1
|
Krickau T, Naumann-Bartsch N, Aigner M, Kharboutli S, Kretschmann S, Spoerl S, Vasova I, Völkl S, Woelfle J, Mackensen A, Schett G, Metzler M, Müller F. CAR T-cell therapy rescues adolescent with rapidly progressive lupus nephritis from haemodialysis. Lancet 2024; 403:1627-1630. [PMID: 38642568 DOI: 10.1016/s0140-6736(24)00424-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 04/22/2024]
Affiliation(s)
- Tobias Krickau
- Department of Paediatrics and Adolescent Medicine, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - Nora Naumann-Bartsch
- Department of Paediatrics and Adolescent Medicine, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany
| | - Michael Aigner
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - Soraya Kharboutli
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Department of Internal Medicine 5, Haematology and Oncology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany
| | - Sascha Kretschmann
- Department of Internal Medicine 5, Haematology and Oncology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany
| | - Silvia Spoerl
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany; Department of Internal Medicine 5, Haematology and Oncology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - Ingrid Vasova
- Department of Internal Medicine 5, Haematology and Oncology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany
| | - Simon Völkl
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Department of Internal Medicine 5, Haematology and Oncology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany
| | - Joachim Woelfle
- Department of Paediatrics and Adolescent Medicine, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - Andreas Mackensen
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Department of Internal Medicine 5, Haematology and Oncology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany
| | - Georg Schett
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany
| | - Markus Metzler
- Department of Paediatrics and Adolescent Medicine, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany.
| | - Fabian Müller
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Department of Internal Medicine 5, Haematology and Oncology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany; Bavarian Cancer Research Center (BZKF), partner site Erlangen, Germany
| |
Collapse
|
2
|
Rejeski K, Wang Y, Hansen DK, Iacoboni G, Bachy E, Bansal R, Penack O, Müller F, Bethge W, Munoz J, Mohty R, Bücklein VL, Barba P, Locke FL, Lin Y, Jain MD, Subklewe M. Applying the EHA/EBMT grading for ICAHT after CAR-T: comparative incidence and association with infections and mortality. Blood Adv 2024; 8:1857-1868. [PMID: 38181508 PMCID: PMC11007437 DOI: 10.1182/bloodadvances.2023011767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024] Open
Abstract
ABSTRACT Cytopenias represent the most common side effect of CAR T-cell therapy (CAR-T) and can predispose for severe infectious complications. Current grading systems, such as the Common Terminology Criteria for Adverse Events (CTCAE), neither reflect the unique quality of post-CAR-T neutrophil recovery, nor do they reflect the inherent risk of infections due to protracted neutropenia. For this reason, a novel EHA/EBMT consensus grading was recently developed for Immune Effector Cell-Associated HematoToxicity (ICAHT). In this multicenter, observational study, we applied the grading system to a large real-world cohort of 549 patients treated with BCMA- or CD19-directed CAR-T for refractory B-cell malignancies (112 multiple myeloma [MM], 334 large B-cell lymphoma [LBCL], 103 mantle cell lymphoma [MCL]) and examined the clinical sequelae of severe (≥3°) ICAHT. The ICAHT grading was strongly associated with the cumulative duration of severe neutropenia (r = 0.92, P < .0001), the presence of multilineage cytopenias, and the use of platelet and red blood cell transfusions. We noted an increased rate of severe ICAHT in patients with MCL vs those with LBCL and MM (28% vs 23% vs 15%). Severe ICAHT was associated with a higher rate of severe infections (49% vs 13%, P < .0001), increased nonrelapse mortality (14% vs 4%, P < .0001), and inferior survival outcomes (1-year progression-free survival: 35% vs 51%, 1-year overall survival: 52% vs 73%, both P < .0001). Importantly, the ICAHT grading demonstrated superior capacity to predict severe infections compared with the CTCAE grading (c-index 0.73 vs 0.55, P < .0001 vs nonsignificant). Taken together, these data highlight the clinical relevance of the novel grading system and support the reporting of ICAHT severity in clinical trials evaluating CAR-T therapies.
Collapse
Affiliation(s)
- Kai Rejeski
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Berlin Sites, and German Cancer Research Center, Heidelberg, Germany
- Adult BMT and Cellular Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yucai Wang
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Doris K. Hansen
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
| | - Gloria Iacoboni
- Department of Hematology, Vall d’Hebron Institute of Oncology, University Hospital Vall d’Hebron and Autonomous University of Barcelona, Barcelona, Spain
| | - Emmanuel Bachy
- Department of Hematology, Lyon Sud Hospital, Claude Bernard University Lyon 1, INSERM 1052, Pierre-Bénite, France
| | | | - Olaf Penack
- German Cancer Consortium (DKTK), Munich and Berlin Sites, and German Cancer Research Center, Heidelberg, Germany
- Department of Hematology, Oncology and Tumorimmunology, Charité – Berlin University Medicine, Corporate Member of Free University of Berlin and Humboldt University, Berlin, Germany
| | - Fabian Müller
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - Wolfgang Bethge
- Department of Hematology, Oncology, Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany
| | - Javier Munoz
- Division of Hematology and Oncology, Mayo Clinic, Phoenix, AZ
| | - Razan Mohty
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
| | - Veit L. Bücklein
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
| | - Pere Barba
- Department of Hematology, Vall d’Hebron Institute of Oncology, University Hospital Vall d’Hebron and Autonomous University of Barcelona, Barcelona, Spain
| | - Frederick L. Locke
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
| | - Yi Lin
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Michael D. Jain
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL
| | - Marion Subklewe
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Berlin Sites, and German Cancer Research Center, Heidelberg, Germany
| |
Collapse
|
3
|
Taubmann J, Müller F, Yalcin Mutlu M, Völkl S, Aigner M, Bozec A, Mackensen A, Grieshaber-Bouyer R, Schett G. CD19 Chimeric Antigen Receptor T Cell Treatment: Unraveling the Role of B Cells in Systemic Lupus Erythematosus. Arthritis Rheumatol 2024; 76:497-504. [PMID: 38114423 DOI: 10.1002/art.42784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/09/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023]
Abstract
B cell generation of autoantibodies is a crucial step in the pathogenesis of systemic lupus erythematosus (SLE). After their differentiation in the bone marrow, B cells populate the secondary lymphatic organs, where they undergo further maturation leading to the development of memory B cells as well as antibody-producing plasmablasts and plasma cells. Targeting B cells is an important strategy to treat autoimmune diseases such as SLE, in which B cell tolerance is disturbed and autoimmune B cells and autoantibodies emerge. This review discusses the functional aspects of antibody- and cell-based B cell-depleting therapy in SLE. It thereby particularly focuses on lessons learned from chimeric antigen receptor (CAR) T cell treatment on the role of B cells in SLE for understanding B cell pathology in SLE. CAR T cells model a deep B cell depletion and thereby allow understanding the role of aberrant B cell activation in the pathogenesis of SLE. Furthermore, the effects of B cell depletion on autoantibody production can be better described, ie, explaining the concept of different cellular sources of (auto-) antibodies in the form of short-lived plasmablasts and long-lived plasma cells, which differ in their susceptibility to B cell depletion and require different targeted therapeutic approaches. Finally, the safety of deep B cell depletion in autoimmune disease is discussed.
Collapse
Affiliation(s)
- Jule Taubmann
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Fabian Müller
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Melek Yalcin Mutlu
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Simon Völkl
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Aigner
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Aline Bozec
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Mackensen
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Ricardo Grieshaber-Bouyer
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Friedrich-Alexander-Universität Erlangen Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| |
Collapse
|
4
|
Cepika AM, Amaya L, Waichler C, Narula M, Mantilla MM, Thomas BC, Chen PP, Freeborn RA, Pavel-Dinu M, Nideffer J, Porteus M, Bacchetta R, Müller F, Greenleaf WJ, Chang HY, Roncarolo MG. Epigenetic signature and key transcriptional regulators of human antigen-specific type 1 regulatory T cells. bioRxiv 2024:2024.03.07.582969. [PMID: 38559096 PMCID: PMC10979855 DOI: 10.1101/2024.03.07.582969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Human adaptive immunity is orchestrated by effector and regulatory T (Treg) cells. Natural Tregs arise in the thymus where they are shaped to recognize self-antigens, while type 1 Tregs or Tr1 cells are induced from conventional peripheral CD4 + T cells in response to peripheral antigens, such as alloantigens and allergens. Tr1 cells have been developed as a potential therapy for inducing antigen-specific tolerance, because they can be rapidly differentiated in vitro in response to a target antigen. However, the epigenetic landscape and the identity of transcription factors (TFs) that regulate differentiation, phenotype, and functions of human antigen-specific Tr1 cells is largely unknown, hindering Tr1 research and broader clinical development. Here, we reveal the unique epigenetic signature of antigen-specific Tr1 cells, and TFs that regulate their differentiation, phenotype and function. We showed that in vitro induced antigen-specific Tr1 cells are distinct both clonally and transcriptionally from natural Tregs and other conventional CD4 + T cells on a single-cell level. An integrative analysis of Tr1 cell epigenome and transcriptome identified a TF signature unique to antigen-specific Tr1 cells, and predicted that IRF4, BATF, and MAF act as their transcriptional regulators. Using functional genomics, we showed that each of these TFs play a non-redundant role in regulating Tr1 cell differentiation, suppressive function, and expression of co-inhibitory and cytotoxic proteins. By using the Tr1-specific TF signature as a molecular fingerprint, we tracked Tr1 cells in peripheral blood of recipients of allogeneic hematopoietic stem cell transplantation treated with adoptive Tr1 cell therapy. Furthermore, the same signature identified Tr1 cells in resident CD4 + T cells in solid tumors. Altogether, these results reveal the epigenetic signature and the key transcriptional regulators of human Tr1 cells. These data will guide mechanistic studies of human Tr1 cell biology and the development and optimization of adoptive Tr1 cell therapies.
Collapse
|
5
|
Greco R, Alexander T, Del Papa N, Müller F, Saccardi R, Sanchez-Guijo F, Schett G, Sharrack B, Snowden JA, Tarte K, Onida F, Sánchez-Ortega I, Burman J, Castilla Llorente C, Cervera R, Ciceri F, Doria A, Henes J, Lindsay J, Mackensen A, Muraro PA, Ricart E, Rovira M, Zuckerman T, Yakoub-Agha I, Farge D. Innovative cellular therapies for autoimmune diseases: expert-based position statement and clinical practice recommendations from the EBMT practice harmonization and guidelines committee. EClinicalMedicine 2024; 69:102476. [PMID: 38361991 PMCID: PMC10867419 DOI: 10.1016/j.eclinm.2024.102476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/05/2024] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
Autoimmune diseases (ADs) are characterized by loss of immune tolerance, high chronicity, with substantial morbidity and mortality, despite conventional immunosuppression (IS) or targeted disease modifying therapies (DMTs), which usually require repeated administration. Recently, novel cellular therapies (CT), including mesenchymal stromal cells (MSC), Chimeric Antigen Receptors T cells (CART) and regulatory T cells (Tregs), have been successfully adopted in ADs. An international expert panel of the European Society for Blood and Marrow Transplantation and the International Society for the Cell and Gene Therapy, reviewed all available evidence, based on the current literature and expert practices, on use of MSC, CART and Tregs, in AD patients with rheumatological, neurological, and gastroenterological indications. Expert-based consensus and recommendations for best practice and quality of patient care were developed to support clinicians, scientists, and their multidisciplinary teams, as well as patients and care providers and will be regularly updated.
Collapse
Affiliation(s)
- Raffaella Greco
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
- Co-Chair of the Practice Harmonization and Guidelines Committee of EBMT and Chair of the ADWP of the EBMT, Barcelona, Spain
| | - Tobias Alexander
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Rheumatology and Clinical Immunology, Berlin, Germany
| | - Nicoletta Del Papa
- Scleroderma Clinic, Rheumatology Department, ASST G. Pini-CTO, Università degli Studi di Milano, Milano, Italy
| | - Fabian Müller
- Department of Internal Medicine 5 - Hematology and Oncology, University Hospital of Erlangen, Erlangen, Germany
- Bayrisches Zentrum für Krebsforschung (BZKF) Erlangen, Germany
| | - Riccardo Saccardi
- Cellular Therapies and Transfusion Medicine Unit, Careggi University Hospital, Florence, Italy
| | - Fermin Sanchez-Guijo
- Department of Hematology, IBSAL-University Hospital of Salamanca and Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, FAU Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander University (FAU) Erlangen- Nürnberg, Erlangen, Germany
| | - Basil Sharrack
- Department of Neuroscience and Sheffield NIHR Translational Neuroscience BRC, Sheffield Teaching Hospitals NHS Foundation Trust & University of Sheffield, Sheffield, England, United Kingdom
| | - John A. Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust, Division of Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
| | - Karin Tarte
- SITI Lab, CHU Rennes, EFS Bretagne, University Rennes, Rennes, France
| | - Francesco Onida
- Hematology & ASCT Unit, ASST Fatebenefratelli-Sacco, University of Milan, Italy
- Co-Chair of the Practice Harmonization and Guidelines Committee of EBMT, Spain
| | - Isabel Sánchez-Ortega
- Secretary of the Practice Harmonization and Guidelines Committee of EBMT, Barcelona, Spain
- EBMT Medical Officer, Executive Office, Barcelona, Spain
| | - Joachim Burman
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | | | - Ricard Cervera
- Department of Autoimmune Diseases, Reference Centre for Systemic Autoimmune Diseases (UEC, CSUR) of the Catalan and Spanish Health Systems/Member of ERN-ReCONNET, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Fabio Ciceri
- Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Doria
- Rheumatology Unit, Department of Medicine (DiMED), University of Padua, Padua, Italy
| | - Jörg Henes
- Center for Interdisciplinary Rheumatology, Immunology and Autoimmune diseases and Department of Internal Medicine II (Haematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tuebingen, Germany
| | - James Lindsay
- Department of Gastroenterology, The Royal London Hospital, Barts Health NHS Trust, London, UK
- Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Andreas Mackensen
- Department of Internal Medicine 5 - Hematology and Oncology, University Hospital of Erlangen, Erlangen, Germany
- Bayrisches Zentrum für Krebsforschung (BZKF) Erlangen, Germany
| | - Paolo A. Muraro
- Department of Brain Sciences, Imperial College London, London, UK
| | - Elena Ricart
- Gastroenterology Department. Hospital Clínic Barcelona. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS). Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - Montserrat Rovira
- BMT Unit, Haematology Department, Institute of Haematology and Oncology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
- Josep Carreras Leukaemia Research Foundation, Spain
| | - Tsila Zuckerman
- Rambam Health Care Campus and Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Ibrahim Yakoub-Agha
- CHU de Lille, University Lille, INSERM U1286, Infinite, 59000, Lille, France
- Chair of the Practice Harmonization and Guidelines Committee of EBMT, Spain
| | - Dominique Farge
- Internal Medicine Unit (04): CRMR MATHEC, Maladies Auto-immunes et Thérapie Cellulaire, Centre de Référence des Maladies auto-immunes systémiques Rares d’Ile-de-France, AP-HP, St-Louis Hospital Paris-Cite University, France
- Department of Medicine, McGill University, Montreal, QC, Canada
| |
Collapse
|
6
|
Müller F, Taubmann J, Bucci L, Wilhelm A, Bergmann C, Völkl S, Aigner M, Rothe T, Minopoulou I, Tur C, Knitza J, Kharboutli S, Kretschmann S, Vasova I, Spoerl S, Reimann H, Munoz L, Gerlach RG, Schäfer S, Grieshaber-Bouyer R, Korganow AS, Farge-Bancel D, Mougiakakos D, Bozec A, Winkler T, Krönke G, Mackensen A, Schett G. CD19 CAR T-Cell Therapy in Autoimmune Disease - A Case Series with Follow-up. N Engl J Med 2024; 390:687-700. [PMID: 38381673 DOI: 10.1056/nejmoa2308917] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
BACKGROUND Treatment for autoimmune diseases such as systemic lupus erythematosus (SLE), idiopathic inflammatory myositis, and systemic sclerosis often involves long-term immune suppression. Resetting aberrant autoimmunity in these diseases through deep depletion of B cells is a potential strategy for achieving sustained drug-free remission. METHODS We evaluated 15 patients with severe SLE (8 patients), idiopathic inflammatory myositis (3 patients), or systemic sclerosis (4 patients) who received a single infusion of CD19 chimeric antigen receptor (CAR) T cells after preconditioning with fludarabine and cyclophosphamide. Efficacy up to 2 years after CAR T-cell infusion was assessed by means of Definition of Remission in SLE (DORIS) remission criteria, American College of Rheumatology-European League against Rheumatism (ACR-EULAR) major clinical response, and the score on the European Scleroderma Trials and Research Group (EUSTAR) activity index (with higher scores indicating greater disease activity), among others. Safety variables, including cytokine release syndrome and infections, were recorded. RESULTS The median follow-up was 15 months (range, 4 to 29). The mean (±SD) duration of B-cell aplasia was 112±47 days. All the patients with SLE had DORIS remission, all the patients with idiopathic inflammatory myositis had an ACR-EULAR major clinical response, and all the patients with systemic sclerosis had a decrease in the score on the EUSTAR activity index. Immunosuppressive therapy was completely stopped in all the patients. Grade 1 cytokine release syndrome occurred in 10 patients. One patient each had grade 2 cytokine release syndrome, grade 1 immune effector cell-associated neurotoxicity syndrome, and pneumonia that resulted in hospitalization. CONCLUSIONS In this case series, CD19 CAR T-cell transfer appeared to be feasible, safe, and efficacious in three different autoimmune diseases, providing rationale for further controlled clinical trials. (Funded by Deutsche Forschungsgemeinschaft and others.).
Collapse
Affiliation(s)
- Fabian Müller
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Jule Taubmann
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Laura Bucci
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Artur Wilhelm
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Christina Bergmann
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Simon Völkl
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Michael Aigner
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Tobias Rothe
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Ioanna Minopoulou
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Carlo Tur
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Johannes Knitza
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Soraya Kharboutli
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Sascha Kretschmann
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Ingrid Vasova
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Silvia Spoerl
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Hannah Reimann
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Luis Munoz
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Roman G Gerlach
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Simon Schäfer
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Ricardo Grieshaber-Bouyer
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Anne-Sophie Korganow
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Dominique Farge-Bancel
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Dimitrios Mougiakakos
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Aline Bozec
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Thomas Winkler
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Gerhard Krönke
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Andreas Mackensen
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| | - Georg Schett
- From the Departments of Internal Medicine 5-Hematology and Oncology (F.M., S.V., M.A., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., A.M.) and Internal Medicine 3-Rheumatology and Immunology (J.T., L.B., A.W., C.B., T.R., I.M., C.T., J.K., L.M., R.G.-B., A.B., G.K., G.S.), Deutsches Zentrum Immuntherapie (F.M., J.T., L.B., A.W., C.B., S.V., M.A., T.R., I.M., C.T., J.K., S. Kharboutli, S. Kretschmann, I.V., S. Spoerl, H.R., L.M., R.G.-B., A.B., G.K., A.M., G.S.), and the Institute of Clinical Microbiology, Immunology, and Hygiene (R.G.G.), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, and the Department of Biology, Division of Genetics, Nikolaus-Fiebiger Center for Molecular Medicine, FAU Erlangen-Nürnberg (S. Schäfer, T.W.), Erlangen, the Department of Hematology and Oncology and Health Campus Immunology, Infectiology, and Inflammation, Medical Center, Otto-von-Guericke University, Magdeburg (D.M.), and the Department of Rheumatology, Charité-Universitätsmedizin Berlin, Berlin (G.K.) - all in Germany; the Department of Rheumatology, Catholic University of the Sacred Heart, Rome (C.T., G.S.); the Department of Clinical Immunology, Nouvel Hôpital Civil, Strasbourg University, Strasbourg (A.-S.K.), and Centre de Référence des Maladies Auto-immunes Systémiques Rares d'Ile-de-France, Hôpital Saint-Louis and Université Paris Cité, Paris (D.F.-B.) - both in France; and Karolinska Institutet, Stockholm (G.S.)
| |
Collapse
|
7
|
Gagelmann N, Dima D, Merz M, Hashmi H, Ahmed N, Tovar N, Oliver-Caldés A, Stölzel F, Rathje K, Fischer L, Born P, Schäfer L, Albici AM, Schub N, Kfir-Erenfeld S, Assayag M, Asherie N, Wulf GG, Kharboutli S, Müller F, Shune L, Davis JA, Anwer F, Vucinic V, Platzbecker U, Ayuk F, Kröger N, Khouri J, Gurnari C, McGuirk J, Stepensky P, Abdallah AO, Fernández de Larrea C. Development and Validation of a Prediction Model of Outcome After B-Cell Maturation Antigen-Directed Chimeric Antigen Receptor T-Cell Therapy in Relapsed/Refractory Multiple Myeloma. J Clin Oncol 2024:JCO2302232. [PMID: 38358946 DOI: 10.1200/jco.23.02232] [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] [Received: 10/12/2023] [Revised: 11/21/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
PURPOSE Although chimeric antigen receptor T therapy (CAR-T) cells are an established therapy for relapsed/refractory multiple myeloma (RRMM), there are no established models predicting outcome to identify patients who may benefit the most from CAR-T. PATIENTS AND METHODS This is an international retrospective observational study including patients with RRMM infused with currently available commercial or academically produced anti-B-cell maturation antigen (BCMA) CAR-T. We describe characteristics and outcomes in Europe (n = 136) and the United States (n = 133). Independent predictors of relapse/progression built a simple prediction model (Myeloma CAR-T Relapse [MyCARe] model) in the training cohort (Europe), which was externally validated (US cohort) and tested within patient- and treatment-specific subgroups. RESULTS The overall response rate was 87% and comparable between both cohorts, and complete responses were seen in 48% (Europe) and 49% (the United States). The median time to relapse was 5 months, and early relapse <5 months from infusion showed poor survival across cohorts, with the 12-month overall survival of 30% (Europe) and 14% (the United States). The presence of extramedullary disease or plasma cell leukemia, lenalidomide-refractoriness, high-risk cytogenetics, and increased ferritin at the time of lymphodepletion were independent predictors of early relapse or progression. Each factor received one point, forming the three-tiered MyCARe model: scores 0-1 (low risk), scores 2-3 (intermediate risk), and a score of 4 (high risk). The MyCARe model was significantly associated with distinct 5-month incidence of relapse/progression (P < .001): 7% for low-risk, 27% for intermediate-risk, and 53% for high-risk groups. The model was validated in the US cohort and maintained prognostic utility for response, survival, and outcomes across subgroups. CONCLUSION Outcomes of patients with RRMM after CAR-T are comparable between Europe and the United States. The MyCARe model may facilitate optimal timing of CAR-T cells in patient-specific subgroups.
Collapse
Affiliation(s)
- Nico Gagelmann
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Danai Dima
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
| | - Maximilian Merz
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Hamza Hashmi
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- Medical University of South Carolina, Charleston, SC
| | - Nausheen Ahmed
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- The University of Kansas Medical Center, Kansas City, KS
| | - Natalia Tovar
- Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Aina Oliver-Caldés
- Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Friedrich Stölzel
- Division for Stem Cell Transplantation and Cellular Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
| | - Kristin Rathje
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Luise Fischer
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Patrick Born
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Lisa Schäfer
- Department of Hematology and Medical Oncology, Medical Center University of Göttingen, Göttingen, Germany
| | - Anca-Maria Albici
- Division for Stem Cell Transplantation and Cellular Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
| | - Natalie Schub
- Division for Stem Cell Transplantation and Cellular Immunotherapy, Department of Medicine II, University Hospital Schleswig-Holstein Kiel, Kiel University, Kiel, Germany
| | - Shlomit Kfir-Erenfeld
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Miri Assayag
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nathalie Asherie
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gerald Georg Wulf
- Department of Hematology and Medical Oncology, Medical Center University of Göttingen, Göttingen, Germany
| | - Soraya Kharboutli
- Department of Internal Medicine, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Fabian Müller
- Department of Internal Medicine, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Leyla Shune
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- The University of Kansas Medical Center, Kansas City, KS
| | - James A Davis
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- Medical University of South Carolina, Charleston, SC
| | - Faiz Anwer
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
| | - Vladan Vucinic
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Uwe Platzbecker
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectiology, University Hospital of Leipzig, Leipzig, Germany
| | - Francis Ayuk
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jack Khouri
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
| | - Carmelo Gurnari
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
- Department of Biomedicine and Prevention, PhD in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Joseph McGuirk
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- The University of Kansas Medical Center, Kansas City, KS
| | - Polina Stepensky
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Al-Ola Abdallah
- US Myeloma Innovations Research Collaborative (USMIRC), Kansas City, KS
- The University of Kansas Medical Center, Kansas City, KS
| | | |
Collapse
|
8
|
Feuchtinger T, Bader P, Subklewe M, Breidenbach M, Willier S, Metzler M, Gökbuget N, Hauer J, Müller F, Schlegel PG, Frühwald M, Schmid C, Troeger A, Baldus C, Meisel R, Künkele A, Topp M, Bourquin JP, Cario G, Von Stackelberg A, Peters C. Approaches for bridging therapy prior to chimeric antigen receptor T cells for relapsed/refractory acute lymphoblastic B-lineage leukaemia in children and young adults. Haematologica 2024. [PMID: 38356450 DOI: 10.3324/haematol.2023.283780] [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] [Received: 06/20/2023] [Indexed: 02/16/2024] Open
Abstract
The ongoing development of immunotherapies, including chimeric antigen receptor (CAR) T cells, has revolutionized cancer treatment. In paediatric relapsed/refractory B-lineage acute leukaemia antiCD19-CARs induced impressive initial response rates, with event-free survival plateauing at 30-50% in long-term follow-up data. During the interval between diagnosis of relapse or refractoriness and CAR T cell infusion, patients require a bridging therapy. To date, this therapy has consisted of highly variable approaches based on local experience. Here, in an European collaborative effort of paediatric and adult haematologists, we summarise current knowledge with the aim of establishing a guidance for bridging therapy. This includes treatment strategies for different patient subgroups, the advantages and disadvantages of low- and highintensity regimens, and the potential impact of bridging therapy on outcome after CAR T cell infusion. This guidance is a step towards a cross-institutional harmonization of bridging therapy, including personalized approaches. This will allow better comparability of clinical data and increase the level of evidence for the treatment of children and young adults with relapsed/refractory B-lineage ALL until CAR T cell infusion.
Collapse
Affiliation(s)
- Tobias Feuchtinger
- Department of Paediatric Haematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Germany; Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg.
| | - Peter Bader
- Goethe University, University Hospital, Department for Children and Adolescents, Division for Stern Cell Transplantation, Immunology and Intensive Care, Frankfurt
| | - Marion Subklewe
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Medicine III, University Hospital, LMU Munich, Munich
| | - Maike Breidenbach
- Department of Paediatric Haematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Germany; Bavarian Cancer Research Center (BZKF), R/R ALL Study Group
| | - Semjon Willier
- Department of Paediatric Haematology, Oncology, Hemostaseology and Stem Cell Transplantation, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Germany; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg
| | - Markus Metzler
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen
| | - Nicola Gökbuget
- Department of Medicine II, Haematology/Oncology, Goethe University, Frankfurt
| | - Julia Hauer
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Pediatrics and Children's Cancer Research Centre, TUM School of Medicine, Children's Hospital Munich Schwabing, Technical University of Munich, Munich
| | - Fabian Müller
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich- Alexander University of Erlangen- Nuremberg (FAU), Erlangen
| | - Paul-Gerhardt Schlegel
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; University Children's Hospital Wuerzburg, Wuerzburg
| | - Michael Frühwald
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Pediatrics and Adolescent Medicine, Swabian Children's Cancer Center, University Medical Center Augsburg, Augsburg
| | - Christoph Schmid
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Internal Medicine, University Medical Centre Augsburg, Augsburg
| | - Anja Troeger
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Paediatric Haematology, Oncology and Stem Cell Transplantation, University of Regensburg, Regensburg
| | - Claudia Baldus
- Department of Internal Medicine II, University Hospital Schleswig-Holstein, Kiel
| | - Roland Meisel
- Division of Paediatric Stern Cell Therapy, Department of Paediatric Oncology, Haematology and Clinical Immunology, Medical Faculty, Heinrich-Heine- University, Duesseldorf
| | - Annette Künkele
- Charite-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Paediatric Oncology and Haematology, Berlin
| | - Max Topp
- Bavarian Cancer Research Center (BZKF), R/R ALL Study Group; Department of Medicine II, University Hospital of Wuerzburg, Wuerzburg
| | | | - Gunnar Cario
- Department of Pediatrics, University Medical Center Schleswig-Holstein, Campus Kiel, Germany, Kiel, Schleswig-Holstein
| | - Arend Von Stackelberg
- Charite-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Paediatric Oncology and Haematology, Berlin
| | - Christina Peters
- St. Anna Children's Hospital, St. Anna Children's Research Institute, Medical University Vienna, Vienna
| |
Collapse
|
9
|
Kuut TA, Buffart LM, Braamse AMJ, Csorba I, Bleijenberg G, Nieuwkerk P, Moss-Morris R, Müller F, Knoop H. Does the effect of cognitive behavior therapy for chronic fatigue syndrome (ME/CFS) vary by patient characteristics? A systematic review and individual patient data meta-analysis. Psychol Med 2024; 54:447-456. [PMID: 37927223 DOI: 10.1017/s0033291723003148] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Debate is ongoing on the efficacy of cognitive behavior therapy (CBT) for myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). With an individual patient data (IPD) meta-analysis we investigated whether the effect of CBT varied by patient characteristics. These included post-exertional malaise (PEM), a central feature of ME/CFS according to many. We searched for randomized controlled trials similar with respect to comparison condition, outcomes and treatment-protocol. Moderation on fatigue severity (Checklist Individual Strength, subscale fatigue severity), functional impairment (Sickness Impact Profile-8) and physical functioning (Short Form-36, subscale physical functioning) was investigated using linear mixed model analyses and interaction tests. PROSPERO (CRD42022358245). Data from eight trials (n = 1298 patients) were pooled. CBT showed beneficial effects on fatigue severity (β = -11.46, 95% CI -15.13 to -7.79); p < 0.001, functional impairment (β = -448.40, 95% CI -625.58 to -271.23); p < 0.001; and physical functioning (β = 9.64, 95% CI 3.30 to 15.98); p < 0.001. The effect of CBT on fatigue severity varied by age (pinteraction = 0.003), functional impairment (pinteraction = 0.045) and physical activity pattern (pinteraction = 0.027). Patients who were younger, reported less functional impairments and had a fluctuating activity pattern benefitted more. The effect on physical functioning varied by self-efficacy (pinteraction = 0.025), with patients with higher self-efficacy benefitting most. No other moderators were found. It can be concluded from this study that CBT for ME/CFS can lead to significant reductions of fatigue, functional impairment, and physical limitations. There is no indication patients meeting different case definitions or reporting additional symptoms benefit less from CBT. Our findings do not support recent guidelines in which evidence from studies not mandating PEM was downgraded.
Collapse
Affiliation(s)
- T A Kuut
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - L M Buffart
- Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A M J Braamse
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - I Csorba
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - G Bleijenberg
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - P Nieuwkerk
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - R Moss-Morris
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - F Müller
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - H Knoop
- Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
10
|
Himmelbauer D, Müller F, Schweinzer C, Casas F, Pribanic B, Le Corre G, Thöny D, Trincado M, Grützmacher H. Selective dehydrogenation of ammonia borane to polycondensated BN rings catalysed by ruthenium olefin complexes. Chem Commun (Camb) 2024; 60:885-888. [PMID: 38165285 PMCID: PMC10795514 DOI: 10.1039/d3cc05709g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Dehydrogenation of ammonia borane to well-defined products is an important but challenging reaction. A dinuclear ruthenium complex with a Ru-Ru bond bearing a diazadiene (dad) unit and olefins as non-innocent ligands catalyzes the highly selective formation of conjugated polycondensed borazine oligomers (BxNxHy), predominantly B21N21H18, the BN analogue of superbenzene.
Collapse
Affiliation(s)
- Daniel Himmelbauer
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
- Institute of Applied Synthetic Chemistry, TU Wien, Getreidemarkt 9/163Vienna A-1060Austria
| | - Fabian Müller
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
| | - Clara Schweinzer
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
| | - Fernando Casas
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
| | - Bruno Pribanic
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
| | - Grégoire Le Corre
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
| | - Debora Thöny
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
| | - Monica Trincado
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
| | - Hansjörg Grützmacher
- Department of Chemistry and Applied Biosciences, ETH Zurich Vladimir-Prelog-Weg 1Zurich CH-8049Switzerlandtrincado@inorg,chem.ethz.ch
| |
Collapse
|
11
|
Taubmann J, Knitza J, Müller F, Völkl S, Aigner M, Kleyer A, Gary R, Kretschmann S, Boeltz S, Atzinger A, Kuwert T, Roemer F, Uder M, Mackensen A, Schett G. Rescue therapy of antisynthetase syndrome with CD19-targeted CAR-T cells after failure of several B-cell depleting antibodies. Rheumatology (Oxford) 2024; 63:e12-e14. [PMID: 37432378 PMCID: PMC10765150 DOI: 10.1093/rheumatology/kead330] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/12/2023] Open
Affiliation(s)
- Jule Taubmann
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Johannes Knitza
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Fabian Müller
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Simon Völkl
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Aigner
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Regina Gary
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sascha Kretschmann
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sebastian Boeltz
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Armin Atzinger
- Department Nuclear Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Torsten Kuwert
- Department Nuclear Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Frank Roemer
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Mackensen
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| |
Collapse
|
12
|
King MT, Revicki DA, Norman R, Müller F, Viney RC, Pickard AS, Cella D, Shaw JW. United States Value Set for the Functional Assessment of Cancer Therapy-General Eight Dimensions (FACT-8D), a Cancer-Specific Preference-Based Quality of Life Instrument. Pharmacoecon Open 2024; 8:49-63. [PMID: 38060096 PMCID: PMC10781923 DOI: 10.1007/s41669-023-00448-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES To develop a value set reflecting the United States (US) general population's preferences for health states described by the Functional Assessment of Cancer Therapy (FACT) eight-dimensions preference-based multi-attribute utility instrument (FACT-8D), derived from the FACT-General cancer-specific health-related quality-of-life (HRQL) questionnaire. METHODS A US online panel was quota-sampled to achieve a general population sample representative by sex, age (≥ 18 years), race and ethnicity. A discrete choice experiment (DCE) was used to value health states. The valuation task involved choosing between pairs of health states (choice-sets) described by varying levels of the FACT-8D HRQL dimensions and survival (life-years). The DCE included 100 choice-sets; each respondent was randomly allocated 16 choice-sets. Data were analysed using conditional logit regression parameterized to fit the quality-adjusted life-year framework, weighted for sociodemographic variables that were non-representative of the US general population. Preference weights were calculated as the ratio of HRQL-level coefficients to the survival coefficient. RESULTS 2562 panel members opted in, 2462 (96%) completed at least one choice-set and 2357 (92%) completed 16 choice-sets. Pain and nausea were associated with the largest utility weights, work and sleep had more moderate utility weights, and sadness, worry and support had the smallest utility weights. Within dimensions, more severe HRQL levels were generally associated with larger weights. A preference-weighting algorithm to estimate US utilities from responses to the FACT-General questionnaire was generated. The worst health state's value was -0.33. CONCLUSIONS This value set provides US population utilities for health states defined by the FACT-8D for use in evaluating oncology treatments.
Collapse
Affiliation(s)
- Madeleine T King
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.
| | - D A Revicki
- Revicki Outcomes Research Consulting, Sarasota, FL, USA
| | - R Norman
- School of Population Health, Curtin University, Perth, WA, Australia
| | - F Müller
- Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - R C Viney
- Centre for Health Economics Research & Evaluation, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - A S Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - D Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - J W Shaw
- Patient-Reported Outcomes Assessment, Global Health Economics and Outcomes Research, Bristol Myers Squibb, Lawrenceville, NJ, USA
| |
Collapse
|
13
|
Taubmann J, Knitza J, Müller F, Völkl S, Aigner M, Kretschmann S, Atzinger A, Kuwert T, Mackensen A, Schett G. Comment on: Rescue therapy of antisynthetase syndrome with CD19-targeted CAR-T-cells after failure of several B cell depleting antibodies: reply. Rheumatology (Oxford) 2023:kead669. [PMID: 38127905 DOI: 10.1093/rheumatology/kead669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Affiliation(s)
- Jule Taubmann
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Johannes Knitza
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Fabian Müller
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Simon Völkl
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Aigner
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sascha Kretschmann
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Armin Atzinger
- Department Nuclear Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Torsten Kuwert
- Department Nuclear Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Mackensen
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5- Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| |
Collapse
|
14
|
Nunez D, Patel D, Volkov J, Wong S, Vorndran Z, Müller F, Aigner M, Völkl S, Mackensen A, Schett G, Basu S. Cytokine and reactivity profiles in SLE patients following anti-CD19 CART therapy. Mol Ther Methods Clin Dev 2023; 31:101104. [PMID: 37744005 PMCID: PMC10514439 DOI: 10.1016/j.omtm.2023.08.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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] [Indexed: 09/26/2023]
Abstract
Chimeric antigen receptor (CAR) T cells targeting CD19+ B cells have demonstrated efficacy in refractory systemic lupus erythematosus (SLE). Although initial clinical data suggest that anti-CD19 CAR T cell therapy is well tolerated and highly effective, the immunologic consequences of CAR T cell therapy in SLE patients remain unclear. We profiled serum in six refractory SLE patients prior to and 3 months following CAR T cell infusion. Three months post T cell infusion, the inflammatory cytokines IL-6 and TNFα decreased in patient sera. This was accompanied by elevations in serum IL-7 and BAFF. Furthermore, SLE-associated antibodies dropped profoundly in five of six patients. Last, consistent with other reports of CD19 CAR T therapy in B cell malignancies, we were able to show marginal impact of anti-CD19 CART therapy on pre-existing humoral immune responses in SLE patients. Together, these results provide insights into the mechanisms of efficacy of anti-CD19 CAR T cell therapy in SLE.
Collapse
Affiliation(s)
- Daniel Nunez
- Department of Computational Biology, Cabaletta Bio, Philadelphia, PA, USA
| | - Darshil Patel
- Department of Protein and Molecular Biology, Cabaletta Bio, Philadelphia, PA, USA
| | - Jenell Volkov
- Department of Translational Medicine, Cabaletta Bio, Philadelphia, PA, USA
| | - Steven Wong
- Department of Protein and Molecular Biology, Cabaletta Bio, Philadelphia, PA, USA
| | - Zachary Vorndran
- Department of Translational Medicine, Cabaletta Bio, Philadelphia, PA, USA
| | - Fabian Müller
- Department of Medicine 5, Haematology and Oncology, Friedrich Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Michael Aigner
- Department of Medicine 5, Haematology and Oncology, Friedrich Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Simon Völkl
- Department of Medicine 5, Haematology and Oncology, Friedrich Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Andreas Mackensen
- Department of Medicine 5, Haematology and Oncology, Friedrich Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Medicine 3, Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nürnberg (FAU) and University Hospital Erlangen, Erlangen, Germany
| | - Samik Basu
- Department of Translational Medicine, Cabaletta Bio, Philadelphia, PA, USA
| |
Collapse
|
15
|
Bteich Y, Assaf JF, Gendy JE, Müller F, Jacob S, Hafezi F, Awwad ST. Asymmetric All-Femtosecond Laser-Cut Corneal Allogenic Intrastromal Ring Segments. J Refract Surg 2023; 39:856-862. [PMID: 38063823 DOI: 10.3928/1081597x-20231018-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
PURPOSE To describe a novel technique for cutting asymmetric allogenic segments using the femtosecond laser for the management of cases of keratoconus with non-coinciding astigmatism and coma axes. METHODS Four eyes of 2 patients with irregular keratoconus and asymmetric allogenic segments were included. Visual, refractive, tomographic, and aberrometric outcomes, and optical coherence tomography (OCT) sections were measured preoperatively and 6 months postoperatively. Evaluations included slit-lamp examination, manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuity, and simulated and maximum anterior keratometry (Kmax) using anterior segment OCT. RESULTS Spherical and cylindrical refractive errors decreased from -2.38 ± 2.96 and -2.94 ± 2.16 to -1.81 ± 2.77 (P = .04) and -1.75 ± 2.07 (P = .01) diopters (D), respectively, 6 months postoperatively. There was an average gain of three lines of CDVA. Kmax decreased from 50.02 ± 1.99 to 47.89 ± 3.05 D (P= .03) and coma from 1.05 ± 0.21 to 0.21 ± 0.19 D (P = .01). CONCLUSIONS Asymmetric femtosecond laser-cut allogenic segments allow a higher level of customization based on size, shape, and arc length, in contrast to the limited range of available synthetic asymmetrical segments. [J Refract Surg. 2023;39(12):856-862.].
Collapse
|
16
|
Nambiar MH, Seiler TG, Senti S, Liechti L, Müller F, Studer H, Roy AS, Büchler P. Depth-dependent mechanical properties of the human cornea by uniaxial extension. Exp Eye Res 2023; 237:109718. [PMID: 37952725 DOI: 10.1016/j.exer.2023.109718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
The purpose of this study was to investigate the depth-dependent biomechanical properties of the human corneal stroma under uniaxial tensile loading. Human stroma samples were obtained after the removal of Descemet's membrane in the course of Descemet's membrane endothelial keratoplasty (DMEK) transplantation. Uniaxial tensile tests were performed at three different depths: anterior, central, and posterior on 2 × 6 × 0.15 mm strips taken from the central DMEK graft. The measured force-displacement data were used to calculate stress-strain curves and to derive the tangent modulus. The study showed that mechanical strength decreased significantly with depth. The anterior cornea appeared to be the stiffest, with a stiffness approximately 18% higher than that of the central cornea and approximately 38% higher than that of the posterior layer. Larger variations in mechanical response were observed in the posterior group, probably due to the higher degree of alignment of the collagen fibers in the posterior sections of the cornea. This study contributes to a better understanding of the biomechanical tensile properties of the cornea, which has important implications for the development of new treatment strategies for corneal diseases. Accurate quantification of tensile strength as a function of depth is critical information that is lacking in human corneal biomechanics to develop numerical models and new treatment methods.
Collapse
Affiliation(s)
- Malavika H Nambiar
- ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010, Bern, Switzerland.
| | - Theo G Seiler
- IROC AG, Institut für Refraktive und Ophthalmo-Chirurgie, Stockerstrasse 37, 8002, Zürich, Switzerland; Universitätsklinik für Augenheilkunde, Inselspital Bern, Freiburgstrasse 15, 3010, Bern, Switzerland; Klinik für Augenheilkunde, Universitätsklinikum Düsseldorf, Moorenstr, 540225, Düsseldorf, Germany.
| | - Sebastian Senti
- ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010, Bern, Switzerland.
| | - Layko Liechti
- Ziemer Ophthalmic Systems AG, Allmendstrasse 11, 2562, Port, Switzerland.
| | - Fabian Müller
- Ziemer Ophthalmic Systems AG, Allmendstrasse 11, 2562, Port, Switzerland.
| | - Harald Studer
- Optimo Medical, Robert-Walser-Platz 7, 2503, Biel, Switzerland.
| | - Abhijit S Roy
- Narayana Nethralaya Eye Clinic, Bengaluru, Karnataka, 560010, India.
| | - Philippe Büchler
- ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010, Bern, Switzerland.
| |
Collapse
|
17
|
Blumenberg V, Busch G, Baumann S, Jitschin R, Iacoboni G, Gallur L, Iraola-Truchuelo J, Hoster E, Winkelmann M, Hellwig K, Schmidt C, Frölich L, Tast B, Hildebrand F, Rejeski K, Dekorsy F, Schmidkonz C, Bäuerle T, Kunz WG, Mougiakakos D, Müller F, von Bergwelt-Baildon M, Barba P, Bücklein VL, Mackensen A, Völkl S, Subklewe M. Early quantification of anti-CD19 CAR T cells by flow cytometry predicts response in R/R DLBCL. Blood Adv 2023; 7:6844-6849. [PMID: 37748131 PMCID: PMC10679803 DOI: 10.1182/bloodadvances.2023010364] [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] [Received: 04/03/2023] [Revised: 08/02/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023] Open
Affiliation(s)
- Viktoria Blumenberg
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
- Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
| | - Galina Busch
- Laboratory for Translational Cancer Immunology, LMU Gene Center, LMU Munich, Munich, Germany
| | - Stephan Baumann
- Laboratory for Translational Cancer Immunology, LMU Gene Center, LMU Munich, Munich, Germany
| | - Regina Jitschin
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Department for Hematology and Oncology, Otto-von-Guericke University, Magdeburg, Germany
| | - Gloria Iacoboni
- Department of Hematology, Vall d'Hebron University Hospital, Experimental Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Department of Medicine, Universitat Autònoma of Barcelona, Barcelona, Spain
| | - Laura Gallur
- Department of Hematology, Vall d'Hebron University Hospital, Experimental Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Department of Medicine, Universitat Autònoma of Barcelona, Barcelona, Spain
| | - Josu Iraola-Truchuelo
- Department of Hematology, Vall d'Hebron University Hospital, Experimental Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Eva Hoster
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
- Institute for Medical Informatics, Biometry and Epidemiology, LMU Munich, Munich, Germany
| | - Michael Winkelmann
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Konstantin Hellwig
- Department of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - Christian Schmidt
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lisa Frölich
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
| | - Benjamin Tast
- Laboratory for Translational Cancer Immunology, LMU Gene Center, LMU Munich, Munich, Germany
| | | | - Kai Rejeski
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
- Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
| | - Franziska Dekorsy
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christian Schmidkonz
- Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
- Department of Nuclear Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Institute for Medical Engineering, University of Applied Sciences Amberg-Weiden, Weiden, Germany
| | - Tobias Bäuerle
- Department of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - Wolfgang G. Kunz
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Dimitrios Mougiakakos
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Department for Hematology and Oncology, Otto-von-Guericke University, Magdeburg, Germany
- Bavarian Cancer Research Center (BZKF), partner site Erlangen, Erlangen, Germany
| | - Fabian Müller
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), partner site Erlangen, Erlangen, Germany
| | - Michael von Bergwelt-Baildon
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
- Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
| | - Pere Barba
- Department of Hematology, Vall d'Hebron University Hospital, Experimental Hematology, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Department of Medicine, Universitat Autònoma of Barcelona, Barcelona, Spain
| | - Veit L. Bücklein
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, LMU Munich, Munich, Germany
- Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
| | - Andreas Mackensen
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), partner site Erlangen, Erlangen, Germany
| | - Simon Völkl
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), partner site Erlangen, Erlangen, Germany
| | - Marion Subklewe
- Department of Medicine III, LMU University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
- Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
| |
Collapse
|
18
|
Mackensen A, Haanen JBAG, Koenecke C, Alsdorf W, Wagner-Drouet E, Borchmann P, Heudobler D, Ferstl B, Klobuch S, Bokemeyer C, Desuki A, Lüke F, Kutsch N, Müller F, Smit E, Hillemanns P, Karagiannis P, Wiegert E, He Y, Ho T, Kang-Fortner Q, Schlitter AM, Schulz-Eying C, Finlayson A, Flemmig C, Kühlcke K, Preußner L, Rengstl B, Türeci Ö, Şahin U. CLDN6-specific CAR-T cells plus amplifying RNA vaccine in relapsed or refractory solid tumors: the phase 1 BNT211-01 trial. Nat Med 2023; 29:2844-2853. [PMID: 37872225 PMCID: PMC10667102 DOI: 10.1038/s41591-023-02612-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023]
Abstract
The oncofetal antigen Claudin 6 (CLDN6) is highly and specifically expressed in many solid tumors, and could be a promising treatment target. We report dose escalation results from the ongoing phase 1/2 BNT211-01 trial evaluating the safety and feasibility of chimeric antigen receptor (CAR) T cells targeting the CLDN6 with or without a CAR-T cell-amplifying RNA vaccine (CARVac) at two dose levels (DLs) in relapsed/refractory CLDN6-positive solid tumors. The primary endpoints were safety and tolerability, maximum tolerated dose and recommended phase 2 dose (RP2D). Secondary endpoints included objective response rate (ORR) and disease control rate. We observed manageable toxicity, with 10 out of 22 patients (46%) experiencing cytokine release syndrome including one grade 3 event and 1 out of 22 (5%) with grade 1 immune effector cell-associated neurotoxicity syndrome. Dose-limiting toxicities occurred in two patients at the higher DL, resolving without sequelae. CAR-T cell engraftment was robust, and the addition of CARVac was well tolerated. The unconfirmed ORR in 21 evaluable patients was 33% (7 of 21), including one complete response. The disease control rate was 67% (14 of 21), with stable disease in seven patients. Patients with germ cell tumors treated at the higher DL exhibited the highest response rate (ORR 57% (4 of 7)). The maximum tolerated dose and RP2D were not established as the trial has been amended to utilize an automated manufacturing process. A repeat of the dose escalation is ongoing and will identify a RP2D for pivotal trials. ClinicalTrials.gov Identifier: NCT04503278 .
Collapse
Affiliation(s)
- Andreas Mackensen
- University Hospital Erlangen, Department of Internal Medicine 5, Hematology/Oncology, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - John B A G Haanen
- Netherlands Cancer Institute, Division of Medical Oncology, Amsterdam, the Netherlands
- Leiden University Medical Center, Department of Oncology, Leiden, the Netherlands
| | - Christian Koenecke
- Hannover Medical School, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover, Germany
| | - Winfried Alsdorf
- University Medical Center Hamburg-Eppendorf, Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, Hamburg, Germany
| | - Eva Wagner-Drouet
- University Medical Center Mainz, 3rd Medical Department, Hematology and Oncology, Mainz, Germany
| | - Peter Borchmann
- University Hospital of Cologne, Department I of Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Cologne, Germany
| | - Daniel Heudobler
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
- University Hospital Regensburg, Department of Internal Medicine III, Hematology and Oncology, Regensburg, Germany
| | - Barbara Ferstl
- University Hospital Erlangen, Department of Internal Medicine 5, Hematology/Oncology, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Sebastian Klobuch
- Netherlands Cancer Institute, Division of Medical Oncology, Amsterdam, the Netherlands
| | - Carsten Bokemeyer
- University Medical Center Hamburg-Eppendorf, Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, Hamburg, Germany
| | - Alexander Desuki
- University Medical Center Mainz, 3rd Medical Department, Hematology and Oncology, Mainz, Germany
| | - Florian Lüke
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
- University Hospital Regensburg, Department of Internal Medicine III, Hematology and Oncology, Regensburg, Germany
| | - Nadine Kutsch
- University Hospital of Cologne, Department I of Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Cologne, Germany
| | - Fabian Müller
- University Hospital Erlangen, Department of Internal Medicine 5, Hematology/Oncology, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Eveline Smit
- Netherlands Cancer Institute, Division of Medical Oncology, Amsterdam, the Netherlands
| | - Peter Hillemanns
- Hannover Medical School, Department of Gynecology and Obstetrics, Hannover, Germany
| | - Panagiotis Karagiannis
- University Medical Center Hamburg-Eppendorf, Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, Hamburg, Germany
| | - Erol Wiegert
- Bexon Clinical Consulting, Upper Montclair, NJ, USA
| | | | | | | | | | | | | | | | - Klaus Kühlcke
- BioNTech Innovative Manufacturing Services GmbH, Idar-Oberstein, Germany
| | | | - Benjamin Rengstl
- BioNTech SE, Mainz, Germany
- BioNTech Cell & Gene Therapies GmbH, Mainz, Germany
| | - Özlem Türeci
- BioNTech SE, Mainz, Germany
- BioNTech US, Cambridge, MA, USA
- BioNTech Innovative Manufacturing Services GmbH, Idar-Oberstein, Germany
- BioNTech Cell & Gene Therapies GmbH, Mainz, Germany
| | - Uğur Şahin
- BioNTech SE, Mainz, Germany.
- BioNTech US, Cambridge, MA, USA.
- BioNTech Innovative Manufacturing Services GmbH, Idar-Oberstein, Germany.
- BioNTech Cell & Gene Therapies GmbH, Mainz, Germany.
| |
Collapse
|
19
|
Gessner A, Müller F, Wenisch P, Heinrich MR, König J, Stopfer P, Fromm MF. A Metabolomic Analysis of Sensitivity and Specificity of 23 Previously Proposed Biomarkers for Renal Transporter-Mediated Drug-Drug Interactions. Clin Pharmacol Ther 2023; 114:1058-1072. [PMID: 37540045 DOI: 10.1002/cpt.3017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023]
Abstract
Endogenous biomarkers are discussed as tools for detection of drug-drug interactions (DDIs) mediated by renal transport proteins, such as organic cation transporter 2 (OCT2), multidrug and toxin extrusion proteins (MATE1 and MATE2-K) and organic anion transporters (OAT1 and OAT3). Whereas sensitivity of some endogenous biomarkers against at least one clinical transporter inhibitor has frequently been shown, intra-study comparisons of the extent of effects of inhibitors on different biomarkers are frequently lacking. Moreover, in vivo specificity of such discussed biomarkers has frequently not been studied. We therefore investigated changes of 10 previously described putative biomarkers for inhibition of OCT2/MATEs, as well as 15 previously described putative biomarkers for OATs in human plasma and urine samples of healthy volunteers in response to treatment with 4 inhibitors of transport proteins [verapamil (P-glycoprotein), rifampin (organic anion transporting polypeptides), cimetidine (OCT2/MATEs), and probenecid (OATs)]. Two of the putative biomarkers had been suggested for both OCT2/MATEs and OATs. All substances were unequivocally identified in an untargeted metabolomics assay. The OCT2/MATE biomarkers choline and trimethylamine N-oxide were both sensitive and specific (median log2-fold changes -1.18 in estimated renal elimination and -0.85 in urinary excretion, respectively). For renal OATs, indoleacetyl glutamine and indoleacetic acid (median log2-fold changes -3.77 and -2.85 in estimated renal elimination, respectively) were the candidates for sensitive and specific biomarkers with the most extensive change, followed by taurine, indolelactic acid, and hypoxanthine. This comprehensive study adds further knowledge on sensitivity and specificity of 23 previously described biomarkers of renal OCT2/MATE- and OAT-mediated DDIs.
Collapse
Affiliation(s)
- Arne Gessner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Fabian Müller
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Pia Wenisch
- Department of Chemistry and Pharmacy, Pharmaceutical Chemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Markus R Heinrich
- Department of Chemistry and Pharmacy, Pharmaceutical Chemistry, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jörg König
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Stopfer
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Martin F Fromm
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
20
|
Mackensen A, Müller F, Mougiakakos D, Böltz S, Wilhelm A, Aigner M, Völkl S, Simon D, Kleyer A, Munoz L, Kretschmann S, Kharboutli S, Gary R, Reimann H, Rösler W, Uderhardt S, Bang H, Herrmann M, Ekici AB, Buettner C, Habenicht KM, Winkler TH, Krönke G, Schett G. Author Correction: Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus. Nat Med 2023; 29:2956. [PMID: 36329355 DOI: 10.1038/s41591-022-02091-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Andreas Mackensen
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Fabian Müller
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Dimitrios Mougiakakos
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Hematology and Oncology, Otto-von-Guericke University Magdeburg (OVGU), Magdeburg, Germany
| | - Sebastian Böltz
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Artur Wilhelm
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Aigner
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Simon Völkl
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - David Simon
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Luis Munoz
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sascha Kretschmann
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Soraya Kharboutli
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Regina Gary
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Hannah Reimann
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Wolf Rösler
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Stefan Uderhardt
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Martin Herrmann
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arif Bülent Ekici
- Institute of Human Genetics, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Christian Buettner
- Institute of Human Genetics, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Thomas H Winkler
- Division of Genetics, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Gerhard Krönke
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.
| |
Collapse
|
21
|
Rejeski K, Perez A, Iacoboni G, Blumenberg V, Bücklein VL, Völkl S, Penack O, Albanyan O, Stock S, Müller F, Karschnia P, Petrera A, Reid K, Faramand R, Davila ML, Modi K, Dean EA, Bachmeier C, von Bergwelt-Baildon M, Locke FL, Bethge W, Bullinger L, Mackensen A, Barba P, Jain MD, Subklewe M. Severe hematotoxicity after CD19 CAR-T therapy is associated with suppressive immune dysregulation and limited CAR-T expansion. Sci Adv 2023; 9:eadg3919. [PMID: 37738350 PMCID: PMC10516499 DOI: 10.1126/sciadv.adg3919] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 08/23/2023] [Indexed: 09/24/2023]
Abstract
Prolonged cytopenias after chimeric antigen receptor (CAR) T cell therapy are a significant clinical problem and the underlying pathophysiology remains poorly understood. Here, we investigated how (CAR) T cell expansion dynamics and serum proteomics affect neutrophil recovery phenotypes after CD19-directed CAR T cell therapy. Survival favored patients with "intermittent" neutrophil recovery (e.g., recurrent neutrophil dips) compared to either "quick" or "aplastic" recovery. While intermittent patients displayed increased CAR T cell expansion, aplastic patients exhibited an unfavorable relationship between expansion and tumor burden. Proteomics of patient serum collected at baseline and in the first month after CAR-T therapy revealed higher markers of endothelial dysfunction, inflammatory cytokines, macrophage activation, and T cell suppression in the aplastic phenotype group. Prolonged neutrophil aplasia thus occurs in patients with systemic immune dysregulation at baseline with subsequently impaired CAR-T expansion and myeloid-related inflammatory changes. The association between neutrophil recovery and survival outcomes highlights critical interactions between host hematopoiesis and the immune state stimulated by CAR-T infusion.
Collapse
Affiliation(s)
- Kai Rejeski
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Berlin sites, and German Cancer Research Center, Heidelberg, Germany
- Bavarian Cancer Research Center (BZKF), partner sites, Munich and Erlangen, Germany
| | - Ariel Perez
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
- Blood and Marrow Transplant Program, Miami Cancer Institute, Miami, FL, USA
| | - Gloria Iacoboni
- Department of Hematology, University Hospital Vall d’Hebron, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Viktoria Blumenberg
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Berlin sites, and German Cancer Research Center, Heidelberg, Germany
- Bavarian Cancer Research Center (BZKF), partner sites, Munich and Erlangen, Germany
| | - Veit L. Bücklein
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Berlin sites, and German Cancer Research Center, Heidelberg, Germany
- Bavarian Cancer Research Center (BZKF), partner sites, Munich and Erlangen, Germany
| | - Simon Völkl
- Bavarian Cancer Research Center (BZKF), partner sites, Munich and Erlangen, Germany
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - Olaf Penack
- German Cancer Consortium (DKTK), Munich and Berlin sites, and German Cancer Research Center, Heidelberg, Germany
- Department of Hematology, Oncology and Tumorimmunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Berlin, Germany
| | - Omar Albanyan
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
- Adult Hematology-Oncology and Stem Cell Transplantation, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Sophia Stock
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Berlin sites, and German Cancer Research Center, Heidelberg, Germany
| | - Fabian Müller
- Bavarian Cancer Research Center (BZKF), partner sites, Munich and Erlangen, Germany
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - Philipp Karschnia
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
| | - Agnese Petrera
- Metabolomics and Proteomics Core Facility, Helmholtz Zentrum Munich – German Research Center for Environmental Health, Munich, Germany
| | - Kayla Reid
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Rawan Faramand
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Marco L. Davila
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Karnav Modi
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Erin A. Dean
- Division of Hematology and Oncology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Christina Bachmeier
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Michael von Bergwelt-Baildon
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Berlin sites, and German Cancer Research Center, Heidelberg, Germany
- Bavarian Cancer Research Center (BZKF), partner sites, Munich and Erlangen, Germany
| | - Frederick L Locke
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Wolfgang Bethge
- Department of Hematology, Oncology, Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany
| | - Lars Bullinger
- German Cancer Consortium (DKTK), Munich and Berlin sites, and German Cancer Research Center, Heidelberg, Germany
- Department of Hematology, Oncology and Tumorimmunology, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Mackensen
- Bavarian Cancer Research Center (BZKF), partner sites, Munich and Erlangen, Germany
- Department of Internal Medicine 5, Hematology and Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - Pere Barba
- Department of Hematology, University Hospital Vall d’Hebron, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Michael D. Jain
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Marion Subklewe
- Department of Medicine III – Hematology/Oncology, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, LMU Gene Center, Munich, Germany
- German Cancer Consortium (DKTK), Munich and Berlin sites, and German Cancer Research Center, Heidelberg, Germany
- Bavarian Cancer Research Center (BZKF), partner sites, Munich and Erlangen, Germany
| |
Collapse
|
22
|
Gsottberger F, Meier C, Ammon A, Parker S, Wendland K, George R, Petkovic S, Mellenthin L, Emmerich C, Lutzny-Geier G, Metzler M, Mackensen A, Chandramohan V, Müller F. Targeted inhibition of protein synthesis renders cancer cells vulnerable to apoptosis by unfolded protein response. Cell Death Dis 2023; 14:561. [PMID: 37626037 PMCID: PMC10457359 DOI: 10.1038/s41419-023-06055-w] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023]
Abstract
Cellular stress responses including the unfolded protein response (UPR) decide over the fate of an individual cell to ensure survival of the entire organism. During physiologic UPR counter-regulation, protective proteins are upregulated to prevent cell death. A similar strategy induces resistance to UPR in cancer. Therefore, we hypothesized that blocking protein synthesis following induction of UPR substantially enhances drug-induced apoptosis of malignant cells. In line, upregulation of the chaperone BiP was prevented by simultaneous arrest of protein synthesis in B cell malignancies. Cytotoxicity by immunotoxins-approved inhibitors of protein synthesis-was synergistically enhanced in combination with UPR-inducers in seven distinct hematologic and three solid tumor entities in vitro. Synergistic cell death depended on mitochondrial outer membrane permeabilization via BAK/BAX, which correlated with synergistic, IRE1α-dependent reduction of BID, accompanied by an additive fall of MCL-1. The strong synergy was reproduced in vivo against xenograft mouse models of mantle cell lymphoma, Burkitt's lymphoma, and patient-derived acute lymphoblastic leukemia. In contrast, synergy was absent in blood cells of healthy donors suggesting a tumor-specific vulnerability. Together, these data support clinical evaluation of blocking stress response counter-regulation using inhibitors of protein synthesis as a novel therapeutic strategy.
Collapse
Affiliation(s)
- Franziska Gsottberger
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Christina Meier
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Anna Ammon
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Scott Parker
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Kerstin Wendland
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Rebekka George
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Srdjan Petkovic
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Lisa Mellenthin
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Charlotte Emmerich
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Gloria Lutzny-Geier
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Markus Metzler
- Deptartment of Pediatrics and Adolescent Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Andreas Mackensen
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | | | - Fabian Müller
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany.
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany.
| |
Collapse
|
23
|
Bergmann C, Müller F, Distler JHW, Györfi AH, Völkl S, Aigner M, Kretschmann S, Reimann H, Harrer T, Bayerl N, Boeltz S, Wirsching A, Taubmann J, Rösler W, Spriewald B, Wacker J, Atzinger A, Uder M, Kuwert T, Mackensen A, Schett G. Treatment of a patient with severe systemic sclerosis (SSc) using CD19-targeted CAR T cells. Ann Rheum Dis 2023; 82:1117-1120. [PMID: 37147112 PMCID: PMC10359520 DOI: 10.1136/ard-2023-223952] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/06/2023] [Indexed: 05/07/2023]
Affiliation(s)
- Christina Bergmann
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Fabian Müller
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5-Haematology and Clinical Oncology, FAU Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jörg H W Distler
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Rheumatology, Universitatsklinikum Dusseldorf, Dusseldorf, Germany
- Hiller Research Unit, University of Düsseldorf, Duesseldorf, Germany
| | - Andrea-Hermina Györfi
- Department of Rheumatology, Universitatsklinikum Dusseldorf, Dusseldorf, Germany
- Hiller Research Unit, University of Düsseldorf, Duesseldorf, Germany
| | - Simon Völkl
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5-Haematology and Clinical Oncology, FAU Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Aigner
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5-Haematology and Clinical Oncology, FAU Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sascha Kretschmann
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5-Haematology and Clinical Oncology, FAU Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Hannah Reimann
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5-Haematology and Clinical Oncology, FAU Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Thomas Harrer
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Nadine Bayerl
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sebastian Boeltz
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Wirsching
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jule Taubmann
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Wolf Rösler
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5-Haematology and Clinical Oncology, FAU Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Bernd Spriewald
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5-Haematology and Clinical Oncology, FAU Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Jochen Wacker
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Armin Atzinger
- Institute of Nuclear Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Torsten Kuwert
- Institute of Nuclear Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Mackensen
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 5-Haematology and Clinical Oncology, FAU Erlangen-Nurnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3- Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander-Universität Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| |
Collapse
|
24
|
Kelly SD, Ovchinnikova OG, Müller F, Steffen M, Braun M, Sweeney RP, Kowarik M, Follador R, Lowary TL, Serventi F, Whitfield C. Identification of a second glycoform of the clinically prevalent O1 antigen from Klebsiella pneumoniae. Proc Natl Acad Sci U S A 2023; 120:e2301302120. [PMID: 37428935 PMCID: PMC10629545 DOI: 10.1073/pnas.2301302120] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/15/2023] [Indexed: 07/12/2023] Open
Abstract
Carbapenemase and extended β-lactamase-producing Klebsiella pneumoniae isolates represent a major health threat, stimulating increasing interest in immunotherapeutic approaches for combating Klebsiella infections. Lipopolysaccharide O antigen polysaccharides offer viable targets for immunotherapeutic development, and several studies have described protection with O-specific antibodies in animal models of infection. O1 antigen is produced by almost half of clinical Klebsiella isolates. The O1 polysaccharide backbone structure is known, but monoclonal antibodies raised against the O1 antigen showed varying reactivity against different isolates that could not be explained by the known structure. Reinvestigation of the structure by NMR spectroscopy revealed the presence of the reported polysaccharide backbone (glycoform O1a), as well as a previously unknown O1b glycoform composed of the O1a backbone modified with a terminal pyruvate group. The activity of the responsible pyruvyltransferase (WbbZ) was confirmed by western immunoblotting and in vitro chemoenzymatic synthesis of the O1b terminus. Bioinformatic data indicate that almost all O1 isolates possess genes required to produce both glycoforms. We describe the presence of O1ab-biosynthesis genes in other bacterial species and report a functional O1 locus on a bacteriophage genome. Homologs of wbbZ are widespread in genetic loci for the assembly of unrelated glycostructures in bacteria and yeast. In K. pneumoniae, simultaneous production of both O1 glycoforms is enabled by the lack of specificity of the ABC transporter that exports the nascent glycan, and the data reported here provide mechanistic understanding of the capacity for evolution of antigenic diversity within an important class of biomolecules produced by many bacteria.
Collapse
Affiliation(s)
- Steven D. Kelly
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ONN1G 2W1, Canada
| | - Olga G. Ovchinnikova
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ONN1G 2W1, Canada
| | | | | | - Martin Braun
- LimmaTech Biologics AG, Schlieren8952, Switzerland
| | - Ryan P. Sweeney
- Department of Chemistry, University of Alberta, Edmonton, ABT6G 2G2, Canada
| | | | | | - Todd L. Lowary
- Department of Chemistry, University of Alberta, Edmonton, ABT6G 2G2, Canada
- Institute of Biological Chemistry, Academia Sinica, Taipei, Nangang11529, Taiwan
- Institute of Biochemical Sciences, National Taiwan University, Taipei10617, Taiwan
| | | | - Chris Whitfield
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ONN1G 2W1, Canada
| |
Collapse
|
25
|
Wang W, Hariharan M, Bartlett A, Barragan C, Castanon R, Rothenberg V, Song H, Nery J, Aldridge A, Altshul J, Kenworthy M, Ding W, Liu H, Tian W, Zhou J, Chen H, Wei B, Gündüz IB, Norell T, Broderick TJ, McClain MT, Satterwhite LL, Burke TW, Petzold EA, Shen X, Woods CW, Fowler VG, Ruffin F, Panuwet P, Barr DB, Beare JL, Smith AK, Spurbeck RR, Vangeti S, Ramos I, Nudelman G, Sealfon SC, Castellino F, Walley AM, Evans T, Müller F, Greenleaf WJ, Ecker JR. Human Immune Cell Epigenomic Signatures in Response to Infectious Diseases and Chemical Exposures. bioRxiv 2023:2023.06.29.546792. [PMID: 37425926 PMCID: PMC10327221 DOI: 10.1101/2023.06.29.546792] [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] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Variations in DNA methylation patterns in human tissues have been linked to various environmental exposures and infections. Here, we identified the DNA methylation signatures associated with multiple exposures in nine major immune cell types derived from peripheral blood mononuclear cells (PBMCs) at single-cell resolution. We performed methylome sequencing on 111,180 immune cells obtained from 112 individuals who were exposed to different viruses, bacteria, or chemicals. Our analysis revealed 790,662 differentially methylated regions (DMRs) associated with these exposures, which are mostly individual CpG sites. Additionally, we integrated methylation and ATAC-seq data from same samples and found strong correlations between the two modalities. However, the epigenomic remodeling in these two modalities are complementary. Finally, we identified the minimum set of DMRs that can predict exposures. Overall, our study provides the first comprehensive dataset of single immune cell methylation profiles, along with unique methylation biomarkers for various biological and chemical exposures.
Collapse
Affiliation(s)
- Wenliang Wang
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Manoj Hariharan
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Anna Bartlett
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Cesar Barragan
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Rosa Castanon
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Vince Rothenberg
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Haili Song
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Joseph Nery
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Andrew Aldridge
- Duke University School of Medicine, Bryan Research Building, 311 Research Drive, Durham, NC 27710, USA
| | - Jordan Altshul
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Mia Kenworthy
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Wubin Ding
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Hanqing Liu
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Wei Tian
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Jingtian Zhou
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Huaming Chen
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Bei Wei
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
| | - Irem B. Gündüz
- Integrative Cellular Biology & Bioinformatics Lab, Saarland University, 66123 Saarbrücken, Germany
| | - Todd Norell
- Healthspan, Resilience, and Performance, Florida Institute for Human and Machine Cognition, 40 S Alcaniz St, Pensacola, FL 32502, USA
| | - Timothy J Broderick
- Healthspan, Resilience, and Performance, Florida Institute for Human and Machine Cognition, 40 S Alcaniz St, Pensacola, FL 32502, USA
| | - Micah T. McClain
- Center for Infectious Disease Diagnostics and Innovation, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710 USA
- Durham Veterans Affairs Medical Center, Durham, NC 27705 USA
| | - Lisa L. Satterwhite
- Department of Civil and Environmental Engineering, Pratt School of Engineering, Duke University, Durham, NC 27708, USA
| | - Thomas W. Burke
- Center for Infectious Disease Diagnostics and Innovation, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710 USA
| | - Elizabeth A. Petzold
- Center for Infectious Disease Diagnostics and Innovation, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710 USA
| | - Xiling Shen
- Terasaki Institute for Biomedical Innovation, Los Angeles, CA 90024, USA
| | - Christopher W. Woods
- Center for Infectious Disease Diagnostics and Innovation, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710 USA
- Durham Veterans Affairs Medical Center, Durham, NC 27705 USA
| | - Vance G. Fowler
- Center for Infectious Disease Diagnostics and Innovation, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710 USA
- Duke Clinical Research Institute, Durham NC 27701 USA
| | - Felicia Ruffin
- Center for Infectious Disease Diagnostics and Innovation, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710 USA
| | - Parinya Panuwet
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA
| | - Dana B. Barr
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322 USA
| | | | - Anthony K. Smith
- Battelle Memorial Institute, 505 King Ave Columbus OH 43201, USA
| | | | - Sindhu Vangeti
- Department of Neurology, Icahn School of Medicine at Mount Sinai; New York, NY 10029, USA
| | - Irene Ramos
- Department of Neurology, Icahn School of Medicine at Mount Sinai; New York, NY 10029, USA
| | - German Nudelman
- Department of Neurology, Icahn School of Medicine at Mount Sinai; New York, NY 10029, USA
| | - Stuart C. Sealfon
- Department of Neurology, Icahn School of Medicine at Mount Sinai; New York, NY 10029, USA
| | - Flora Castellino
- U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response, Biomedical Advanced Research and Development Authority, Washington, DC, USA
| | - Anna Maria Walley
- Vaccitech plc, Unit 6-10, Zeus Building, Rutherford Avenue, Harwell OX11 0DF, United Kingdom
| | - Thomas Evans
- Vaccitech plc, Unit 6-10, Zeus Building, Rutherford Avenue, Harwell OX11 0DF, United Kingdom
| | - Fabian Müller
- Integrative Cellular Biology & Bioinformatics Lab, Saarland University, 66123 Saarbrücken, Germany
| | | | - Joseph R. Ecker
- Genomic Analysis Laboratory, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
- Howard Hughes Medical Institute, The Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| |
Collapse
|
26
|
Brückner S, Müller F, Schadowski L, Kalle T, Weber S, Marino EC, Kutscher B, Möller AM, Adler S, Begerow D, Steinchen W, Bange G, Narberhaus F. (p)ppGpp and moonlighting RNases influence the first step of lipopolysaccharide biosynthesis in Escherichia coli. Microlife 2023; 4:uqad031. [PMID: 37426605 PMCID: PMC10326835 DOI: 10.1093/femsml/uqad031] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/12/2023] [Accepted: 06/13/2023] [Indexed: 07/11/2023]
Abstract
The outer membrane (OM) protects Gram-negative bacteria from harsh environmental conditions and provides intrinsic resistance to many antimicrobial compounds. The asymmetric OM is characterized by phospholipids in the inner leaflet and lipopolysaccharides (LPS) in the outer leaflet. Previous reports suggested an involvement of the signaling nucleotide ppGpp in cell envelope homeostasis in Escherichia coli. Here, we investigated the effect of ppGpp on OM biosynthesis. We found that ppGpp inhibits the activity of LpxA, the first enzyme of LPS biosynthesis, in a fluorometric in vitro assay. Moreover, overproduction of LpxA resulted in elongated cells and shedding of outer membrane vesicles (OMVs) with altered LPS content. These effects were markedly stronger in a ppGpp-deficient background. We further show that RnhB, an RNase H isoenzyme, binds ppGpp, interacts with LpxA, and modulates its activity. Overall, our study uncovered new regulatory players in the early steps of LPS biosynthesis, an essential process with many implications in the physiology and susceptibility to antibiotics of Gram-negative commensals and pathogens.
Collapse
Affiliation(s)
- Simon Brückner
- Microbial Biology, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Fabian Müller
- Microbial Biology, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Laura Schadowski
- Microbial Biology, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Tyll Kalle
- Microbial Biology, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Sophia Weber
- Microbial Biology, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Emily C Marino
- Microbial Biology, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Blanka Kutscher
- Microbial Biology, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Anna-Maria Möller
- Microbial Biology, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Sabine Adler
- Evolution of Plants and Fungi, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
| | - Dominik Begerow
- Evolution of Plants and Fungi, Faculty of Biology and Biotechnology, Ruhr University Bochum, Universitätsstrasse 150, Bochum, Germany
- Organismische Botanik und Mykologie, Institut für Planzenwissenschaften und Mikrobiologie, Fachbereich Biologie, Universität Hamburg,Ohnhorststrasse 18, Hamburg, Germany
| | - Wieland Steinchen
- Center for Synthetic Microbiology (SYNMIKRO) and Department of Chemistry, Philipps-University Marburg, Karl-von-Frisch-Strasse 14, Marburg, Germany
| | - Gert Bange
- Center for Synthetic Microbiology (SYNMIKRO) and Department of Chemistry, Philipps-University Marburg, Karl-von-Frisch-Strasse 14, Marburg, Germany
| | - Franz Narberhaus
- Corresponding author. Faculty of Biology and Biotechnology, Microbial Biology, Ruhr University Bochum, Universitätsstrasse 150, NDEF 06/784, 44780 Bochum, Germany. Tel: +492343223100; Fax: +492343214620; E-mail:
| |
Collapse
|
27
|
Andersen J, Thom N, Shadrach JL, Chen X, Onesto MM, Amin ND, Yoon SJ, Li L, Greenleaf WJ, Müller F, Pașca AM, Kaltschmidt JA, Pașca SP. Single-cell transcriptomic landscape of the developing human spinal cord. Nat Neurosci 2023; 26:902-914. [PMID: 37095394 DOI: 10.1038/s41593-023-01311-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/20/2023] [Indexed: 04/26/2023]
Abstract
Understanding spinal cord assembly is essential to elucidate how motor behavior is controlled and how disorders arise. The human spinal cord is exquisitely organized, and this complex organization contributes to the diversity and intricacy of motor behavior and sensory processing. But how this complexity arises at the cellular level in the human spinal cord remains unknown. Here we transcriptomically profiled the midgestation human spinal cord with single-cell resolution and discovered remarkable heterogeneity across and within cell types. Glia displayed diversity related to positional identity along the dorso-ventral and rostro-caudal axes, while astrocytes with specialized transcriptional programs mapped into white and gray matter subtypes. Motor neurons clustered at this stage into groups suggestive of alpha and gamma neurons. We also integrated our data with multiple existing datasets of the developing human spinal cord spanning 22 weeks of gestation to investigate the cell diversity over time. Together with mapping of disease-related genes, this transcriptomic mapping of the developing human spinal cord opens new avenues for interrogating the cellular basis of motor control in humans and guides human stem cell-based models of disease.
Collapse
Affiliation(s)
- Jimena Andersen
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Stanford Brain Organogenesis, Wu Tsai Neurosciences Institute, Stanford, CA, USA
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Nicholas Thom
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Stanford Brain Organogenesis, Wu Tsai Neurosciences Institute, Stanford, CA, USA
| | | | - Xiaoyu Chen
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Stanford Brain Organogenesis, Wu Tsai Neurosciences Institute, Stanford, CA, USA
| | - Massimo Mario Onesto
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Stanford Brain Organogenesis, Wu Tsai Neurosciences Institute, Stanford, CA, USA
- Neurosciences Graduate Program, Stanford University, Stanford, CA, USA
| | - Neal D Amin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Stanford Brain Organogenesis, Wu Tsai Neurosciences Institute, Stanford, CA, USA
| | - Se-Jin Yoon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Stanford Brain Organogenesis, Wu Tsai Neurosciences Institute, Stanford, CA, USA
| | - Li Li
- Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - William J Greenleaf
- Department of Genetics, Stanford University, Stanford, CA, USA
- Department of Applied Physics, Stanford University, Stanford, CA, USA
| | - Fabian Müller
- Department of Genetics, Stanford University, Stanford, CA, USA
- Center for Bioinformatics, Saarland University, Saarbrücken, Germany
| | - Anca M Pașca
- Department of Pediatrics, Division of Neonatology, Stanford University, Stanford, CA, USA
| | | | - Sergiu P Pașca
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
- Stanford Brain Organogenesis, Wu Tsai Neurosciences Institute, Stanford, CA, USA.
| |
Collapse
|
28
|
Brendefur Corwin LM, Campbell P, Jakobsen K, Müller F, Lai X, Unemo M, Leegaard TM, Vildershøj Bjørnholt J, Olsen AO. Improvement in Neisseria gonorrhoeae culture rates by bedside inoculation and incubation at a clinic for sexually transmitted infections. Ann Clin Microbiol Antimicrob 2023; 22:27. [PMID: 37072830 PMCID: PMC10114361 DOI: 10.1186/s12941-023-00576-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Culture of Neisseria gonorrhoeae is essential for surveillance of complete antimicrobial susceptibility profiles. In 2014, the culture success rate of N. gonorrhoeae from samples taken at the clinic for sexually transmitted infections (STI clinic), Oslo University Hospital, Norway, was only 20%. The present study aimed to improve gonococcal culture rates using bedside inoculation of patient samples on gonococcal agar plates and incubation at the STI clinic. METHODS This prospective quality improvement study was conducted by the STI clinic and the Department of Microbiology at Oslo University Hospital from May 2016 - October 2017. When culture of N. gonorrhoeae was clinically indicated, we introduced a parallel 'bedside culture' at the STI clinic and compared results with the standard culture at the microbiology department. Samples were taken from urethra, anorectum, pharynx and cervix. Culture rates were compared across symptomatic and asymptomatic anatomical sites. RESULTS From 596 gonococcal-positive PCR samples, bedside culture had a significantly higher success rate of 57% compared to 41% with standard culture (p < 0.05). Overall, culture rate from symptomatic sites was 91% v. 45% from asymptomatic sites. The culture rates from different anatomical sites were as follows: urethra 93%, anorectum 64%, pharynx 28% and cervix 70%. Bedside culture significantly (p < 0.05) improved the culture rates for symptomatic urethral and asymptomatic pharyngeal samples. CONCLUSIONS Where feasible, bedside inoculation on gonococcal agar plates and incubation of samples from patients with gonorrhoea is recommended. This will improve the culture diagnostics and provide additional gonococcal isolates for antimicrobial resistance surveillance.
Collapse
Affiliation(s)
- L M Brendefur Corwin
- Department of Microbiology, Oslo University Hospital, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - P Campbell
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
- National Advisory Unit for Sexually Transmitted Infections, Oslo University Hospital, Oslo, Norway
| | - K Jakobsen
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - F Müller
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - X Lai
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - M Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, UK
| | - T M Leegaard
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
| | - J Vildershøj Bjørnholt
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - A O Olsen
- Section for Respiratory, Blood-borne and Sexually Transmitted Infections, Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|
29
|
Rejeski K, Blumenberg V, Iacoboni G, Lopez-Corral L, Kharboutli S, Hernani R, Petrera A, Müller N, Hildebrand F, Frölich L, Karschnia P, Schmidt C, Cordas dos Santos DM, Piñana JL, Müller F, Martin AA, Dreyling M, von Bergwelt-Baildon M, Barba P, Subklewe M, Bücklein VL. Identifying Early Infections in the Setting of CRS With Routine and Exploratory Serum Proteomics and the HT10 Score Following CD19 CAR-T for Relapsed/Refractory B-NHL. Hemasphere 2023; 7:e858. [PMID: 37038465 PMCID: PMC10082278 DOI: 10.1097/hs9.0000000000000858] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/06/2023] [Indexed: 04/08/2023] Open
Abstract
Early fever after chimeric antigen receptor T-cell (CAR-T) therapy can reflect both an infection or cytokine release syndrome (CRS). Identifying early infections in the setting of CRS and neutropenia represents an unresolved clinical challenge. In this retrospective observational analysis, early fever events (day 0-30) were characterized as infection versus CRS in 62 patients treated with standard-of-care CD19.CAR-T for relapsed/refractory B-cell non-Hodgkin lymphoma. Routine serum inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6], procalcitonin [PCT]) were recorded daily. Exploratory plasma proteomics were performed longitudinally in 52 patients using a multiplex proximity extension assay (Olink proteomics). Compared with the CRSonly cohort, we noted increased event-day IL-6 (median 2243 versus 64 pg/mL, P = 0.03) and particularly high PCT levels (median 1.6 versus 0.3 µg/L, P < 0.0001) in the patients that developed severe infections. For PCT, an optimal discriminatory threshold of 1.5 µg/L was established (area under the receiver operating characteristic curve [AUCROC] = 0.78). Next, we incorporated day-of-fever PCT levels with the patient-individual CAR-HEMATOTOX score. In a multicenter validation cohort (n = 125), we confirmed the discriminatory capacity of this so-called HT10 score for early infections at first fever (AUCROC = 0.87, P < 0.0001, sens. 86%, spec. 86%). Additionally, Olink proteomics revealed pronounced immune dysregulation and endothelial dysfunction in patients with severe infections as evidenced by an increased ANGPT2/1 ratio and an altered CD40/CD40L-axis. In conclusion, the high discriminatory capacity of the HT10 score for infections highlights the advantage of dynamic risk assessment and supports the incorporation of PCT into routine inflammatory panels. Candidate markers from Olink proteomics may further refine risk-stratification. If validated prospectively, the score will enable risk-adapted decisions on antibiotic use.
Collapse
|
30
|
Müller F, Boeltz S, Knitza J, Aigner M, Völkl S, Kharboutli S, Reimann H, Taubmann J, Kretschmann S, Rösler W, Manger B, Wacker J, Mougiakakos D, Jabari S, Schröder R, Uder M, Roemer F, Krönke G, Mackensen A, Schett G. CD19-targeted CAR T cells in refractory antisynthetase syndrome. Lancet 2023; 401:815-818. [PMID: 36930673 DOI: 10.1016/s0140-6736(23)00023-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/11/2022] [Accepted: 01/03/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Fabian Müller
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Sebastian Boeltz
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Johannes Knitza
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Michael Aigner
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Simon Völkl
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Soraya Kharboutli
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Hannah Reimann
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Jule Taubmann
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Sascha Kretschmann
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Wolf Rösler
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Bernhard Manger
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Jochen Wacker
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Dimitrios Mougiakakos
- Department of Hematology and Oncology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Samir Jabari
- Institute of Neuropathology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Rolf Schröder
- Institute of Neuropathology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Frank Roemer
- Institute of Radiology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Gerhard Krönke
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Andreas Mackensen
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany
| | - Georg Schett
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany; Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen 91054, Germany.
| |
Collapse
|
31
|
Mello SS, Flowers BM, Mazur PK, Lee JJ, Müller F, Denny SK, Ferreira S, Hanson K, Kim SK, Greenleaf WJ, Wood LD, Attardi LD. Multifaceted role for p53 in pancreatic cancer suppression. Proc Natl Acad Sci U S A 2023; 120:e2211937120. [PMID: 36848578 PMCID: PMC10013849 DOI: 10.1073/pnas.2211937120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 01/05/2023] [Indexed: 03/01/2023] Open
Abstract
The vast majority of human pancreatic ductal adenocarcinomas (PDACs) harbor TP53 mutations, underscoring p53's critical role in PDAC suppression. PDAC can arise when pancreatic acinar cells undergo acinar-to-ductal metaplasia (ADM), giving rise to premalignant pancreatic intraepithelial neoplasias (PanINs), which finally progress to PDAC. The occurrence of TP53 mutations in late-stage PanINs has led to the idea that p53 acts to suppress malignant transformation of PanINs to PDAC. However, the cellular basis for p53 action during PDAC development has not been explored in detail. Here, we leverage a hyperactive p53 variant-p5353,54-which we previously showed is a more robust PDAC suppressor than wild-type p53, to elucidate how p53 acts at the cellular level to dampen PDAC development. Using both inflammation-induced and KRASG12D-driven PDAC models, we find that p5353,54 both limits ADM accumulation and suppresses PanIN cell proliferation and does so more effectively than wild-type p53. Moreover, p5353,54 suppresses KRAS signaling in PanINs and limits effects on the extracellular matrix (ECM) remodeling. While p5353,54 has highlighted these functions, we find that pancreata in wild-type p53 mice similarly show less ADM, as well as reduced PanIN cell proliferation, KRAS signaling, and ECM remodeling relative to Trp53-null mice. We find further that p53 enhances chromatin accessibility at sites controlled by acinar cell identity transcription factors. These findings reveal that p53 acts at multiple stages to suppress PDAC, both by limiting metaplastic transformation of acini and by dampening KRAS signaling in PanINs, thus providing key new understanding of p53 function in PDAC.
Collapse
Affiliation(s)
- Stephano S. Mello
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA94305
- Department of Biomedical Genetics, University of Rochester Medical Center, Rochester, NY14642
| | - Brittany M. Flowers
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA94305
| | - Pawel K. Mazur
- Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX77030
| | - James J. Lee
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA94305
- Calico Life Sciences LLC, South San Francisco, CA94080
| | - Fabian Müller
- Department of Genetics, Stanford University School of Medicine, Stanford, CA94305
- Integrative Cellular Biology and Bioinformatics, Saarland University, 66123Saarbrücken, Germany
| | - Sarah K. Denny
- Department of Genetics, Stanford University School of Medicine, Stanford, CA94305
| | - Sofia Ferreira
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA94305
| | - Kathryn Hanson
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA94305
- Department of Genetics, Stanford University School of Medicine, Stanford, CA94305
| | - Seung K. Kim
- Department of Developmental Biology, Stanford University School of Medicine, Stanford, CA94305
| | - William J. Greenleaf
- Department of Genetics, Stanford University School of Medicine, Stanford, CA94305
| | - Laura D. Wood
- Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD21287
| | - Laura D. Attardi
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA94305
- Department of Genetics, Stanford University School of Medicine, Stanford, CA94305
| |
Collapse
|
32
|
Desch M, Schlecker C, Hohl K, Liesenfeld KH, Chan T, Müller F, Wunderlich G, Keller S, Ishiguro N, Wind S. Pharmacokinetic-Interactions of BI 425809, a Novel Glycine Transporter 1 Inhibitor, With Cytochrome P450 and P-Glycoprotein Substrates: Findings From In Vitro Analyses and an Open-Label, Single-Sequence Phase I Study. J Clin Psychopharmacol 2023; 43:113-121. [PMID: 36700734 PMCID: PMC9988221 DOI: 10.1097/jcp.0000000000001656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE/BACKGROUND Glycine transporter-1 inhibitors may ameliorate cognitive deficits in schizophrenia. This study evaluated potential drug-drug interactions with the glycine transporter-1 inhibitor BI 425809. METHODS/PROCEDURES Interactions with cytochromes P450 (CYP) and P-glycoprotein (P-gp) were assessed in in vitro assays using human hepatocytes and Caco-2 cells, respectively. Pharmacokinetic characteristics of probe drugs were subsequently assessed in a Phase I, open-label, single-sequence crossover study in healthy male participants. Participants received a probe-drug cocktail containing midazolam (CYP3A4), warfarin (CYP2C9), and omeprazole (CYP2C19) and a separate dose of digoxin (P-gp), alone and on a background of steady-state BI 425809 25 mg once daily in 2 treatment periods. Adverse events were monitored. FINDINGS/RESULTS In vitro assays revealed concentration-dependent induction of CYP3A4 and inhibition of P-gp by BI 425809. In the clinical study, 12 of 13 participants completed both periods. With BI 425809, area under the plasma concentration curve from administration to the last measurement (AUC 0-tz ) and maximum plasma concentration ( Cmax ) for midazolam were lower than when administered alone. Adjusted geometric mean ratios (90% confidence interval) were 70.6% (63.9%-78.1%) for AUC 0-tz and 77.6% (67.3%-89.4%) for Cmax . For warfarin and digoxin, AUC 0-tz and Cmax were similar with and without BI 425809. For omeprazole, BI 425809 slightly reduced AUC 0-tz but not Cmax versus omeprazole alone. No new safety signals were identified. IMPLICATIONS/CONCLUSIONS These findings indicate induction of CYP3A4 by once-daily BI 425809 25 mg (the assumed highest therapeutic dose) and no meaningful effects on CYP2C9, CYP2C19, or P-gp in vivo.
Collapse
Affiliation(s)
- Michael Desch
- From the Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss
| | | | - Kathrin Hohl
- From the Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss
| | | | - Tom Chan
- Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, CT
| | | | | | - Sascha Keller
- From the Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss
| | | | - Sven Wind
- From the Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss
| |
Collapse
|
33
|
Müller F, Hohl K, Keller S, Schmidt-Gerets S, Deutsch B, Schuler-Metz A, Fromm MF, Stopfer P, Gessner A. N 1 -Methylnicotinamide as Biomarker for MATE-Mediated Renal Drug-Drug Interactions: Impact of Cimetidine, Rifampin, Verapamil, and Probenecid. Clin Pharmacol Ther 2023; 113:1070-1079. [PMID: 36636898 DOI: 10.1002/cpt.2849] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/04/2023] [Indexed: 01/14/2023]
Abstract
N1 -methylnicotinamide (NMN) has been proposed as endogenous biomarker for drug-drug interactions mediated by inhibition of multidrug and toxin extrusion proteins (MATEs) at the renal proximal tubule. We analyzed NMN in plasma and urine samples of two clinical trials investigating a new probe drug cocktail (consisting of digoxin, metformin, furosemide, and rosuvastatin) dedicated to clinically relevant drug transporters. In trial 1, NMN was investigated after single-dose treatment with individual cocktail components or after cocktail treatment. In trial 2, NMN was investigated after treatment with cocktail alone or with cocktail + inhibitor (cimetidine, a MATE inhibitor; or rifampin, verapamil, or probenecid, inhibitors of other transporters). In trial 1, NMN kinetics in plasma and urine were essentially not affected by individual cocktail components or after cocktail treatment. In trial 2, NMN renal clearance from 0 to 12 hours (CLR,0-12 ) geometric mean ratio (GMR) after cocktail + cimetidine vs. cocktail alone was 75% (90% confidence interval (CI): 65-87%). NMN CLR GMR after cocktail + verapamil, + rifampin, or + probenecid vs. cocktail alone was 99% (90% CI: 81-121%), 91% (90% CI: 75-111%), and 107% (90% CI: 91-126%), respectively. Compared with creatinine CLR and creatinine area under the plasma-concentration time curve, NMN CLR was more specific and more sensitive for renal MATE inhibition. Absence of impact of the cocktail on NMN in trial 1 allows for utilization of NMN in studies using this transporter cocktail. Trial 2 data support that NMN CLR is a specific and sensitive marker for MATE-mediated renal drug-drug interactions.
Collapse
Affiliation(s)
- Fabian Müller
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany.,Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Kathrin Hohl
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Sascha Keller
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | | | - Birgit Deutsch
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Martin F Fromm
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Stopfer
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | - Arne Gessner
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
34
|
Kretschmann S, Völkl S, Reimann H, Krönke G, Schett G, Achenbach S, Lutzny-Geier G, Müller F, Mougiakakos D, Dingfelder J, Flamann C, Hanssens L, Gary R, Mackensen A, Aigner M. Successful Generation of CD19 Chimeric Antigen Receptor T Cells from Patients with Advanced Systemic Lupus Erythematosus. Transplant Cell Ther 2023; 29:27-33. [PMID: 36241147 DOI: 10.1016/j.jtct.2022.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/16/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022]
Abstract
Although it has been shown that the production of functional chimeric antigen receptor T cells is feasible in patients with B-cell malignancies, it is currently unclear whether sufficient amounts of functional autologous CAR T cells can be generated from patients with autoimmune diseases. Intrinsic T-cell abnormalities and T-cell-targeted immune suppression in patients with autoimmunity may hamper the retrieval of sufficient T cells and their transduction and expansion into CAR T cells. Patients with active systemic lupus erythematosus (SLE) underwent leukapheresis after tapering glucocorticoids and stopping T-cell-suppressive drugs. This material was used as source for manufacturing anti-CD19 CAR T-cell products (CAR) in clinical scale. Cells were transduced with a lentiviral anti-CD19 CAR vector and expanded under good manufacturing practice (GMP) conditions using a closed, semi-automatic system. Functionality of these CAR T cells derived from autoimmune patient cells was tested in vitro. Six SLE patients were analyzed. Leukapheresis could be successfully performed in all patients yielding sufficient T-cell numbers for clinical scale CAR T-cell production. In addition, CAR T cells showed high expansion rates and viability, leading to CAR T cells in sufficient doses and quality for clinical use. CAR T cells from all patients showed specific cytotoxicity against CD19+ cell lines in vitro. GMP grade generation of CD19 CAR T-cell products suitable for clinical use is feasible in patients with autoimmune disease.
Collapse
Affiliation(s)
- S Kretschmann
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - S Völkl
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - H Reimann
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - G Krönke
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany; Department of Internal Medicine 3 - Rheumatology and Immunology, University Hospital of Erlangen, Erlangen, Germany
| | - G Schett
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany; Department of Internal Medicine 3 - Rheumatology and Immunology, University Hospital of Erlangen, Erlangen, Germany
| | - S Achenbach
- Department of Transfusion Medicine and Haemostaseology, University Hospital of Erlangen, Erlangen, Germany
| | - G Lutzny-Geier
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - F Müller
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - D Mougiakakos
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany; Department of Hematology and Oncology, University of Magdeburg, Magdeburg, Germany
| | - J Dingfelder
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - C Flamann
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - L Hanssens
- Miltenyi Biomedicine GmbH, Bergisch Gladbach, Germany
| | - R Gary
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - A Mackensen
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - M Aigner
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany; Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany.
| |
Collapse
|
35
|
Schuhwerk H, Kleemann J, Gupta P, van Roey R, Armstark I, Kreileder M, Feldker N, Ramesh V, Hajjaj Y, Fuchs K, Mahapatro M, Hribersek M, Volante M, Groenewoud A, Engel FB, Ceppi P, Eckstein M, Hartmann A, Müller F, Kroll T, Stemmler MP, Brabletz S, Brabletz T. The EMT transcription factor ZEB1 governs a fitness-promoting but vulnerable DNA replication stress response. Cell Rep 2022; 41:111819. [PMID: 36516781 DOI: 10.1016/j.celrep.2022.111819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/14/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
The DNA damage response (DDR) and epithelial-to-mesenchymal transition (EMT) are two crucial cellular programs in cancer biology. While the DDR orchestrates cell-cycle progression, DNA repair, and cell death, EMT promotes invasiveness, cellular plasticity, and intratumor heterogeneity. Therapeutic targeting of EMT transcription factors, such as ZEB1, remains challenging, but tumor-promoting DDR alterations elicit specific vulnerabilities. Using multi-omics, inhibitors, and high-content microscopy, we discover a chemoresistant ZEB1-high-expressing sub-population (ZEB1hi) with co-rewired cell-cycle progression and proficient DDR across tumor entities. ZEB1 stimulates accelerated S-phase entry via CDK6, inflicting endogenous DNA replication stress. However, DDR buildups involving constitutive MRE11-dependent fork resection allow homeostatic cycling and enrichment of ZEB1hi cells during transforming growth factor β (TGF-β)-induced EMT and chemotherapy. Thus, ZEB1 promotes G1/S transition to launch a progressive DDR benefitting stress tolerance, which concurrently manifests a targetable vulnerability in chemoresistant ZEB1hi cells. Our study thus highlights the translationally relevant intercept of the DDR and EMT.
Collapse
Affiliation(s)
- Harald Schuhwerk
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.
| | - Julia Kleemann
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Pooja Gupta
- Core Unit for Bioinformatics, Data Integration and Analysis, Center for Medical Information and Communication Technology, University Hospital Erlangen, Erlangen Germany
| | - Ruthger van Roey
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Isabell Armstark
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Martina Kreileder
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Nora Feldker
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Vignesh Ramesh
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense M, Denmark
| | - Yussuf Hajjaj
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Kathrin Fuchs
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Mousumi Mahapatro
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Mojca Hribersek
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Marco Volante
- Department of Oncology, University of Turin, Orbassano, Turin, Italy
| | - Arwin Groenewoud
- Experimental Renal and Cardiovascular Research, Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Felix B Engel
- Experimental Renal and Cardiovascular Research, Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Paolo Ceppi
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense M, Denmark
| | - Markus Eckstein
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen- Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen- Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Fabian Müller
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital Erlangen, Erlangen Germany
| | - Torsten Kroll
- Leibniz Institute on Aging - Fritz-Lipmann Institute (FLI), Jena, Germany
| | - Marc P Stemmler
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Simone Brabletz
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Brabletz
- Department of Experimental Medicine 1, Nikolaus-Fiebiger Center for Molecular Medicine, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
| |
Collapse
|
36
|
Mackensen A, Müller F, Mougiakakos D, Böltz S, Wilhelm A, Aigner M, Völkl S, Simon D, Kleyer A, Munoz L, Kretschmann S, Kharboutli S, Gary R, Reimann H, Rösler W, Uderhardt S, Bang H, Herrmann M, Ekici AB, Buettner C, Habenicht KM, Winkler TH, Krönke G, Schett G. Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus. Nat Med 2022; 28:2124-2132. [PMID: 36109639 DOI: 10.1038/s41591-022-02017-5] [Citation(s) in RCA: 215] [Impact Index Per Article: 107.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/18/2022] [Indexed: 02/06/2023]
Abstract
Systemic lupus erythematosus (SLE) is a life-threatening autoimmune disease characterized by adaptive immune system activation, formation of double-stranded DNA autoantibodies and organ inflammation. Five patients with SLE (four women and one man) with a median (range) age of 22 (6) years, median (range) disease duration of 4 (8) years and active disease (median (range) SLE disease activity index Systemic Lupus Erythematosus Disease Activity Index: 16 (8)) refractory to several immunosuppressive drug treatments were enrolled in a compassionate-use chimeric antigen receptor (CAR) T cell program. Autologous T cells from patients with SLE were transduced with a lentiviral anti-CD19 CAR vector, expanded and reinfused at a dose of 1 × 106 CAR T cells per kg body weight into the patients after lymphodepletion with fludarabine and cyclophosphamide. CAR T cells expanded in vivo, led to deep depletion of B cells, improvement of clinical symptoms and normalization of laboratory parameters including seroconversion of anti-double-stranded DNA antibodies. Remission of SLE according to DORIS criteria was achieved in all five patients after 3 months and the median (range) Systemic Lupus Erythematosus Disease Activity Index score after 3 months was 0 (2). Drug-free remission was maintained during longer follow-up (median (range) of 8 (12) months after CAR T cell administration) and even after the reappearance of B cells, which was observed after a mean (±s.d.) of 110 ± 32 d after CAR T cell treatment. Reappearing B cells were naïve and showed non-class-switched B cell receptors. CAR T cell treatment was well tolerated with only mild cytokine-release syndrome. These data suggest that CD19 CAR T cell transfer is feasible, tolerable and highly effective in SLE.
Collapse
Affiliation(s)
- Andreas Mackensen
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Fabian Müller
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Dimitrios Mougiakakos
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Hematology and Oncology, Otto-von-Guericke University Magdeburg (OVGU), Magdeburg, Germany
| | - Sebastian Böltz
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Artur Wilhelm
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Michael Aigner
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Simon Völkl
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - David Simon
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Luis Munoz
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sascha Kretschmann
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Soraya Kharboutli
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Regina Gary
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Hannah Reimann
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Wolf Rösler
- Department of Internal Medicine 5-Hematology and Oncology, Friedrich Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Stefan Uderhardt
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Martin Herrmann
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arif Bülent Ekici
- Institute of Human Genetics, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Christian Buettner
- Institute of Human Genetics, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Thomas H Winkler
- Division of Genetics, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Gerhard Krönke
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany. .,Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.
| |
Collapse
|
37
|
Nambiar MH, Liechti L, Müller F, Bernau W, Studer H, Roy AS, Seiler TG, Büchler P. Orientation and depth dependent mechanical properties of the porcine cornea: Experiments and parameter identification. Exp Eye Res 2022; 224:109266. [PMID: 36179857 DOI: 10.1016/j.exer.2022.109266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/31/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022]
Abstract
The porcine cornea is a standard animal model in ophthalmic research, making its biomechanical characterization and modeling important to develop novel treatments such as crosslinking and refractive surgeries. In this study, we present a numerical model of the porcine cornea based on experimental measurements that captures both the depth dependence and orientation dependence of the mechanical response. The mechanical parameters of the established anisotropic hyperelastic material models of Gasser, Holzapfel and Ogden (HGO) and Markert were determined using tensile tests. Corneas were cut with a femtosecond laser in the anterior (100 μm), central (350 μm), and posterior (600 μm) regions into nasal-temporal, superior-inferior, and diagonal strips of 150 μm thickness. These uniformly thick strips were tested at a low speed using a single-axis testing machine. The results showed that the corneal mechanical properties remained constant in the anterior half of the cornea regardless of orientation, but that the material softened in the posterior layer. These results are consistent with the circular orientation of collagen observed in porcine corneas using X-ray scattering. In addition, the parameters obtained for the HGO model were able to reproduce the published inflation tests, indicating that it is suitable for simulating the mechanical response of the entire cornea. Such a model constitutes the basis for in silico platforms to develop new ophthalmic treatments. In this way, researchers can match their experimental surrogate porcine model with a numerical counterpart and validate the prediction of their algorithms in a complete and accessible environment.
Collapse
Affiliation(s)
- Malavika H Nambiar
- ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010, Bern, Switzerland.
| | - Layko Liechti
- ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010, Bern, Switzerland.
| | - Fabian Müller
- Ziemer Ophthalmic Systems AG, Allmendstrasse 11, 2562, Port, Switzerland.
| | - Werner Bernau
- Ziemer Ophthalmic Systems AG, Allmendstrasse 11, 2562, Port, Switzerland.
| | - Harald Studer
- Optimo Medical, Robert-Walser-Platz 7, 2503, Biel, Switzerland.
| | - Abhijit S Roy
- Narayana Nethralaya Eye Clinic, Bengaluru, Karnataka, 560010, India.
| | - Theo G Seiler
- IROC AG, Institut für Refraktive und Ophthalmo-Chirurgie, Stockerstrasse 37, 8002, Zürich, Switzerland; Universitätsklinik für Augenheilkunde, Inselspital Bern, Freiburgstrasse 15, 3010, Bern, Switzerland; Universitätsklinikum Düsseldorf, Germany.
| | - Philippe Büchler
- ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010, Bern, Switzerland.
| |
Collapse
|
38
|
Debnath S, Jorewitz M, Asmis KR, Müller F, Stückrath JB, Bischoff FA, Sauer J. Infrared photodissociation spectroscopy of (Al 2O 3) 2-5FeO +: influence of Fe-substitution on small alumina clusters. Phys Chem Chem Phys 2022; 24:20913-20920. [PMID: 36017635 DOI: 10.1039/d2cp02938c] [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
The infrared photodissociation spectra of He-tagged (Al2O3)nFeO+ (n = 2-5), are reported in the Al-O and Fe-O stretching and bending spectral region (430-1200 cm-1) and assigned based on calculated harmonic IR spectra from density functional theory (DFT). The substitution of Fe for an Al center occurs preferentially at 3-fold oxygen coordination sites located at the cluster rim and with the Fe atom in the +III oxidation state. The accompanying elongation of metal oxygen bonds leaves the Al-O network structure nearly unperturbed (isomorphous substitution). Contrary to the Al2FeO4+ (n = 1), valence isomerism is not observed, which is attributed to a smaller M:O ratio (M = Al, Fe) and consequently decreasing electron affinities with increasing cluster size.
Collapse
Affiliation(s)
- Sreekanta Debnath
- Wilhelm-Ostwald-Institut für Physikalische und Theoretische Chemie, Universität Leipzig, Linnéstrasse 2, 04103 Leipzig, Germany. .,Fritz-Haber-Institut der Max-Plank-Gesellschaft, Faradayweg 4-6, 14195 Berlin, Germany
| | - Marcel Jorewitz
- Wilhelm-Ostwald-Institut für Physikalische und Theoretische Chemie, Universität Leipzig, Linnéstrasse 2, 04103 Leipzig, Germany.
| | - Knut R Asmis
- Wilhelm-Ostwald-Institut für Physikalische und Theoretische Chemie, Universität Leipzig, Linnéstrasse 2, 04103 Leipzig, Germany.
| | - Fabian Müller
- Wilhelm-Ostwald-Institut für Physikalische und Theoretische Chemie, Universität Leipzig, Linnéstrasse 2, 04103 Leipzig, Germany. .,Fritz-Haber-Institut der Max-Plank-Gesellschaft, Faradayweg 4-6, 14195 Berlin, Germany.,Institut für Chemie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
| | - Julius B Stückrath
- Institut für Chemie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
| | - Florian A Bischoff
- Institut für Chemie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
| | - Joachim Sauer
- Institut für Chemie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany.
| |
Collapse
|
39
|
Albrink K, Joos C, Schröder D, Müller F, Noack EM. Benutzerfreundlichkeit einer Anamnese-App für die
primärärztliche Versorgung aus Sicht der
Patient*innen. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
40
|
Degen C, Mikuteit M, Niewolik J, Joosten T, Schröder D, Vahldiek K, Mücke U, Heinemann S, Müller F, Behrens G, Klawonn F, Lenarz T, Dopfer-Jablonka A, Steffens S. Audiological profile of adult long COVID patients. Am J Otolaryngol 2022; 43:103579. [PMID: 35988361 PMCID: PMC9354445 DOI: 10.1016/j.amjoto.2022.103579] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/01/2022] [Indexed: 12/03/2022]
Abstract
Introduction Hearing loss is one of the self-reported symptoms of Long COVID patients, however data from objective and subjective audiological tests demonstrating diminished hearing in Long COVID patients has not been published. Materials and methods Respondents of a large Long COVID online survey were invited to the ENT-department for an otologic exam. The participants were split into three groups based on their history of SARS-CoV-2 infection and persistence of symptoms. Respondents with a history of a SARS-CoV-2 infection were allocated to the Long COVID group, if they reported persistent symptoms and to the Ex COVID group, if they had regained their previous level of health. Participants without a history of SARS-CoV-2 infection made up the No COVID control group. In total, 295 ears were examined with otoscopy, tympanograms, pure tone audiometry and otoacoustic emissions. Ears with known preexisting hearing loss or status post ear surgery, as well as those with abnormal otoscopic findings, non-type A tympanograms or negative Rinne test were excluded. Results Compared to the No COVID and Ex COVID groups, we did not find a clinically significant difference in either hearing thresholds or frequency specific TEOAEs. However, at 500 Hz the data from the left ear, but not the right ear showed a significantly better threshold in the Ex COVID group, compared to Long COVID and No COVID groups. Any of the other tested frequencies between 500 Hz and 8 kHz were not significantly different between the different groups. There was a significantly lower frequency-specific signal-to-noise-ratio of the TEOAEs in the Long COVID compared to the No COVID group at 2.8 kHz. At all other frequencies, there were no significant differences between the three groups in the TEOAE signal-to-noise-ratio. Conclusion This study detected no evidence of persistent cochlear damage months after SARS-CoV-2 infection in a large cohort of Long COVID patients, as well as those fully recovered.
Collapse
|
41
|
Joos C, Albrink K, Noack EM, Müller F, Schröder D. Liefert eine digitale Anamnese zuverlässige Angaben von
Patient*innen? Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
42
|
Li YK, Müller F, Schöllkopf W, Asmis KR, Sauer J. Gas-Phase Mechanism of O .- /Ni 2+ -Mediated Methane Conversion to Formaldehyde. Angew Chem Int Ed Engl 2022; 61:e202202297. [PMID: 35460320 PMCID: PMC9400983 DOI: 10.1002/anie.202202297] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Indexed: 01/05/2023]
Abstract
The gas-phase reaction of NiAl2 O4 + with CH4 is studied by mass spectrometry in combination with vibrational action spectroscopy and density functional theory (DFT). Two product ions, NiAl2 O4 H+ and NiAl2 O3 H2 + , are identified in the mass spectra. The DFT calculations predict that the global minimum-energy isomer of NiAl2 O4 + contains Ni in the +II oxidation state and features a terminal Al-O.- oxygen radical site. They show that methane can react along two competing pathways leading to formation of either a methyl radical (CH3 ⋅) or formaldehyde (CH2 O). Both reactions are initiated by hydrogen atom transfer from methane to the terminal O.- site, followed by either CH3 ⋅ loss or CH3 ⋅ migration to an O2- site next to the Ni2+ center. The CH3 ⋅ attaches as CH3 + to O2- and its unpaired electron is transferred to the Ni-center reducing it to Ni+ . The proposed mechanism is experimentally confirmed by vibrational spectroscopy of the reactant and two different product ions.
Collapse
Affiliation(s)
- Ya-Ke Li
- Wilhelm-Ostwald Institut für Physikalische und Theoretische Chemie, Universität Leipzig, Linnéstr. 2, 04103, Leipzig, Germany.,Fritz-Haber-Institut der Max-Planck-Gesellschaft, Faradayweg 4-6, 14195, Berlin, Germany.,Present address: Green Catalysis Center and College of Chemistry, Zhengzhou University, Zhengzhou, 450001, China
| | - Fabian Müller
- Wilhelm-Ostwald Institut für Physikalische und Theoretische Chemie, Universität Leipzig, Linnéstr. 2, 04103, Leipzig, Germany.,Fritz-Haber-Institut der Max-Planck-Gesellschaft, Faradayweg 4-6, 14195, Berlin, Germany.,Institut für Chemie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Wieland Schöllkopf
- Fritz-Haber-Institut der Max-Planck-Gesellschaft, Faradayweg 4-6, 14195, Berlin, Germany
| | - Knut R Asmis
- Wilhelm-Ostwald Institut für Physikalische und Theoretische Chemie, Universität Leipzig, Linnéstr. 2, 04103, Leipzig, Germany
| | - Joachim Sauer
- Institut für Chemie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| |
Collapse
|
43
|
Schett G, Boeltz S, Müller F, Kleyer A, Völkl S, Aigner M, Gary R, Kretschmann S, Simon D, Kharboutli S, Mougiakakos D, Krönke G, Andreas M. OP0279 CAR-T CELL TREATMENT OF REFRACTORY SYSTEMIC LUPUS ERYTHEMATOSUS- SAFETY AND PRELIMINARY EFFICACY DATA FROM THE FIRST FOUR PATIENTS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundWhile treatment of Systemic lupus erythematosus (SLE) has substantially improved, a subset of patients experiences severe progressive disease despite T- and B cell targeted therapy. Furthermore, drug-free remission and seroconversion is difficult to achieve in SLE to dateObjectivesTo study the safety, tolerability, and preliminary efficacy of deep B cell depletion using autologous CD19 chimeric antigen receptor (CAR) T cells in patients with severe and treatment-refractory SLEMethodsThe CAR product was manufactured by CliniMACS Prodigy system (Miltenyi Biotec, Bergisch Gladbach, Germany). T-cells were enriched from the patients’ peripheral blood apheresis product and 1x108 cells were used as starting cell population. The cells were transfected with a lentiviral vector encoding an anti-CD19 CAR is composed of the FMC63 scFv, a CD8- derived hinge region, TNFRSF19-derived transmembrane domain, CD3ζ intracellular domain, and 4-1BB co-stimulatory domain (Miltenyi Biotec) and expanded for 12 days. After conditioning with cyclophosphamide/ fludarabine patients received 1x106 CD19-CAR-T cells/kg body weight as a single infusion. All SLE treatments with the exception of low dose prednisolone were stopped before CAR-T cell administration. After CAR-T cell treatment, also prednisolone was stopped. Tolerability was assessed by monitoring for Cytokine-release syndrome (CRS), immune-related effector cell neurotoxicity syndrome (ICANS) and infections. Preliminary efficacy was assessed by reaching a Lupus Low Disease Activity State (LLDAS), seroconversion in dsDNA antibodies and ANA and cessation of all SLE-specific treatmentsResultsAs of January 22, 2022, our 4 SLE patients had been treated with CD19 CAR-T cells with a follow up of 10 months (patient 1, female aged 20, SLEDAI-2K: 16), 7 months (patient 2, male aged 22; SLEDAI-2K:8), 2 months (patient 3, female aged 22; SLEDAI 2K: 6), and 1 month (patient 4; female aged 24; SLEDAI-2K: 6), respectively. All patients had active severe SLE with failure of standard treatment including pulsed steroids, hydroxychloroquine, mycophenolate, cyclophosphamide, intravenous immunoglobulins, rituximab and belimumab before CD19 CAR-T cell administration. All patients had active kidney disease. No infections occurred. All four patients experienced fever without proof of infectious disease (CRS °I); only one patient was treated with a single dose of tocilizumab. No ICANS and no CRS of other organs occurred. In vivo, CAR-T cells rapidly expanded to a maximum of 27,6% (day 9, patient 1), 41,2% (day 9, patient 2), 11,5% (day 9, patient 3) and 59,1% (day 9, patient 4) of total circulating T cells followed by a typical decline, with circulating CAR-T cells being continuously detectable during the next months. Expansion of CAR T cells preceded the complete and sustained depletion of circulating B cells. Patient 1 experienced sustained drug-free remission (SLEDAI-2K=0) with complete loss of ANA and dsDNA antibodies despite reappearance of B cells at 6 months. Patient 2 also experienced complete loss of ANA and dsDNA antibodies with B cells not yet returned. Low-level proteinuria remained most likely due to previously accrued damage in glomerular filter function (SLEDAI-2K: 2). Patient 3 and patient 4 had a shorter observation period to date but also achieved clinical remission (both SLEDAI-2K 0). All patients met LLDAS and could successfully stop all SLE-specific medication, including glucocorticoids. No SLE flare occurred so far.ConclusionTaken together, these data show that CD19 CAR T-cell therapy is well tolerated and may induce rapid remission of severe refractory SLE.References[1]Mougiakakos D et al., CD19-Targeted CAR T Cells in Refractory Systemic Lupus Erythematosus. N Engl J Med 2021;385:567-569.Disclosure of InterestsNone declared
Collapse
|
44
|
Li Y, Müller F, Schöllkopf W, Asmis KR, Sauer J. Gas‐Phase Mechanism of O
.−
/Ni
2+
‐Mediated Methane Conversion to Formaldehyde. Angew Chem Int Ed Engl 2022. [DOI: 10.1002/ange.202202297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ya‐Ke Li
- Wilhelm-Ostwald Institut für Physikalische und Theoretische Chemie Universität Leipzig Linnéstr. 2 04103 Leipzig Germany
- Fritz-Haber-Institut der Max-Planck-Gesellschaft Faradayweg 4–6 14195 Berlin Germany
- Present address: Green Catalysis Center and College of Chemistry Zhengzhou University Zhengzhou 450001 China
| | - Fabian Müller
- Wilhelm-Ostwald Institut für Physikalische und Theoretische Chemie Universität Leipzig Linnéstr. 2 04103 Leipzig Germany
- Fritz-Haber-Institut der Max-Planck-Gesellschaft Faradayweg 4–6 14195 Berlin Germany
- Institut für Chemie Humboldt-Universität zu Berlin Unter den Linden 6 10099 Berlin Germany
| | - Wieland Schöllkopf
- Fritz-Haber-Institut der Max-Planck-Gesellschaft Faradayweg 4–6 14195 Berlin Germany
| | - Knut R. Asmis
- Wilhelm-Ostwald Institut für Physikalische und Theoretische Chemie Universität Leipzig Linnéstr. 2 04103 Leipzig Germany
| | - Joachim Sauer
- Institut für Chemie Humboldt-Universität zu Berlin Unter den Linden 6 10099 Berlin Germany
| |
Collapse
|
45
|
Türk D, Müller F, Fromm MF, Selzer D, Dallmann R, Lehr T. Renal Transporter-Mediated Drug-Biomarker Interactions of the Endogenous Substrates Creatinine and N 1 -Methylnicotinamide: A PBPK Modeling Approach. Clin Pharmacol Ther 2022; 112:687-698. [PMID: 35527512 DOI: 10.1002/cpt.2636] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/28/2022] [Indexed: 01/06/2023]
Abstract
Endogenous biomarkers for transporter-mediated drug-drug interaction (DDI) predictions represent a promising approach to facilitate and improve conventional DDI investigations in clinical studies. This approach requires high sensitivity and specificity of biomarkers for the targets of interest (e.g., transport proteins), as well as rigorous characterization of their kinetics, which can be accomplished utilizing physiologically-based pharmacokinetic (PBPK) modeling. Therefore, the objective of this study was to develop PBPK models of the endogenous organic cation transporter (OCT)2 and multidrug and toxin extrusion protein (MATE)1 substrates creatinine and N1 -methylnicotinamide (NMN). Additionally, this study aimed to predict kinetic changes of the biomarkers during administration of the OCT2 and MATE1 perpetrator drugs trimethoprim, pyrimethamine, and cimetidine. Whole-body PBPK models of creatinine and NMN were developed utilizing studies investigating creatinine or NMN exogenous administration and endogenous synthesis. The newly developed models accurately describe and predict observed plasma concentration-time profiles and urinary excretion of both biomarkers. Subsequently, models were coupled to the previously built and evaluated perpetrator models of trimethoprim, pyrimethamine, and cimetidine for interaction predictions. Increased creatinine plasma concentrations and decreased urinary excretion during the drug-biomarker interactions with trimethoprim, pyrimethamine, and cimetidine were well-described. An additional inhibition of NMN synthesis by trimethoprim and pyrimethamine was hypothesized, improving NMN plasma and urine interaction predictions. To summarize, whole-body PBPK models of creatinine and NMN were built and evaluated to better assess creatinine and NMN kinetics while uncovering knowledge gaps for future research. The models can support investigations of renal transporter-mediated DDIs during drug development.
Collapse
Affiliation(s)
- Denise Türk
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | - Fabian Müller
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Martin F Fromm
- Institute of Experimental and Clinical Pharmacology and Toxicology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Dominik Selzer
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| | - Robert Dallmann
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Thorsten Lehr
- Clinical Pharmacy, Saarland University, Saarbrücken, Germany
| |
Collapse
|
46
|
Müller F, Al-Nosairy KO, Kramer FH, Meltendorf C, Djouoma N, Thieme H, Hoffmann MB, Hoffmann F. Rapid Campimetry-A Novel Screening Method for Glaucoma Diagnosis. J Clin Med 2022; 11:2156. [PMID: 35456248 PMCID: PMC9031552 DOI: 10.3390/jcm11082156] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/28/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
One of the most important functions of the retina-the enabling of perception of fast movements-is largely suppressed in standard automated perimetry (SAP) and kinetic perimetry (Goldmann) due to slow motion and low contrast between test points and environment. Rapid campimetry integrates fast motion (=10°/4.7 s at 40 cm patient-monitor distance) and high contrast into the visual field (VF) examination in order to facilitate the detection of absolute scotomas. A bright test point moves on a dark background through the central 10° VF. Depending on the distance to the fixation point, the test point automatically changes diameter (≈0.16° to ≈0.39°). This method was compared to SAP (10-2 program) for six subjects with glaucoma. Rapid campimetry proved to be comparable and possibly better than 10-2 SAP in identifying macular arcuate scotomas. In four subjects, rapid campimetry detected a narrow arcuate absolute scotoma corresponding to the nerve fiber course, which was not identified as such with SAP. Rapid campimetry promises a fast screening method for the detection of absolute scotomas in the central 10° visual field, with a potential for cloud technologies and telemedical applications. Our proof-of-concept study motivates systematic testing of this novel method in a larger cohort.
Collapse
Affiliation(s)
| | - Khaldoon O. Al-Nosairy
- Ophthalmology Department, Faculty of Medicine, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Francie H. Kramer
- Ophthalmology Department, Faculty of Medicine, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Christian Meltendorf
- Department of Optometry, Berlin University of Applied Sciences and Technology, 10785 Berlin, Germany
| | - Nidele Djouoma
- Ophthalmology Department, Faculty of Medicine, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Hagen Thieme
- Ophthalmology Department, Faculty of Medicine, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Michael B. Hoffmann
- Ophthalmology Department, Faculty of Medicine, Otto-von-Guericke University, 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences, 39118 Magdeburg, Germany
| | - Friedrich Hoffmann
- Ophthalmology Department, Charité—Universitätsmedizin Berlin, 12203 Berlin, Germany
| |
Collapse
|
47
|
Kyriakopoulos C, Nordström K, Kramer PL, Gottfreund JY, Salhab A, Arand J, Müller F, von Meyenn F, Ficz G, Reik W, Wolf V, Walter J, Giehr P. A comprehensive approach for genome-wide efficiency profiling of DNA modifying enzymes. Cell Rep Methods 2022; 2:100187. [PMID: 35475220 PMCID: PMC9017147 DOI: 10.1016/j.crmeth.2022.100187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/19/2022] [Accepted: 03/01/2022] [Indexed: 10/25/2022]
Abstract
A precise understanding of DNA methylation dynamics is of great importance for a variety of biological processes including cellular reprogramming and differentiation. To date, complex integration of multiple and distinct genome-wide datasets is required to realize this task. We present GwEEP (genome-wide epigenetic efficiency profiling) a versatile approach to infer dynamic efficiencies of DNA modifying enzymes. GwEEP relies on genome-wide hairpin datasets, which are translated by a hidden Markov model into quantitative enzyme efficiencies with reported confidence around the estimates. GwEEP predicts de novo and maintenance methylation efficiencies of Dnmts and furthermore the hydroxylation efficiency of Tets. Its design also allows capturing further oxidation processes given available data. We show that GwEEP predicts accurately the epigenetic changes of ESCs following a Serum-to-2i shift and applied to Tet TKO cells confirms the hypothesized mutual interference between Dnmts and Tets.
Collapse
Affiliation(s)
| | - Karl Nordström
- Department of Genetics and Epigenetics, Saarland University, Campus A2.4, 66123 Saarbrücken, Germany
| | - Paula Linh Kramer
- Computer Science Department, Saarland University, Campus E1.3, 66123 Saarbrücken, Germany
| | - Judith Yumiko Gottfreund
- Department of Genetics and Epigenetics, Saarland University, Campus A2.4, 66123 Saarbrücken, Germany
| | - Abdulrahman Salhab
- Department of Genetics and Epigenetics, Saarland University, Campus A2.4, 66123 Saarbrücken, Germany
| | - Julia Arand
- Division of Cell and Developmental Biology, Medical University of Vienna, 1090 Vienna, Austria
| | - Fabian Müller
- Department of Integrative Cellular Biology and Bioinformatics, Campus A2.4, 66123 Saarbrücken, Germany
| | - Ferdinand von Meyenn
- Department of Health Sciences and Technology, ETH Zürich, Schorenstrasse 16, Schwerzenbach, 8603 Zürich, Switzerland
| | - Gabriella Ficz
- Haemato-Oncology, Queen Mary University of London, London EC1M 6BQ, UK
| | - Wolf Reik
- Epigenetics Department, Babraham Institute, Cambridge CB22 3AT, UK
| | - Verena Wolf
- Computer Science Department, Saarland University, Campus E1.3, 66123 Saarbrücken, Germany
| | - Jörn Walter
- Department of Genetics and Epigenetics, Saarland University, Campus A2.4, 66123 Saarbrücken, Germany
| | - Pascal Giehr
- Department of Genetics and Epigenetics, Saarland University, Campus A2.4, 66123 Saarbrücken, Germany
- Department of Health Sciences and Technology, ETH Zürich, Schorenstrasse 16, Schwerzenbach, 8603 Zürich, Switzerland
| |
Collapse
|
48
|
Ammon A, Mellenthin L, Emmerich C, Naschberger E, Stürzl M, Mackensen A, Müller F. Reduced cytotoxicity by mutation of Lysine 590 of Pseudomonas exotoxin can be restored in an optimized, Lysine-free immunotoxin. Immunotherapy Advances 2022; 2:ltac007. [PMID: 35919491 PMCID: PMC9327129 DOI: 10.1093/immadv/ltac007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/17/2022] [Indexed: 12/02/2022] Open
Abstract
Immunotoxins, which are fusion proteins of an antibody fragment and a fragment of a bacterial or a plant toxin, induce apoptosis in target cells by inhibition of protein synthesis. ADP-ribosylating toxins often have few lysine residues in their catalytic domain. As they are the target for ubiquitination, the low number of lysines possibly prevents ubiquitin-dependent degradation of the toxin in the cytosol. To reduce this potential degradation, we aimed to generate a lysine-free (noK), Pseudomonas exotoxin (PE)-based immunotoxin. The new generation 24 kDa PE, which lacks all but the furin-cleavage site of domain II, was mutated at lysine 590 (K590) and at K606 in a CD22-targeting immunotoxin and activity was determined against various B cell malignancies in vitro and in vivo. On average, K590 mutated to arginine (R) reduced cytotoxicity by 1.3-fold and K606R enhanced cytotoxicity by 1.3-fold compared to wild type (wt). Mutating K590 to histidine or deleting K590 did not prevent this loss in cytotoxicity. Neither stability nor internalization rate of K590R could explain reduced cytotoxicity. These results highlight the relevance of lysine 590 for PE intoxication. In line with in vitro results, the K606R mutant was more than 1.8-fold more active than the other variants in vivo suggesting that this single mutation may be beneficial when targeting CD22-positive malignancies. Finally, reduced cytotoxicity by K590R was compensated for by K606R and the resulting lysine-free variant achieved wt-like activity in vitro and in vivo. Thus, PE24-noK may represent a promising candidate for down-stream applications that would interfere with lysines.
Collapse
Affiliation(s)
- Anna Ammon
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany
| | - Lisa Mellenthin
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany
| | - Charlotte Emmerich
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany
| | - Elisabeth Naschberger
- Division of Molecular and Experimental Surgery, Translational Research Center, Department of Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany
| | - Michael Stürzl
- Division of Molecular and Experimental Surgery, Translational Research Center, Department of Surgery, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany
| | - Andreas Mackensen
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany
| | - Fabian Müller
- Department of Internal Medicine 5, Haematology and Oncology, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany
| |
Collapse
|
49
|
Dahlem C, Abuhaliema A, Kessler SM, Kröhler T, Zoller BGE, Chanda S, Wu Y, Both S, Müller F, Lepikhov K, Kirsch SH, Laggai S, Müller R, Empting M, Kiemer AK. First Small-Molecule Inhibitors Targeting the RNA-Binding Protein IGF2BP2/IMP2 for Cancer Therapy. ACS Chem Biol 2022; 17:361-375. [PMID: 35023719 DOI: 10.1021/acschembio.1c00833] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The RNA-binding protein IGF2BP2/IMP2/VICKZ2/p62 is overexpressed in several tumor entities, promotes tumorigenesis and tumor progression, and has been suggested to worsen the disease outcome. The aim of this study is to (I) validate IMP2 as a potential target for colorectal cancer, (II) set up a screening assay for small-molecule inhibitors of IMP2, and (III) test the biological activity of the obtained hit compounds. Analyses of colorectal and liver cancer gene expression data showed reduced survival in patients with a high IMP2 expression and in patients with a higher IMP2 expression in advanced tumors. In vitro target validation in 2D and 3D cell cultures demonstrated a reduction in cell viability, migration, and proliferation in IMP2 knockout cells. Also, xenotransplant tumor cell growth in vivo was significantly reduced in IMP2 knockouts. Different compound libraries were screened for IMP2 inhibitors using a fluorescence polarization assay, and the results were confirmed by the thermal shift assay and saturation-transfer difference NMR. Ten compounds, which belong to two classes, that is, benzamidobenzoic acid class and ureidothiophene class, were validated in vitro and showed a biological target specificity. The three most active compounds were also tested in vivo and exhibited reduced tumor xenograft growth in zebrafish embryos. In conclusion, our findings support that IMP2 represents a druggable target to reduce tumor cell proliferation.
Collapse
Affiliation(s)
- Charlotte Dahlem
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken 66123, Germany
| | - Ali Abuhaliema
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken 66123, Germany
| | - Sonja M. Kessler
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken 66123, Germany
- Institute of Pharmacy, Experimental Pharmacology for Natural Sciences, Martin Luther University Halle-Wittenberg, Halle 06108, Germany
| | - Tarek Kröhler
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken 66123, Germany
| | - Ben G. E. Zoller
- Department of Drug Design and Optimization, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken 66123, Germany
| | - Shilpee Chanda
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken 66123, Germany
| | - Yingwen Wu
- Department of Drug Design and Optimization, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken 66123, Germany
| | - Simon Both
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken 66123, Germany
| | - Fabian Müller
- Center for Bioinformatics, Saarland University, Saarbrücken 66123, Germany
| | | | - Susanne H. Kirsch
- Department of Microbial Natural Products, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research, Saarland University, Saarbrücken 66123, Germany
| | - Stephan Laggai
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken 66123, Germany
| | - Rolf Müller
- Department of Microbial Natural Products, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research, Saarland University, Saarbrücken 66123, Germany
- Department of Pharmacy, Saarland University, Saarbrücken 66123, Germany
| | - Martin Empting
- Department of Drug Design and Optimization, Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University, Saarbrücken 66123, Germany
- Department of Pharmacy, Saarland University, Saarbrücken 66123, Germany
| | - Alexandra K. Kiemer
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken 66123, Germany
| |
Collapse
|
50
|
Müller F, Sand M, Wunderlich G, Link J, Schultheis C, Dansirikul C, Sane R, Laszlo R, Steinacker JM. The effect of BI 409306 on heart rate in healthy volunteers: a randomised, double-blind, placebo-controlled, crossover study. Eur J Clin Pharmacol 2022; 78:801-812. [PMID: 35089373 PMCID: PMC9005427 DOI: 10.1007/s00228-022-03274-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 01/04/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE The potent, selective phosphodiesterase-9A inhibitor BI 409306 may be beneficial for patients with attenuated psychosis syndrome and could prevent relapse in patients with schizophrenia. Transient BI 409306-dependent increases in heart rate (HR) demonstrated previously necessitated cardiac safety characterisation. We evaluated cardiac effects of BI 409306 in healthy volunteers during rest and exercise. METHODS In this double-blind, three-way crossover study, volunteers received placebo, BI 409306 50 mg or 200 mg in randomised order (same treatment on Days 1 [resting] and 3 [exercise]). Cardiopulmonary exercise testing was performed twice post treatment on Day 3 of each period. BI 409306-mediated effects on placebo-corrected change from baseline in resting HR (ΔΔHR) were evaluated based on exposure-response analysis and a random coefficient model. Adverse events (AEs) were recorded. RESULTS Overall, 19/20 volunteers completed. Resting ΔΔHR versus BI 409306 concentration yielded a slope of 0.0029 beats/min/nmol/L. At the geometric mean (gMean) maximum plasma concentration (Cmax) for BI 409306 50 and 200 mg, predicted mean (90% CI) ΔΔHRs were 0.80 (- 0.76, 2.36) and 5.46 (2.44, 8.49) beats/min, respectively. Maximum adjusted mean differences from placebo (90% CI) in resting HR for BI 409306 50 and 200 mg were 3.85 (0.73, 6.97) and 4.93 (1.69, 8.16) beats/min. Maximum differences from placebo in resting HR occurred at/near gMean Cmax and returned to baseline after approximately 4 h. The proportion of volunteers with AEs increased with BI 409306 dose. CONCLUSION Observed hemodynamic effects following BI 409306 administration were of low amplitude, transient, and followed the pharmacokinetic profile of BI 409306.
Collapse
Affiliation(s)
- Fabian Müller
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany.
| | - Michael Sand
- Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, USA
| | - Glen Wunderlich
- Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, USA
| | - Jasmin Link
- Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
| | | | | | - Rucha Sane
- Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, USA
| | - Roman Laszlo
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Jürgen M Steinacker
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| |
Collapse
|