The use of cells from ANPEP knockout pigs to evaluate the role of aminopeptidase N (APN) as a receptor for porcine deltacoronavirus (PDCoV)

The coronaviruses, porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), and porcine deltacoronavirus (PDCoV) represent important sources of neonatal diarrhea on pig farms. The requirement for aminopeptidase N (APN) as a receptor for TGEV, but not for PEDV, is well established. In this study, the biological relevance of APN as a receptor for PDCoV was tested by using CRISPR/Cas9 to knockout the APN gene, ANPEP, in pigs. Porcine alveolar macrophages (PAMs) from ANPEP knockout (KO) pigs showed resistance to PDCoV infection. However, lung fibroblast-like cells, derived from the ANPEP KO PAM cultures, supported PDCoV infection to high levels. The results suggest that APN is a receptor for PDCoV in PAMs but is not necessary for infection of lung-derived fibroblast cells. The infection of the ANPEP KO pigs with PDCoV further confirmed that APN is dispensable as a receptor for PDCoV.

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APN is a receptor for PDCoV in PAMS, but not fibroblast cells.

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ANPEP KO pigs are not resistant to PDCoV.

Adenovirus-vectored African Swine Fever Virus antigen cocktails are immunogenic but not protective against intranasal challenge with Georgia 2007/1 isolate

African Swine Fever Virus (ASFV) causes a hemorrhagic disease in swine and wild boars with a fatality rate close to 100%. Less virulent strains cause subchronic or chronic forms of the disease. The virus is endemic in sub-Saharan Africa and an outbreak in Georgia in 2007 spread to Armenia, Russia, Ukraine, Belarus, Poland, Lithuania, and Latvia. In August 2018, there was an outbreak in China and in April 2019, ASFV was reported in Vietnam and Cambodia. Since no vaccine or treatment exists, a vaccine is needed to safeguard the swine industry. Previously, we evaluated immunogenicity of two adenovirus-vectored cocktails containing ASFV antigens and demonstrated induction of unprecedented robust antibody and T cell responses, including cytotoxic T lymphocytes. In the present study, we evaluated protective efficacy of both cocktails by intranasal challenge of pigs with ASFV-Georgia 2007/1. A nine antigen cocktail-(I) formulated in BioMize adjuvant induced strong IgG responses, but when challenged, the vaccinees had more severe reaction relative to the controls. A seven antigen cocktail-(II) was evaluated using two adjuvants: BioMize and ZTS-01. The BioMize formulation induced stronger antibody responses, but 8/10 vaccinees and 4/5 controls succumbed to the disease or reached experimental endpoint at 17 days post-challenge. In contrast, the ZTS-01 formulation induced weaker antibody responses, but 4/9 pigs succumbed to the disease while the 5 survivors exhibited low clinical scores and no viremia at 17 days post-challenge, whereas 4/5 controls succumbed to the disease or reached experimental endpoint. Overall, none of the immunogens conferred statistically significant protection.

Abstract P5-09-14: Prevalence and type of BRCA mutations in young breast cancer patients undergoing genetic cancer risk assessment in two developing countries: Analysis of two cohorts from Romania and Mexico

Background: a previous study found significant clinicopathological differences between young Breast Cancer BrCA patients (pts) from Romania (Ro) and from Mexico (Mx). Here, we provide a molecular and clinical description of pts carrying BRCA mutations of both cohorts.

Methods: in this retrospective study, we analyzed 2 cohorts of BRCA1/2 mutations carriers tested in COEI from Mx between 2014-2017 and IOCN from Ro between 2015 to 2016. Ro pts were selected according to NCCN criteria, while Mx pts were selected based on risk evaluation models. NGS analysis and MLPA for BRCA1&2 were performed in all pts. We compared demographic, clinicopathological and molecular data.

Results: 65 pts, 21 (32.7%) from Mx and 44(67.7%) from Ro carried a BRCA mutation. 66.7% of Mx pts and 65.9% of Ro pts carried a BRCA1 mutation. We found clinical similarities: Mean age was 44.5y for Mx and 40.59y for Ro pts. IDC was the most frequent type of BrCa in both series (90.5 vs 90.9%). TNBC was seen in 13 Mx vs 27 Ro pts (61.9% vs 61.4%), HR positive was seen in 7 (33.3%) and 12 (27.3%) cases. Grading 3 was more frequently seen in Ro, while grading 2 was mainly noted in MX pts(p=<0.020). BRCA1/2 pathogenic mutations were different between the 2 cohorts and no BRCA 1/2 identical mutation was identified. 15 different mutations in 21 Mx pts, and 16 different mutations in 44 Ro pts were found. Mutations were different between 2 cohorts. Notably for the Ro cohort, 4 founder mutations (c.181T>G, c.3607C>T, c.5266dupC in BRCA1,and c.9928A>G[GPC1] in BRCA2) were found in 31/44 pts, while the Mx cohort, c.5123C>A and del 9-12del ex in BRCA1 were found in 6/21 mutations. Three Large rearrangements (LR) were exclusively seen in the Mx pts (5/21).

Conclusions Both cohorts didn't share any mutation, but the clinical features are similar. BRCA1 del 9-12del is a Mexican founder mutation, we found it in 14% of Mx pts, LR have been described more frequently in Latin American Populations, we found it in 30% of the MX cohort, while for Ro cohort four recurrent mutations qualify as founder mutations.

Citation Format: Campos-Gomez S, Antone N, Pacheco-Cuéllar G, Pop L, Campos Gomez K, Stoian A, Eniu R, Valdes-Andrade J, Dronca E, Matei R, Ligtenberg M, Ouchene H, Onisim A, Rotaru O, Eniu AE. Prevalence and type of BRCA mutations in young breast cancer patients undergoing genetic cancer risk assessment in two developing countries: Analysis of two cohorts from Romania and Mexico [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-09-14.

Efficacy of a Prototype Live-vectored Multi-antigen African Swine Fever Virus Vaccine

Subunit vaccine development against some complex pathogens require inclusion of multiple targets to optimize efficacy and or broaden protection against diverse strains. To hasten vaccine development, it is rational to evaluate efficacy of a prototype vaccine in the actual outbred host that require protection. African Swine Fever Virus (ASFV) is a complex high-consequence Transboundary Animal Disease pathogen for which there is no vaccine or treatment available. Current evidence shows that protection against the ASFV can be stimulated with a vaccine since pigs that recover from infection with less virulent isolates are protected against closely related virulent isolates. In addition, there is evidence that ASFV-specific cytotoxic T lymphocytes (CTLs) are required for viral clearance. We have tested protective efficacy of several adenovirus-vectored prototype formulations containing multiple rationally selected ASFV antigens. Homologous prime-boost immunization of commercial pigs with one of the experimental vaccine induced significant and unprecedented antigen-specific CTL responses that were detectable in peripheral blood mononuclear cells (PBMCs). Significant IFN-gamma-secreting cells were also detected in PBMCs post-priming and the memory was recalled upon boost. In addition, the immunogen primed antibody responses that were recalled upon boost. More importantly, the prototype vaccine conferred protection in 5/9 of vaccinees following intranasal challenge with the ASFV Georgia 2007/1 isolate. Notably, these survivors were healthy with low clinical scores. In comparison, only 2/5 of the negative controls were alive 17 days post-challenge and they had high clinical scores that necessitated termination.

Abstract P4-06-11: Is myriad a reliable genetic risk model for prediction BRCA1/2 mutations in Romanian high-risk breast cancer patients?

Aim: To assess the predictive efficacies of genetic risk model Myriad for BRCA1/2 mutations in high-risk Romanian breast cancer patients (pts).

Methods: This prospective study evaluated the validity of Myriad risk assessment model for 250 high-risk breast cancer pts tested for BRCA1/2 mutations between 02.2015-12.2016 at IOCN. Inclusion criteria selected pts diagnosed with triple negative breast cancer under the age of 50, or having conventional family history criteria. All pts signed an informed consent. Myriad calculator software was utilized in order to assess the score for all 250 patients. BRCA testing was performed using an AmpliSeq-based sequencing analysis, on the Ion Torrent Personal Genome Machine at RCFG. Pathogenic mutations were validated using Sanger technology. MLPA was performed for all pts.

Results:The mean Myriad scores for all patients was 8.09% (2.2-26.6%) and the mean Myriad score for BRCA1/2 mutated pts was 11.56% (2.2-26.6%). The majority of pts, 166 (66,4%) presented a Myriad score between 2.2-4.8%, out of which 18 pts (40.9%) were BRCA1/2 mutated. Considering a higher score and the presence of deleterious BRCA1/2 mutations, 12 (27.27%) pts presented a score of 10.3-10.4%, 9 (20.45%) pts a score of 21.2-21.9%, and respectively 5 (11.36%)pts had a score of 26.6%. The subgroup analyzes revealed that the prediction of Myriad genetic risk model in high-risk breast cancer pts was statistical significant when the groups present scores between 10.3 and 26.2%. Other subgroup analysis failed to demonstrate statistical significance.

Table 1: Frequency analysis according to Myriad genetic risk model scores and BRCA1/2 mutational status.Myriad genetic risk model scores* (n=250)BRCA 1/2 mutated (n=44)No BRCA1/2 mutation (n= 191)Variants of unknown significance # (n=18)2.2-4.8% (n=166)18(40.9%)136(71.20%)12(66.66%)6.9%-8% (n=8)08(4.18%)010.3-10.4% (n=45)12(27.27%)29(15.18%)4(22.22%)15.9%(n=1)01(0.52%)021.2%-21.9% (n=14)9(20.45%)4(2.09%)1(5.55%)26.6% (n=16)5(11.36%)10(5.23%)1(5.55%)* The risk was calculated using BRCA risk calculator available at http://www.myriadpro.com/brca-risk-calculator/calc.html # Number of VUS results includes 3 pts that presented BRCA mutations positive results.

Table 2: Myriad genetic risk model stratified by 10.3 and 21.2% scores and BRCA test results.Data analyzedBRCA 1/2 mutatedNo BRCA1/2 mutationTotalP valueMyriad score 10.3%1229410.0100Myriad score 21.2%9413 Total213354 

Conclusions: The Myriad genetic risk model can be an acceptable risk assessment tool for determining the risk of carrying BRCA mutations in Romanian population if the score is between 10-20%. The inaccuracy in carrier prediction using Myriad model represents a challenge worthy of additional investigation and comparison with other genetic models. Genetic counselors should recognize this limitation when using Myriad model and recommending genetic testing for Romanian high-risk breast cancer pts.ClinicalTrials.gov Identifier: NCT02317120.

Citation Format: Eniu A, Pop L, Stoian A, Dronca E, Matei R, Ligtenberg M, Ouchene H, Onisim A, Rotaru O, Eniu R, Antone N. Is myriad a reliable genetic risk model for prediction BRCA1/2 mutations in Romanian high-risk breast cancer patients? [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-06-11.

[Epidural analgesia for surgical treatment of peritoneal carcinomatosis: a risky technique?]

BACKGROUND

To study the risks of haemodynamic instability, and the possible occurrence of spinal haematoma, meningitis and epidural abscess when epidural analgesia is performed for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

METHODS

We retrospectively analyzed the data of 35 patients treated by HIPEC with oxaliplatin or cisplatin. An epidural catheter was inserted before induction of general anaesthesia. Postoperatively, a continuous epidural infusion of ropivacain, then a patient-controlled epidural analgesia were started.

RESULTS

The epidural catheter was used peroperatively before HIPEC in 12 subjects (34%), and after HIPEC in 23 subjects (66%). The median dose of ropivacain given peroperatively in the epidural catheter was 40 mg (30-75). Norepinephrin was used in two subjects (6%) peroperatively (median infusion rate 0.325 μg/kg per minute [0.32-0.33]), and in four subjects (11%) in the postoperative 24 hours. No spinal haematoma, meningitis or epidural abscess were noted. Five subjects (14%) had a thrombopenia or a prothrombin time less than 60% before catheter removal. Two subjects (6%) had a leukopenia before catheter removal. No thrombopenia or blood coagulation disorders were recorded the day of catheter removal.

CONCLUSION

In this series of 35 patients, the use of epidural analgesia for HIPEC does not seem to be associated with a worse risk of haemodynamic instability, spinal haematoma, meningitis or epidural abscess. HIPEC with platinum salt is not incompatible with the safety of epidural analgesia, with an optimized fluid management peroperatively and the following of perimedullary anesthesia practice guidelines.

Free-floating left atrial thrombus and systemic embolization

A patient with mitral stenosis and systemic thromboemboli is presented. Two-dimensional echocardiography demonstrated a spherical thrombus floating freely within the left atrium which was corroborated by postmortem examination. This case is unique in its clinical outcome and provides insight into the pathogenesis of such left atrial thrombi.