infection. Although the virus does not usually cause overt clinical symptoms in immunocompetent individuals it can have deleterious effects in immunocompromised patients, such as those on post-transplant medication or with HIV infection. hCMV is the most common congenital infection and can lead to serious fetal sequelae. Endothelial cells (ECs) are natural hosts for hCMV in vivo, therefore, investigations of how this cell type is modulated by infection are key to understanding hCMV pathogenesis. Previous studies have examined the effect of secretomes from hCMV-infected cells on EC angiogenesis, whereas the effect of direct infection on this process has not been so well investigated. Here, we show that placental ECs are viral targets during congenital infection and that vessels in infected tissue appear morphologically abnormal. We demonstrate that the clinical hCMV strain VR1814 impaired EC tube assembly in in vitro angiogenesis assays and inhibited wound healing ability in scratch assays. Secretomes from infected cultures did not impair angiogenesis of uninfected ECs, suggesting that cell-intrinsic changes, as opposed to secreted factors, were responsible. We observed viral gene transcription dependent downregulation of the expression of angiogenesis-associated genes, including angiopoietin-2, TEK receptor and vascular endothelial growth factor receptors. An alternative clinical hCMV stain, TB40E showed similar effects on EC angiogenesis. Together, our data indicate that direct infection with hCMV can induce an anti-migratory and anti-angiogenic EC phenotype, which could have a detrimental effect on the vasculature development in infected tissues.
Collapse
Affiliation(s)
- Rasmus K L Gustafsson
- Clinical Chemistry, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.,Institute for Clinical Chemistry and Laboratory Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah C Jeffery
- Department of Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Koon-Chu Yaiw
- Department of Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Vanessa Wilhelmi
- Department of Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Ourania N Kostopoulou
- Department of Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Belghis Davoudi
- Department of Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Melinda Benard
- INSERM UMR 1043, Hospital Purpan, Paul Sabatier University, Toulouse 31024, France
| | - Thomas Renné
- Clinical Chemistry, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.,Institute for Clinical Chemistry and Laboratory Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Lynn M Butler
- Clinical Chemistry, Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.,Institute for Clinical Chemistry and Laboratory Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
40
|
Söderberg-Nauclér C, Fornara O, Rahbar A. Cytomegalovirus driven immunosenescence-An immune phenotype with or without clinical impact? Mech Ageing Dev 2016; 158:3-13. [PMID: 27318107 DOI: 10.1016/j.mad.2016.06.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 06/13/2016] [Accepted: 06/14/2016] [Indexed: 11/30/2022]
Abstract
The continuous emerging increase in life span has led to vulnerability to a number of different diseases in the elderly. Some of these risks may be attributed to specific changes in the immune system referred to as immunoscenescence. This term aims to describe decreased immune functions among elderly individuals, and is characterized to be harmful age-associated changes in the immune system that lead to its gradual immune dysfunction. An impaired function of the immune system may increase susceptibility to various diseases in the elderly population such as infections, cardiovascular diseases and cancer. Although it is unclear how this immune phenotype develops, emerging evidence suggest that it may reflect an exhaustion of the immune system, possibly caused by one or several chronic infections. The main candidate is human cytomegalovirus (CMV), which can induce immune dysfunctions observed in immunoscenescence. Although the immune system is currently considered to be exhausted in CMV positive elderly individuals, it is not known whether such dysfunction of the immune system is a main reason for increased susceptibility to other diseases, or if direct effects of the virus in disease pathogenesis reflect the increased vulnerability to them. These aspects will be discussed in this review.
Collapse
Affiliation(s)
- Cecilia Söderberg-Nauclér
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden.
| | - Olesja Fornara
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Exp Cardiovascular Research Unit and Department of Neurology, Center for Molecular Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
41
|
Yaiw KC, Mohammad AA, Costa H, Taher C, Badrnya S, Assinger A, Wilhelmi V, Ananthaseshan S, Estekizadeh A, Davoudi B, Ovchinnikova O, Shlyakhto E, Rafnsson A, Khan Z, Butler L, Rahbar A, Pernow J, Söderberg-Nauclér C. Human Cytomegalovirus Up-Regulates Endothelin Receptor Type B: Implication for Vasculopathies? Open Forum Infect Dis 2015; 2:ofv155. [PMID: 26719843 PMCID: PMC4690546 DOI: 10.1093/ofid/ofv155] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/19/2015] [Indexed: 12/20/2022] Open
Abstract
Background. Both endothelin receptor type B ([ETBR], a G protein-coupled receptor that mediates the vascular effects of the potent vasoconstrictor endothelin-1) and human cytomegalovirus ([HCMV], a ubiquitous herpesvirus) have been implicated in the pathogenesis of cardiovascular disease (CVD). The effects of HCMV infection on ETBR expression are unknown. We hypothesized that HCMV may contribute to the pathogenesis of CVD via ETBR modulation. Methods. Human CMV effects on ETBR were studied in vitro in endothelial cells (ECs) and smooth muscle cells (SMCs) and ex vivo in human carotid plaque tissue specimens. Expression of ETBR and viral immediate-early were quantified using quantitative polymerase chain reaction. Functional consequences after ETBR blockade in ECs were examined by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide proliferation, wound healing, tube formation, and flow adhesion assays. Results. Human CMV is capable of upregulating both ETBR mRNA and protein expression in ECs and SMCs. The ETBR was also abundantly expressed in ECs, foam cells, and SMCs, and, more importantly, in HCMV-positive cells in human carotid plaques. Endothelin receptor type B blockade led to decreased proliferation and reduced tumor necrosis factor α-mediated leukocyte recruitment in both uninfected and HCMV-infected ECs. Direct HCMV infection was antimigratory and antiangiogenic in ECs. Conclusions. Human CMV may contribute to CVD via ETBR induction.
Collapse
Affiliation(s)
- Koon-Chu Yaiw
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Abdul-Aleem Mohammad
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Helena Costa
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Chato Taher
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Sigrun Badrnya
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet ; Center for Physiology and Pharmacology , Institute of Physiology, Medical University of Vienna , Austria
| | - Alice Assinger
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet ; Center for Physiology and Pharmacology , Institute of Physiology, Medical University of Vienna , Austria
| | - Vanessa Wilhelmi
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Sharan Ananthaseshan
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Atosa Estekizadeh
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Belghis Davoudi
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Olga Ovchinnikova
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Eugene Shlyakhto
- Almazov Federal Heart, Blood and Endocrinology Centre , St . Petersburg , Russia
| | - Arnar Rafnsson
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet ; Department of Medicine, Cardiology Unit , Karolinska University Hospital Solna , Stockholm , Sweden
| | - Zahidul Khan
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Lynn Butler
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - Afsar Rahbar
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| | - John Pernow
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet ; Department of Medicine, Cardiology Unit , Karolinska University Hospital Solna , Stockholm , Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Solna, Center for Molecular Medicine, Microbial Pathogenesis Unit , Karolinska University Hospital, Karolinska Institutet
| |
Collapse
|
42
|
Peredo I, Helldén A, Wolmer-Solberg N, Pohanka A, Stragliotto G, Rahbar A, Ståhle L, Bellander BM, Söderberg-Nauclér C. Ganciclovir concentrations in the cerebral extracellular space after valganciclovir treatment; a case study. BMJ Case Rep 2015; 2015:bcr-2014-207694. [PMID: 26670887 DOI: 10.1136/bcr-2014-207694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Nearly all glioblastomas (GBMs), brain tumours with very poor prognosis, are infected with human cytomegalovirus (CMV). The anti-CMV drug valganciclovir (VGCV) has shown promise as a treatment option for patients with GBM, but its penetration into the central nervous system (CNS) is unknown. Here we describe a patient with GMB receiving VGCV in whom an intracerebral microdialysis catheter was implanted and ganciclovir (GCV) concentrations in brain extracellular fluid (BECF) and serum were monitored. GCV was rapidly absorbed. Cmax values (at 3 h) in serum and BECF were 19.6 and 10.2 µmol/L, T½ values were 3.2 and 4.5 h, and plasma and BECF AUC0-∞ values were 90.7 and 75.9 µmol h/L, respectively. Thus, VGCV treatment results in significant intracerebral levels of GCV that may be sufficient for therapeutic effects. Further studies of this drug in patients with GBM are warranted.
Collapse
Affiliation(s)
- Inti Peredo
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden Department of Medicine, Unit for Microbial Pathogenesis, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Helldén
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Nina Wolmer-Solberg
- Department of Medicine, Unit for Microbial Pathogenesis, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Anton Pohanka
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Giuseppe Stragliotto
- Department of Medicine, Unit for Microbial Pathogenesis, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine, Unit for Microbial Pathogenesis, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Ståhle
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | | | - Cecilia Söderberg-Nauclér
- Department of Medicine, Unit for Microbial Pathogenesis, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
43
|
Rahbar A, Cederarv M, Wolmer-Solberg N, Tammik C, Stragliotto G, Peredo I, Fornara O, Xu X, Dzabic M, Taher C, Skarman P, Söderberg-Nauclér C. Enhanced neutrophil activity is associated with shorter time to tumor progression in glioblastoma patients. Oncoimmunology 2015; 5:e1075693. [PMID: 27057448 DOI: 10.1080/2162402x.2015.1075693] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/08/2015] [Accepted: 07/17/2015] [Indexed: 02/02/2023] Open
Abstract
Glioblastoma multiforme (GBM) is a highly malignant tumor with a poor outcome that is often positive for human cytomegalovirus (HCMV). GBM patients often have excessive numbers of neutrophils and macrophages near and within the tumor. Here, we characterized the cytokine patterns in the blood of GBM patients with and without Valganciclovir treatment. Furthermore, we determined whether neutrophil activation is related to HCMV status and patient outcome. Blood samples for analyses of cytokines and growth factors were collected from 42 GBM patients at the time of diagnosis (n = 42) and at weeks 12 and 24 after surgery. Blood neutrophils of 28 GBM patients were examined for CD11b expression. The levels of pro- and anti-inflammatory cytokines and chemokines-including interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, IL-12p70, IL-17A, transforming growth factor (TGF)-β1, interferon-γ, interferon-α, tumor necrosis factor α, and monocyte chemoattractant protein (MCP)-1were analyzed with a bead-based flow cytometry assay. During the first six months after surgery, neutrophil activity was increased in 12 patients and was unchanged or decreased in 16. Patients with increased neutrophil activity had enhanced IL-12p70, high grade HCMV and a shorter time to tumor progression (TTP) than patients without or decreased neutrophil activity (median TTP; 5.4 vs. 12 months, 95% confidence interval; 1.6-10 vs. 0.1-0.6, hazard ratio = 3 vs. 0.4, p = 0.004). The levels of IL-12p70 were significantly decreased in Valganciclovir treated patients (n = 22, T 12W vs. T 24W, p = 0.03). In conclusion, our findings suggest that neutrophil activation is an early sign of tumor progression in GBM patients.
Collapse
Affiliation(s)
- Afsar Rahbar
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Madeleine Cederarv
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Nina Wolmer-Solberg
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Charlotte Tammik
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Giuseppe Stragliotto
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| | - Inti Peredo
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| | - Olesja Fornara
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Xinling Xu
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Mensur Dzabic
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Chato Taher
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Petra Skarman
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine Solna, Microbial Pathogenesis Research Unit, Center for Molecular Medicine, Karolinska Institute , Stockholm, Sweden
| |
Collapse
|
44
|
Fornara O, Bartek J, Rahbar A, Odeberg J, Khan Z, Peredo I, Hamerlik P, Bartek J, Stragliotto G, Landázuri N, Söderberg-Nauclér C. Cytomegalovirus infection induces a stem cell phenotype in human primary glioblastoma cells: prognostic significance and biological impact. Cell Death Differ 2015; 23:261-9. [PMID: 26138445 DOI: 10.1038/cdd.2015.91] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 04/29/2015] [Accepted: 05/22/2015] [Indexed: 12/11/2022] Open
Abstract
Glioblastoma (GBM) is associated with poor prognosis despite aggressive surgical resection, chemotherapy, and radiation therapy. Unfortunately, this standard therapy does not target glioma cancer stem cells (GCSCs), a subpopulation of GBM cells that can give rise to recurrent tumors. GBMs express human cytomegalovirus (HCMV) proteins, and previously we found that the level of expression of HCMV immediate-early (IE) protein in GBMs is a prognostic factor for poor patient survival. In this study, we investigated the relation between HCMV infection of GBM cells and the presence of GCSCs. Primary GBMs were characterized by their expression of HCMV-IE and GCSCs marker CD133 and by patient survival. The extent to which HCMV infection of primary GBM cells induced a GCSC phenotype was evaluated in vitro. In primary GBMs, a large fraction of CD133-positive cells expressed HCMV-IE, and higher co-expression of these two proteins predicted poor patient survival. Infection of GBM cells with HCMV led to upregulation of CD133 and other GSCS markers (Notch1, Sox2, Oct4, Nestin). HCMV infection also promoted the growth of GBM cells as neurospheres, a behavior typically displayed by GCSCs, and this phenotype was prevented by either chemical inhibition of the Notch1 pathway or by treatment with the anti-viral drug ganciclovir. GBM cells that maintained expression of HCMV-IE failed to differentiate into neuronal or astrocytic phenotypes. Our findings imply that HCMV infection induces phenotypic plasticity of GBM cells to promote GCSC features and may thereby increase the aggressiveness of this tumor.
Collapse
Affiliation(s)
- O Fornara
- Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Cell and Molecular Immunology, Microbial Pathogenesis Unit, Stockholm, Sweden.,Department of Neurology and Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| | - J Bartek
- Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Cell and Molecular Immunology, Microbial Pathogenesis Unit, Stockholm, Sweden.,Department of Neurology and Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - A Rahbar
- Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Cell and Molecular Immunology, Microbial Pathogenesis Unit, Stockholm, Sweden
| | - J Odeberg
- Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Cell and Molecular Immunology, Microbial Pathogenesis Unit, Stockholm, Sweden
| | - Z Khan
- Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Cell and Molecular Immunology, Microbial Pathogenesis Unit, Stockholm, Sweden
| | - I Peredo
- Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Cell and Molecular Immunology, Microbial Pathogenesis Unit, Stockholm, Sweden
| | - P Hamerlik
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - J Bartek
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm, Sweden.,Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - G Stragliotto
- Department of Neurology and Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| | - N Landázuri
- Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Cell and Molecular Immunology, Microbial Pathogenesis Unit, Stockholm, Sweden
| | - C Söderberg-Nauclér
- Karolinska Institute, Department of Medicine, Center for Molecular Medicine, Cell and Molecular Immunology, Microbial Pathogenesis Unit, Stockholm, Sweden
| |
Collapse
|
45
|
Fornara O, Odeberg J, Wolmer Solberg N, Tammik C, Skarman P, Peredo I, Stragliotto G, Rahbar A, Söderberg-Nauclér C. Poor survival in glioblastoma patients is associated with early signs of immunosenescence in the CD4 T-cell compartment after surgery. Oncoimmunology 2015; 4:e1036211. [PMID: 26405601 DOI: 10.1080/2162402x.2015.1036211] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/23/2015] [Accepted: 03/26/2015] [Indexed: 02/07/2023] Open
Abstract
Patients with glioblastoma multiforme (GBM) are immunosuppressed and have a broad range of immunological defects in both innate and adaptive immune responses. GBMs are frequently infected with human cytomegalovirus (HCMV), a virus capable of causing immunosuppression. In 42 HCMV-positive GBM patients in a clinical trial (VIGAS), we investigated T-cell phenotypes in the blood and assessed their relation to survival. Blood was collected before and 3, 12, and 24 weeks after surgery, and the frequency of T-cell subsets was compared with that in 26 age-matched healthy controls. GBM patients had lower levels of CD3 cells than the controls, but had significantly higher levels of CD4+CD28- T cells before and 3 and 12 weeks after surgery and increased levels of CD4+CD57+ and CD4+CD57+CD28+ T cells at all-time points. These T-cell subsets were associated with both immunosenescence and HCMV infection. GBM patients also had higher levels of γδ T cells at all-times after surgery and lower levels of CD4+CD25+ cells before and 3 weeks after surgery than healthy controls. Overall survival was significantly shorter in patients with higher levels of CD4+CD28- T cells (p = 0.025), CD4+CD57+ T (p = 0.025) cells, and CD4+CD28-CD57+CD28- T cells (p < 0.0004) at 3 weeks after surgery. Our findings indicate that signs of immunosenescence in the CD4+ compartment are associated with poor prognosis in patients with HCMV-positive GBMs and may reflect the HCMV activity in their tumors.
Collapse
Affiliation(s)
- Olesja Fornara
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Jenny Odeberg
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Nina Wolmer Solberg
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Charlotte Tammik
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Petra Skarman
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Inti Peredo
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden ; Department of Neurosurgery; Karolinska University Hospital ; Stockholm, Sweden
| | - Giuseppe Stragliotto
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden ; Department of Neuropathology; Karolinska University Hospital ; Stockholm, Sweden
| | - Afsar Rahbar
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| |
Collapse
|
46
|
Stragliotto G, Rahbar A, Soederberg-Naucler C. Update on valganciclovir as add-on therapy for glioblastoma: Effect in de novo and recurrent disease. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e22199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
47
|
Rahbar A, Peredo I, Solberg NW, Taher C, Dzabic M, Xu X, Skarman P, Fornara O, Tammik C, Yaiw K, Wilhelmi V, Assinger A, Stragliotto G, Söderberg-Naucler C. Discordant humoral and cellular immune responses to Cytomegalovirus (CMV) in glioblastoma patients whose tumors are positive for CMV. Oncoimmunology 2015; 4:e982391. [PMID: 25949880 DOI: 10.4161/2162402x.2014.982391] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 10/28/2014] [Indexed: 01/22/2023] Open
Abstract
Background. Glioblastoma (GBM) is the most common malignant brain tumor in adults and is nearly always fatal. Emerging evidence suggests that human Cytomegalovirus (HCMV) is present in 90-100% of GBMs and that add-on antiviral treatment for HCMV show promise to improve survival. Methods. In a randomized, placebo-controlled trial of valganciclovir in 42 GBM patients, blood samples were collected for analyses of HCMV DNA, RNA, reactivity against HCMV peptides, IgG, and IgM at baseline and at 3, 12, and 24 weeks of treatment. Results. All 42 tumors were positive for HCMV protein. All patients examined had at least one blood sample positive for HCMV DNA, 63% were HCMV RNA positive, and 21% were IgM positive. However, 29% of GBM patients were IgG negative for HCMV. Five of these samples were positive in an enzyme-linked immunosorbent assay (ELISA) that used antigens derived from a clinical isolate. Blood T cells from 11 of 13 (85%) HCMV IgG-negative GBM patients reacted against HCMV peptides. Valganciclovir did not affect IgG titers, DNA, or RNA levels of the HCMV immediate early (HCMV IE) gene in blood. Conclusion. In GBM patients, HCMV activity is higher than in healthy controls and serology is a poor test to define previous or active HCMV infection in these patients.
Collapse
Key Words
- ELISA, enzyme-linked immunosorbent assay
- FACS, flow cytometry analyses
- FITC, fluorescein isothiocyanate
- GBM, glioblastoma
- HCMV IE, human Cytomegalovirus-immediate early
- HCMV, human Cytomegalovirus
- HIV, human immunodeficiency virus
- HSV, herpes simplex virus
- PBMC, Peripheral blood mononuclear cells
- PBS, Phosphate buffered saline
- PCR, polymerase chain reaction
- SEB, staphylococcal snterotoxin B
- VIGAS study, Efficacy and Safety of Valcyte® as an Add-on Therapy in Patients with Malignant Glioblastoma and cytomegalovirus infection
- Valcyte
- cytomegalovirus
- glioblastoma
- peptides stimulation
- serology
- valganciclovir
Collapse
Affiliation(s)
- Afsar Rahbar
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Inti Peredo
- Departments of Neurosurgery; Karolinska University Hospital ; Stockholm, Sweden
| | - Nina Wolmer Solberg
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Chato Taher
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Mensur Dzabic
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Xinling Xu
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Petra Skarman
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Olesja Fornara
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Charlotte Tammik
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Koon Yaiw
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Vanessa Wilhelmi
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | - Alice Assinger
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| | | | - Cecilia Söderberg-Naucler
- Department of Medicine; Solna; Center for Molecular Medicine; Karolinska Institute ; Stockholm, Sweden
| |
Collapse
|
48
|
Mohammad AA, Rahbar A, Lui WO, Davoudi B, Catrina A, Stragliotto G, Mellbin L, Hamsten A, Rydén L, Yaiw KC, Söderberg-Nauclér C. Detection of circulating hcmv-miR-UL112-3p in patients with glioblastoma, rheumatoid arthritis, diabetes mellitus and healthy controls. PLoS One 2014; 9:e113740. [PMID: 25462570 PMCID: PMC4252052 DOI: 10.1371/journal.pone.0113740] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 10/30/2014] [Indexed: 12/12/2022] Open
Abstract
Background microRNAs (miRNA) are 18–22 nucleotides long non-coding RNAs that regulate gene expression at a post-transcriptional level. Human cytomegalovirus (HCMV) encodes at least 26 known mature miRNAs. hcmv-miR-UL112-3p (miR-UL112-3p) is the most well characterized HCMV miRNA, which is suggested to play role in establishment and maintenance of viral latency. Elevated miR-UL112-3p levels have been reported to be present in plasma of patients with hypertension. Objectives In this study, we aimed to quantify miR-UL112-3p levels in the plasma/serum of patients with Diabetes Mellitus (DM; from the DIGAMI-2 cohort), Glioblastoma multiforme (GBM), Rheumatoid Arthritis (RA) and Healthy Controls (HC). Study Design Total RNA was isolated from plasma/serum samples of 87 patients and controls, a TaqMan miRNA assay was performed to detect miR-UL112-3p and the copy numbers were normalized to 10 ng of total RNA. HCMV IgG and IgM were analysed using ELISA. Results HCMV miR-UL112-3p was detected in 14/27 (52%) of DM, 5/20 (25%) of GBM, 1/20 (5%) of RA patients and in 2/20 (10%) of HC, respectively. Anti-HCMV IgG was detected in 85%, 65%, 75% of patients and 70% of HC, respectively. Anti-HCMV IgM was found only in one GBM patient of 87 examined patients and controls. Conclusions A higher prevalence of miR-UL112-3p was detected in DM and GBM patients than in RA patients and HC. Elevated levels of miR-UL112-3p and higher prevalence of HCMV IgG were observed in DM patients. Whether the presence of circulating miR-UL112-3p denotes a biomarker of HCMV latency or active replication in patients warrants further investigation.
Collapse
Affiliation(s)
- Abdul-Aleem Mohammad
- Experimental Cardiovascular Research Unit, Department of Medicine-Solna, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Afsar Rahbar
- Experimental Cardiovascular Research Unit, Department of Medicine-Solna, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Weng-Onn Lui
- Department of Oncology-Pathology, Karolinksa Institutet, Cancer Center Karolinska, Karolinska University Hospital, Stockholm, Sweden
| | - Belghis Davoudi
- Experimental Cardiovascular Research Unit, Department of Medicine-Solna, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anca Catrina
- Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Giuseppe Stragliotto
- Experimental Cardiovascular Research Unit, Department of Medicine-Solna, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Linda Mellbin
- Cardiology Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Anders Hamsten
- Atherosclerosis Research Unit, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Lars Rydén
- Cardiology Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Koon-Chu Yaiw
- Experimental Cardiovascular Research Unit, Department of Medicine-Solna, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
| | - Cecilia Söderberg-Nauclér
- Experimental Cardiovascular Research Unit, Department of Medicine-Solna, Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- * E-mail:
| |
Collapse
|
49
|
Stragliotto G, Rahbar A, Bartek J, Soderberg-Naucler C. P17.85 * LOW LEVELS OF HUMAN CYTOMEGALOVIRUS INFECTION IN GLIOBLASTOMA MULTIFORME ASSOCIATES WITH PATIENT SURVIVAL; A PROSPECTIVE STUDY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
50
|
Stragliotto G, Peredo I, Rahbar A, Andersson M, Nauclér CS. [Questionable debate on antiviral therapy in malignant glioblastoma]. Lakartidningen 2014; 111:1191-1192. [PMID: 25162110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|