1
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Murphy DM, Walsh A, Stein L, Petrasca A, Cox DJ, Brown K, Duffin E, Jameson G, Connolly SA, O'Connell F, O'Sullivan J, Basdeo SA, Keane J, Phelan JJ. Human Macrophages Activate Bystander Neutrophils' Metabolism and Effector Functions When Challenged with Mycobacterium tuberculosis. Int J Mol Sci 2024; 25:2898. [PMID: 38474145 DOI: 10.3390/ijms25052898] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Neutrophils are dynamic cells, playing a critical role in pathogen clearance; however, neutrophil infiltration into the tissue can act as a double-edged sword. They are one of the primary sources of excessive inflammation during infection, which has been observed in many infectious diseases including pneumonia and active tuberculosis (TB). Neutrophil function is influenced by interactions with other immune cells within the inflammatory lung milieu; however, how these interactions affect neutrophil function is unclear. Our study examined the macrophage-neutrophil axis by assessing the effects of conditioned medium (MΦ-CM) from primary human monocyte-derived macrophages (hMDMs) stimulated with LPS or a whole bacterium (Mycobacterium tuberculosis) on neutrophil function. Stimulated hMDM-derived MΦ-CM boosts neutrophil activation, heightening oxidative and glycolytic metabolism, but diminishes migratory potential. These neutrophils exhibit increased ROS production, elevated NET formation, and heightened CXCL8, IL-13, and IL-6 compared to untreated or unstimulated hMDM-treated neutrophils. Collectively, these data show that MΦ-CM from stimulated hMDMs activates neutrophils, bolsters their energetic profile, increase effector and inflammatory functions, and sequester them at sites of infection by decreasing their migratory capacity. These data may aid in the design of novel immunotherapies for severe pneumonia, active tuberculosis and other diseases driven by pathological inflammation mediated by the macrophage-neutrophil axis.
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Affiliation(s)
- Dearbhla M Murphy
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Anastasija Walsh
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Laura Stein
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Andreea Petrasca
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute (TBSI), Trinity College Dublin, The University of Dublin, D02 R590 Dublin, Ireland
| | - Donal J Cox
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Kevin Brown
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Emily Duffin
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Gráinne Jameson
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Sarah A Connolly
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Fiona O'Connell
- Department of Surgery, Trinity St. James's Cancer Institute, Trinity Translational Medicine Institute (TTMI), St. James's Hospital, Dublin 8, D08 W9RT Dublin, Ireland
| | - Jacintha O'Sullivan
- Department of Surgery, Trinity St. James's Cancer Institute, Trinity Translational Medicine Institute (TTMI), St. James's Hospital, Dublin 8, D08 W9RT Dublin, Ireland
| | - Sharee A Basdeo
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - Joseph Keane
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
| | - James J Phelan
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute (TTMI), Trinity Centre for Health Sciences, St. James's Hospital, Trinity College Dublin, The University of Dublin, Dublin 8, D08 W9RT Dublin, Ireland
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Solomon S, Stone K, Yu P, Murphy DM, Kinnison D, Ravishankara AR, Wang P. Chlorine activation and enhanced ozone depletion induced by wildfire aerosol. Nature 2023; 615:259-264. [PMID: 36890371 DOI: 10.1038/s41586-022-05683-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/22/2022] [Indexed: 03/10/2023]
Abstract
Remarkable perturbations in the stratospheric abundances of chlorine species and ozone were observed over Southern Hemisphere mid-latitudes following the 2020 Australian wildfires1,2. These changes in atmospheric chemical composition suggest that wildfire aerosols affect stratospheric chlorine and ozone depletion chemistry. Here we propose that wildfire aerosol containing a mixture of oxidized organics and sulfate3-7 increases hydrochloric acid solubility8-11 and associated heterogeneous reaction rates, activating reactive chlorine species and enhancing ozone loss rates at relatively warm stratospheric temperatures. We test our hypothesis by comparing atmospheric observations to model simulations that include the proposed mechanism. Modelled changes in 2020 hydrochloric acid, chlorine nitrate and hypochlorous acid abundances are in good agreement with observations1,2. Our results indicate that wildfire aerosol chemistry, although not accounting for the record duration of the 2020 Antarctic ozone hole, does yield an increase in its area and a 3-5% depletion of southern mid-latitude total column ozone. These findings increase concern2,12,13 that more frequent and intense wildfires could delay ozone recovery in a warming world.
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Affiliation(s)
- Susan Solomon
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Kane Stone
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | - Pengfei Yu
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - D M Murphy
- NOAA Chemical Sciences Laboratory, Boulder, CO, USA
| | - Doug Kinnison
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - A R Ravishankara
- Department of Chemistry, Colorado State University, Fort Collins, CO, USA.,Department of Atmospheric Science, Colorado State University, Fort Collins, CO, USA
| | - Peidong Wang
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
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3
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Katich JM, Apel EC, Bourgeois I, Brock CA, Bui TP, Campuzano-Jost P, Commane R, Daube B, Dollner M, Fromm M, Froyd KD, Hills AJ, Hornbrook RS, Jimenez JL, Kupc A, Lamb KD, McKain K, Moore F, Murphy DM, Nault BA, Peischl J, Perring AE, Peterson DA, Ray EA, Rosenlof KH, Ryerson T, Schill GP, Schroder JC, Weinzierl B, Thompson C, Williamson CJ, Wofsy SC, Yu P, Schwarz JP. Pyrocumulonimbus affect average stratospheric aerosol composition. Science 2023; 379:815-820. [PMID: 36821693 DOI: 10.1126/science.add3101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Pyrocumulonimbus (pyroCb) are wildfire-generated convective clouds that can inject smoke directly into the stratosphere. PyroCb have been tracked for years, yet their apparent rarity and episodic nature lead to highly uncertain climate impacts. In situ measurements of pyroCb smoke reveal its distinctive and exceptionally stable aerosol properties and define the long-term influence of pyroCb activity on the stratospheric aerosol budget. Analysis of 13 years of airborne observations shows that pyroCb are responsible for 10 to 25% of the black carbon and organic aerosols in the "present-day" lower stratosphere, with similar impacts in both the North and South Hemispheres. These results suggest that, should pyroCb increase in frequency and/or magnitude in future climates, they could generate dominant trends in stratospheric aerosol.
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Affiliation(s)
- J M Katich
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - E C Apel
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - I Bourgeois
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - C A Brock
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA
| | - T P Bui
- NASA Ames Research Center, Moffett Field, CA, USA
| | - P Campuzano-Jost
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA.,Department of Chemistry, University of Colorado, Boulder, CO, USA
| | - R Commane
- Department of Earth and Environmental Sciences and School of Engineering and Applied Sciences, Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA
| | - B Daube
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - M Dollner
- Aerosol Physics and Environmental Physics, Faculty of Physics, University of Vienna, Vienna, Austria
| | - M Fromm
- Naval Research Laboratory, Washington, DC, USA
| | - K D Froyd
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - A J Hills
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - R S Hornbrook
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - J L Jimenez
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA.,Department of Chemistry, University of Colorado, Boulder, CO, USA
| | - A Kupc
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA.,Aerosol Physics and Environmental Physics, Faculty of Physics, University of Vienna, Vienna, Austria
| | - K D Lamb
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - K McKain
- NOAA Global Monitoring Laboratory, Boulder, CO, USA
| | - F Moore
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA.,NOAA Global Monitoring Laboratory, Boulder, CO, USA
| | - D M Murphy
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA
| | - B A Nault
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA.,Department of Chemistry, University of Colorado, Boulder, CO, USA.,Center for Aerosol and Cloud Chemistry, Aerodyne Research Inc., Billerica, MA, USA
| | - J Peischl
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - A E Perring
- Department of Chemistry, Colgate University, Hamilton, NY, USA
| | | | - E A Ray
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - K H Rosenlof
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA
| | - T Ryerson
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA
| | - G P Schill
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - J C Schroder
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA.,Department of Chemistry, University of Colorado, Boulder, CO, USA.,Colorado Department of Public Health and Environment, Denver, CO, USA
| | - B Weinzierl
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - C Thompson
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - C J Williamson
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA.,Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - S C Wofsy
- Department of Earth and Planetary Sciences, Harvard University, Cambridge, MA, USA
| | - P Yu
- Institute of Environmental and Climate Research, Jinan University, Guangzhou, People's Republic of China
| | - J P Schwarz
- National Oceanic and Atmospheric Administration (NOAA) Chemical Sciences Laboratory (CSL), Boulder, CO, USA
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Murphy DM, Cox DJ, Connolly SA, Breen EP, Brugman AA, Phelan JJ, Keane J, Basdeo SA. Trained immunity is induced in humans after immunization with an adenoviral vector COVID-19 vaccine. J Clin Invest 2023; 133:162581. [PMID: 36282571 PMCID: PMC9843058 DOI: 10.1172/jci162581] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/21/2022] [Indexed: 01/22/2023] Open
Abstract
BackgroundHeterologous effects of vaccines are mediated by "trained immunity," whereby myeloid cells are metabolically and epigenetically reprogrammed, resulting in heightened responses to subsequent insults. Adenovirus vaccine vector has been reported to induce trained immunity in mice. Therefore, we sought to determine whether the ChAdOx1 nCoV-19 vaccine (AZD1222), which uses an adenoviral vector, could induce trained immunity in vivo in humans.MethodsTen healthy volunteers donated blood on the day before receiving the ChAdOx1 nCoV-19 vaccine and on days 14, 56, and 83 after vaccination. Monocytes were purified from PBMCs, cell phenotype was determined by flow cytometry, expression of metabolic enzymes was quantified by RT-qPCR, and production of cytokines and chemokines in response to stimulation ex vivo was analyzed by multiplex ELISA.ResultsMonocyte frequency and count were increased in peripheral blood up to 3 months after vaccination compared with their own prevaccine controls. Expression of HLA-DR, CD40, and CD80 was enhanced on monocytes for up to 3 months following vaccination. Moreover, monocytes had increased expression of glycolysis-associated enzymes 2 months after vaccination. Upon stimulation ex vivo with unrelated antigens, monocytes produced increased IL-1β, IL-6, IL-10, CXCL1, and MIP-1α and decreased TNF, compared with prevaccine controls. Resting monocytes produced more IFN-γ, IL-18, and MCP-1 up to 3 months after vaccination compared with prevaccine controls.ConclusionThese data provide evidence for the induction of trained immunity following a single dose of the ChAdOx1 nCoV-19 vaccine.FundingThis work was funded by the Health Research Board (EIA-2019-010) and Science Foundation Ireland Strategic Partnership Programme (proposal ID 20/SPP/3685).
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Affiliation(s)
| | - Donal J. Cox
- Tuberculosis Immunology Group, Department of Clinical Medicine, and
| | | | - Eamon P. Breen
- Core Facilities, Trinity Translational Medicine Institute, St. James’s Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | | | - James J. Phelan
- Tuberculosis Immunology Group, Department of Clinical Medicine, and
| | - Joseph Keane
- Tuberculosis Immunology Group, Department of Clinical Medicine, and
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5
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Singh K, Cogan S, Elekes S, Murphy DM, Cummins S, Curran R, Najda Z, Dunne MR, Jameson G, Gargan S, Martin S, Long A, Doherty DG. SARS-CoV-2 spike and nucleocapsid proteins fail to activate human dendritic cells or γδ T cells. PLoS One 2022; 17:e0271463. [PMID: 35834480 PMCID: PMC9282473 DOI: 10.1371/journal.pone.0271463] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/30/2022] [Indexed: 11/20/2022] Open
Abstract
γδ T cells are thought to contribute to immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the mechanisms by which they are activated by the virus are unknown. Using flow cytometry, we investigated if the two most abundant viral structural proteins, spike and nucleocapsid, can activate human γδ T cell subsets, directly or in the presence of dendritic cells (DC). Both proteins failed to induce interferon-γ production by Vδ1 or Vδ2 T cells within fresh mononuclear cells or lines of expanded γδ T cells generated from healthy donors, but the same proteins stimulated CD3+ cells from COVID-19 patients. The nucleocapsid protein stimulated interleukin-12 production by DC and downstream interferon-γ production by co-cultured Vδ1 and Vδ2 T cells, but protease digestion and use of an alternative nucleocapsid preparation indicated that this activity was due to contaminating non-protein material. Thus, SARS-CoV-2 spike and nucleocapsid proteins do not have stimulatory activity for DC or γδ T cells. We propose that γδ T cell activation in COVID-19 patients is mediated by immune recognition of viral RNA or other structural proteins by γδ T cells, or by other immune cells, such as DC, that produce γδ T cell-stimulatory ligands or cytokines.
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Affiliation(s)
- Kiran Singh
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Sita Cogan
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Stefan Elekes
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Dearbhla M. Murphy
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Sinead Cummins
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Rory Curran
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Zaneta Najda
- Molecular Cell Biology Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Margaret R. Dunne
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Gráinne Jameson
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Siobhan Gargan
- Discipline of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Seamus Martin
- Molecular Cell Biology Laboratory, Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Aideen Long
- Discipline of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
| | - Derek G. Doherty
- Discipline of Immunology, Trinity Translational Medicine Institute, Trinity College Dublin, St. James’s Hospital, Dublin, Ireland
- * E-mail:
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6
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Ronan NJ, Einarsson GG, Deane J, Fouhy F, Rea M, Hill C, Shanahan F, Elborn JS, Ross RP, McCarthy M, Murphy DM, Eustace JA, Mm T, Stanton C, Plant BJ. Modulation, microbiota and inflammation in the adult CF gut: A prospective study. J Cyst Fibros 2022; 21:837-843. [PMID: 35764510 DOI: 10.1016/j.jcf.2022.06.002] [Citation(s) in RCA: 1] [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] [Received: 11/30/2021] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cystic Fibrosis (CF) has prominent gastrointestinal and pancreatic manifestations. The aim of this study was to determine the effect of Cystic fibrosis transmembrane conductance regulator (CFTR) modulation on, gastrointestinal inflammation, pancreatic function and gut microbiota composition in people with cystic fibrosis (CF) and the G551D-CFTR mutation. METHODS Fourteen adult patients with the G551D-CFTR mutation were assessed clinically at baseline and for up to 1 year after treatment with ivacaftor. The change in gut inflammatory markers (calprotectin and lactoferrin), exocrine pancreatic status and gut microbiota composition and structure were assessed in stool samples. RESULTS There was no significant change in faecal calprotectin nor lactoferrin in patients with treatment while all patients remained severely pancreatic insufficient. There was no significant change in gut microbiota diversity and richness following treatment. CONCLUSION There was no significant change in gut inflammation after partial restoration of CFTR function with ivacaftor, suggesting that excess gut inflammation in CF is multi-factorial in aetiology. In this adult cohort, exocrine pancreatic function was irreversibly lost. Longer term follow-up may reveal more dynamic changes in the gut microbiota and possible restoration of CFTR function.
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Affiliation(s)
- N J Ronan
- Cork Adult CF Centre, Cork University Hospital, Wilton, Cork; HRB Clinical research facility, University College Cork
| | - G G Einarsson
- Halo Research Group, Queen's University Belfast, Belfast, UK; Wellcome-Wolfson Institute for Experimental Medicine. School of Medicine, Dentistry and Biomedical Sciences Queen's University Belfast, Belfast, UK
| | - J Deane
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland; APC Microbiome Ireland, University College Cork, NUI, Cork, Ireland
| | - F Fouhy
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland; APC Microbiome Ireland, University College Cork, NUI, Cork, Ireland
| | - M Rea
- Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland; APC Microbiome Ireland, University College Cork, NUI, Cork, Ireland
| | - C Hill
- APC Microbiome Ireland, University College Cork, NUI, Cork, Ireland
| | - F Shanahan
- APC Microbiome Ireland, University College Cork, NUI, Cork, Ireland
| | - J S Elborn
- Halo Research Group, Queen's University Belfast, Belfast, UK; Wellcome-Wolfson Institute for Experimental Medicine. School of Medicine, Dentistry and Biomedical Sciences Queen's University Belfast, Belfast, UK
| | - R P Ross
- APC Microbiome Ireland, University College Cork, NUI, Cork, Ireland
| | - M McCarthy
- Cork Adult CF Centre, Cork University Hospital, Wilton, Cork
| | - D M Murphy
- Cork Adult CF Centre, Cork University Hospital, Wilton, Cork
| | - J A Eustace
- HRB Clinical research facility, University College Cork
| | - Tunney Mm
- Halo Research Group, Queen's University Belfast, Belfast, UK; School of Pharmacy, Queen's University Belfast, Belfast, UK; HRB Clinical research facility, University College Cork
| | - C Stanton
- Wellcome-Wolfson Institute for Experimental Medicine. School of Medicine, Dentistry and Biomedical Sciences Queen's University Belfast, Belfast, UK; Teagasc Food Research Centre, Moorepark, Fermoy, Cork, Ireland
| | - B J Plant
- Cork Adult CF Centre, Cork University Hospital, Wilton, Cork; HRB Clinical research facility, University College Cork; APC Microbiome Ireland, University College Cork, NUI, Cork, Ireland.
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7
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Ó Maoldomhnaigh C, Cox DJ, Phelan JJ, Mitermite M, Murphy DM, Leisching G, Thong L, O'Leary SM, Gogan KM, McQuaid K, Coleman AM, Gordon SV, Basdeo SA, Keane J. Lactate Alters Metabolism in Human Macrophages and Improves Their Ability to Kill Mycobacterium tuberculosis. Front Immunol 2021; 12:663695. [PMID: 34691015 PMCID: PMC8526932 DOI: 10.3389/fimmu.2021.663695] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 02/03/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
In order to mount an appropriate immune response to infection, the macrophage must alter its metabolism by increasing aerobic glycolysis and concomitantly decreasing oxidative phosphorylation; a process known as the Warburg effect. Consequently, lactate, the end-product of glycolysis, accumulates in the extracellular environment. The subsequent effect of lactate on surrounding macrophages is poorly understood. Mycobacterium tuberculosis (Mtb), the causative organism of Tuberculosis (TB), is phagocytosed by macrophages in the airways. Mtb infected macrophages upregulate aerobic glycolysis and effector functions to try to kill the bacteria. Our lab has previously shown that human macrophages produce lactate in response to infection with Mtb. Although lactate has largely been considered a waste product of aerobic glycolysis, we hypothesised that the presence of extracellular lactate would impact subsequent immunometabolic responses and modulate macrophage function. We demonstrate that the presence of exogenous lactate has an immediate effect on the cellular metabolism of resting human macrophages; causing a decrease in extracellular acidification rate (ECAR; analogous to the rate of glycolysis) and an increase in the oxygen consumption rate (OCR; analogous to oxidative phosphorylation). When lactate-treated macrophages were stimulated with Mtb or LPS, glycolysis proceeds to increase immediately upon stimulation but oxidative phosphorylation remains stable compared with untreated cells that display a decrease in OCR. This resulted in a significantly reduced ECAR/OCR ratio early in response to stimulation. Since altered metabolism is intrinsically linked to macrophage function, we examined the effect of lactate on macrophage cytokine production and ability to kill Mtb. Lactate significantly reduced the concentrations of TNF and IL-1β produced by human macrophages in response to Mtb but did not alter IL-10 and IL-6 production. In addition, lactate significantly improved bacillary clearance in human macrophages infected with Mtb, through a mechanism that is, at least in part, mediated by promoting autophagy. These data indicate that lactate, the product of glycolysis, has a negative feedback effect on macrophages resulting in an attenuated glycolytic shift upon subsequent stimulation and reduced pro-inflammatory cytokine production. Interestingly, this pro-resolution effect of lactate is associated with increased capacity to kill Mtb.
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Affiliation(s)
- Cilian Ó Maoldomhnaigh
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Donal J Cox
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - James J Phelan
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Morgane Mitermite
- School of Veterinary Medicine and Conway Institute, University College Dublin, Dublin, Ireland
| | - Dearbhla M Murphy
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Gina Leisching
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Lorraine Thong
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Seónadh M O'Leary
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Karl M Gogan
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Kate McQuaid
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Amy M Coleman
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Stephen V Gordon
- School of Veterinary Medicine and Conway Institute, University College Dublin, Dublin, Ireland
| | - Sharee A Basdeo
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Joseph Keane
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
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8
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Murphy DM, Mills KHG, Basdeo SA. The Effects of Trained Innate Immunity on T Cell Responses; Clinical Implications and Knowledge Gaps for Future Research. Front Immunol 2021; 12:706583. [PMID: 34489958 PMCID: PMC8417102 DOI: 10.3389/fimmu.2021.706583] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 05/07/2021] [Accepted: 07/30/2021] [Indexed: 12/16/2022] Open
Abstract
The burgeoning field of innate immune training, also called trained immunity, has given immunologists new insights into the role of innate responses in protection against infection and in modulating inflammation. Moreover, it has led to a paradigm shift in the way we think about immune memory and the interplay between innate and adaptive immune systems in conferring immunity against pathogens. Trained immunity is the term used to describe the medium-term epigenetic and metabolic reprogramming of innate immune cells in peripheral tissues or in the bone marrow stem cell niche. It is elicited by an initial challenge, followed by a significant period of rest that results in an altered response to a subsequent, unrelated challenge. Trained immunity can be associated with increased production of proinflammatory mediators, such as IL-1β, TNF and IL-6, and increased expression of markers on innate immune cells associated with antigen presentation to T cells. The microenvironment created by trained innate immune cells during the secondary challenge may have profound effects on T cell responses, such as altering the differentiation, polarisation and function of T cell subtypes, including Th17 cells. In addition, the Th1 cytokine IFN-γ plays a critical role in establishing trained immunity. In this review, we discuss the evidence that trained immunity impacts on or can be impacted by T cells. Understanding the interplay between innate immune training and how it effects adaptive immunity will give insights into how this phenomenon may affect the development or progression of disease and how it could be exploited for therapeutic interventions or to enhance vaccine efficacy.
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Affiliation(s)
- Dearbhla M Murphy
- Human and Translational Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Kingston H G Mills
- Immune Regulation Research Group, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Sharee A Basdeo
- Human and Translational Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, St James's Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
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9
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Melo AM, Mylod E, Fitzgerald V, Donlon NE, Murphy DM, Foley EK, Bhardwaj A, Reynolds JV, Doherty DG, Lysaght J, Dunne MR, Conroy MJ. Tissue distribution of γδ T cell subsets in oesophageal adenocarcinoma. Clin Immunol 2021; 229:108797. [PMID: 34273585 DOI: 10.1016/j.clim.2021.108797] [Citation(s) in RCA: 8] [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: 02/15/2021] [Revised: 06/25/2021] [Accepted: 07/10/2021] [Indexed: 12/16/2022]
Abstract
The global obesity epidemic is contributing to increased prevalence of diseases fuelled by chronic inflammation, including cancer. Oesophageal adenocarcinoma (OAC) is an obesity-associated malignancy with increasing prevalence, dismal prognosis, and severely dysregulated immune processes. We previously reported that αβ T cells migrate to omentum and liver in OAC and contribute to inflammation in these tissues. Here, we assessed the tissue distribution and phenotype of gamma/delta (γδ) T cells in the blood, omentum, liver and tumour of OAC patients. Our data show that the Vδ1 and Vδ3 subsets of γδ T cells are most prevalent in omentum and liver of OAC patients. Furthermore, γδ T cells are predominantly pro-inflammatory in these tissues, and co-express IFN-γ and IL-17. Moreover, γδ T cells exhibit cytotoxic capabilities in OAC omentum and liver. This study provides the first indication that γδ T cells contribute to obesity-associated inflammation in OAC and might be exploited therapeutically.
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Affiliation(s)
- Ashanty M Melo
- Cancer Immunology and Immunotherapy Group, Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
| | - Eimear Mylod
- Cancer Immunology and Immunotherapy Group, Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
| | - Vivienne Fitzgerald
- Cancer Immunology and Immunotherapy Group, Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
| | - Noel E Donlon
- Cancer Immunology and Immunotherapy Group, Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
| | | | - Emma K Foley
- Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
| | - Anshul Bhardwaj
- Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
| | - John V Reynolds
- Gastro-Intestinal Medicine and Surgery, St. James's Hospital, Dublin 8, Ireland
| | | | - Joanne Lysaght
- Cancer Immunology and Immunotherapy Group, Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
| | - Margaret R Dunne
- Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
| | - Melissa J Conroy
- Cancer Immunology and Immunotherapy Group, Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland.
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10
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Ibrahim H, Walsh J, Casey D, Murphy J, Plant BJ, O'Leary P, Murphy DM. Recurrent asthma exacerbations: co-existing asthma and common variable immunodeficiency. J Asthma 2021; 59:1177-1180. [PMID: 33902374 DOI: 10.1080/02770903.2021.1922913] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
Common variable immunodeficiency is characterized by impaired B-cell differentiation and defective immunoglobulin production manifesting as recurrent respiratory tract infections. While the condition can masquerade as asthma, late diagnosis of CVID in known asthmatic is rarely reported. We present the case of a 43-year-old lady with recurrent episodes of wheeze, cough, sinusitis and multiple lower respiratory tract infections. Transiently responsive to antibiotics and steroids. These episodes had been occurring for many years and she had a longstanding clinical diagnosis of asthma. As part of her work up for recurrent respiratory tract infections a CT thorax was performed and demonstrated bronchiectasis. Further tests including Immunoglobulin levels revealed critically low IgG, IgM, and IgA levels. Immunoglobulin replacement therapy was commenced with a reduction in exacerbation frequency and severity, and objective improvement of asthma control. Subsequent lung function tests demonstrated reversible airflow limitation (obstructive lung function with 13% reversibility in FEV1 post-bronchodilator) consistent with asthma. Our case illustrates the importance of searching for alternate and co-existent diagnoses in patients diagnosed with asthma who are unresponsive to conventional therapy. We believe that serum immunoglobulin measurement should form a component of such a workup.
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Affiliation(s)
- H Ibrahim
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - J Walsh
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - D Casey
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - J Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - B J Plant
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.,The HRB funded Clinical Research Facility, University College Cork, Cork, Ireland
| | - P O'Leary
- The Department of Medicine, School of Medicine, University College Cork, Cork, Ireland
| | - D M Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.,The HRB funded Clinical Research Facility, University College Cork, Cork, Ireland
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11
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Deslyper G, Murphy DM, Sowemimo OA, Holland CV, Doherty DG. Distinct hepatic myeloid and lymphoid cell repertoires are associated with susceptibility and resistance to Ascaris infection. Parasitology 2021; 148:539-549. [PMID: 33431071 PMCID: PMC10090783 DOI: 10.1017/s0031182021000020] [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: 08/31/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 02/02/2023]
Abstract
The soil-transmitted helminth Ascaris lumbricoides infects ~800 million people worldwide. Some people are heavily infected, harbouring many worms, whereas others are only lightly infected. The mechanisms behind this difference are unknown. We used a mouse model of hepatic resistance to Ascaris, with C57BL/6J mice as a model for heavy infection and CBA/Ca mice as a model for light infection. The mice were infected with the porcine ascarid, Ascaris suum or the human ascarid, A. lumbricoides and immune cells in their livers and spleens were enumerated using flow cytometry. Compared to uninfected C57BL/6J mice, uninfected CBA/Ca mice had higher splenic CD4+ and γδ T cell counts and lower hepatic eosinophil, Kupffer cell and B cell counts. Infection with A. suum led to expansions of eosinophils, Kupffer cells, monocytes and dendritic cells in the livers of both mouse strains and depletions of hepatic natural killer (NK) cells in CBA/Ca mice only. Infection with A. lumbricoides led to expansions of hepatic eosinophils, monocytes and dendritic cells and depletions of CD8+, αβ, NK and NK T cells in CBA/Ca mice, but not in C57BL/6J mice where only monocytes expanded. Thus, susceptibility and resistance to Ascaris infection are governed, in part, by the hepatic immune system.
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Affiliation(s)
- Gwendoline Deslyper
- Department of Zoology, School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
| | - Dearbhla M. Murphy
- Department of Immunology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Celia V. Holland
- Department of Zoology, School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
| | - Derek G. Doherty
- Department of Immunology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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12
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Danish H, Dukelow T, Plant BJ, Curtin R, Henry MT, Kennedy MK, Murphy DM. Outcomes Post Thrombolysis for Acute Pulmonary Embolism. Ir Med J 2020; 113:103. [PMID: 32816438] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background Pulmonary embolism (PE) remains a significant cause of mortality in Europe1. Thrombolytic therapy is often utilised as a therapeutic strategy in massive and sub-massive PE. There is a dearth of research on short term complications and subsequent outcomes in patients who have received thrombolysis for PE in Ireland. Methods This retrospective study examined patients who underwent thrombolysis for acute sub massive PE whilst under the care of the respiratory service in Cork University Hospital (CUH) from 2010-2018. All patients had CTPA done for diagnosis of PE. Alteplase was used as a thrombolytic agent. Patient records were perused. Follow-up pulmonary functions tests (PFTs) and trans-thoracic echocardiogram (TTE) results were assessed for evidence of impairment of diffusing capacity (DLCO) and pulmonary hypertension (PH) respectively. Results Twenty five patients were included in the study. Nine patients (36%) were women and 64% men. Average age was 55.1 years. Four patients suffered complications related to thrombolysis (average age 63.3 years). Twenty-Two patients (88%) underwent a follow-up echocardiography (mean 30 weeks post PE). Three patients (13%) had echocardiographic evidence of possible mild PH (i.e. RVSP >40mmhg) at initial follow-up. Fourteen patients (56%) who underwent thrombolysis had follow-up PFTs (mean 11.8 months post PE). The diffusing capacity (DLCO) was normal in all patients. Conclusion Thrombolysis was a relatively safe intervention in this small study.
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Affiliation(s)
- H Danish
- The Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork
| | - T Dukelow
- The Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork
| | - B J Plant
- The Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork
| | - R Curtin
- The Department of Cardiology, Cork University Hospital, Wilton, Cork
| | - M T Henry
- The Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork
| | - M K Kennedy
- The Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork
| | - D M Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork
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13
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Ibrahim H, O'Sullivan R, Casey D, Murphy J, MacSharry J, Plant BJ, Murphy DM. The effectiveness of Reslizumab in severe asthma treatment: a real-world experience. Respir Res 2019; 20:289. [PMID: 31861993 PMCID: PMC6923853 DOI: 10.1186/s12931-019-1251-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/27/2019] [Indexed: 12/31/2022] Open
Abstract
Background Increased numbers of blood and sputum eosinophils are associated with higher exacerbation frequency and increased asthma severity. In clinical trials, targeting Interleukin-5 has been shown to be a useful therapeutic strategy for patients with severe eosinophilic asthma. Methods Twenty-six patients have been commenced on Reslizumab in our institution since early 2017. Safety and clinical efficacy parameters were recorded at regular intervals. Results Mean ACQ-6 score at the start of treatment was 3.5. The average number of exacerbations in the year preceding treatment was 8.3 per person. 30% of patients had been admitted to hospital at least once over the 12 months preceding therapy. 54% of our patients were on long term oral steroid. Our data showed sustained improvement of Asthma control (Mean improvement in ACQ-6 was 1.7 at 1 year, and 2.0 at 2 years, P = 0.0001). Of the patients who were on long term systemic steroids, 35.7% discontinued steroids completely, with a mean reduction of prednisolone dose of 5.2 mg at 1 year. There was a 79% reduction in the annual exacerbation frequency at 1 year, and 88% at 2 years (P = < 0.0001). Modest, albeit statistically significant increases in creatine kinase which seemed to plateau by 1 year were noted. Conclusions Overall, Reslizumab was well tolerated with discontinuation of treatment due to side effects recorded in only one patient. Our data confirm the utility of anti-IL5 therapy in a carefully selected phenotype of severe asthma with evidence of eosinophilic airway inflammation.
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Affiliation(s)
- H Ibrahim
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - R O'Sullivan
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - D Casey
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - J Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland
| | - J MacSharry
- The Schools of Medicine and Microbiology, University College Cork, Cork, Ireland
| | - B J Plant
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.,The HRB funded Clinical Research Facility, University College Cork, Cork, Ireland
| | - D M Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland. .,The HRB funded Clinical Research Facility, University College Cork, Cork, Ireland.
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14
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Moloney C, Long A, Pastores GM, Plant BJ, Murphy DM. A bolt from the blue; A case report of an unusual asthma exacerbation. Respir Med Case Rep 2019; 29:100983. [PMID: 31908916 PMCID: PMC6938945 DOI: 10.1016/j.rmcr.2019.100983] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 11/29/2022] Open
Abstract
Background We describe this case of a young gentleman presenting with acute dyspnoea on a background history of known, long-standing asthma. His dramatic presentation, notable for profound hypoxia and cyanosis, led to an unexpected additional diagnosis of type one congenital methaemoglobinaemia. Case presentation A 26-year-old Irish gentleman was transferred urgently to the emergency department resuscitation room with marked cyanosis and tachypnoea. His oxygen saturation was 70% on 100% high flow oxygen. His arterial blood gas (On Fi02 90%) demonstrated a PaO2 = 76.8 kPa, SpO2 = 99%, pCO2 = 3 kPa and pH = 7.51. A saturation gap was evident and on further analysing the arterial blood gas, the methaemoglobin level was noted to be 28%. No contributing drugs were identified. Our patient was diagnosed with type one congenital methaemoglobinaemia. He recovered well from this admission, however, has had recurrent presentations to hospital since with high methaemoglobin levels noted on each occasion. Discussion Congenital methemoglobinemia is a rare, often overlooked differential diagnosis in patients presenting with cyanosis and dyspnoea. This is the only case, to our knowledge, of a patient with both asthma and congenital methaemoglobinaemia. Congenital methaemoglobinaemia was first described in 1943 by Dr Deeny who described two siblings as suffering from 'Familial Idiopathic Methaemoglobinaemia'. The case we present is the first reported Irish case of congenital methaemoglobinaemia, we are aware of, since 1943.Current treatment strategies include high-flow oxygen, methylene blue infusion (contraindicated in glucose-6-phosphate-dehydrogenase deficiency) and red cell exchange transfusions in the emergency setting whilst oral ascorbic acid and riboflavin are preventative.
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Affiliation(s)
- C Moloney
- Cork University Hospital, Wilton, Cork, Ireland
| | - A Long
- Cork University Hospital, Wilton, Cork, Ireland
| | | | - B J Plant
- Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork, Ireland
| | - D M Murphy
- Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork, Ireland
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15
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Affiliation(s)
- E B Hunt
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.,The Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - A Sullivan
- The APC Microbiome Institute, Schools of Medicine and Microbiology, University College Cork, Ireland
| | - J Galvin
- The APC Microbiome Institute, Schools of Medicine and Microbiology, University College Cork, Ireland
| | - J MacSharry
- The APC Microbiome Institute, Schools of Medicine and Microbiology, University College Cork, Ireland
| | - D M Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.,The Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
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16
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Walsh J, Murphy DM. Combination Inhaled Corticosteroid/Long Acting Beta Agonist Therapy- An Evolving Role in Asthma Care. Ir Med J 2019; 112:864. [PMID: 30839181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- J Walsh
- The Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork
| | - D M Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Wilton, Cork
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17
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Murphy DM, Froyd KD, Apel E, Blake D, Blake N, Evangeliou N, Hornbrook RS, Peischl J, Ray E, Ryerson TB, Thompson C, Stohl A. An aerosol particle containing enriched uranium encountered in the remote upper troposphere. J Environ Radioact 2018; 184-185:95-100. [PMID: 29407642 DOI: 10.1016/j.jenvrad.2018.01.006] [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] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/05/2018] [Accepted: 01/07/2018] [Indexed: 06/07/2023]
Abstract
We describe a submicron aerosol particle sampled at an altitude of 7 km near the Aleutian Islands that contained a small percentage of enriched uranium oxide. 235U was 3.1 ± 0.5% of 238U. During twenty years of aircraft sampling of millions of particles in the global atmosphere, we have rarely encountered a particle with a similarly high content of 238U and never a particle with enriched 235U. The bulk of the particle consisted of material consistent with combustion of heavy fuel oil. Analysis of wind trajectories and particle dispersion model results show that the particle could have originated from a variety of areas across Asia. The source of such a particle is unclear, and the particle is described here in case it indicates a novel source where enriched uranium was dispersed.
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Affiliation(s)
- D M Murphy
- NOAA ESRL Chemical Sciences Division, Boulder, CO, USA.
| | - K D Froyd
- NOAA ESRL Chemical Sciences Division, Boulder, CO, USA; Cooperative Institute for Research in the Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - E Apel
- Atmospheric Chemistry Observations & Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - D Blake
- Department of Chemistry, University of California, Irvine, Irvine, CA, USA
| | - N Blake
- Department of Chemistry, University of California, Irvine, Irvine, CA, USA
| | - N Evangeliou
- NILU - Norwegian Institute for Air Research, Norway
| | - R S Hornbrook
- Atmospheric Chemistry Observations & Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - J Peischl
- NOAA ESRL Chemical Sciences Division, Boulder, CO, USA; Cooperative Institute for Research in the Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - E Ray
- NOAA ESRL Chemical Sciences Division, Boulder, CO, USA; Cooperative Institute for Research in the Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - T B Ryerson
- NOAA ESRL Chemical Sciences Division, Boulder, CO, USA
| | - C Thompson
- NOAA ESRL Chemical Sciences Division, Boulder, CO, USA; Cooperative Institute for Research in the Environmental Sciences, University of Colorado, Boulder, CO, USA
| | - A Stohl
- NILU - Norwegian Institute for Air Research, Norway
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18
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Hunt EB, Sullivan A, Galvin J, MacSharry J, Murphy DM. Gastric Aspiration and Its Role in Airway Inflammation. Open Respir Med J 2018; 12:1-10. [PMID: 29456774 PMCID: PMC5806178 DOI: 10.2174/1874306401812010001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 11/30/2017] [Revised: 12/22/2017] [Accepted: 01/01/2018] [Indexed: 12/15/2022] Open
Abstract
Gastro-Oesophageal Reflux (GOR) has been associated with chronic airway diseases while the passage of foreign matter into airways and lungs through aspiration has the potential to initiate a wide spectrum of pulmonary disorders. The clinical syndrome resulting from such aspiration will depend both on the quantity and nature of the aspirate as well as the individual host response. Aspiration of gastric fluids may cause damage to airway epithelium, not only because acidity is toxic to bronchial epithelial cells but also due to the effect of digestive enzymes such as pepsin and bile salts. Experimental models have shown that direct instillation of these factors to airways epithelia cause damage with a consequential inflammatory response. The pathophysiology of these responses is gradually being dissected, with better understanding of acute gastric aspiration injury, a major cause of acute lung injury, providing opportunities for therapeutic intervention and potentially, ultimately, improved understanding of the chronic airway response to aspiration. Ultimately, clarification of the inflammatory pathways which are related to micro-aspiration via pepsin and bile acid salts may eventually progress to pharmacological intervention and surgical studies to assess the clinical benefits of such therapies in driving symptom improvement or reducing disease progression.
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Affiliation(s)
- E B Hunt
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.,The Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - A Sullivan
- The APC Microbiome Institute, Schools of Medicine and Microbiology, University College Cork, Ireland
| | - J Galvin
- The APC Microbiome Institute, Schools of Medicine and Microbiology, University College Cork, Ireland
| | - J MacSharry
- The APC Microbiome Institute, Schools of Medicine and Microbiology, University College Cork, Ireland
| | - D M Murphy
- The Department of Respiratory Medicine, Cork University Hospital, Cork, Ireland.,The Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
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19
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Hunt EB, Murphy B, Murphy C, Crowley T, Cronin O, Hay S, Stack M, Bowen B, Ronan NJ, Greene E, Eustace JA, Plant BJ, Murphy DM. A Study To Assess The Prevalence Of Exercise-Induced Bronchoconstriction In Inter-County Hurling. Ir Med J 2017; 110:655. [PMID: 29465845] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Exercise-Induced Bronchoconstriction (EIB) is an acute, transient airway narrowing occurring after exercise which may impact athletic performance. Studies report 10% of the general population and up to 90% of asthmatics experience EIB. Ninety-two players from three elite hurling squads underwent a spirometric field-based provocation test with real-time heart rate monitoring and lactate measurements to ensure adequate exertion. Players with a new diagnosis of EIB and those with a negative field-test but with a previous label of EIB or asthma underwent further reversibility testing and if negative, methacholine challenge. Eight (8.7%) of players had EIB, with one further athlete having asthma with a negative field test. Interestingly, only three out of 12 players who had previously been physician-labelled with EIB or asthma had their diagnosis objectively confirmed. Our study highlights the role of objective testing in EIB.
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Affiliation(s)
- E B Hunt
- Department of Respiratory Medicine, Cork University Hospital
- Health Research Board Clinical Research Facility, University College Cork, Cork
| | | | | | | | - O Cronin
- Department of Respiratory Medicine, Cork University Hospital
| | - S Hay
- Department of Respiratory Medicine, Cork University Hospital
| | - M Stack
- Department of Respiratory Medicine, Cork University Hospital
| | - B Bowen
- Department of Respiratory Medicine, Cork University Hospital
| | - N J Ronan
- Department of Respiratory Medicine, Cork University Hospital
| | - E Greene
- Department of Respiratory Medicine, Cork University Hospital
| | - J A Eustace
- Health Research Board Clinical Research Facility, University College Cork, Cork
| | - B J Plant
- Department of Respiratory Medicine, Cork University Hospital
- Health Research Board Clinical Research Facility, University College Cork, Cork
| | - D M Murphy
- Department of Respiratory Medicine, Cork University Hospital
- Health Research Board Clinical Research Facility, University College Cork, Cork
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20
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Vallotto C, Williams HE, Murphy DM, Ayres ZJ, Edge R, Newton ME, Wedge CJ. An Electron Paramagnetic Resonance (EPR) spectroscopy study on the γ-irradiation sterilization of the pharmaceutical excipient l-histidine: Regeneration of the radicals in solution. Int J Pharm 2017; 533:315-319. [PMID: 28964903 DOI: 10.1016/j.ijpharm.2017.09.068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 07/31/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 11/17/2022]
Abstract
The effects of γ-radiation sterilization on the parenteral excipient l-histidine were analysed by means of EPR spectroscopy. The irradiation process was found to induce the formation of a deamination radical which was persistent in the solid state. The nature and reactivity of the radicals following dissolution in water was evaluated using spin-trapping EPR experiments. The deamination radical was found to regenerate in solution in the presence of trace metals, potentially leading to radical induced degradation reactions occurring up to an hour after the dissolution process. Understanding this process is significant for the improved design of parental pharmaceutical formulations in which unwanted radical reactions after γ-radiation sterilization could lead to degradation of active ingredients.
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Affiliation(s)
- C Vallotto
- Department of Physics, University of Warwick, Coventry, CV4 7AL, UK
| | - H E Williams
- Product Development, AstraZeneca, Silk Road Business Park, Macclesfield, SK10 2NA, UK
| | - D M Murphy
- School of Chemistry, Cardiff University, Main Building, Park Place, Cardiff, CF10 3AT, UK
| | - Z J Ayres
- Department of Chemistry, University of Warwick, Coventry, CV4 7AL, UK
| | - R Edge
- Dalton Cumbrian Facility, The University of Manchester, Westlakes Science & Technology Park, Moor Row, Cumbria CA24 3HA, UK
| | - M E Newton
- Department of Physics, University of Warwick, Coventry, CV4 7AL, UK
| | - C J Wedge
- Department of Physics, University of Warwick, Coventry, CV4 7AL, UK; Department of Chemical Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
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Burke DG, Harrison MJ, Fleming C, McCarthy M, Shortt C, Sulaiman I, Murphy DM, Eustace JA, Shanahan F, Hill C, Stanton C, Rea MC, Ross RP, Plant BJ. Clostridium difficile carriage in adult cystic fibrosis (CF); implications for patients with CF and the potential for transmission of nosocomial infection. J Cyst Fibros 2016; 16:291-298. [PMID: 27908697 DOI: 10.1016/j.jcf.2016.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 04/27/2016] [Revised: 09/18/2016] [Accepted: 09/22/2016] [Indexed: 01/29/2023]
Abstract
Clostridium difficile is an anaerobic Gram-positive, spore-forming, toxin-producing bacillus transmitted among humans through the faecal-oral route. Despite increasing carriage rates and the presence of C. difficile toxin in stool, patients with CF rarely appear to develop typical manifestations of C. difficile infection (CDI). In this study, we examined the carriage, toxin production, ribotype distribution and antibiotic susceptibility of C. difficile in a cohort of 60 adult patients with CF who were pre-lung transplant. C. difficile was detected in 50% (30/60) of patients with CF by culturing for the bacteria. C. difficile toxin was detected in 63% (19/30) of C. difficile-positive stool samples. All toxin-positive stool samples contained toxigenic C. difficile strains harbouring toxin genes, tcdA and tcdB. Despite the presence of C. difficile and its toxin in patient stool, no acute gastrointestinal symptoms were reported. Ribotyping of C. difficile strains revealed 16 distinct ribotypes (RT), 11 of which are known to be disease-causing including the hyper-virulent RT078. Additionally, strains RT002, RT014, and RT015, which are common in non-CF nosocomial infection were described. All strains were susceptible to vancomycin, metronidazole, fusidic acid and rifampicin. No correlation was observed between carriage of C. difficile or any characteristics of isolated strains and any recorded clinical parameters or treatment received. We demonstrate a high prevalence of hypervirulent, toxigenic strains of C. difficile in asymptomatic patients with CF. This highlights the potential role of asymptomatic patients with CF in nosocomial transmission of C. difficile.
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Affiliation(s)
- D G Burke
- APC Microbiome Institute, University College Cork, Ireland
| | - M J Harrison
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - C Fleming
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - M McCarthy
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - C Shortt
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - I Sulaiman
- Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - D M Murphy
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - J A Eustace
- Health Research Board, Clinical Research Facility, University College Cork, Ireland
| | - F Shanahan
- APC Microbiome Institute, University College Cork, Ireland
| | - C Hill
- School of Microbiology, University College Cork, Ireland
| | - C Stanton
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - M C Rea
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - R P Ross
- APC Microbiome Institute, University College Cork, Ireland
| | - B J Plant
- Cork Adult CF Centre, Dept. of Medicine, Cork University Hospital, University College Cork, Ireland.
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Hui CCK, Murphy DM, Neighbour H, Al-Sayegh M, O'Byrne S, Thong B, Denburg JA, Larché M. T cell-mediated induction of thymic stromal lymphopoietin in differentiated human primary bronchial epithelial cells. Clin Exp Allergy 2015; 44:953-64. [PMID: 24773145 DOI: 10.1111/cea.12330] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 04/14/2014] [Accepted: 04/14/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND Inhaled peptide challenge has been shown to induce T cell-mediated, isolated late asthmatic reaction (LAR), characterized by recruitment of CD4(+) T cells and increased levels of thymus and activation-regulated chemokine (TARC; CCL17). Epithelial-derived thymic stromal lymphopoietin (TSLP) has been shown to modulate dendritic cell function to promote TH 2 responses via CCL17 production. OBJECTIVES To elucidate the mechanisms involved in allergen-specific T cell-induced LAR and recruitment of CD4(+) T cells by examining the effects of T cell-derived factors on the induction of TSLP in primary bronchial epithelial cells (PBEC). METHODS PBEC grown at air-liquid interface from healthy individuals and patients with asthma were stimulated with double-stranded RNA (dsRNA) or supernatants from activated allergen-specific T cells. TSLP was measured in PBEC culture supernatants. Neutralizing antibodies and signalling inhibitors were used to examine the mechanisms responsible for the induction of epithelial-derived TSLP. The functional activity of PBEC-derived TSLP was measured using a bioassay involving the induction of CCL17 production from monocyte-derived dendritic cells (moDC). RESULTS Both dsRNA and allergen-specific T cells induced enhanced TSLP secretion from asthmatic PBEC compared to healthy PBEC. Activated PBEC culture supernatant induced TSLP-dependent CCL17 production from moDC in a manner related to clinical asthmatic status. IL-1β, IL-6, and CXCL8, rather than TH 2 cytokines (IL-4/5/13), appeared to be the principle mediators of allergen-specific T cell-dependent induction of epithelial-derived TSLP, which was regulated by the MEK, MAPK, and NFκB pathways. CONCLUSION AND CLINICAL RELEVANCE Our data reveal a novel effect of allergen-specific T cells as a positive regulator of TSLP production by epithelial cells, suggesting T cell-airway epithelium interactions that may lead to maintenance and amplification of allergic inflammation. TSLP is currently a candidate for therapeutic intervention in asthma, but the factors that drive TSLP expression (T cell-derived factors) may be equally relevant in the treatment of allergic inflammation.
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Affiliation(s)
- C C K Hui
- Division of Allergy & Clinical Immunology, Department of Medicine, McMaster University, Hamilton, ON, Canada
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Planells-Ferrer L, Urresti J, Soriano A, Reix S, Murphy DM, Ferreres JC, Borràs F, Gallego S, Stallings RL, Moubarak RS, Segura MF, Comella JX. MYCN repression of Lifeguard/FAIM2 enhances neuroblastoma aggressiveness. Cell Death Dis 2014; 5:e1401. [PMID: 25188511 PMCID: PMC4540192 DOI: 10.1038/cddis.2014.356] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 03/27/2014] [Revised: 07/15/2014] [Accepted: 07/22/2014] [Indexed: 01/20/2023]
Abstract
Neuroblastoma (NBL) is the most common solid tumor in infants and accounts for 15% of all pediatric cancer deaths. Several risk factors predict NBL outcome: age at the time of diagnosis, stage, chromosome alterations and MYCN (V-Myc Avian Myelocytomatosis Viral Oncogene Neuroblastoma-Derived Homolog) amplification, which characterizes the subset of the most aggressive NBLs with an overall survival below 30%. MYCN-amplified tumors develop exceptional chemoresistance and metastatic capacity. These properties have been linked to defects in the apoptotic machinery, either by silencing components of the extrinsic apoptotic pathway (e.g. caspase-8) or by overexpression of antiapoptotic regulators (e.g. Bcl-2, Mcl-1 or FLIP). Very little is known on the implication of death receptors and their antagonists in NBL. In this work, the expression levels of several death receptor antagonists were analyzed in multiple human NBL data sets. We report that Lifeguard (LFG/FAIM2 (Fas apoptosis inhibitory molecule 2)/NMP35) is downregulated in the most aggressive and undifferentiated tumors. Intringuingly, although LFG has been initially characterized as an antiapoptotic protein, we have found a new association with NBL differentiation. Moreover, LFG repression resulted in reduced cell adhesion, increased sphere growth and enhanced migration, thus conferring a higher metastatic capacity to NBL cells. Furthermore, LFG expression was found to be directly repressed by MYCN at the transcriptional level. Our data, which support a new functional role for a hitherto undiscovered MYCN target, provide a new link between MYCN overexpression and increased NBL metastatic properties.
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Affiliation(s)
- L Planells-Ferrer
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Urresti
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Soriano
- Laboratory of Translational Research in Pediatric Cancer, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Reix
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D M Murphy
- Molecular and Cellular Therapeutics, Royal College of Surgeons and National Children's Research Centre Our Lady's Children's Hospital, Dublin, Ireland
| | - J C Ferreres
- Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - F Borràs
- Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Gallego
- 1] Laboratory of Translational Research in Pediatric Cancer, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain [2] Hospital Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R L Stallings
- Molecular and Cellular Therapeutics, Royal College of Surgeons and National Children's Research Centre Our Lady's Children's Hospital, Dublin, Ireland
| | - R S Moubarak
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M F Segura
- Laboratory of Translational Research in Pediatric Cancer, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J X Comella
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
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O'Brien ME, Murphy DM, Plant BJ. A 76 year old female diagnosed with cystic fibrosis. Ir Med J 2014; 107:240-241. [PMID: 25282963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The diagnosis of Cystic Fibrosis (CF) requires a high clinical suspicion in patients presenting at all ages. Early recognition permits referral to a specialist centre and may reduce the morbidity and mortality associated with CF. We report the case of the oldest patient in Ireland diagnosed with CF at 76 years of age and highlight the clinical features of her presentation.
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Harnett CM, Hunt EB, Bowen BR, O'Connell OJ, Edgeworth DM, Mitchell P, Eustace JA, Henry MT, Kennedy MP, Plant BJ, Murphy DM. A study to assess inhaler technique and its potential impact on asthma control in patients attending an asthma clinic. J Asthma 2014; 51:440-5. [PMID: 24393080 DOI: 10.3109/02770903.2013.876650] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate inhaler technique and symptom control in patients with poorly controlled asthma at baseline and at follow-up in a dedicated asthma clinic in a tertiary hospital. We also investigated the impact of asthma on these patients' quality of life. METHODS Patients referred to a newly established asthma clinic in Cork University Hospital were prospectively recruited over a 6-month period. Their inhaler technique was assessed by a pulmonary nurse specialist using a validated scoring system. They received instruction on inhaler usage when scores were suboptimal. Patients completed a validated asthma control questionnaire (ACQ) and asthma quality of life questionnaire (AQLQ). At follow-up 3-4 months later, the inhaler technique was reassessed and the ACQ questionnaire repeated. RESULTS Forty-six patients were recruited (female = 74%), and 40/46 were followed up. Mean [SD] FEV1 % predicted at baseline = 76.5% [21.5]. About 63% of the patients were classified as incorrectly using their inhaler at their initial assessment. This decreased to 20% at follow-up, indicating an overall significant improvement in inhaler usage post-training (p = 0.003). ACQ scores improved significantly from median [interquartile range] 2.70 [1.66] to 2.00 [1.90] (p = 0.002). Baseline measurement indicated that patients' quality of life was moderately affected by asthma, with a median AQLQ score of 4.75 [1.97]. CONCLUSION This study demonstrates the importance of educating and formally assessing inhaler technique in patients with asthma as a part of their ongoing clinical review.
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Affiliation(s)
- C M Harnett
- The Department of Respiratory Medicine, Cork University Hospital, University College Cork , Cork , Ireland
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26
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Murphy DT, Murphy DM, Murray JG, Gaine SP. Case 2: Silicosis. Ir Med J 2013; 106:181-182. [PMID: 23909156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- D T Murphy
- Mater Misericordiae University Hospital, Eccles St, Dublin 7
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Murphy DT, Murphy DM, Murray JG, Gaine SP. Case 1: chronic thromboembolic pulmonary hypertension (CTEPH). Ir Med J 2013; 106:146-147. [PMID: 23914576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- D T Murphy
- Mater Misericordiae University Hospital, Eccles St, Dublin 7
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28
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Murphy DM. Concluding remarks: challenges for aerosols and climate. Faraday Discuss 2013; 165:558-62. [PMID: 24601022 DOI: 10.1039/c3fd00107e] [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: 11/21/2022]
Abstract
We study aerosols for many reasons, including their effects on human health and climate. For climate, it is important to distinguish between the overall radiative effect of aerosols and the radiative forcing, which has been the anthropogenic change (after rapid atmospheric adjustments) since pre-industrial times. The radiative forcing is in principle much harder to observe than the overall effect because one must understand which particles are natural in today's atmosphere and what aerosols were like in the atmosphere before large-scale human influence. Because we cannot go back and measure the past, the only way to calculate radiative forcing may often require modeling detailed aerosol processes. This is a motivation for many of the processes studied at the Faraday Discussion 165. Other processes may need more attention by the aerosol climate community.
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Affiliation(s)
- D M Murphy
- National Oceanic and Atmospheric Administration, Chemical Sciences Division, Boulder, CO 80305, USA
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29
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de Gouw JA, Middlebrook AM, Warneke C, Ahmadov R, Atlas EL, Bahreini R, Blake DR, Brock CA, Brioude J, Fahey DW, Fehsenfeld FC, Holloway JS, Le Henaff M, Lueb RA, McKeen SA, Meagher JF, Murphy DM, Paris C, Parrish DD, Perring AE, Pollack IB, Ravishankara AR, Robinson AL, Ryerson TB, Schwarz JP, Spackman JR, Srinivasan A, Watts LA. Organic aerosol formation downwind from the Deepwater Horizon oil spill. Science 2011; 331:1295-9. [PMID: 21393539 DOI: 10.1126/science.1200320] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
A large fraction of atmospheric aerosols are derived from organic compounds with various volatilities. A National Oceanic and Atmospheric Administration (NOAA) WP-3D research aircraft made airborne measurements of the gaseous and aerosol composition of air over the Deepwater Horizon (DWH) oil spill in the Gulf of Mexico that occurred from April to August 2010. A narrow plume of hydrocarbons was observed downwind of DWH that is attributed to the evaporation of fresh oil on the sea surface. A much wider plume with high concentrations of organic aerosol (>25 micrograms per cubic meter) was attributed to the formation of secondary organic aerosol (SOA) from unmeasured, less volatile hydrocarbons that were emitted from a wider area around DWH. These observations provide direct and compelling evidence for the importance of formation of SOA from less volatile hydrocarbons.
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Affiliation(s)
- J A de Gouw
- Chemical Sciences Division, Earth System Research Laboratory, National Oceanic and Atmospheric Administration, Boulder, CO 80305, USA.
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30
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Costello RW, Murphy DM. Unsticking eosinophils. Clin Exp Allergy 2010; 39:1778-9. [PMID: 20085592 DOI: 10.1111/j.1365-2222.2009.03394.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Murphy DM, Forrest IA, Curran D, Ward C. Macrolide antibiotics and the airway: antibiotic or non-antibiotic effects? Expert Opin Investig Drugs 2010; 19:401-14. [DOI: 10.1517/13543781003636480] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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32
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Lavelle A, Sugrue R, Lawler G, Mulligan N, Kelleher B, Murphy DM, Gaine SP. Sitaxentan-induced hepatic failure in two patients with pulmonary arterial hypertension. Eur Respir J 2010; 34:770-1. [PMID: 19720812 DOI: 10.1183/09031936.00058409] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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33
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Robertson AGN, Griffin SM, Murphy DM, Pearson JP, Forrest IA, Dark JH, Corris PA, Ward C. Targeting allograft injury and inflammation in the management of post-lung transplant bronchiolitis obliterans syndrome. Am J Transplant 2009; 9:1272-8. [PMID: 19459806 DOI: 10.1111/j.1600-6143.2009.02648.x] [Citation(s) in RCA: 23] [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: 01/25/2023]
Abstract
Chronic allograft dysfunction, manifesting as bronchiolitis obliterans syndrome (BOS), is the major cause of morbidity and mortality in human lung transplant recipients. While alloimmunity has a definite role, there is increasing interest in overall allograft injury and subsequent inflammation and remodeling. This review deals with nonalloimmune factors that may potentiate alloimmune injury. We discuss infection and reflux/aspiration as examples of allograft injury, which may lead to chronic loss of graft function and BOS. Surgical and nonsurgical treatments aimed at preventing these insults and improving survival are considered. The need for further evidence, including randomized-controlled trials, to evaluate the role of medical and surgical therapies is emphasized by the current literature.
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Affiliation(s)
- A G N Robertson
- Northern Oesophago-Gastric Unit, Royal Victoria Infirmary, Newcastle University, Newcastle, UK
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34
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Robertson AGN, Griffin SM, Murphy DM, Pearson JP, Forrest IA, Dark JH, Corris PA, Ward C. Targeting allograft injury and inflammation in the management of post-lung transplant bronchiolitis obliterans syndrome. Am J Transplant 2009. [PMID: 19459806 DOI: 10.1111/j.1600-7143.2009.02648.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Chronic allograft dysfunction, manifesting as bronchiolitis obliterans syndrome (BOS), is the major cause of morbidity and mortality in human lung transplant recipients. While alloimmunity has a definite role, there is increasing interest in overall allograft injury and subsequent inflammation and remodeling. This review deals with nonalloimmune factors that may potentiate alloimmune injury. We discuss infection and reflux/aspiration as examples of allograft injury, which may lead to chronic loss of graft function and BOS. Surgical and nonsurgical treatments aimed at preventing these insults and improving survival are considered. The need for further evidence, including randomized-controlled trials, to evaluate the role of medical and surgical therapies is emphasized by the current literature.
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Affiliation(s)
- A G N Robertson
- Northern Oesophago-Gastric Unit, Royal Victoria Infirmary, Newcastle University, Newcastle, UK
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35
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Yates B, Murphy DM, Fisher AJ, Gould FK, Lordan JL, Dark JH, Corris PA. Pseudomembranous colitis in four patients with cystic fibrosis following lung transplantation. BMJ Case Rep 2009; 2009:bcr11.2008.1218. [PMID: 21686410 DOI: 10.1136/bcr.11.2008.1218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In the present study, 4 patients with cystic fibrosis undergoing lung transplantation (from a total of 137) who developed fulminant pseudomembranous colitis are described. Initial presentation was variable and the mortality rate was 50% despite urgent colectomy. In one case the presenting abdominal distension was thought to be due to meconium ileus equivalent. It is concluded that Clostridium difficile colitis may be a difficult diagnosis in patients with cystic fibrosis and follows a fulminant course after lung transplantation.
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Affiliation(s)
- B Yates
- Institute of Cellular Medicine, University of Newcastle and The Freeman Hospital, High Heaton, Newcastle upon Tyne, NE7 7DN, UK
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Abstract
In situ analyses with a laser ionization mass spectrometer have shown that a large fraction of aerosols in the bottom few kilometers of the stratosphere contain small amounts of mercury (1). Electron microscopy of particles collected near the tropopause has also detected mercury. The distribution of mercury onto many particles, including those less than 20 nm in diameter, indicates that the mercury is from local condensation of mercury compounds onto particles rather than transport of mercury-rich aerosols from surface sources. Although the results are only semiquantitative, they suggest that most of the mercury in the lower stratosphere is converted into the particulate phase. Mercury-containing particles were present at both middle latitudes and the tropics in two seasons. There is therefore good reason to believe that particulate mercury above the tropopause is global and could affect the atmospheric lifetime of mercury. There are indications that bromine and/ or iodine may be involved in the conversion of mercury from the gas to particle phase. Measurements at altitudes below 5 km did not find mercury in any particles despite sampling some particles that clearly originated in the stratosphere. This indicates that the particulate mercury from the lower stratosphere may be volatile enough to evaporate or decompose once particles reach warmer temperatures.
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Affiliation(s)
- D M Murphy
- Earth System Research Laboratory, National Oceanic and Atmospheric Administration, Boulder, Colorado 80305-3337, USA.
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Forrest IA, Murphy DM, Ward C, Jones D, Johnson GE, Archer L, Gould FK, Cawston TE, Lordan JL, Corris PA. Primary airway epithelial cell culture from lung transplant recipients. Eur Respir J 2006; 26:1080-5. [PMID: 16319339 DOI: 10.1183/09031936.05.00141404] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Long-term survival in lung transplantation is limited by the development of obliterative bronchiolitis, a condition characterised by inflammation, epithelial injury, fibroproliferation and obliteration of bronchioles leading to airflow obstruction. To investigate the role of the bronchial epithelium in the pathogenesis of obliterative bronchiolitis the current study aimed to establish primary bronchial epithelial cell cultures (PBEC) from lung allografts. Four to six bronchial brushings were obtained from sub-segmental bronchi of lung allografts. Cells were seeded onto collagen-coated plates and grown to confluence in bronchial epithelial growth medium. Bronchial brushings (n=33) were obtained from 27 patients. PBECs were grown to confluence from 12 out of 33 (39%) brushings. Failure to reach confluence was due to early innate infection. Bacteria were usually isolated from both bronchoalveolar lavage and culture media, but a separate population was identified in culture media only. Primary culture of bronchial epithelial cells from lung transplant recipients is feasible, despite a high rate of early, patient-derived infection. Latent infection of the allograft, identified only by bronchial brushings, may itself be a persistent stimulus for epithelial injury. This technique facilitates future mechanistic studies of airway epithelial responses in the pathogenesis of obliterative bronchiolitis.
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Affiliation(s)
- I A Forrest
- Applied Immunobiology and Transplantation Research Group, University of Newcastle upon Tyne, UK.
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38
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Yates B, Murphy DM, Fisher AJ, Gould FK, Lordan JL, Dark JH, Corris PA. Pseudomembranous colitis in four patients with cystic fibrosis following lung transplantation. Thorax 2006; 62:554-6. [PMID: 16601087 PMCID: PMC2117205 DOI: 10.1136/thx.2005.048652] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Pseudomembranous colitis is an uncommon complication in patients with cystic fibrosis, despite the use of multiple high-dose antibiotic regimens and the frequency of hospital admissions. Four patients from a total of 137 patients with cystic fibrosis undergoing lung transplantation are described who developed fulminant pseudomembranous colitis. Initial presentation was variable and the mortality rate was 50% despite urgent colectomy. In one case the presenting abdominal distension was thought to be due to meconium ileus equivalent. It is concluded that Clostridium difficile colitis may be a difficult diagnosis in patients with cystic fibrosis and follows a fulminant course after lung transplantation.
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Affiliation(s)
- B Yates
- Institute of Cellular Medicine, University of Newcastle and The Freeman Hospital, High Heaton, Newcastle upon Tyne, NE7 7DN, UK
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39
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McGloughlin TM, Murphy DM, Kavanagh AG. A machine for the preliminary investigation of design features influencing the wear behaviour of knee prostheses. Proc Inst Mech Eng H 2005; 218:51-62. [PMID: 14982346 DOI: 10.1243/095441104322807758] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Degradation of tibial inserts in vivo has been found to be multifactorial in nature, resulting in a complex interaction of many variables. A range of kinematic conditions occurs at the tibio-femoral interface, giving rise to various degrees of rolling and sliding at this interface. The movement of the tibio-femoral contact point may be an influential factor in the overall wear of ultra-high molecular weight polyethylene (UHMWPE) tibial components. As part of this study a three-station wear-test machine was designed and built to investigate the influence of rolling and sliding on the wear behaviour of specific design aspects of contemporary knee prostheses. Using the machine, it is possible to monitor the effect of various slide-roll ratios on the performance of contemporary bearing designs from a geometrical and materials perspective.
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Affiliation(s)
- T M McGloughlin
- Biomedical Engineering Research Centre, Department of Mechanical and Aeronautical Engineering, University of Limerick, Limerick, Ireland
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Ward C, Forrest IA, Brownlee IA, Johnson GE, Murphy DM, Pearson JP, Dark JH, Corris PA. Pepsin like activity in bronchoalveolar lavage fluid is suggestive of gastric aspiration in lung allografts. Thorax 2005; 60:872-4. [PMID: 16055614 PMCID: PMC1747219 DOI: 10.1136/thx.2004.036426] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND A biologically plausible link between gastro-oesophageal reflux (GOR), aspiration, and lung allograft dysfunction has been suggested, but there is no systematic evidence indicating the presence of gastric contents in the lung. We have tested the hypothesis that pepsin, as a marker of aspiration, is detectable in bronchoalveolar lavage (BAL) fluid of allograft recipients who had not reported symptoms of GOR. METHODS Standardised 3 x 60 ml surveillance BAL fluid samples from 13 chronologically sequential stable lung allograft recipients without chronic rejection (10 patients treated with a prophylactic proton pump inhibitor) were studied. Lavage supernatants were assayed by an ELISA based on a monospecific goat antibody for pepsin/pepsinogen. Pepsin levels were compared with those from four normal volunteer controls. RESULTS Pepsin levels were measurable in all allograft recipients, in keeping with gastric aspiration (median 109 ng/ml (range 35-1375)). In the control group the pepsin levels were below the limit of detection. Treatment with a proton pump inhibitor was not correlated with pepsin levels. There was no correlation between BAL fluid neutrophils and pepsin levels. CONCLUSION These data demonstrate lung epithelial lining fluid concentrations of pepsin in lung allograft recipients which are much higher than blood reference levels, with no detectable pepsin in controls. This provides direct evidence of gastric aspiration, which is potentially injurious to the allograft.
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Affiliation(s)
- C Ward
- Applied Immunobiology and Transplantation Research Group, Freeman Hospital and University of Newcastle upon Tyne, Newcastle upon Tyne NE7 7DN, UK.
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Ward C, Forrest IA, Brownlee IA, Johnson GE, Murphy DM, Pearson JP, Dark JH, Corris PA. Pepsin like activity in bronchoalveolar lavage fluid is suggestive of gastric aspiration in lung allografts. Thorax 2005. [PMID: 16055614 DOI: 10.1163/thx.2004.036426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND A biologically plausible link between gastro-oesophageal reflux (GOR), aspiration, and lung allograft dysfunction has been suggested, but there is no systematic evidence indicating the presence of gastric contents in the lung. We have tested the hypothesis that pepsin, as a marker of aspiration, is detectable in bronchoalveolar lavage (BAL) fluid of allograft recipients who had not reported symptoms of GOR. METHODS Standardised 3 x 60 ml surveillance BAL fluid samples from 13 chronologically sequential stable lung allograft recipients without chronic rejection (10 patients treated with a prophylactic proton pump inhibitor) were studied. Lavage supernatants were assayed by an ELISA based on a monospecific goat antibody for pepsin/pepsinogen. Pepsin levels were compared with those from four normal volunteer controls. RESULTS Pepsin levels were measurable in all allograft recipients, in keeping with gastric aspiration (median 109 ng/ml (range 35-1375)). In the control group the pepsin levels were below the limit of detection. Treatment with a proton pump inhibitor was not correlated with pepsin levels. There was no correlation between BAL fluid neutrophils and pepsin levels. CONCLUSION These data demonstrate lung epithelial lining fluid concentrations of pepsin in lung allograft recipients which are much higher than blood reference levels, with no detectable pepsin in controls. This provides direct evidence of gastric aspiration, which is potentially injurious to the allograft.
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Affiliation(s)
- C Ward
- Applied Immunobiology and Transplantation Research Group, Freeman Hospital and University of Newcastle upon Tyne, Newcastle upon Tyne NE7 7DN, UK.
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Ward C, Forrest IA, Murphy DM, Johnson GE, Robertson H, Cawston TE, Fisher AJ, Dark JH, Lordan JL, Kirby JA, Corris PA. Phenotype of airway epithelial cells suggests epithelial to mesenchymal cell transition in clinically stable lung transplant recipients. Thorax 2005; 60:865-71. [PMID: 15972366 PMCID: PMC1747194 DOI: 10.1136/thx.2005.043026] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Obliterative bronchiolitis in chronic rejection of lung allografts is characterised by airway epithelial damage and fibrosis. The process whereby normal epithelium is lost and replaced by fibroblastic scar tissue is poorly understood, but recent findings suggest that epithelial cells can become fibroblasts through epithelial-mesenchymal transition (EMT). It is hypothesised that EMT occurs in lung allografts and plays a potential role in airway remodelling. METHODS Sixteen stable lung transplant recipients underwent bronchoscopy with bronchoalveolar lavage (BAL), endobronchial biopsies, and bronchial brushings. Biopsy sections were stained for the fibroblast marker S100A4. Brushings were cultured on collagen, stained with anti-S100A4, and examined for further EMT markers including matrix metalloproteinase (MMP) zymographic activity and epithelial invasion through collagen coated filters. RESULTS A median 15% (0-48%) of the biopsy epithelium stained for S100A4 in stable lung transplant recipients and MMP-7 co-localisation was observed. In non-stimulated epithelial cultures from lung allografts, S100A4 staining was identified with MMP-2 and MMP-9 production and zymographic activity. MMP total protein and activity was increased following stimulation with transforming growth factor (TGF)-beta1. Non-stimulated transplant epithelial cells were invasive and penetration of collagen coated filters increased following TGF-beta1 stimulation. CONCLUSIONS This study provides evidence of EMT markers in lung allografts of patients without loss of lung function. The EMT process may represent a final common pathway following injury in more common diseases characterised by airway remodelling.
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Affiliation(s)
- C Ward
- Applied Immunobiology and Transplantation Research Group, Faculty of Medical Sciences, Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK
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Chandler KJ, Johnston HM, Murphy DM. Polycystic kidney disease in an aged pony. Vet Rec 2003; 153:754-6. [PMID: 14703182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Affiliation(s)
- K J Chandler
- Department of Veterinary Pathology, University of Glasgow Veterinary School, Bearsden Road, Glasgow
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DeMott PJ, Cziczo DJ, Prenni AJ, Murphy DM, Kreidenweis SM, Thomson DS, Borys R, Rogers DC. Measurements of the concentration and composition of nuclei for cirrus formation. Proc Natl Acad Sci U S A 2003; 100:14655-60. [PMID: 14657330 PMCID: PMC299754 DOI: 10.1073/pnas.2532677100] [Citation(s) in RCA: 448] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This article addresses the need for new data on indirect effects of natural and anthropogenic aerosol particles on atmospheric ice clouds. Simultaneous measurements of the concentration and composition of tropospheric aerosol particles capable of initiating ice in cold (cirrus) clouds are reported. Measurements support that cirrus formation occurs both by heterogeneous nucleation by insoluble particles and homogeneous (spontaneous) freezing of particles containing solutions. Heterogeneous ice nuclei concentrations in the cirrus regime depend on temperature, relative humidity, and the concentrations and physical and chemical properties of aerosol particles. The cirrus-active concentrations of heterogeneous nuclei measured in November over the western U.S. were <0.03 cm-3. Considering previous modeling studies, this result suggests a predominant potential impact of these nuclei on cirrus formed by slow, large-scale lifting or small cooling rates, including subvisual cirrus. The most common heterogeneous ice nuclei were identified as relatively pure mineral dusts and metallic particles, some of which may have origin through anthropogenic processes. Homogeneous freezing of large numbers of particles was detected above a critical relative humidity along with a simultaneous transition in nuclei composition toward that of the sulfate-dominated total aerosol population. The temperature and humidity conditions of the homogeneous nucleation transition were reasonably consistent with expectations based on previous theoretical and laboratory studies but were highly variable. The strong presence of certain organic pollutants was particularly noted to be associated with impedance of homogeneous freezing.
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Affiliation(s)
- P J DeMott
- Department of Atmospheric Science, Colorado State University, Fort Collins, CO 80523, USA.
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Alberola A, Less RJ, Pask CM, Rawson JM, Palacio F, Oliete P, Paulsen C, Yamaguchi A, Farley RD, Murphy DM. A Thiazyl-Based Organic Ferromagnet. Angew Chem Int Ed Engl 2003; 42:4782-5. [PMID: 14562348 DOI: 10.1002/anie.200352194] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Antonio Alberola
- The Department of Chemistry, The University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK
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Eng MMP, Power RE, Hickey DP, Murphy DM, Little DM. Renal transplantation and tuberculous renal tract disease. Transplant Proc 2003; 35:858-9. [PMID: 12644166 DOI: 10.1016/s0041-1345(02)04029-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- M M-P Eng
- Department of Transplantation and Urology, Beaumont Hospital, Dublin, Ireland
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Abstract
OBJECTIVE To compare the surgical outcome in patients with or with no bowel preparation before cystectomy and ileal conduit urinary diversion, specifically assessing local and systemic complications. PATIENTS AND METHODS All patients undergoing cystectomy and ileal conduit urinary diversion between January 1991 and December 1999 were assessed retrospectively. Twenty-two receive no bowel preparation (group 1) and were compared with 64 who had (group 2). Patients had similar demographic characteristics, stage and grade of tumour. Patients in group 2 received a standard 4-day bowel preparation and group 1 received no lavage or enemas. All patients underwent a standard iliac and obturator lymph node dissection, and cystoprostatectomy or anterior exenteration and ileal conduit urinary diversion. All patients received intraoperative metronidazole and gentamicin intravenously, and two further doses after surgery. RESULTS Deaths after surgery were comparable in the two groups (two in group 1 and four in group 2) and the incidence of wound infection was similar (three and seven, respectively). There were no significant differences between the respective groups for fistula and anastomotic dehiscence (two and six) or sepsis (three and six). Group 2 had a higher incidence of wound dehiscence (one) than in group 1 (none). The incidence of prolonged postoperative ileus was lower in group 1 (one vs 12), as was the length of hospital stay (31.6 days vs 22.8 days). CONCLUSIONS Bowel preparation had no advantage for the surgical outcome but it increased the length of hospital stay.
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Affiliation(s)
- M Shafii
- Department of Urology and Transplantation, Beaumont Hospital, Dublin, Ireland
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Biagini RE, Murphy DM, Sammons DL, Smith JP, Striley CAF, MacKenzie BA. Development of multiplexed fluorescence microbead covalent assays (FMCAs) for pesticide biomonitoring. Bull Environ Contam Toxicol 2002; 68:470-477. [PMID: 12069049 DOI: 10.1007/s001280278] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- R E Biagini
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA
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Hanna JN, Young DM, Brookes DL, Dostie BG, Murphy DM. The initial coverage and impact of the pneumococcal and influenza vaccination program for at-risk indigenous adults in Far North Queensland. Aust N Z J Public Health 2001; 25:543-6. [PMID: 11824992 DOI: 10.1111/j.1467-842x.2001.tb00321.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To describe the initial coverage and impact of a pneumococcal and influenza vaccination program for at-risk Indigenous adults in Far North Queensland that formally commenced in 1996. DESIGN Ascertainment of vaccine coverages, and prospective laboratory surveillance of invasive pneumococcal disease occurring in Indigenous adults in the region. MAIN OUTCOME MEASURES Coverages of the first doses of both vaccines administered since 1995, and the incidence of invasive pneumococcal disease in Indigenous adults in the region between 1993-2000. RESULTS Most (96% and 73%) of the Indigenous adults > or = 50 years of age received influenza and pneumococcal vaccines, respectively, for the first time between 1995-2000. Assuming that either 33% or 50% of Indigenous adults 15-49 years of age in Far North Queensland were eligible for vaccination, then either 109% or 72% of this population received influenza vaccine, and either 75% or 50% received pneumococcal vaccine, respectively, for the first time between 1995-2000. The incidence of vaccine-preventable invasive pneumococcal disease fell from 111 (95% confidence interval [CI] 77-154) cases per 100,000 per year in 1993/94 to 28 (95% CI 13-53) cases per 100,000 per year in 1999-2000 (p<0.05). CONCLUSION Although there was a significant decline in the incidence of invasive pneumococcal disease, the vaccine coverages after five years of the program were suboptimal. Because of the difficulties in targeting the 15-49 years age group and because of unrecognised risk factors, we suggest that a universal Indigenous adult pneumococcal and influenza vaccination program should be considered.
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Affiliation(s)
- J N Hanna
- Tropical Public Health Unit, Queensland Health, Cairns.
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Abstract
OBJECTIVES To describe the epidemiology of invasive pneumococcal disease in children under 5 years of age in Far North Queensland and to examine the potential impact of a seven- and 11-valent conjugate pneumococcal vaccine. METHODS A review of all cases of invasive pneumococcal disease in children under 5 years of age in Far North Queensland over a 9 year period (1992-2000). The distribution of the serotypes of isolates causing invasive pneumococcal disease was compared with the serotypes contained in the two vaccines. RESULTS The annual incidence in indigenous and non-indigenous children under 5 years of age was 163 (95% confidence interval (CI) 122-213) and 42 (95% CI 31-55) cases per 100 000 children, respectively. For children under 2 years of age, these figures were 297 (95% CI 208-411) and 71 (95% CI 49-100), respectively. There was a greater variety of serotypes isolated from indigenous children (n=17) than from non-indigenous children (n=9; P < 0.01). The serotypes within the seven-valent vaccine accounted for 62% (95% CI 46-75%) and 88% (95% CI 76-95%) of the isolates from indigenous and non-indigenous children, respectively (P < 0.01). Serotypes within the 11-valent vaccine accounted for 72% (95% CI 57-84%) of the isolates from indigenous children under 5 years of age, but did not account for any extra isolates from non-indigenous children. CONCLUSION Although the seven- and 11-valent conjugate pneumococcal vaccines cover only approximately 60 and 70%, respectively, of the isolates that cause invasive disease in indigenous children in Far North Queensland, they nevertheless have the potential to prevent much morbidity in and hospitalization of these children. It will be essential to maintain surveillance following the introduction of conjugate pneumococcal vaccines so as to monitor changes in the incidence of invasive pneumococcal disease, particularly in high-risk children.
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Affiliation(s)
- R L Fagan
- Tropical Public Health Unit, Cairns and Pneumococcal Reference Laboratory, Queensland Health Scientific Services, Coopers Plains, Queensland, Australia
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