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Danishuddin, Malik MZ, Kashif M, Haque S, Kim JJ. Exploring chemical space, scaffold diversity, and activity landscape of spleen tyrosine kinase active inhibitors. SAR QSAR Environ Res 2024; 35:325-342. [PMID: 38690773 DOI: 10.1080/1062936x.2024.2345618] [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] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/14/2024] [Indexed: 05/03/2024]
Abstract
This study aims to comprehensively characterize 576 inhibitors targeting Spleen Tyrosine Kinase (SYK), a non-receptor tyrosine kinase primarily found in haematopoietic cells, with significant relevance to B-cell receptor function. The objective is to gain insights into the structural requirements essential for potent activity, with implications for various therapeutic applications. Through chemoinformatic analyses, we focus on exploring the chemical space, scaffold diversity, and structure-activity relationships (SAR). By leveraging ECFP4 and MACCS fingerprints, we elucidate the relationship between chemical compounds and visualize the network using RDKit and NetworkX platforms. Additionally, compound clustering and visualization of the associated chemical space aid in understanding overall diversity. The outcomes include identifying consensus diversity patterns to assess global chemical space diversity. Furthermore, incorporating pairwise activity differences enhances the activity landscape visualization, revealing heterogeneous SAR patterns. The dataset analysed in this work has three activity cliff generators, CHEMBL3415598, CHEMBL4780257, and CHEMBL3265037, compounds with high affinity to SYK are very similar to compounds analogues with reasonable potency differences. Overall, this study provides a critical analysis of SYK inhibitors, uncovering potential scaffolds and chemical moieties crucial for their activity, thereby advancing the understanding of their therapeutic potential.
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Affiliation(s)
- Danishuddin
- Department of Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
| | - M Z Malik
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute (DDI), Dasman, Kuwait
| | - M Kashif
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, India
| | - S Haque
- Research and Scientific Studies Unit, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - J J Kim
- Department of Biotechnology, Yeungnam University, Gyeongsan, Republic of Korea
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2
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Walters JN, Schouest B, Patel A, Reuschel EL, Schultheis K, Parzych E, Maricic I, Gary EN, Purwar M, Andrade VM, Doan A, Elwood D, Eblimit Z, Nguyen B, Frase D, Zaidi FI, Kulkarni A, Generotti A, Joseph Kim J, Humeau LM, Ramos SJ, Smith TR, Weiner DB, Broderick KE. Prime-boost vaccination regimens with INO-4800 and INO-4802 augment and broaden immune responses against SARS-CoV-2 in nonhuman primates. Vaccine 2022; 40:2960-2969. [PMID: 35428500 PMCID: PMC8977452 DOI: 10.1016/j.vaccine.2022.03.060] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/02/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
The enhanced transmissibility and immune evasion associated with emerging SARS-CoV-2 variants demands the development of next-generation vaccines capable of inducing superior protection amid a shifting pandemic landscape. Since a portion of the global population harbors some level of immunity from vaccines based on the original Wuhan-Hu-1 SARS-CoV-2 sequence or natural infection, an important question going forward is whether this immunity can be boosted by next-generation vaccines that target emerging variants while simultaneously maintaining long-term protection against existing strains. Here, we evaluated the immunogenicity of INO-4800, our synthetic DNA vaccine candidate for COVID-19 currently in clinical evaluation, and INO-4802, a next-generation DNA vaccine designed to broadly target emerging SARS-CoV-2 variants, as booster vaccines in nonhuman primates. Rhesus macaques primed over one year prior with the first-generation INO-4800 vaccine were boosted with either INO-4800 or INO-4802 in homologous or heterologous prime-boost regimens. Both boosting schedules led to an expansion of T cells and antibody responses which were characterized by improved neutralizing and ACE2 blocking activity across wild-type SARS-CoV-2 as well as multiple variants of concern. These data illustrate the durability of immunity following vaccination with INO-4800 and additionally support the use of either INO-4800 or INO-4802 in prime-boost regimens.
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3
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Kraynyak KA, Blackwood E, Agnes J, Tebas P, Giffear M, Amante D, Reuschel EL, Purwar M, Christensen-Quick A, Liu N, Andrade VM, Diehl MC, Wani S, Lupicka M, Sylvester A, Morrow MP, Pezzoli P, McMullan T, Kulkarni AJ, Zaidi FI, Frase D, Liaw K, Smith TRF, Ramos SJ, Ervin J, Adams M, Lee J, Dallas M, Brown AS, Shea JE, Kim JJ, Weiner DB, Broderick KE, Humeau LM, Boyer JD, Mammen MP. SARS-CoV-2 DNA Vaccine INO-4800 Induces Durable Immune Responses Capable of Being Boosted in a Phase 1 Open-Label Trial. J Infect Dis 2022; 225:1923-1932. [PMID: 35079784 PMCID: PMC8807286 DOI: 10.1093/infdis/jiac016] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/24/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Additional SARS-CoV-2 vaccines that are safe and effective as primary vaccines and boosters remain urgently needed to combat the COVID-19 pandemic. We describe the safety and durability of the immune responses following two primary doses and a homologous booster dose of an investigational DNA vaccine (INO-4800) targeting the full-length spike antigen.
Methods
Three dosage strengths of INO-4800 (0.5 mg, 1.0 mg, and 2.0 mg) were evaluated in 120 age-stratified healthy adults. Intradermal injection of INO-4800 followed by electroporation at 0 and 4 weeks preceded an optional booster 6-10.5 months after the second dose.
Results
INO-4800 appeared well tolerated, with no treatment-related serious adverse events. Most adverse events were mild and did not increase in frequency with age and subsequent dosing. A durable antibody response was observed 6 months following the second dose; a homologous booster dose significantly increased immune responses. Cytokine producing T cells and activated CD8+ T cells with lytic potential were significantly increased in the 2.0 mg dose group.
Conclusion
INO-4800 was well tolerated in a 2-dose primary series and as a homologous booster in all adults, including the elderly. These results support further development of INO-4800 for use as a primary vaccine and as a booster.
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Affiliation(s)
| | | | - Joseph Agnes
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Pablo Tebas
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Mary Giffear
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Dinah Amante
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Emma L Reuschel
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | - Mansi Purwar
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | | | - Neiman Liu
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | | | | | - Snehal Wani
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | | | | | | | | | | | | | - Faraz I Zaidi
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | - Drew Frase
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | - Kevin Liaw
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | | | | | - John Ervin
- Alliance for Multispecialty Research, Kansas City, MO, USA
| | - Mark Adams
- Alliance for Multispecialty Research, Lexington, KY, USA
| | - Jessica Lee
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | | | | | | | - J Joseph Kim
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - David B Weiner
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | | | | | - Jean D Boyer
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
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Tebas P, Agnes J, Giffear M, Kraynyak KA, Blackwood E, Amante D, Reuschel E, Liu N, Purwar M, Christensen-Quick A, Andrade VM, Carter J, Garufi G, Diehl M, Sylvester A, Morrow MP, Pezzoli PP, Kulkarni AJ, Zaidi FI, Frase D, Liaw K, Patel A, Buttigieg KR, Ervin JE, Pawlicki J, Gillespie E, Maricic I, Schultheis K, Badie H, Herring TA, Simon KO, Smith TRF, Ramos S, Spitz R, Lee J, Dallas M, Brown AS, Shea JE, Kim JJ, Weiner D, Broderick K, McMullan T, Boyer J, Humeau L, Mammen Jr. MP. 571. Safety and Immunogenicity of INO-4800, a COVID-19 DNA Vaccine as a Primary Series and Booster. Open Forum Infect Dis 2021. [PMCID: PMC8644048 DOI: 10.1093/ofid/ofab466.769] [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] [Indexed: 11/20/2022] Open
Abstract
Background DNA vaccines are safe, tolerable, elicit humoral and cellular responses, allow for repeated dosing over time, are thermostable at room temperature, and are easy to manufacture. We present a compilation of Phase 1 and Phase 2 data of Inovio’s US COVID-19 DNA Vaccine (INO-4800) targeting the full-length Spike antigen of SARS-CoV-2. A South Korean Phase 2 study is ongoing. Methods Participants in the open-label Phase 1 trial received 0.5 mg, 1.0 mg or 2.0 mg intradermally (ID) followed by electroporation (EP) at Days 0 and 28. An optional booster dose was administered >6 months post-dose 2. The Phase 2 further compared the 1.0 mg and 2.0 mg doses against placebo in a total of 401 participants randomized at a 3:3:1:1 ratio. ClinicalTrials.gov identifiers: NCT04336410 and NCT04642638 Results The majority of adverse events (AEs) related to INO-4800 across both trials were mild in severity and did not increase in frequency with age and subsequent doses. In Phase 1, 78% (14/18) and 84% (16/19) of subjects generated neutralizing antibody responses with geometric mean titers (GMTs) of 17.4 (95%CI 8.3, 36.5) and 62.3 (95% CI 36.4, 106.7) in the 1.0 and 2.0 groups, respectively (Figure 1). By week 8, 74% (14/19) and 100% (19/19) subjects generated T cell responses by Th1- associated IFNγ ELISPOT assay . Following a booster dose, neutralizing GMTs rose to 82.2 (95% CI 38.2, 176.9) and 124.7 (95% CI 62.8, 247.7) in the 1.0 mg and 2.0 mg groups, respectively, demonstrating the ability of INO-4800 to boost (Figure 2). In Phase 2, neutralizing antibody responses demonstrated GMTs of 93.6 (95%CI 77.3, 113.4) in the 1.0 mg dose group and 150.6 (95%CI 123.8, 183.1) in the 2.0 mg dose group (Figure 3). ![]()
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Conclusion INO-4800 appears safe and tolerable as a primary series and as a booster with the induction of both humoral and cellular immune responses. In addition to eliciting neutralizing antibodies, INO-4800 also induced T cell immune responses as demonstrated by IFNγ ELISpot. Finally, as a homologous booster, INO-4800, when administered 6-10.5 months following the primary series, resulted in an increased immune response without increase in reactogenicity. The 2.0 mg dose was selected for Phase 3 evaluation. Disclosures Joseph Agnes, PhD, Inovio (Employee, Shareholder) Mary Giffear, BS, Inovio Pharmaceuticals, Inc. (Employee) Kimberly A. Kraynyak, PhD, Inovio Pharmaceuticals (Employee, Other Financial or Material Support, Stock options) Dinah Amante, BS, Inovio (Employee) Emma Reuschel, PhD, Inovio Pharmaceuticals (Employee) Aaron Christensen-Quick, PhD, Inovio Pharmaceuticals, Inc (Employee) Viviane M. Andrade, PhD, Inovio Pharmaceuticals Inc. (Employee) Gabriella Garufi, PhD, Inovio Pharmaceuticals, Inc. (Employee) Albert Sylvester, MS, Inovio (Employee, Shareholder) Matthew P. Morrow, PhD, Inovio Pharmaceuticals (Employee) Patrick P. Pezzoli, BS, Inovio Pharmaceuticals, Inc. (Employee) Jan Pawlicki, PhD, Inovio Pharmaceuticals (Employee) Elisabeth Gillespie, PhD, Inovio Pharmaceuticals, Inc. (Employee) Katherine Schultheis, MSc, Inovio Pharmaceuticals (Employee) Hedieh Badie, PhD, INOVIO Pharmaceuticals (Employee) Timothy A. Herring, MPH, Inovio Pharmaceuticals, Inc. (Employee, Other Financial or Material Support, Own stock in the company) Keiko O. Simon, PhD, Inovio Pharmaceuticals (Employee) Trevor R. F. Smith, PhD, Inovio (Employee, Shareholder) Stephanie Ramos, PhD, Inovio Pharmaceuticals (Employee) Jessica Lee, MPH, Inovio Pharmaceuticals (Employee) Michael Dallas, PhD, Inovio Pharmaceuticals, Inc. (Employee, Shareholder) Ami Shah Brown, PhD, Abbot Laboratories (Shareholder)IBB Biotech ETF (Shareholder)Inovio Pharmaceuticals (Employee)J & J (Shareholder)Moderna (Shareholder) Jacqueline E. Shea, PhD, Inovio Pharmaceuticals (Employee, Shareholder) J Joseph Kim, PhD, Inovio (Employee) David Weiner, PhD, Inovio (Board Member, Grant/Research Support, Shareholder, I serve on the SAB in addition to the above activities) Kate Broderick, PhD, Inovio (Employee) Trevor McMullan, MSc, Inovio (Shareholder) Jean Boyer, PhD, Inovio (Employee) Laurent Humeau, PhD, Inovio Pharmaceuticals (Employee) Mammen P. Mammen Jr., MD, Inovio Pharmaceuticals (Employee)
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Affiliation(s)
- Pablo Tebas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph Agnes
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | - Mary Giffear
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | - Dinah Amante
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | - Emma Reuschel
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | - Neiman Liu
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | | | - Julie Carter
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | - Malissa Diehl
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | | | | | - Faraz I Zaidi
- Wistar Institute Vaccine Center, Philadelphia, Pennsylvania
| | - Drew Frase
- Wistar Institute Vaccine Center, Philadelphia, Pennsylvania
| | - Kevin Liaw
- Wistar Institute Vaccine Center, Philadelphia, Pennsylvania
| | - Ami Patel
- Wistar Institute, philadelphia, Pennsylvania
| | - Karen R Buttigieg
- National Infection Service, Public Health England, Salisbury, United Kingdom
| | - John E Ervin
- Alliance for Multispecialty Research - KCM, KANSAS CITY, Missouri
| | - Jan Pawlicki
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | - Igor Maricic
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | - Hedieh Badie
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | - Keiko O Simon
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | | | - Jessica Lee
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | | | - J Joseph Kim
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | | | - Jean Boyer
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
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5
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Andrade VM, Christensen-Quick A, Agnes J, Tur J, Reed CC, Kalia R, Marrero I, Elwood D, Schultheis K, Purwar M, Reuschel E, McMullan T, Pezzoli P, Kraynyak KA, Sylvester A, Mammen Jr. MP, Tebas P, Kim JJ, Weiner D, Smith TRF, Ramos S, Humeau L, Boyer J, Broderick K. 578. INO-4800 DNA Vaccine Induces Neutralizing Antibodies and T cell Activity Against Global SARS-CoV-2 Variants. Open Forum Infect Dis 2021. [PMCID: PMC8644766 DOI: 10.1093/ofid/ofab466.776] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Global surveillance has identified emerging SARS-CoV-2 variants of concern (VOC) associated with increased transmissibility, disease severity, and resistance to neutralization by current vaccines under emergency use authorization (EUA). Here we assessed cross-immune responses of INO-4800 vaccinated subjects against SARS-CoV-2 VOCs.
Methods
We used a SARS-CoV-2 IgG ELISA and a pseudo neutralization assay to assess humoral responses, and an IFNγ ELISpot to measure cellular responses against SARS-CoV-2 VOC in subjects immunized with the DNA vaccine, INO-4800.
Results
IgG binding titers were not impacted between wild-type (WT) and B.1.1.7 or B.1.351 variants. An average 1.9-fold reduction was observed for the P.1 variant in subjects tested at week 8 after receiving two doses of INO-4800 (Figure 1a). We performed a SARS-CoV-2 pseudovirus neutralization assay using sera collected from 13 subjects two weeks after administration of a third dose of either 0.5 mg, 1 mg, or 2 mg of INO-4800. Neutralization was detected against WT and the emerging variants in all samples tested. The mean ID50 titers for the WT, B.1.1.7, B.1.351 and P.1. were 643 (range: 70-729), 295 (range: 46-886), 105 (range: 25-309), and 664 (range: 25-2087), respectively. Compared to WT, there was a 2.1 and 6.9-fold reduction for B.1.1.7 and B.1.351, respectively, while there was no difference between WT and the P.1 variant (Figure 1b). Next, we compared cellular immune responses to WT and SARS-CoV-2 Spike variants elicited by INO-4800 vaccination. We observed similar cellular responses to WT (median = 82.2 IQR = 58.9-205.3), B.1.1.7 (79.4, IQR = 38.9- 179.7), B.1.351 (80, IQR = 40.0-208.6) and P.1 (78.3, IQR = 53.1-177.8) Spike peptides (Figure 2).
Conclusion
INO-4800 vaccination induced neutralizing antibodies against all variants tested, with reduced levels detected against B.1.351. IFNγ T cell responses were fully maintained against all variants tested.
Disclosures
Viviane M. Andrade, PhD, Inovio Pharmaceuticals Inc. (Employee) Aaron Christensen-Quick, PhD, Inovio Pharmaceuticals, Inc (Employee) Joseph Agnes, PhD, Inovio (Employee, Shareholder) Jared Tur, PhD, Inovio (Employee) Charles C. Reed, PhD, Inovio Pharmaceuticals (Employee, Shareholder) Richa Kalia, MS, Inovio Pharmaceuticals (Employee, Other Financial or Material Support, I have stock options with Inovio Pharmaceuticals as an employee.) Idania Marrero, MD, PhD, Inovio Pharmaceuticals (Employee, Shareholder) Dustin Elwood, PhD, Inovio Pharmaceuticals (Employee) Katherine Schultheis, MSc, Inovio Pharmaceuticals (Employee) Emma Reuschel, PhD, Inovio Pharmaceuticals (Employee) Trevor McMullan, MSc, Inovio (Shareholder) Patrick Pezzoli, BS, Inovio (Employee) Kimberly A. Kraynyak, PhD, Inovio Pharmaceuticals (Employee, Other Financial or Material Support, Stock options) Albert Sylvester, MS, Inovio (Employee, Shareholder) Mammen P. Mammen Jr., MD, Inovio Pharmaceuticals (Employee) J Joseph Kim, PhD, Inovio (Employee) David Weiner, PhD, Inovio (Board Member, Grant/Research Support, Shareholder, I serve on the SAB in addition to the above activities) Trevor R. F. Smith, PhD, Inovio (Employee, Shareholder) Stephanie Ramos, PhD, Inovio Pharmaceuticals (Employee) Laurent Humeau, PhD, Inovio Pharmaceuticals (Employee) Jean Boyer, PhD, Inovio (Employee) Kate Broderick, PhD, Inovio (Employee)
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Affiliation(s)
| | | | - Joseph Agnes
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | - Jared Tur
- Inovio Pharmaceuticals, San Diego, California
| | | | - Richa Kalia
- Inovio Pharmaceuticals, San Diego, California
| | | | | | | | | | - Emma Reuschel
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | | | | | | | - Pablo Tebas
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - J Joseph Kim
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | | | | | - Jean Boyer
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
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6
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Schultheis K, Reed CC, Andrade VM, Kalia R, Tur J, Schouest B, Elwood D, Maricic I, Doan A, Eblimit Z, Pezzoli P, Amante D, yang M, Fader JG, Ferrer R, Weiner D, Kim JJ, Humeau L, Ramos S, Smith TRF, Broderick K. 579. Design and Immunogenicity of a Pan-SARS-CoV-2 Synthetic DNA Vaccine. Open Forum Infect Dis 2021. [PMCID: PMC8644724 DOI: 10.1093/ofid/ofab466.777] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
First-generation COVID-19 vaccines are matched to spike protein of the Wuhan-H1 (WT) strain. Convalescent and vaccinee samples show reduced neutralization of SARS-CoV-2 variants of concern (VOC). Next generation DNA vaccines could be matched to single variants or synthetically designed for broader coverage of multiple VOCs.
Methods
The synthetic consensus (SynCon®) sequence for INO-4802 SARS-CoV-2 spike with focused RBD changes and dual proline mutations was codon-optimized (Figure 1). Sequences for wild-type (pWT) and B.1.351 (pB.1.351) were similarly optimized. Immunogenicity was evaluated in BALB/c mice. Pre-clinical efficacy was assessed in the Syrian Hamster model.
Figure 1. Design Strategy for INO-4802
Results
INO-4802 induced potent neutralizing antibody responses against WT, B.1.1.7, P.1, and B.1.351 VOC in a murine model. pWT vaccinated animals showed a 3-fold reduction in mean neutralizing ID50 for the B.1.351 pseudotyped virus. INO-4802 immunized animals had significantly higher (p = 0.0408) neutralizing capacity (mean ID50 816.16). ID50 of pB.1.351 serum was reduced 7-fold for B.1.1.7 and significantly lower (p = 0.0068) than INO-4802 (317.44). INO-4802 neutralized WT (548.28) comparable to pWT. INO-4802 also neutralized P.1 (1026.6) (Figure 2). pWT, pB.1.351 or INO-4802 induced similar T-cell responses against all variants. INO-4802 skewed towards a TH1-response. All hamsters vaccinated with INO-4802 or pB.1.351 were protected from weight loss after B.1.351 live virus challenge. 4/6 pWT immunized hamsters were completely protected. pWT immunized hamsters neutralized WT (1090) but not B.1.351 (39.16). INO-4802 neutralized both WT (672.2) and B.1.351 (1121) (Figure 3). We observed higher increase of binding titers following heterologous boost with INO-4802 (3.6 – 4.4 log2-fold change) than homologous boost with pWT (2.0 – 2.4 log2 fold change) (Figure 4).
Figure 2. INO-4802 Induces Functional Humoral Immune Response Against SARS-CoV-2 Variants of Concern
Figure 3. INO-4802 Protects Hamsters Against Challenge With B.1.351 Live Virus
Figure 4. Heterologous Boost with INO-4802 Induces Humoral Immune Response Against SARS-CoV-2 Variants
Conclusion
Vaccines matching single VOCs, like pB.1.351 and pWT, elicit responses against the matched antigen but have reduced cross-reactivity. Presenting a pan-SARS-CoV-2 approach, INO-4802 may offer substantial advantages in terms of cross-strain protection, reduced susceptibility to escape mutants and non-restricted geographical use.
Disclosures
Katherine Schultheis, MSc, Inovio Pharmaceuticals (Employee) Charles C. Reed, PhD, Inovio Pharmaceuticals (Employee, Shareholder) Viviane M. Andrade, PhD, Inovio Pharmaceuticals Inc. (Employee) Richa Kalia, MS, Inovio Pharmaceuticals (Employee, Other Financial or Material Support, I have stock options with Inovio Pharmaceuticals as an employee.) Jared Tur, PhD, Inovio (Employee) Blake Schouest, PhD, Inovio Pharmaceuticals (Employee) Dustin Elwood, PhD, Inovio Pharmaceuticals (Employee) Arthur Doan, n/a, Inovio (Employee) Patrick Pezzoli, BS, Inovio (Employee) Dinah Amante, BS, Inovio (Employee) David Weiner, PhD, Inovio (Board Member, Grant/Research Support, Shareholder, I serve on the SAB in addition to the above activities) J Joseph Kim, PhD, Inovio (Employee) Laurent Humeau, PhD, Inovio Pharmaceuticals (Employee) Stephanie Ramos, PhD, Inovio Pharmaceuticals (Employee) Trevor R. F. Smith, PhD, Inovio (Employee, Shareholder) Kate Broderick, PhD, Inovio (Employee).
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Affiliation(s)
| | | | | | - Richa Kalia
- Inovio Pharmaceuticals, San Diego, California
| | - Jared Tur
- Inovio Pharmaceuticals, San Diego, California
| | | | | | - Igor Maricic
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | - Zeena Eblimit
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | - Dinah Amante
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | | | | | - J Joseph Kim
- INOVIO Pharmaceuticals, Plymouth Meeting, Pennsylvania
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7
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Andrade VM, Christensen-Quick A, Agnes J, Tur J, Reed C, Kalia R, Marrero I, Elwood D, Schultheis K, Purwar M, Reuschel E, McMullan T, Pezzoli P, Kraynyak K, Sylvester A, Mammen MP, Tebas P, Joseph Kim J, Weiner DB, Smith TRF, Ramos SJ, Humeau LM, Boyer JD, Broderick KE. INO-4800 DNA vaccine induces neutralizing antibodies and T cell activity against global SARS-CoV-2 variants. NPJ Vaccines 2021; 6:121. [PMID: 34650089 PMCID: PMC8516974 DOI: 10.1038/s41541-021-00384-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/06/2021] [Indexed: 11/15/2022] Open
Abstract
Global surveillance has identified emerging SARS-CoV-2 variants of concern (VOC) associated with broadened host specificity, pathogenicity, and immune evasion to vaccine-induced immunity. Here we compared humoral and cellular responses against SARS-CoV-2 VOC in subjects immunized with the DNA vaccine, INO-4800. INO-4800 vaccination induced neutralizing antibodies against all variants tested, with reduced levels detected against B.1.351. IFNγ T cell responses were fully maintained against all variants tested.
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Affiliation(s)
| | | | - Joseph Agnes
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Jared Tur
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Charles Reed
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Richa Kalia
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | | | | | | | - Mansi Purwar
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | - Emma Reuschel
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | | | | | - Kim Kraynyak
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | | | | | - Pablo Tebas
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - J Joseph Kim
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - David B Weiner
- Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA, USA
| | | | | | | | - Jean D Boyer
- Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
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8
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Bandres-Ciga S, Saez-Atienzar S, Kim JJ, Makarious MB, Faghri F, Diez-Fairen M, Iwaki H, Leonard H, Botia J, Ryten M, Hernandez D, Gibbs JR, Ding J, Gan-Or Z, Noyce A, Pihlstrom L, Torkamani A, Soltis AR, Dalgard CL, Scholz SW, Traynor BJ, Ehrlich D, Scherzer CR, Bookman M, Cookson M, Blauwendraat C, Nalls MA, Singleton AB. Correction to: Large‑scale pathway specific polygenic risk and transcriptomic community network analysis identifies novel functional pathways in Parkinson disease. Acta Neuropathol 2021; 142:223-224. [PMID: 33944973 PMCID: PMC8496667 DOI: 10.1007/s00401-021-02309-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A correction to this paper has been published: https://doi.org/10.1007/s00401-021-02309-z
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Affiliation(s)
- S Bandres-Ciga
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - S Saez-Atienzar
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - J J Kim
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - M B Makarious
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - F Faghri
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - M Diez-Fairen
- Fundació Docència i Recerca Mútua Terrassa and Movement Disorders Unit, Department of Neurology, University Hospital Mútua Terrassa, Terrassa, 08221, Barcelona, Spain
| | - H Iwaki
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - H Leonard
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - J Botia
- Departamento de Ingeniería de la Información y las Comunicaciones, Universidad de Murcia, Murcia, Spain
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - M Ryten
- Department of Neurodegenerative Disease, University College London (UCL) Institute of Neurology, London, UK
| | - D Hernandez
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - J R Gibbs
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - J Ding
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Z Gan-Or
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada
- Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - A Noyce
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London and Department of Neurology, Royal London Hospital, London, UK
| | - L Pihlstrom
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - A Torkamani
- The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - A R Soltis
- The American Genome Center, Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MA, USA
| | - C L Dalgard
- Department of Anatomy, Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MA, USA
- The American Genome Center, Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MA, USA
| | - S W Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, 20892, USA
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, 21287, USA
| | - B J Traynor
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, 21287, USA
| | - D Ehrlich
- Parkinson's Disease Clinic, Office of the Clinical Director, National Institute of Neurological, Disorders and Stroke, National Institutes of Health, Bethesda, MD, 20892, USA
| | - C R Scherzer
- Center for Advanced Parkinson Research, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, 0115, USA
| | - M Bookman
- Verily Life Sciences, South San Francisco, CA, USA
| | - M Cookson
- Cell Biology and Gene Expression Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MA, USA
| | - C Blauwendraat
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - M A Nalls
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
- Data Tecnica International, Glen Echo, MD, 20812, USA
| | - A B Singleton
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA.
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9
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Bordoloi D, Xiao P, Choi H, Ho M, Perales-Puchalt A, Khoshnejad M, Kim JJ, Humeau L, Srinivasan A, Weiner DB, Muthumani K. Immunotherapy of prostate cancer using novel synthetic DNA vaccines targeting multiple tumor antigens. Genes Cancer 2021; 12:51-64. [PMID: 33884106 PMCID: PMC8045963 DOI: 10.18632/genesandcancer.214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/10/2021] [Indexed: 01/07/2023] Open
Abstract
Prostate cancer is a prevalent cancer in men and consists of both indolent and aggressive phenotypes. While active surveillance is recommended for the former, current treatments for the latter include surgery, radiation, chemo and hormonal therapy. It has been observed that the recurrence in the treated patients is high and results in castration resistant prostate cancer for which treatment options are limited. This scenario has prompted us to consider immunotherapy with synthetic DNA vaccines, as this approach can generate antigen-specific tumor-killing immune cells. Given the multifocal and heterogeneous nature of prostate cancer, we hypothesized that synthetic DNA vaccines targeting different prostate specific antigens are likely to induce broader and improved immunity who are at high risk as well as advanced clinical stage of prostate cancer, compared to a single antigen approach. Utilizing a bioinformatics approach, synthetic enhanced DNA vaccine (SEV) constructs were generated against STEAP1, PAP, PARM1, PSCA, PCTA and PSP94. Synthetic enhanced vaccines for prostate cancer antigens were shown to elicit antigen-specific immune responses in mice and the anti-tumor activity was evident in a prostate tumor challenge mouse model. These studies support further evaluation of the DNA tools for immunotherapy of prostate cancer and perhaps other cancers.
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Affiliation(s)
- Devivasha Bordoloi
- 1Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA,
USA,*authors contributed equally
| | - Peng Xiao
- 1Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA,
USA,*authors contributed equally
| | - Hyeree Choi
- 1Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA,
USA
| | - Michelle Ho
- 1Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA,
USA
| | | | - Makan Khoshnejad
- 1Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA,
USA
| | | | | | | | - David B. Weiner
- 1Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA,
USA
| | - Kar Muthumani
- 1Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA,
USA,4GeneOne Life Science Inc., Seoul, Korea
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10
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Singla DR, Meltzer-Brody SE, Silver RK, Vigod SN, Kim JJ, La Porte LM, Ravitz P, Schiller CE, Schoueri-Mychasiw N, Hollon SD, Kiss A, Clark D, Dalfen AK, Dimidjian S, Gaynes BN, Katz SR, Lawson A, Leszcz M, Maunder RG, Mulsant BH, Murphy KE, Naslund JA, Reyes-Rodríguez ML, Stuebe AM, Dennis CL, Patel V. Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) through non-specialist providers and telemedicine: a study protocol for a non-inferiority randomized controlled trial. Trials 2021; 22:186. [PMID: 33673867 PMCID: PMC7933917 DOI: 10.1186/s13063-021-05075-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/28/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Depression and anxiety impact up to 1 in 5 pregnant and postpartum women worldwide. Yet, as few as 20% of these women are treated with frontline interventions such as evidence-based psychological treatments. Major barriers to uptake are the limited number of specialized mental health treatment providers in most settings, and problems with accessing in-person care, such as childcare or transportation. Task sharing of treatment to non-specialist providers with delivery on telemedicine platforms could address such barriers. However, the equivalence of these strategies to specialist and in-person models remains unproven. METHODS This study protocol outlines the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) randomized trial. SUMMIT is a pragmatic, non-inferiority test of the comparable effectiveness of two types of providers (specialist vs. non-specialist) and delivery modes (telemedicine vs. in-person) of a brief, behavioral activation (BA) treatment for perinatal depressive and anxiety symptoms. Specialists (psychologists, psychiatrists, and social workers with ≥ 5 years of therapy experience) and non-specialists (nurses and midwives with no formal training in mental health care) were trained in the BA protocol, with the latter supervised by a BA expert during treatment delivery. Consenting pregnant and postpartum women with Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10 (N = 1368) will be randomized to one of four arms (telemedicine specialist, telemedicine non-specialist, in-person specialist, in-person non-specialist), stratified by pregnancy status (antenatal/postnatal) and study site. The primary outcome is participant-reported depressive symptoms (EPDS) at 3 months post-randomization. Secondary outcomes are maternal symptoms of anxiety and trauma symptoms, perceived social support, activation levels and quality of life at 3-, 6-, and 12-month post-randomization, and depressive symptoms at 6- and 12-month post-randomization. Primary analyses are per-protocol and intent-to-treat. The study has successfully continued despite the COVID-19 pandemic, with needed adaptations, including temporary suspension of the in-person arms and ongoing randomization to telemedicine arms. DISCUSSION The SUMMIT trial is expected to generate evidence on the non-inferiority of BA delivered by a non-specialist provider compared to specialist and telemedicine compared to in-person. If confirmed, results could pave the way to a dramatic increase in access to treatment for perinatal depression and anxiety. TRIAL REGISTRATION ClinicalTrials.gov NCT04153864 . Registered on November 6, 2019.
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Affiliation(s)
- D R Singla
- Department of Psychiatry, Sinai Health and Lunenfeld Tanenbaum Research Institute, Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - S E Meltzer-Brody
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - R K Silver
- Department of Obstetrics & Gynecology, NorthShore University HealthSystem, Chicago, IL, USA
| | - S N Vigod
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- Women's College Hospital and Research Institute, Toronto, Canada
| | - J J Kim
- Department of Obstetrics & Gynecology, NorthShore University HealthSystem, Chicago, IL, USA
- Department of Obstetrics & Gynecology, University of Chicago Pritzker School of Medicine, Chicago, USA
| | - L M La Porte
- Department of Obstetrics & Gynecology, NorthShore University HealthSystem, Chicago, IL, USA
| | - P Ravitz
- Department of Psychiatry, Sinai Health and Lunenfeld Tanenbaum Research Institute, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - C E Schiller
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - N Schoueri-Mychasiw
- Department of Psychiatry, Sinai Health and Lunenfeld Tanenbaum Research Institute, Toronto, Canada
| | - S D Hollon
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - A Kiss
- Sunnybrook Research Institute, Toronto, ON, Canada
| | - D Clark
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - A K Dalfen
- Department of Psychiatry, Sinai Health and Lunenfeld Tanenbaum Research Institute, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - S Dimidjian
- Renee Crown Wellness Institute and Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA
| | - B N Gaynes
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - S R Katz
- Department of Psychiatry, Sinai Health and Lunenfeld Tanenbaum Research Institute, Toronto, Canada
| | - A Lawson
- Department of Obstetrics & Gynecology, University of Chicago Pritzker School of Medicine, Chicago, USA
| | - M Leszcz
- Department of Psychiatry, Sinai Health and Lunenfeld Tanenbaum Research Institute, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - R G Maunder
- Department of Psychiatry, Sinai Health and Lunenfeld Tanenbaum Research Institute, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - B H Mulsant
- Department of Obstetrics and Gynecology, Sinai Health and University of Toronto, Toronto, Canada
| | - K E Murphy
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
| | - J A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - M L Reyes-Rodríguez
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - A M Stuebe
- Department of Obstetrics & Gynecology, School of Medicine, University of North Carolina, Chapel Hill, USA
| | - C-L Dennis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing and Department of Psychiatry, University of Toronto, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - V Patel
- Department of Obstetrics & Gynecology, School of Medicine, University of North Carolina, Chapel Hill, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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11
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Bandres-Ciga S, Saez-Atienzar S, Kim JJ, Makarious MB, Faghri F, Diez-Fairen M, Iwaki H, Leonard H, Botia J, Ryten M, Hernandez D, Gibbs JR, Ding J, Gan-Or Z, Noyce A, Pihlstrom L, Torkamani A, Soltis AR, Dalgard CL, Scholz SW, Traynor BJ, Ehrlich D, Scherzer CR, Bookman M, Cookson M, Blauwendraat C, Nalls MA, Singleton AB. Large-scale pathway specific polygenic risk and transcriptomic community network analysis identifies novel functional pathways in Parkinson disease. Acta Neuropathol 2020; 140:341-358. [PMID: 32601912 PMCID: PMC8096770 DOI: 10.1007/s00401-020-02181-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/07/2020] [Accepted: 06/14/2020] [Indexed: 01/21/2023]
Abstract
Polygenic inheritance plays a central role in Parkinson disease (PD). A priority in elucidating PD etiology lies in defining the biological basis of genetic risk. Unraveling how risk leads to disruption will yield disease-modifying therapeutic targets that may be effective. Here, we utilized a high-throughput and hypothesis-free approach to determine biological processes underlying PD using the largest currently available cohorts of genetic and gene expression data from International Parkinson's Disease Genetics Consortium (IPDGC) and the Accelerating Medicines Partnership-Parkinson's disease initiative (AMP-PD), among other sources. We applied large-scale gene-set specific polygenic risk score (PRS) analyses to assess the role of common variation on PD risk focusing on publicly annotated gene sets representative of curated pathways. We nominated specific molecular sub-processes underlying protein misfolding and aggregation, post-translational protein modification, immune response, membrane and intracellular trafficking, lipid and vitamin metabolism, synaptic transmission, endosomal-lysosomal dysfunction, chromatin remodeling and apoptosis mediated by caspases among the main contributors to PD etiology. We assessed the impact of rare variation on PD risk in an independent cohort of whole-genome sequencing data and found evidence for a burden of rare damaging alleles in a range of processes, including neuronal transmission-related pathways and immune response. We explored enrichment linked to expression cell specificity patterns using single-cell gene expression data and demonstrated a significant risk pattern for dopaminergic neurons, serotonergic neurons, hypothalamic GABAergic neurons, and neural progenitors. Subsequently, we created a novel way of building de novo pathways by constructing a network expression community map using transcriptomic data derived from the blood of PD patients, which revealed functional enrichment in inflammatory signaling pathways, cell death machinery related processes, and dysregulation of mitochondrial homeostasis. Our analyses highlight several specific promising pathways and genes for functional prioritization and provide a cellular context in which such work should be done.
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Affiliation(s)
- S Bandres-Ciga
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - S Saez-Atienzar
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - J J Kim
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - M B Makarious
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - F Faghri
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - M Diez-Fairen
- Fundació Docència i Recerca Mútua Terrassa and Movement Disorders Unit, Department of Neurology, University Hospital Mútua Terrassa, Terrassa, 08221, Barcelona, Spain
| | - H Iwaki
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - H Leonard
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - J Botia
- Departamento de Ingeniería de la Información y las Comunicaciones, Universidad de Murcia, Murcia, Spain
- Department of Molecular Neuroscience, UCL, Institute of Neurology, London, UK
| | - M Ryten
- Department of Neurodegenerative Disease, University College London (UCL) Institute of Neurology, London, UK
| | - D Hernandez
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - J R Gibbs
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - J Ding
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Z Gan-Or
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada
- Department of Human Genetics, McGill University, Montréal, QC, Canada
| | - A Noyce
- Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London and Department of Neurology, Royal London Hospital, London, UK
| | - L Pihlstrom
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - A Torkamani
- The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - A R Soltis
- The American Genome Center, Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MA, USA
| | - C L Dalgard
- Department of Anatomy, Physiology & Genetics, Uniformed Services University of the Health Sciences, Bethesda, MA, USA
- The American Genome Center, Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, MA, USA
| | - S W Scholz
- Neurodegenerative Diseases Research Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, 20892, USA
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, 21287, USA
| | - B J Traynor
- Neuromuscular Diseases Research Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
- Department of Neurology, Johns Hopkins University Medical Center, Baltimore, MD, 21287, USA
| | - D Ehrlich
- Parkinson's Disease Clinic, Office of the Clinical Director, National Institute of Neurological, Disorders and Stroke, National Institutes of Health, Bethesda, MD, 20892, USA
| | - C R Scherzer
- Center for Advanced Parkinson Research, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, 0115, USA
| | - M Bookman
- Verily Life Sciences, South San Francisco, CA, USA
| | - M Cookson
- Cell Biology and Gene Expression Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MA, USA
| | - C Blauwendraat
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
| | - M A Nalls
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA
- Data Tecnica International, Glen Echo, MD, 20812, USA
| | - A B Singleton
- Molecular Genetics Section, Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, 20892, USA.
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12
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Smith TRF, Patel A, Ramos S, Elwood D, Zhu X, Yan J, Gary EN, Walker SN, Schultheis K, Purwar M, Xu Z, Walters J, Bhojnagarwala P, Yang M, Chokkalingam N, Pezzoli P, Parzych E, Reuschel EL, Doan A, Tursi N, Vasquez M, Choi J, Tello-Ruiz E, Maricic I, Bah MA, Wu Y, Amante D, Park DH, Dia Y, Ali AR, Zaidi FI, Generotti A, Kim KY, Herring TA, Reeder S, Andrade VM, Buttigieg K, Zhao G, Wu JM, Li D, Bao L, Liu J, Deng W, Qin C, Brown AS, Khoshnejad M, Wang N, Chu J, Wrapp D, McLellan JS, Muthumani K, Wang B, Carroll MW, Kim JJ, Boyer J, Kulp DW, Humeau LMPF, Weiner DB, Broderick KE. Immunogenicity of a DNA vaccine candidate for COVID-19. Nat Commun 2020; 11:2601. [PMID: 32433465 PMCID: PMC7239918 DOI: 10.1038/s41467-020-16505-0] [Citation(s) in RCA: 415] [Impact Index Per Article: 103.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/08/2020] [Indexed: 01/07/2023] Open
Abstract
The coronavirus family member, SARS-CoV-2 has been identified as the causal agent for the pandemic viral pneumonia disease, COVID-19. At this time, no vaccine is available to control further dissemination of the disease. We have previously engineered a synthetic DNA vaccine targeting the MERS coronavirus Spike (S) protein, the major surface antigen of coronaviruses, which is currently in clinical study. Here we build on this prior experience to generate a synthetic DNA-based vaccine candidate targeting SARS-CoV-2 S protein. The engineered construct, INO-4800, results in robust expression of the S protein in vitro. Following immunization of mice and guinea pigs with INO-4800 we measure antigen-specific T cell responses, functional antibodies which neutralize the SARS-CoV-2 infection and block Spike protein binding to the ACE2 receptor, and biodistribution of SARS-CoV-2 targeting antibodies to the lungs. This preliminary dataset identifies INO-4800 as a potential COVID-19 vaccine candidate, supporting further translational study.
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Affiliation(s)
- Trevor R. F. Smith
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Ami Patel
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Stephanie Ramos
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Dustin Elwood
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Xizhou Zhu
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Jian Yan
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Ebony N. Gary
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Susanne N. Walker
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Katherine Schultheis
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Mansi Purwar
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Ziyang Xu
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Jewell Walters
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Pratik Bhojnagarwala
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Maria Yang
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Neethu Chokkalingam
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Patrick Pezzoli
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Elizabeth Parzych
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Emma L. Reuschel
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Arthur Doan
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Nicholas Tursi
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Miguel Vasquez
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Jihae Choi
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Edgar Tello-Ruiz
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Igor Maricic
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Mamadou A. Bah
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Yuanhan Wu
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Dinah Amante
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Daniel H. Park
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Yaya Dia
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Ali Raza Ali
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Faraz I. Zaidi
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Alison Generotti
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Kevin Y. Kim
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Timothy A. Herring
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Sophia Reeder
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Viviane M. Andrade
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Karen Buttigieg
- 0000 0004 5909 016Xgrid.271308.fNational Infection Service, Public Health England, Porton Down, Wiltshire, UK
| | - Gan Zhao
- Advaccine (Suzhou) Biopharmaceuticals Co., Ltd, Suzhou, China
| | - Jiun-Ming Wu
- Advaccine (Suzhou) Biopharmaceuticals Co., Ltd, Suzhou, China
| | - Dan Li
- 0000 0001 0125 2443grid.8547.eKey Laboratory of Medical Molecular Virology of MOH and MOE and Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Linlin Bao
- 0000 0001 0125 2443grid.8547.eKey Laboratory of Medical Molecular Virology of MOH and MOE and Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Jiangning Liu
- 0000 0001 0125 2443grid.8547.eKey Laboratory of Medical Molecular Virology of MOH and MOE and Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Wei Deng
- 0000 0001 0125 2443grid.8547.eKey Laboratory of Medical Molecular Virology of MOH and MOE and Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Chuan Qin
- 0000 0001 0125 2443grid.8547.eKey Laboratory of Medical Molecular Virology of MOH and MOE and Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Ami Shah Brown
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Makan Khoshnejad
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Nianshuang Wang
- 0000 0004 1936 9924grid.89336.37Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712 USA
| | - Jacqueline Chu
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Daniel Wrapp
- 0000 0004 1936 9924grid.89336.37Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712 USA
| | - Jason S. McLellan
- 0000 0004 1936 9924grid.89336.37Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712 USA
| | - Kar Muthumani
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Bin Wang
- 0000 0001 0125 2443grid.8547.eKey Laboratory of Medical Molecular Virology of MOH and MOE and Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Miles W. Carroll
- 0000 0004 5909 016Xgrid.271308.fNational Infection Service, Public Health England, Porton Down, Wiltshire, UK
| | - J. Joseph Kim
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Jean Boyer
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - Daniel W. Kulp
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Laurent M. P. F. Humeau
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
| | - David B. Weiner
- 0000 0001 1956 6678grid.251075.4Vaccine and Immunotherapy Center, Wistar Institute, Philadelphia, PA 19104 USA
| | - Kate E. Broderick
- 0000 0004 0417 098Xgrid.421774.3Inovio Pharmaceuticals, Plymouth Meeting, Philadelphia, PA 19462 USA
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13
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Haq S, Wang H, Kim JJ, Kwon EY, Banskota S, Grondin J, Hassan N, Brumell J, Philpott D, Khan WI. A209 ROLE OF SEROTONIN-AUTOPHAGY AXIS IN REGULATION OF EPITHELIAL CELL FUNCTION AND MICROBIOTA COMPOSITION IN GUT. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.208] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Serotonin (5-hydroxytryptamine; 5-HT), an enteric signalling molecule mainly produced by the enterochromaffin (EC) cells of the intestinal epithelium regulates various processes of the gut. Tryptophan hydroxylase 1 (Tph1) is the rate-limiting enzyme of 5-HT biosynthesis in EC cells. In inflammatory bowel disease (IBD) and experimental colitis, there are alterations in 5-HT content and microbiota composition in the gut. Previously we reported, Tph1-deficient (Tph1-/-) mice with reduced 5-HT in the gut exhibit reduced susceptibility to colitis. The mechanism by which 5-HT regulates colitis is unknown. Autophagy, a catabolic process regulates the function of intestinal epithelial cells (IECs), gut microbiota, and protects against intestinal inflammation. Both aberrant 5-HT signalling and autophagy is implicated in colitis. It is unclear whether they interact in regulation of production of pro-inflammatory cytokines from IECs and gut microbiota composition in relation to colitis. Our hypothesis is, an increase in 5-HT signalling inhibits autophagy in the IECs, which results in up-regulation of colitis by increasing the production of pro-inflammatory cytokines, and by selection for a more colitogenic microbiota.
Aims
To define the role of 5-HT-autophagy axis in the production of pro-inflammatory cytokines from IECs and gut microbiota composition in intestinal inflammation.
Methods
We investigated level of autophagy with or without 5% dextran sodium sulphate (DSS) in colons, mucosal scraping and IECs of Tph1-/- and their wild-type (WT) littermates. In addition, autophagy and proinflammatory cytokine production were investigated in human colonic epithelial cells (HT-29) following stimulation by 5-HT. We evaluated colitis and gut microbiota composition in WT, Tph1-/-, epithelial-specific autophagy gene Atg7 deficient (Atg7ΔIEC), and Atg7ΔIECTph1-/- (double knock out; DKO) mice.
Results
Tph1 -/- mice, with less 5-HT in the gut than WT mice following DSS administration exhibited an up-regulation of autophagy markers in the colon, mucosal scraping and IECs along with reduction of colitis severity. 5-HT treatment of HT-29 cells resulted in down-regulation of autophagy and upregulation of pro-inflammatory cytokine, IL-8. DKO mice exhibited increased severity of DSS-colitis, and altered microbiota composition compared to Tph1-/- mice.
Conclusions
These findings suggest, an increase in 5-HT in colitis inhibits autophagy in the IECs that contribute to alteration of the gut microbiota and disease severity. Blocking 5-HT signalling may promote autophagy in the IECs and alleviate the severity of colitis. Understanding the contribution of 5-HT in autophagy may identify new therapeutic target in IBD and other intestinal inflammatory conditions that exhibit dysregulated autophagy.
Funding Agencies
CAG, CIHR
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Affiliation(s)
- S Haq
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - H Wang
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - J J Kim
- Pathology and Molecular Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - E Y Kwon
- Department of Pathology and Molecular Medicine, McMaster University, Shakespeare, ON, Canada
| | - S Banskota
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - J Grondin
- Pathology and Molecular Medicine, McMaster University, Dundas, ON, Canada
| | - N Hassan
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - J Brumell
- Cell Biology, Hospital for Sick Children, Toronto, ON, Canada
| | - D Philpott
- University of Toronto, Toronto, ON, Canada
| | - W I Khan
- Department of Pathology and Molecular Medicine, McMaster University, Shakespeare, ON, Canada
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14
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Aggarwal C, Cohen RB, Morrow MP, Kraynyak KA, Sylvester AJ, Cheung J, Dickerson K, Schulten V, Knoblock D, Gillespie E, Bauml JM, Yan J, Diehl M, Boyer J, Dallas M, Kim JJ, Weiner DB, Skolnik JM. Immune Therapy Targeting E6/E7 Oncogenes of Human Paillomavirus Type 6 (HPV-6) Reduces or Eliminates the Need for Surgical Intervention in the Treatment of HPV-6 Associated Recurrent Respiratory Papillomatosis. Vaccines (Basel) 2020; 8:vaccines8010056. [PMID: 32013270 PMCID: PMC7158680 DOI: 10.3390/vaccines8010056] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 11/15/2019] [Accepted: 01/23/2020] [Indexed: 01/07/2023] Open
Abstract
: Background: Recurrent respiratory papillomatosis (RRP) is a rare disorder characterized by the generation of papillomas of the aerodigestive tract, usually associated with human papilloma virus (HPV) subtypes 6, 11. INO-3106 is a DNA plasmid-based immunotherapy targeting E6 and E7 proteins of HPV6, in order to create a robust immune T cell response. METHODS Testing of INO-3016 in animal models confirmed immunogenicity of the DNA-based therapy. A single-site open-label Phase 1 study was initiated for patients with HPV6-positive RRP. Patients were dosed with INO-3106 with or without INO-9012, a DNA plasmid immunotherapy that encodes IL-12, delivered intramuscularly (IM) in combination with electroporation (EP) with the CELLECTRA® device. Patients received an escalating dose of INO-3106, 3 mg once and then 6 mg for three additional doses, each dose three weeks apart, with the third and fourth doses co-administered with INO-9012. The primary objective of the study was to evaluate the safety and tolerability of INO-3106 with and without INO-9012. The secondary objective was to determine cellular immune responses to INO-3106 with and without INO-9012. Exploratory objectives included preliminary clinical efficacy to the therapy. RESULTS Three patients were enrolled in this study, of which two had RRP. Study therapy was well-tolerated, with no related serious adverse events and all related adverse events (AEs) were low-grade. Injection site pain was the most common related AE reported. Immunogenicity was evidenced by multiple immune assays showing engagement and expansion of an HPV6-specific cellular response, including cytotoxic T cells. Preliminary efficacy was demonstrated in patients with RRP in the form of reduction in need for surgical intervention for papilloma growth. Prior to intervention, both patients required surgical intervention approximately every 180 days. One patient demonstrated a greater than three-fold increase in surgery avoidance (584 days) and the other patient remains completely surgery-free as of the last contact at 915 days, a greater than 5-fold increase in surgery interval. CONCLUSION INO-3106 with and without INO-9012 was well tolerated, immunogenic and demonstrated preliminary efficacy in patients with HPV6-associated RRP aerodigestive lesions. Further clinical study is indicated.
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Affiliation(s)
- Charu Aggarwal
- Division of Hematology Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.A.); (R.B.C.); (J.M.B.)
| | - Roger B. Cohen
- Division of Hematology Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.A.); (R.B.C.); (J.M.B.)
| | - Matthew P. Morrow
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
- Correspondence: ; Tel.: +1-267-440-4236
| | - Kimberly A. Kraynyak
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Albert J. Sylvester
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Jocelyn Cheung
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Kelsie Dickerson
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Veronique Schulten
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Dawson Knoblock
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Elisabeth Gillespie
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Joshua M. Bauml
- Division of Hematology Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.A.); (R.B.C.); (J.M.B.)
| | - Jian Yan
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Malissa Diehl
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Jean Boyer
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - Michael Dallas
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - J. Joseph Kim
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
| | - David B. Weiner
- The Wistar Institute Vaccine and Immunotherapy Center, Philadelphia, PA 19104, USA;
| | - Jeffrey M. Skolnik
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, PA 19462, USA; (K.A.K.); (A.J.S.); (J.C.); (K.D.); (V.S.); (D.K.); (E.G.); (J.Y.); (M.D.); (J.B.); (J.J.K.); (J.M.S.)
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15
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Lukovic J, Alfaraj FA, Mierzwa ML, Marta GN, Xu W, Su J, Moraes FY, Huang SH, Bratman SV, O'Sullivan B, Kim JJ, Ringash JG, Waldron J, de Almeida JR, Goldstein DP, Casper KA, Rosko AJ, Spector ME, Kowalski LP, Hope A, Hosni A. Development and validation of a clinical prediction-score model for distant metastases in major salivary gland carcinoma. Ann Oncol 2020; 31:295-301. [PMID: 31959347 DOI: 10.1016/j.annonc.2019.10.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 10/15/2019] [Accepted: 10/25/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The most common pattern of failure in major salivary gland carcinoma (SGC) is development of distant metastases (DMs). The objective of this study was to develop and validate a prediction score for DM in SGC. PATIENTS AND METHODS Patients with SGC treated curatively at four tertiary cancer centers were divided into discovery (n = 619) and validation cohorts (n = 416). Multivariable analysis using competing risk regression was used to identify predictors of DM in the discovery cohort and create a prediction score of DM; the optimal score cut-off was determined using a minimal P value approach. The prediction score was subsequently evaluated in the validation cohort. The cumulative incidence and Kaplan-Meier methods were used to analyze DM and overall survival (OS), respectively. RESULTS In the discovery cohort, DM predictors (risk coefficient) were: positive margin (0.6), pT3-4 (0.7), pN+ (0.7), lymphovascular invasion (0.8), and high-risk histology (1.2). High DM-risk SGC was defined by sum of coefficients greater than two. In the discovery cohort, the 5-year incidence of DM for high- versus low-risk SGC was 50% versus 8% (P < 0.01); this was similar in the validation cohort (44% versus 4%; P < 0.01). In the pooled cohorts, this model performed similarly in predicting distant-only failure (40% versus 6%, P < 0.01) and late (>2 years post surgery) DM (22% versus 4%; P < 0.01). Patients with high-risk SGC had an increased incidence of DM in the subgroup receiving postoperative radiation therapy (46% versus 8%; P < 0.01). The 5-year OS for high- versus low-risk SGC was 48% versus 92% (P < 0.01). CONCLUSION This validated prediction-score model may be used to identify SGC patients at increased risk for DM and select those who may benefit from prospective evaluation of treatment intensification and/or surveillance strategies.
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Affiliation(s)
- J Lukovic
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - F A Alfaraj
- Department of Radiation Oncology, BC Cancer Agency Centre for the North, Prince George, Canada
| | - M L Mierzwa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, USA
| | - G N Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil
| | - W Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada
| | - J Su
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada
| | - F Y Moraes
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - S H Huang
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - S V Bratman
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - B O'Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - J J Kim
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - J G Ringash
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - J Waldron
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - J R de Almeida
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - D P Goldstein
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - K A Casper
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, USA
| | - A J Rosko
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, USA
| | - M E Spector
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, USA
| | - L P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil
| | - A Hope
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada
| | - A Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, Canada.
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16
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Choi H, Kudchodkar SB, Reuschel EL, Asija K, Borole P, Agarwal S, Van Gorder L, Reed CC, Gulendran G, Ramos S, Broderick KE, Kim JJ, Ugen KE, Kobinger G, Siegel DL, Weiner DB, Muthumani K. Synthetic nucleic acid antibody prophylaxis confers rapid and durable protective immunity against Zika virus challenge. Hum Vaccin Immunother 2019; 16:907-918. [PMID: 31799896 PMCID: PMC7227701 DOI: 10.1080/21645515.2019.1688038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Significant concerns have arisen over the past 3 y from the increased global spread of the mosquito-borne flavivirus, Zika. Accompanying this spread has been an increase in cases of the devastating birth defect microcephaly as well as of Guillain-Barré syndrome in adults in many affected countries. Currently there is no vaccine or therapy for this infection; however, we sought to develop a combination approach that provides more rapid and durable protection than traditional vaccination alone. A novel immune-based prophylaxis/therapy strategy entailing the facilitated delivery of a synthetic DNA consensus prME vaccine along with DNA-encoded anti-ZIKV envelope monoclonal antibodies (dMAb) were developed and evaluated for antiviral efficacy. This immediate and persistent protection strategy confers the ability to overcome shortcomings inherent with conventional active vaccination or passive immunotherapy. A collection of novel dMAbs were developed which were potent against ZIKV and could be expressed in serum within 24-48 h of in vivo administration. The DNA vaccine, from a previous development, was potent after adaptive immunity was developed, protecting against infection, brain and testes pathology in relevant mouse challenge models and in an NHP challenge. Delivery of potent dMAbs protected mice from the same murine viral challenge within days of delivery. Combined injection of dMAb and the DNA vaccine afforded rapid and long-lived protection in this challenge model, providing an important demonstration of the advantage of this synergistic approach to pandemic outbreaks.
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Affiliation(s)
- Hyeree Choi
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | | | - Emma L. Reuschel
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | - Kanika Asija
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | - Piyush Borole
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | - Sangya Agarwal
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | - Lucas Van Gorder
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | | | - Gayathri Gulendran
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, PA, USA
| | | | | | - J Joseph Kim
- R&D, Inovio Pharmaceuticals, Plymouth Meeting, PA, USA
| | - Kenneth E. Ugen
- Department of Molecular Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | | | - Don L. Siegel
- Department of Pathology & Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - David B. Weiner
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
| | - Kar Muthumani
- Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA,CONTACT Kar Muthumani Vaccine & Immunotherapy Center, The Wistar Institute, Philadelphia, PA, USA
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17
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Abstract
Traditional tobacco products have well-known systemic and local oral effects, including inflammation, vasoconstriction, delayed wound healing, and increased severity of periodontal disease. Specifically in the oral cavity and the lung, cigarette smoking produces cancer, increased infectivity, acute and chronic inflammation, changes in gene expression in epithelial lining cells, and microbiome changes. In recent years, cigarette smoking has greatly decreased in the United States, but the use of new tobacco products has gained tremendous popularity. Without significant knowledge of the oral sequelae of products such as electronic cigarettes, researchers must evaluate current in vitro and in vivo methods to study these agents, as well as develop new tools to adequately study their effects. Some in vitro testing has been performed for electronic cigarettes, including toxicologic models and assays, but these mostly study the effect on the respiratory tract. Recently, direct exposure of the aerosol to in vitro 3-dimensional tissue constructs has been performed, demonstrating changes in cell viability and inflammatory cytokines. For in vivo studies, a universal e-cigarette testing machine or standard vaping regime is needed. A standard research electronic cigarette has recently been developed by the National Institute of Drug Abuse, and other devices delivering aerosols with different nicotine concentrations are becoming available. One of the biggest challenges in this research is keeping up with the new products and the rapidly changing technologies in the industry.
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Affiliation(s)
- T Aghaloo
- Section of Oral and Maxillofacial Surgery, UCLA School of Dentistry, Los Angeles, CA, USA
| | - J J Kim
- Volpe Research Center, American Dental Association Foundation, Gaithersburg, MD, USA
| | - T Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - H P Behrsing
- Institute for In Vitro Sciences, Gaithersburg, MD, USA
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18
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de La Vega MA, Piret J, Griffin BD, Rhéaume C, Venable MC, Carbonneau J, Couture C, das Neves Almeida R, Tremblay RR, Magalhães KG, Park YK, Roberts CC, Maslow JN, Sardesai NY, Kim JJ, Muthumani K, Weiner DB, Kobinger GP, Boivin G. Zika-Induced Male Infertility in Mice Is Potentially Reversible and Preventable by Deoxyribonucleic Acid Immunization. J Infect Dis 2019; 219:365-374. [PMID: 30053014 DOI: 10.1093/infdis/jiy336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/01/2018] [Indexed: 11/13/2022] Open
Abstract
Background Zika virus (ZIKV) infection has been associated with prolonged viral excretion in human semen and causes testicular atrophy and infertility in 10-week-old immunodeficient mice. Methods Male IFNAR-/- mice, knockout for type I interferon receptor, were immunized with GLS-5700, a deoxyribonucleic acid-based vaccine, before a subcutaneous ZIKV challenge with 6 × 105 plaque-forming units at 13 weeks of age. On day 28 postinfection, testes and epididymides were collected in some mice for histological and functional analyses, whereas others were mated with naive female wild-type C57BL/6J. Results Although all mice challenged with ZIKV developed viremia, most of them were asymptomatic, showed no weight loss, and survived infection. On day 28 postinfection, none of the unvaccinated, infected mice (9 of 9) exhibited abnormal spermatozoa counts or motility. However, 33% (3 of 9) and 36% (4 of 11) of mated males from this group were infertile, from 2 independent studies. Contrarily, males from the noninfected and the vaccinated, infected groups were all fertile. On days 75 and 207 postinfection, partial recovery of fertility was observed in 66% (2 of 3) of the previously infertile males. Conclusions This study reports the effects of ZIKV infection on male fertility in a sublethal, immunodeficient mouse model and the efficacy of GLS-5700 vaccination in preventing male infertility.
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Affiliation(s)
- Marc-Antoine de La Vega
- Département de Microbiologie-Infectiologie et d'Immunologie, Université Laval, Québec, Canada.,Centre de Recherche en Infectiologie du CHU de Québec - Université Laval, Canada
| | - Jocelyne Piret
- Centre de Recherche en Infectiologie du CHU de Québec - Université Laval, Canada
| | - Bryan D Griffin
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg.,Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Chantal Rhéaume
- Centre de Recherche en Infectiologie du CHU de Québec - Université Laval, Canada
| | | | - Julie Carbonneau
- Centre de Recherche en Infectiologie du CHU de Québec - Université Laval, Canada
| | - Christian Couture
- Département d'Anatomo-Pathologie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Canada.,Département de Biologie Moléculaire, Biochimie Médicale et Pathologie, Université Laval, Québec, Canada
| | | | - Roland R Tremblay
- Unité de Recherche en Reproduction, Santé de la Mère et de l'Enfant, Centre de Recherche du CHU de Québec - Université Laval, Canada
| | - Kelly G Magalhães
- Laboratory of Immunology and Inflammation, University of Brasilia, Brazil
| | | | | | - Joel N Maslow
- GeneOne Life Science Inc., Seoul, Korea.,Department of Medicine, Morristown Medical Center, New Jersey
| | | | - J Joseph Kim
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
| | | | | | - Gary P Kobinger
- Département de Microbiologie-Infectiologie et d'Immunologie, Université Laval, Québec, Canada.,Centre de Recherche en Infectiologie du CHU de Québec - Université Laval, Canada.,Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.,Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia
| | - Guy Boivin
- Département de Microbiologie-Infectiologie et d'Immunologie, Université Laval, Québec, Canada.,Centre de Recherche en Infectiologie du CHU de Québec - Université Laval, Canada
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19
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Cho JY, Kim KH, Lee SE, Lee HY, Choi JO, Jeon ES, Kim MS, Kim JJ, Hwang KK, Chae SC, Kang SM, Choi DJ, Yoo BS, Cho MC, Oh BH. P3520Admission hyperglycemia is a predictor of mortality of acute heart failure: comparison between patients with and without diabetes mellitus. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0384] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Regardless of diabetes mellitus (DM), admission hyperglycemia is not uncommon in patients with acute heart failure (AHF). Although DM is a well-known predictor of mortality in AHF, the impacts of admission hyperglycemia on clinical outcomes in non-DM patients with AHF have been poorly studied. The aim of this study, therefore, was to compare the impact of admission hyperglycemia on long-term clinical outcomes in AHF patients with or without DM.
Methods
Among 5,625 AHF patients enrolled in a nationwide registry, a total of 5,541 patients were enrolled and divided into 2 groups; DM group (n=2,125, 70.4±11.4 years) vs. non-DM group (n=3,416, 67.3±16.0 years). Each group were further divided into 2 groups according to the presence of admission hyperglycemia (admission serum glucose level >200mg/dl); admission hyperglycemia (n=248) and no hyperglycemia (n=3,168) in non-DM; admission hyperglycemia (n=799) and no hyperglycemia (n=1,326) in DM. All-cause death and hospitalization due to HF (HHF) during 1-year follow-up were compared.
Results
Death was developed in 1,220 patients (22.2%) including 269 inhospital deaths (4.9%) during 1-year of follow-up. Death rate were significantly higher in DM than in non-DM group (24.8% vs 20.5%, p<0.001), however there was no difference in inhospital death (5.1% vs 4.7%, p=0.534). Both inhospital death (7.6% vs. 4.2%, p<0.001) and 1-year death (26.2% vs. 21.3%, p=0.001) were more frequent in AHF patients with hyperglycemia. On Kaplan-Meier survival curve analysis, however, admission hyperglycemia was associated with significantly higher death (p<0.001 by log-rank test) and rehospitalization (p=0.006 by log-rank test) in non-DM group, but not in DM group. In non-DM group, admission hyperglycemia was an independent predictor of 1-year mortality (HR 1.46, 95% CI 1.10–1.93, p=0.009).
Conclusion
DM was a significant predictor of long-term mortality in patients with AHF. Admission hyperglycemia was associated with both higher inhospital and 1-year mortality. The present study also demonstrated that admission hyperglycemia is an independent predictor of mortality in non-DM patients with AHF, but not in DM patients. In addition to the presence of DM, admission hyperglycemia would be a useful marker in the risk stratification of AHF, especially in non-DM patients.
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Affiliation(s)
- J Y Cho
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - K H Kim
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - S E Lee
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - H Y Lee
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - J O Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - E S Jeon
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - M S Kim
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - J J Kim
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - K K Hwang
- Chungbuk National University Hospital, Cheongju, Korea (Republic of)
| | - S C Chae
- Chungbuk National University Hospital, Cheongju, Korea (Republic of)
| | - S M Kang
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - D J Choi
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - B S Yoo
- Chonnam National University Hospital, Cardiology, Gwangju, Korea (Republic of)
| | - M C Cho
- Chungbuk National University Hospital, Cheongju, Korea (Republic of)
| | - B H Oh
- Seoul National University Hospital, Seoul, Korea (Republic of)
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20
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Kim HJ, Kim MA, Lee DI, Kim HL, Choi DJ, Han S, Cho MC, Jeon ES, Kim JJ, Yoo BS, Shin MS, Chae SC, Ryu KH, Kang SM. P3453Gender difference in impact of ischemic heart disease on long-term outcome in patients with heart failure reduced ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0326] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Ischemic heart disease (IHD) is a major underlying etiology in patients with heart failure (HF). Although the impact of IHD on HF is evolving, there is a lack of understanding of how IHD affects long-term clinical outcomes and uncertainty about the role of IHD in determining the risk of clinical outcomes by gender.
Purpose
This study aims to evaluate the gender difference in impact of IHD on long-term clinical outcomes in patients with heart failure reduced ejection fraction (HFrEF).
Methods
Study data were obtained from the nationwide registry which is a prospective multicenter cohort and included patients who were hospitalized for HF composed of 3,200 patients. A total of 1,638 patients with HFrEF were classified into gender (women 704 and men 934). The primary outcome was all-cause death during follow-up and the composite clinical events of all-cause death and HF readmission during follow-up were also obtained. HF readmission was defined as re-hospitalization because of HF exacerbation.
Results
133 women (18.9%) were died and 168 men (18.0%) were died during follow-up (median 489 days; inter-quartile range, 162–947 days). As underlying cause of HF, IHD did not show significant difference between genders. Women with HFrEF combined with IHD had significantly lower cumulative survival rate than women without IHD at long-term follow-up (74.8% vs. 84.9%, Log Rank p=0.001, Figure 1). However, men with HFrEF combined with IHD had no significant difference in survival rate compared with men without IHD (79.3% vs. 83.8%, Log Rank p=0.067). After adjustment for confounding factors, Cox regression analysis showed that IHD had a 1.43-fold increased risk for all-cause mortality independently only in women. (odds ratio 1.43, 95% confidence interval 1.058–1.929, p=0.020). On the contrary to the death-free survival rates, there were significant differences in composite clinical events-free survival rates between patients with HFrEF combined with IHD and HFrEF without IHD in both genders.
Figure 1
Conclusions
IHD as predisposing cause of HF was an important risk factor for long-term mortality in women with HFrEF. Clinician need to aware of gender-based characteristics in patients with HF and should manage and monitor them appropriately and gender-specifically. Women with HF caused by IHD also should be treated more meticulously to avoid a poor prognosis.
Acknowledgement/Funding
None
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Affiliation(s)
- H J Kim
- Chungbuk National University Hospital, Cardiology, Cheongju, Korea (Republic of)
| | - M A Kim
- Boramae Hospital, Cardiology, Seoul, Korea (Republic of)
| | - D I Lee
- Chungbuk National University Hospital, Cardiology, Cheongju, Korea (Republic of)
| | - H L Kim
- Boramae Hospital, Cardiology, Seoul, Korea (Republic of)
| | - D J Choi
- Seoul National University Bun-Dang Hospital, Department of Internal medicine, Division of Cardiology, Seoul, Korea (Republic of)
| | - S Han
- Dongtan Sacred Heart Hospital, Cardiology, Hwaseong, Korea (Republic of)
| | - M C Cho
- Chungbuk National University Hospital, Cardiology, Cheongju, Korea (Republic of)
| | - E S Jeon
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - J J Kim
- Asan Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - B S Yoo
- Wonju Christian Hospital, Cardiology, Wonju, Korea (Republic of)
| | - M S Shin
- Inha University Hospital, Cardiology, Incheon, Korea (Republic of)
| | - S C Chae
- Kyungpook National University Hospital, Cardiology, Daegu, Korea (Republic of)
| | - K H Ryu
- Dongtan Sacred Heart Hospital, Cardiology, Hwaseong, Korea (Republic of)
| | - S M Kang
- Severance Hospital, Cardiology, Seoul, Korea (Republic of)
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21
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Mitrofanova A, Mallela SK, Ducasa GM, Yoo TH, Rosenfeld-Gur E, Zelnik ID, Molina J, Varona Santos J, Ge M, Sloan A, Kim JJ, Pedigo C, Bryn J, Volosenco I, Faul C, Zeidan YH, Garcia Hernandez C, Mendez AJ, Leibiger I, Burke GW, Futerman AH, Barisoni L, Ishimoto Y, Inagi R, Merscher S, Fornoni A. SMPDL3b modulates insulin receptor signaling in diabetic kidney disease. Nat Commun 2019; 10:2692. [PMID: 31217420 PMCID: PMC6584700 DOI: 10.1038/s41467-019-10584-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 05/15/2019] [Indexed: 12/22/2022] Open
Abstract
Sphingomyelin phosphodiesterase acid-like 3b (SMPDL3b) is a lipid raft enzyme that regulates plasma membrane (PM) fluidity. Here we report that SMPDL3b excess, as observed in podocytes in diabetic kidney disease (DKD), impairs insulin receptor isoform B-dependent pro-survival insulin signaling by interfering with insulin receptor isoforms binding to caveolin-1 in the PM. SMPDL3b excess affects the production of active sphingolipids resulting in decreased ceramide-1-phosphate (C1P) content as observed in human podocytes in vitro and in kidney cortexes of diabetic db/db mice in vivo. Podocyte-specific Smpdl3b deficiency in db/db mice is sufficient to restore kidney cortex C1P content and to protect from DKD. Exogenous administration of C1P restores IR signaling in vitro and prevents established DKD progression in vivo. Taken together, we identify SMPDL3b as a modulator of insulin signaling and demonstrate that supplementation with exogenous C1P may represent a lipid therapeutic strategy to treat diabetic complications such as DKD.
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Affiliation(s)
- A Mitrofanova
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Department of Surgery, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - S K Mallela
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - G M Ducasa
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Department of Molecular and Cellular Pharmacology, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - T H Yoo
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, 03722, Korea
| | - E Rosenfeld-Gur
- Department of Biological Chemistry, Weizmann Institute of Science, Rehovot, 76100, Israel
| | - I D Zelnik
- Department of Biological Chemistry, Weizmann Institute of Science, Rehovot, 76100, Israel
| | - J Molina
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - J Varona Santos
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - M Ge
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Department of Molecular and Cellular Pharmacology, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - A Sloan
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - J J Kim
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - C Pedigo
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Department of Internal Medicine, Yale University School of Medicine, New Haven, 06510, CT, USA
| | - J Bryn
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - I Volosenco
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Lewis Gale Medical Center, Salem, 24153, VI, USA
| | - C Faul
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, 35233, AL, USA
| | - Y H Zeidan
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Department of Radiation Oncology, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Department of Radiation Oncology, American University of Beirut, Beirut, 1107 2020, Lebanon
| | - C Garcia Hernandez
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Department of Radiation Oncology, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - A J Mendez
- Diabetes Research Institute, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - I Leibiger
- The Rolf Luft Research Center for Diabetes and Endocrinology, Karolinska Institutet, Stockholm, 17176, Sweden
| | - G W Burke
- Department of Surgery, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Diabetes Research Institute, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - A H Futerman
- Department of Biological Chemistry, Weizmann Institute of Science, Rehovot, 76100, Israel
| | - L Barisoni
- Department of Pathology, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - Y Ishimoto
- Division of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, 113-8654, Japan
- Division of CKD Pathophysiology, University of Tokyo Graduate School of Medicine, Tokyo, 113-8654, Japan
| | - R Inagi
- Division of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, 113-8654, Japan
- Division of CKD Pathophysiology, University of Tokyo Graduate School of Medicine, Tokyo, 113-8654, Japan
| | - S Merscher
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA
| | - A Fornoni
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA.
- Peggy and Harold Katz Family Drug Discovery Center, University of Miami, Miller School of Medicine, Miami, 33136, FL, USA.
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22
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Haq S, Wang H, Kim JJ, Steinberg G, Brumell J, Khan WI. A33 ROLE OF SEROTONIN-AUTOPHAGY AXIS IN INTESTINAL INFLAMMATION. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.032] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Haq
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - H Wang
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - J J Kim
- Pathology and Molecular Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | | | - J Brumell
- Cell Biology, Hospital for Sick Children, Toronto, ON, Canada
| | - W I Khan
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
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23
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Yan J, Morrow MP, Chu JS, Racine T, Reed CC, Khan AS, Broderick KE, Kim JJ, Kobinger GP, Sardesai NY, Weiner DB. Broad cross-protective anti-hemagglutination responses elicited by influenza microconsensus DNA vaccine. Vaccine 2019; 36:3079-3089. [PMID: 29100705 DOI: 10.1016/j.vaccine.2017.09.086] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 07/28/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
Abstract
Despite the routine development and distribution of seasonal influenza vaccines, influenza remains an important pathogen contributing to significant human morbidity as well as mortality each year. The seasonal variability of influenza creates a significant issue for vaccine development of seasonal strains that can afford protection from infection or disease based on serotype matching. It is appreciated that the globular head of the HA antigen contained in the vaccines generates antibodies that result in HAI activity that are a major correlates of the protection against a particular strain. Due to seasonal genetic changes in the HA protein, however, new vaccine strains are needed to be developed continually to match the new HA antigen of that seasons virus. A distinct advantage in seasonal vaccine development would be if a small group of antigens could be developed that could span many seasons without needed to be replaced due to this genetic drift. Here we report on a synthetic microconsensus approach that relies on a small collection of 4 synthetic H1HA DNA antigens which together induce broad protective HAI immunity spanning decades of H1 influenza viruses in mice, guinea pigs and non-human primates. The protective HAI titers induced by microconsensus immunogens are fully functional in vivo as immunized ferrets were completely protected from A/Mexico/InDRE4487/2009 virus infection and morbidity associated with lethal challenge. These results are encouraging that a limited easy-to-formulate collection of invariant antigens can be developed which can span seasonal vaccine changes allowing for continued immune protection.
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Affiliation(s)
- Jian Yan
- Inovio Pharmaceuticals Inc, 660 W. Germantown Pike, Suite 110, Plymouth Meeting, PA 19462, USA
| | - Matthew P Morrow
- Inovio Pharmaceuticals Inc, 660 W. Germantown Pike, Suite 110, Plymouth Meeting, PA 19462, USA
| | - Jaemi S Chu
- The Wistar Institute of Anatomy & Biology, 3601 Spruce St, Philadelphia, PA 19104, USA
| | - Trina Racine
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Charles C Reed
- Inovio Pharmaceuticals Inc, 660 W. Germantown Pike, Suite 110, Plymouth Meeting, PA 19462, USA
| | - Amir S Khan
- Inovio Pharmaceuticals Inc, 660 W. Germantown Pike, Suite 110, Plymouth Meeting, PA 19462, USA
| | - Kate E Broderick
- Inovio Pharmaceuticals Inc, 660 W. Germantown Pike, Suite 110, Plymouth Meeting, PA 19462, USA
| | - J Joseph Kim
- Inovio Pharmaceuticals Inc, 660 W. Germantown Pike, Suite 110, Plymouth Meeting, PA 19462, USA
| | - Gary P Kobinger
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Niranjan Y Sardesai
- Inovio Pharmaceuticals Inc, 660 W. Germantown Pike, Suite 110, Plymouth Meeting, PA 19462, USA
| | - David B Weiner
- The Wistar Institute of Anatomy & Biology, 3601 Spruce St, Philadelphia, PA 19104, USA.
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24
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van Montfort SJT, Numan T, van Dellen E, Kyeong S, Douw L, Kim JJ. Delirium is not associated with altered hub flexibility of the posterior cingulate cortex. Clin Neurophysiol 2018; 129:2541-2543. [PMID: 30384024 DOI: 10.1016/j.clinph.2018.10.002] [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: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 11/15/2022]
Affiliation(s)
- S J T van Montfort
- Department of Intensive Care Medicine and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, The Netherlands; Department of Intensive Care Medicine, University Medical Center Utrecht, HP F.06.149, Postbus 85500, 3508 GA Utrecht, The Netherlands.
| | - T Numan
- Department of Anatomy and Neurosciences, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - E van Dellen
- Department of Psychiatry and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, The Netherlands; Melbourne Neuropsychiatry Center, Department of Psychiatry, University of Melbourne, Australia
| | - S Kyeong
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - L Douw
- Department of Anatomy and Neurosciences, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
| | - J J Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 135-720, Republic of Korea.
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25
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Long Y, Du L, Kim JJ, Chen B, Zhu Y, Zhang Y, Yao S, He H, Zheng X, Huang Z, Dai N. MLCK-mediated intestinal permeability promotes immune activation and visceral hypersensitivity in PI-IBS mice. Neurogastroenterol Motil 2018; 30:e13348. [PMID: 29644768 DOI: 10.1111/nmo.13348] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 03/08/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Alterations in intestinal permeability regulated by tight junctions (TJs) are associated with immune activation and visceral hypersensitivity in irritable bowel syndrome (IBS). Myosin light chain kinase (MLCK) is an important mediator of epithelial TJ. The aim of this study is to investigate the role of MLCK in the pathogenesis of IBS using a post infectious IBS (PI-IBS) mouse model. METHODS Trichinella spiralis-infected PI-IBS mouse model was used. Urine lactulose/mannitol ratio was measured to assess intestinal epithelial permeability. Western blotting was used to evaluate intestinal TJ protein (zonula occludens-1) and MLCK-associated protein expressions. Immune profile was assessed by measuring Th (T helper) 1/Th2 cytokine expression. Visceral sensitivity was determined by abdominal withdrawal reflex in response to colorectal distension. RESULTS Eight weeks after inoculation with T. spiralis, PI-IBS mice developed decreased pain and volume thresholds during colorectal distention, increased urine lactulose/mannitol ratio, elevated colonic Th1/Th2 cytokine ratio, and decreased zonula occludens-1 expression compared to the control mice. MLCK expression was dramatically elevated in the colonic mucosa of PI-IBS mice compared to the control mice, alongside increased pMLC/MLC and decreased MLCP expression. Administration of MLCK inhibitor and TJ blocker both reversed the increased intestinal permeability, visceral hypersensitivity, and Th1-dominant immune profile in PI-IBS mice. CONCLUSION MLCK is a pivotal step in inducing increased intestinal permeability promoting low-grade intestinal immune activation and visceral hypersensitivity in PI-IBS mice. MLCK inhibitor may provide a potential therapeutic option in the treatment of IBS.
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Affiliation(s)
- Y Long
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - L Du
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - J J Kim
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.,Division of Gastroenterology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - B Chen
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Y Zhu
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Y Zhang
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - S Yao
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - H He
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - X Zheng
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Z Huang
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - N Dai
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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Choi Y, Hwang BH, Hwang BH, Lee WJ, Lee KY, Park HW, Kim BH, Lee KY, Byeon JH, Kim JJ, Park HW, Kim JJ, Kim CJ, Chang KY, Kim CJ, Chang KY. P2264A clinical risk score to predict the presence of obstructive coronary artery disease in asymptomatic patients with type 2 diabetes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2264] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Choi
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - B H Hwang
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - B H Hwang
- St.Paul's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - W J Lee
- St.Paul's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - K Y Lee
- St.Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Incheon, Korea Republic of
| | - H W Park
- Daejeon St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Daejeon, Korea Republic of
| | - B H Kim
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - K Y Lee
- St.Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Incheon, Korea Republic of
| | - J H Byeon
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J J Kim
- Yeouido St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H W Park
- Daejeon St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Daejeon, Korea Republic of
| | - J J Kim
- Yeouido St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - C J Kim
- Uijeongbu St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Uijeongbu, Korea Republic of
| | - K Y Chang
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - C J Kim
- Uijeongbu St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Uijeongbu, Korea Republic of
| | - K Y Chang
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
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27
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Cho JY, Kim KH, Lee SE, Lee HY, Choi JO, Jeon ES, Kim JJ, Hwang KK, Chae SC, Baek SH, Kang SM, Choi DJ, Yoo BS, Cho MC, Oh BH. P6542Post-discharge worsening renal function predicts long-term adverse clinical outcomes in patients with acute heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6542] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Y Cho
- Chonnam National University Hospital, Cardiology, Gwangju, Korea Republic of
| | - K H Kim
- Chonnam National University Hospital, Cardiology, Gwangju, Korea Republic of
| | - S E Lee
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - H Y Lee
- Seoul National University Hospital, Seoul, Korea Republic of
| | - J O Choi
- Samsung Medical Center, Seoul, Korea Republic of
| | - E S Jeon
- Samsung Medical Center, Seoul, Korea Republic of
| | - J J Kim
- Asan Medical Center, Cardiology, Seoul, Korea Republic of
| | - K K Hwang
- Chungbuk National University Hospital, Cheongju, Korea Republic of
| | - S C Chae
- Kyungpook National University Hospital, Daegu, Korea Republic of
| | - S H Baek
- Seoul St. Mary's Hospital, Seoul, Korea Republic of
| | - S M Kang
- Yonsei University College of Medicine, Seoul, Korea Republic of
| | - D J Choi
- Seoul National University Bundang Hospital, Seongnam, Korea Republic of
| | - B S Yoo
- Wonju Christian Hospital, Wonju, Korea Republic of
| | - M C Cho
- Chungbuk National University Hospital, Cheongju, Korea Republic of
| | - B H Oh
- Seoul National University Hospital, Seoul, Korea Republic of
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28
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Oh J, Choi JO, Cho HJ, Lee HY, Jung SH, Kim JJ, Jeon ES, Kang SM. P2809The clinical implication of donor-recipient mismatch in heart transplant recipients; data from the Korean organ transplantation registry (KOTRY). Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2809] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Oh
- Yonsei University College of Medicine, Cardiology Division, Seoul, Korea Republic of
| | - J O Choi
- Samsung Medical Center, Department of Cardiology, Seoul, Korea Republic of
| | - H J Cho
- Seoul National University College of Medicine, Department of Cardiology, Seoul, Korea Republic of
| | - H Y Lee
- Seoul National University College of Medicine, Department of Cardiology, Seoul, Korea Republic of
| | - S H Jung
- Asan Medical Center, Department of Cardiovascular Surgery, Seoul, Korea Republic of
| | - J J Kim
- Asan Medical Center, Department of Cardiovascular Surgery, Seoul, Korea Republic of
| | - E S Jeon
- Samsung Medical Center, Department of Cardiology, Seoul, Korea Republic of
| | - S M Kang
- Yonsei University College of Medicine, Cardiology Division, Seoul, Korea Republic of
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29
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Min BH, Hong M, Lee JH, Rhee PL, Sohn TS, Kim S, Kim KM, Kim JJ. Clinicopathological features and outcome of type 3 gastric neuroendocrine tumours. Br J Surg 2018; 105:1480-1486. [PMID: 29893418 DOI: 10.1002/bjs.10901] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 03/10/2018] [Accepted: 05/03/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND With the widespread use of endoscopy, small and low-grade type 3 gastric neuroendocrine tumours (NETs) are increasingly being detected. The clinicopathological features, biological behaviour and appropriate treatment strategy for these NETs remain unclear. METHODS Patients with biopsy-proven gastric NET and a normal fasting serum gastrin level were identified from a prospectively maintained database. Clinicopathological features and long-term outcome of local resection for type 3 NETs were reviewed retrospectively and compared according to tumour grade. RESULTS Some 32 patients with type 3 gastric NETs were included (25 patients with NET grade G1, 5 with G2 and 2 with G3). Pathological tumour size was 2·0 cm or less in 30 patients. All tumours were well differentiated, even G3 lesions, and all tumours but one were confined to the submucosal layer. G1 NETs were significantly smaller and had a significantly lower lymphovascular invasion rate than G2 and G3 NETs. Twenty-two patients with a G1 NET without lymphovascular invasion were treated with wedge or endoscopic resection. After a median follow-up of 59 (range 6-102) months, no patient with a G1 NET of 1·5 cm or smaller developed recurrence and one patient with a G1 NET larger than 1·5 cm had recurrence in a perigastric lymph node. Among seven patients with a G2 or G3 NET, two had lymph node metastasis and one had liver metastases. CONCLUSION Low-grade type 3 gastric NET has non-aggressive features and a favourable prognosis. Wedge or endoscopic resection may be a valid option for patients with type 3 gastric G1 NET no larger than 1·5 cm without lymphovascular invasion.
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Affiliation(s)
- B-H Min
- Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Hong
- Department of Pathology and Translational Genomics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Pathology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - J H Lee
- Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - P-L Rhee
- Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - T S Sohn
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Kim
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K-M Kim
- Department of Pathology and Translational Genomics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J J Kim
- Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
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30
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Du L, Chen B, Kim JJ, Chen X, Dai N. Micro-inflammation in functional dyspepsia: A systematic review and meta-analysis. Neurogastroenterol Motil 2018; 30:e13304. [PMID: 29392796 DOI: 10.1111/nmo.13304] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 01/08/2018] [Indexed: 12/13/2022]
Abstract
Functional dyspepsia (FD) is a gastrointestinal disorder of unknown etiology. Although micro-inflammation appears to be important in the pathogenesis, studies evaluating immune activation in FD have been inconsistent. A systematic review of literature and meta-analysis was performed to compare immunologic cell counts and cytokine levels in the mucosa and peripheral blood of individuals with FD and healthy controls. PubMed, Embase, and the Cochrane library were searched. Data on immunologic cell counts and cytokines levels among individuals with FD and control groups were extracted and compared by calculating standard mean differences (SMD). Thirty-seven studies met the inclusion criteria. Mast cell (SMD = 0.94, 95%CI 0.26-1.62, P = .007) and eosinophil counts (SMD = 0.36, 95%CI 0.06-0.68, P = .03) in the stomach were increased, among individuals with FD compared to controls. Similarly, mast cell (SMD = 0.66, 95%CI 0.20-1.13, P = 0.005) and eosinophil (SMD = 0.95, 95%CI 0.66-1.24; P < .001) counts in the duodenum were also increased in those with FD compared to controls. In a subgroup analysis, elevated eosinophil counts in the duodenum were observed in both post-prandial distress syndrome (SMD = 0.97, 95%CI 0.46-1.47, P = .0002) and epigastric pain syndrome subtypes (SMD = 1.16, 95%CI 0.48-1.83, P = .0008). No differences in mucosal intraepithelial lymphocyte, enterochromaffin cell, and neutrophil counts, as well as, peripheral interlukin-6 (IL-6) and IL-10 levels were observed among individuals with FD and controls. Micro-inflammation in the form of local immune cell infiltration, particularly eosinophils and mast cells, characterizes the pathogenesis of FD.
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Affiliation(s)
- L Du
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - B Chen
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - J J Kim
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Division of Gastroenterology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - X Chen
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - N Dai
- Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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31
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Song BG, Min YW, Lee H, Min BH, Lee JH, Rhee PL, Kim JJ. Clinicomanometric factors associated with clinically relevant esophagogastric junction outflow obstruction from the Sandhill high-resolution manometry system. Neurogastroenterol Motil 2018; 30. [PMID: 29024314 DOI: 10.1111/nmo.13221] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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] [Received: 05/16/2017] [Accepted: 09/07/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Integrated relaxation pressure (IRP) is a key metric for diagnosing esophagogastric junction outflow obstruction (EGJOO). However, its normal value might be different according to the manufacturer of high-resolution manometry (HRM). This study aimed to investigate optimal value of IRP for diagnosing EGJOO in Sandhill HRM and to find clinicomanometric variables to segregate clinically relevant EGJOO. METHODS We analyzed 262 consecutive subjects who underwent HRM between June 2011 and December 2016 showing elevated median IRP (> 15 mm Hg) but did not satisfy criteria for achalasia. Clinically relevant subjects were defined as follows: (i) subsequent HRM met achalasia criteria during follow-up (early achalasia); (ii) Eckardt score was decreased at least two points without exceeding a score of 3 after pneumatic dilatation (variant achalasia); and (iii) significant passage disturbance on esophagogram without structural abnormality (possible achalasia). KEY RESULTS Seven subjects were clinically relevant, including two subjects with early achalasia, four subjects with variant achalasia, and one subject with possible achalasia. All clinically relevant subjects had IRP 20 mm Hg or above. Among subjects (n = 122) with IRP 20 mm Hg or more, clinically relevant group (n = 7) had significantly higher rate of dysphagia (100% vs 24.3%, P < .001) and compartmentalized pressurization (85.7% vs 21.7%, P = .001) compared to clinically non-relevant group (n = 115). CONCLUSIONS & INFERENCES Our results suggest that IRP of 20 mm Hg or higher could segregate clinically relevant subjects showing EGJOO in Sandhill HRM. Additionally, if subjects have both dysphagia and compartmentalized pressurization, careful follow-up is essential.
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Affiliation(s)
- B G Song
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y W Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B-H Min
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - P-L Rhee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J J Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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32
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Lee SS, Lee CM, Kim TH, Kim JJ, Lee JM, Kim HJ, Ha CY, Kim HJ, Jung WT, Lee OJ, Kim DY. Frequency and risk factors of drug-induced liver injury during treatment of multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2018; 20:800-5. [PMID: 27155184 DOI: 10.5588/ijtld.15.0668] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the risk factors for drug-induced liver injury (DILI) during the treatment of multidrug-resistant tuberculosis (MDR-TB) and to compare the frequency of DILI in patients with and those without chronic liver disease (CLD). SETTING This was a retrospective observational cohort study including 299 consecutive patients who started MDR-TB treatment from January 2009 to December 2013. DESIGN Of the 299 patients, 35 had alcoholic liver disease (ALD group), 16 had hepatitis B virus infection (HBV group) and 11 had hepatitis C virus infection (HCV group). The remaining 237 patients without CLD were selected as the control group. RESULTS DILI occurred in 29 (9.7%) patients. The frequency of DILI was significantly higher in the ALD (17.1%, P = 0.038), HBV (31.3%, P = 0.005) and HCV groups (27.3%, P = 0.037) than in the control group (6.3%). Among all patients taken together, having HBV and HCV infection were independent risk factors for the occurrence of DILI during MDR-TB treatment. CONCLUSION DILI during MDR-TB treatment occurred more frequently in patients with CLD due to ALD, HBV and HCV infection than in those without CLD.
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Affiliation(s)
- S S Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - C M Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - T H Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - J J Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - J M Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - H J Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - C Y Ha
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - H J Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - W T Jung
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - O J Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - D Y Kim
- Department of Thoracic Surgery, Mokpo National Hospital, Mokpo, Republic of Korea
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33
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Kim JJ, Nam YK, Bang IC, Gong SP. Effective Condition for Whole Testis Cryopreservation of Endangered Miho Spine Loach (Cobitis choii) Through the Optimization of Mud Loach (Misgurnus mizolepis) Whole Testis Cryopreservation Condition. Cryo Letters 2018; 39:53-59. [PMID: 29734415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED BACKGROUND: Miho spine loach (Cobitis choii) is an endangered Korean endemic fish. Whole testis cryopreservation is a good way for species preservation, but needs to the sacrifice of a large number of fish to optimize the freezing condition. Considering this limitation, a surrogate fish species was used for the protocol development. OBJECTIVE This study was to establish the effective condition for Miho spine loach whole testis cryopreservation by optimizing the conditions for whole testis cryopreservation in an allied species, mud loach (Misgurnus mizolepis). MATERIALS AND METHODS The condition for whole testis cryopreservation was optimized in mud loach first, and then the optimal condition was applied to Miho spine loach testes. RESULTS The optimal condition for mud loach testis cryopreservation consists of the freezing medium containing 1.3 M dimethyl sulfoxide, 6% fetal bovine serum and 0.3 M trehalose, -1 C/min cooling rate and 26 degree C thawing temperature, which also permits effective cryopreservation of Miho spine loach testes. CONCLUSION An effective cryopreservation condition for whole testis of the endangered Miho spine loach has been established by using mud loach as a surrogate fish.
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Affiliation(s)
- J J Kim
- Department of Fisheries Biology, Pukyong National University, Busan, Korea
| | - Y K Nam
- Department of Fisheries Biology and Department of Marine Biomaterials and Aquaculture, Pukyong National University, Busan, Korea
| | - I C Bang
- Department of Life Sciences and Biotechnology, Soonchunhyang University, Asan, Korea
| | - S P Gong
- Department of Fisheries Biology and Department of Marine Biomaterials and Aquaculture, Pukyong National University, Busan, Korea.
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34
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Kim D, Min YW, Park JG, Lee H, Min BH, Lee JH, Rhee PL, Kim JJ, Zo JI. Influence of esophagectomy on the gastroesophageal reflux in patients with esophageal cancer. Dis Esophagus 2017; 30:1-7. [PMID: 28881892 DOI: 10.1093/dote/dox106] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/26/2017] [Indexed: 12/11/2022]
Abstract
This study aims to assess the influence of esophagectomy with gastric transposition on the gastroesophageal reflux (GER) and gastric acidity in patients with esophageal cancer. Data on 53 esophageal cancer patients who underwent 24-hour impedance-pH monitoring after esophagectomy were retrospectively analyzed. We used a solid-state esophageal pH probe in which the esophageal pH sensor is placed 1.5 cm distal to the upper esophageal sphincter and the gastric pH sensor is located 15 cm distal to the esophageal pH channel. 24-hour impedance-pH monitoring data and other clinical data including anastomosis site stricture and incidence of pneumonia were collected. We defined pathologic reflux with reference to known normative data. Stricture was defined when an intervention such as bougienage or balloon dilatation was required to relieve dysphagia. The esophageal and gastric mean pH were 5.47 ± 1.51 and 3.33 ± 1.64, respectively. The percent time of acidic pH (<4) was 6.66 ± 12.49% in the esophagus and 70.53 ± 32.19% in the stomach. Esophageal pathologic acid reflux was noticed in 32.1%, 20.8%, and 35.8% during total, upright, and recumbent time, respectively. Esophageal pathologic bolus reflux was noted in 83.0%, 77.4%, and 64.2% during total, upright, and recumbent time, respectively. Gastric acidity increased with time after esophagectomy. Esophageal acid exposure time correlated with intragastric pH. However, esophageal pathologic acid reflux was not associated with anastomosis site stricture or pneumonia. In conclusion, GER frequently occurs after esophagectomy. Thus, strict lifestyle modifications and acid suppression would be necessary in patients following esophagectomy.
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Affiliation(s)
| | | | | | | | | | | | | | | | - J I Zo
- Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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35
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Morrow MP, Kraynyak KA, Sylvester AJ, Dallas M, Knoblock D, Boyer JD, Yan J, Vang R, Khan AS, Humeau L, Sardesai NY, Kim JJ, Plotkin S, Weiner DB, Trimble CL, Bagarazzi ML. Clinical and Immunologic Biomarkers for Histologic Regression of High-Grade Cervical Dysplasia and Clearance of HPV16 and HPV18 after Immunotherapy. Clin Cancer Res 2017; 24:276-294. [PMID: 29084917 DOI: 10.1158/1078-0432.ccr-17-2335] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/04/2017] [Accepted: 10/24/2017] [Indexed: 02/06/2023]
Abstract
Purpose: As previously reported, treatment of high-grade cervical dysplasia with VGX-3100 resulted in complete histopathologic regression (CR) concomitant with elimination of HPV16/18 infection in 40.0% of VGX-3100-treated patients compared with only 14.3% in placebo recipients in a randomized phase IIb study. Here, we identify clinical and immunologic characteristics that either predicted or correlated with therapeutic benefit from VGX-3100 to identify parameters that might guide clinical decision-making for this disease.Experimental Design: We analyzed samples taken from cervical swabs, whole blood, and tissue biopsies/resections to determine correlates and predictors of treatment success.Results: At study entry, the presence of preexisting immunosuppressive factors such as FoxP3 and PD-L1 in cervical lesions showed no association with treatment outcome. The combination of HPV typing and cervical cytology following dosing was predictive for both histologic regression and elimination of detectable virus at the efficacy assessment 22 weeks later (negative predictive value 94%). Patients treated with VGX-3100 who had lesion regression had a statistically significant >2-fold increase in CD137+perforin+CD8+ T cells specific for the HPV genotype causing disease. Increases in cervical mucosal CD137+ and CD103+ infiltrates were observed only in treated patients. Perforin+ cell infiltrates were significantly increased >2-fold in cervical tissue only in treated patients who had histologic CR.Conclusions: Quantitative measures associated with an effector immune response to VGX-3100 antigens were associated with lesion regression. Consequently, these analyses indicate that certain immunologic responses associate with successful resolution of HPV-induced premalignancy, with particular emphasis on the upregulation of perforin in the immunotherapy-induced immune response. Clin Cancer Res; 24(2); 276-94. ©2017 AACR.
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Affiliation(s)
| | | | | | | | | | - Jean D Boyer
- Inovio Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | - Jian Yan
- Inovio Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | - Russell Vang
- Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Amir S Khan
- Inovio Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | | | | | - J Joseph Kim
- Inovio Pharmaceuticals, Plymouth Meeting, Pennsylvania
| | - Stanley Plotkin
- The University of Pennsylvania, Philadelphia, Pennsylvania.,Vaxconsult, Doylestown, Pennsylvania
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36
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Griffin BD, Muthumani K, Warner BM, Majer A, Hagan M, Audet J, Stein DR, Ranadheera C, Racine T, De La Vega MA, Piret J, Kucas S, Tran KN, Frost KL, De Graff C, Soule G, Scharikow L, Scott J, McTavish G, Smid V, Park YK, Maslow JN, Sardesai NY, Kim JJ, Yao XJ, Bello A, Lindsay R, Boivin G, Booth SA, Kobasa D, Embury-Hyatt C, Safronetz D, Weiner DB, Kobinger GP. DNA vaccination protects mice against Zika virus-induced damage to the testes. Nat Commun 2017; 8:15743. [PMID: 28589934 PMCID: PMC5467228 DOI: 10.1038/ncomms15743] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [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: 01/12/2017] [Accepted: 04/24/2017] [Indexed: 12/13/2022] Open
Abstract
Zika virus (ZIKV) is an emerging pathogen causally associated with serious sequelae in fetuses, inducing fetal microcephaly and other neurodevelopment defects. ZIKV is primarily transmitted by mosquitoes, but can persist in human semen and sperm, and sexual transmission has been documented. Moreover, exposure of type-I interferon knockout mice to ZIKV results in severe damage to the testes, epididymis and sperm. Candidate ZIKV vaccines have shown protective efficacy in preclinical studies carried out in animal models, and several vaccines have entered clinical trials. Here, we report that administration of a synthetic DNA vaccine encoding ZIKV pre-membrane and envelope (prME) completely protects mice against ZIKV-associated damage to the testes and sperm and prevents viral persistence in the testes following challenge with a contemporary strain of ZIKV. These data suggest that DNA vaccination merits further investigation as a potential means to reduce ZIKV persistence in the male reproductive tract.
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Affiliation(s)
- Bryan D Griffin
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9
| | - Kar Muthumani
- The Wistar Institute, 3601 Spruce Street, Philadelphia, Pennsylvania 19104, USA
| | - Bryce M Warner
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9.,Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Anna Majer
- Molecular Pathobiology, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada MB R3E 3R2
| | - Mable Hagan
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9
| | - Jonathan Audet
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9
| | - Derek R Stein
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9.,Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Charlene Ranadheera
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9.,Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Trina Racine
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2.,Department of Microbiology and Immunology, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Québec City, Québec, Canada G1V 0A6
| | - Marc-Antoine De La Vega
- Department of Microbiology and Immunology, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Québec City, Québec, Canada G1V 0A6
| | - Jocelyne Piret
- Research Center in Infectious Diseases of the CHU of Québec and Laval University, 2705 boulevard Laurier, Québec City, Quebec, Canada G1V 4G2
| | - Stephanie Kucas
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2.,Veterinary Technical Services, Public Health Agency of Canada, National Microbiology Laboratory, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Kaylie N Tran
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Kathy L Frost
- Molecular Pathobiology, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada MB R3E 3R2
| | - Christine De Graff
- Veterinary Technical Services, Public Health Agency of Canada, National Microbiology Laboratory, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Geoff Soule
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Leanne Scharikow
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Jennifer Scott
- Heartland Fertility &Gynecology Clinic, 701-1661 Portage Avenue, Winnipeg, Manitoba, Canada R3J 3T7
| | - Gordon McTavish
- Heartland Fertility &Gynecology Clinic, 701-1661 Portage Avenue, Winnipeg, Manitoba, Canada R3J 3T7
| | - Valerie Smid
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3M4
| | - Young K Park
- GeneOne Life Science Inc., 223 Teheran-Ro, Gangnam-Gu, Seoul, Korea
| | - Joel N Maslow
- GeneOne Life Science Inc., 223 Teheran-Ro, Gangnam-Gu, Seoul, Korea
| | - Niranjan Y Sardesai
- Inovio Pharmaceuticals Inc., 660 West Germantown Pike, Plymouth Meeting, Pennsylvania 19462, USA
| | - J Joseph Kim
- Inovio Pharmaceuticals Inc., 660 West Germantown Pike, Plymouth Meeting, Pennsylvania 19462, USA
| | - Xiao-Jian Yao
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9
| | - Alexander Bello
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9
| | - Robbin Lindsay
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9.,Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - Guy Boivin
- Research Center in Infectious Diseases of the CHU of Québec and Laval University, 2705 boulevard Laurier, Québec City, Quebec, Canada G1V 4G2
| | - Stephanie A Booth
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9.,Molecular Pathobiology, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada MB R3E 3R2
| | - Darwyn Kobasa
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2.,Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9
| | - Carissa Embury-Hyatt
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3M4
| | - David Safronetz
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0J9.,Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba, Canada R3E 3R2
| | - David B Weiner
- The Wistar Institute, 3601 Spruce Street, Philadelphia, Pennsylvania 19104, USA
| | - Gary P Kobinger
- Department of Microbiology and Immunology, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Québec City, Québec, Canada G1V 0A6.,Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, 3400 Spruce Street Philadelphia, Pennsylvania 19104-4238, USA
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37
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Kim JJ, Kim D, Yim JY, Kang JH, Han KH, Kim SM, Hwang KR, Ku SY, Suh CS, Kim SH, Choi YM. Polycystic ovary syndrome with hyperandrogenism as a risk factor for non-obese non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2017; 45:1403-1412. [PMID: 28370150 DOI: 10.1111/apt.14058] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 12/13/2016] [Accepted: 03/04/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is known to be associated with polycystic ovary syndrome (PCOS). However, most studies investigated the prevalence of NAFLD in obese PCOS patients. AIM To compare the prevalence of non-obese NAFLD in women with or without PCOS, and to assess an independent association between PCOS and NAFLD in a non-obese Asian cohort. METHODS This was a case-control study using a prospective PCOS cohort. After subjects with other potential causes of chronic liver disease were excluded, 275 non-obese women with PCOS and 892 non-obese controls were enrolled. NAFLD was determined by hepatic ultrasonography. Main outcomes were the prevalence of NAFLD on hepatic ultrasonography between non-obese women with or without PCOS, and an independent association between non-obese NAFLD and PCOS. RESULTS Non-obese women with PCOS had a significantly higher prevalence of NAFLD than those without PCOS (5.5% vs. 2.8%, P = 0.027). PCOS was associated with non-obese NAFLD (odds ratio: 2.62, 95% confidence intervals: 1.25-5.48) after adjustment for age and body mass index (BMI). In women with PCOS, the level of androgenicity represented by free testosterone or free androgen index was associated with NAFLD after adjustment for age, BMI, lipid profile, insulin resistance or glycaemic status. CONCLUSIONS Non-obese NAFLD is more prevalent in women with polycystic ovary syndrome than in those without. In non-obese patients with polycystic ovary syndrome, hyperandrogenemia may be an independent risk factor for non-obese NAFLD.
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Affiliation(s)
- J J Kim
- Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.,The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - D Kim
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.,Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
| | - J Y Yim
- Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - J H Kang
- Department of Radiology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - K H Han
- Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - S M Kim
- Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - K R Hwang
- Department of Obstetrics and Gynecology, Seoul Municipal Boramae Hospital, Seoul, Korea
| | - S Y Ku
- The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - C S Suh
- The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - S H Kim
- The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Y M Choi
- The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
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Morrow MP, Kraynyak KA, Sylvester AJ, Dallas M, Knoblock D, Boyer JD, Yan J, Vang R, Khan A, Humeau L, Sardesai N, Kim JJ, Plotkin S, Weiner D, Trimble CL, Bagarazzi M. Clinical and Immunologic Biomarkers for Regression of High Grade Cervical Dysplasia and Clearance of HPV16 and HPV18 Infection after Immunotherapy with VGX-3100 in a Phase IIb Clinical Trial. The Journal of Immunology 2017. [DOI: 10.4049/jimmunol.198.supp.79.11] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
We have previously demonstrated proof-of-principle of VGX-3100, an immunotherapy which targets HPV16/18 E6 and E7, in a Phase IIb study in women with premalignant cervical lesions caused by HPV16 or HPV18. After completion of the treatment regimen, cervical lesions underwent complete regression (CR) concomitant with elimination of underlying HPV16/18 infection in 40.0% of VGX-3100-treated patients and in only 14.3% of patients receiving placebo (p=0.002). Here we detail characteristics present that either correlated with or predicted therapeutic benefit with VGX-3100. Combining HPV typing and Pap smear data collected following the third dose (Week 14) was predictive for both CR and the elimination of HPV16/18 at the efficacy assessment twenty two weeks later (predictive value 94%, sensitivity 96%). Patients who had a significant elevation of peripheral blood CD137+ Perforin+ CD8+ T cells specific for the HPV type causing disease (p=0.001) were more likely to have lesion regression and HPV elimination than women without a detectable peripheral blood response. In comparisons of the intensity of cervical mucosal CD103+ and Perforin+ cell infiltrates pre- and post-vaccination, significant increases were observed in patients displaying exhibiting CR with elimination of HPV infection (p=0.027 and p=0.043, respectively). In sum, we found that quantitative measures associated with an effector response to VGX-3100 antigens were associated with subsequent lesion regression. These analyses indicate that certain immunologic responses are associated with successful resolution of HPV 16/18-induced pre-malignancy, with particular emphasis on the upregulation of Perforin in the immunotherapy induced immune response.
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39
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Morrow MP, Kraynyak KA, Sylvester AJ, Shen X, Amante D, Sakata L, Parker L, Yan J, Boyer J, Roh C, Humeau L, Khan AS, Broderick K, Marcozzi-Pierce K, Giffear M, Lee J, Trimble CL, Kim JJ, Sardesai NY, Weiner DB, Bagarazzi ML. Augmentation of cellular and humoral immune responses to HPV16 and HPV18 E6 and E7 antigens by VGX-3100. Mol Ther Oncolytics 2016; 3:16025. [PMID: 28054033 PMCID: PMC5147865 DOI: 10.1038/mto.2016.25] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/03/2016] [Indexed: 12/24/2022]
Abstract
We have previously demonstrated the immunogenicity of VGX-3100, a multicomponent DNA immunotherapy for the treatment of Human Papillomavirus (HPV)16/18-positive CIN2/3 in a phase 1 clinical trial. Here, we report on the ability to boost immune responses with an additional dose of VGX-3100. Patients completing our initial phase 1 trial were offered enrollment into a follow on trial consisting of a single boost dose of VGX-3100. Data show both cellular and humoral immune responses could be augmented above pre-boost levels, including the induction of interferon (IFN)γ production, tumor necrosis factor (TNF)α production, CD8+ T cell activation and the synthesis of lytic proteins. Moreover, observation of antigen-specific regulation of immune-related gene transcripts suggests the induction of a proinflammatory response following the boost. Analysis of T cell receptor (TCR) sequencing suggests the localization of putative HPV-specific T cell clones to the cervical mucosa, which underscores the putative mechanism of action of lesion regression and HPV16/18 elimination noted in our double-blind placebo-controlled phase 2B trial. Taken together, these data indicate that VGX-3100 drives the induction of robust cellular and humoral immune responses that can be augmented by a fourth "booster" dose. These data could be important in the scope of increasing the clinical efficacy rate of VGX-3100.
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Affiliation(s)
| | | | | | - Xuefei Shen
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Dinah Amante
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Lindsay Sakata
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Lamar Parker
- Unified Women's Clinical Research , Winston-Salem, North Carolina, USA
| | - Jian Yan
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Jean Boyer
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Christian Roh
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Laurent Humeau
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Amir S Khan
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Kate Broderick
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | | | - Mary Giffear
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | - Jessica Lee
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
| | | | - J Joseph Kim
- Inovio Pharmaceuticals , Plymouth Meeting, Pennsylvania, USA
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40
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Kim WY, Kim JJ. Reduced-Port Robotic Surgery for Myomectomy Using Laparoscopic Single Port Platform. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Maulsby C, Valdiserri RO, Kim JJ, Mahon N, Flynn A, Eriksson E, Jain KM, Enobun B, Holtgrave DR. The Global Engagement in Care Convening: Recommended Actions to Improve Health Outcomes for People Living With HIV. AIDS Educ Prev 2016; 28:405-416. [PMID: 27710081 DOI: 10.1521/aeap.2016.28.5.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The National HIV AIDS Strategy (NHAS) calls for a more coordinated response to the HIV epidemic. The Global Engagement in Care Convening created a forum for domestic and international experts to identify best practices in HIV care. This manuscript summarizes the meeting discussions and recommendations from meeting notes and an audio recording of the meeting. Recommendations include: further standardization of performance goals and performance measures; additional research; a more robust system to support competing needs of clients receiving services; electronic information exchanges for HIV-related data; an expansion of the role of other health professionals to extend the capacity of physicians and other members of the care team; and revisions to current financing systems to increase reimbursement for and access to services that promote linkage to and retention in HIV care. The recommendations provide a unique example of "reverse technical assistance" and will inform U.S. program development, research, and policy.
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Affiliation(s)
- C Maulsby
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Health, Baltimore, Maryland
| | - R O Valdiserri
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Health, Baltimore, Maryland
| | - J J Kim
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Health, Baltimore, Maryland
| | - N Mahon
- M·A·C AIDS Fund and Global Philanthropy and Corporate Citizenship, The Estée Lauder Companies, Inc
| | - A Flynn
- M·A·C AIDS Fund, New York, New York
| | | | - K M Jain
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Health, Baltimore, Maryland
| | - Blessing Enobun
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Health, Baltimore, Maryland
| | - D R Holtgrave
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Health, Baltimore, Maryland
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42
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Sheth J, Chen D, Kim JJ, Bowman WJ, Crozier PA, Tuller HL, Misture ST, Zdzieszynski S, Sheldon BW, Bishop SR. Coupling of strain, stress, and oxygen non-stoichiometry in thin film Pr0.1Ce0.9O2-δ. Nanoscale 2016; 8:16499-16510. [PMID: 27604569 DOI: 10.1039/c6nr04083g] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Stress and strain in thin films of Pr0.1Ce0.9O2-δ, supported on yttria stabilized zirconia (YSZ) and sapphire substrates, induced by large deviations from oxygen stoichiometry (δ = 0) were investigated by in situ high temperature X-ray diffraction and wafer curvature studies. The measured stresses and strains were correlated with change in δ, measured in situ using optical transmission spectroscopy of defect centers in the films and compared with prior chemical capacitance studies. The coefficient of chemical expansion and elastic modulus values for the films were found to be 18% less than, and 16% greater than in the bulk, respectively. Irreproducible stress and strain during cycling on YSZ substrates was observed and related to microstructural changes as observed by TEM. The enthalpy of defect formation was found to be similar for films supported on sapphire and YSZ, and appeared to decrease with tensile stress, and increase with compressive stress. Larger stresses observed for YSZ supported films as compared to sapphire supported films were found and accounted for by the difference in film orientations.
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Affiliation(s)
- J Sheth
- School of Engineering, Brown University, Providence, RI, USA.
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43
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Muthumani K, Falzarano D, Reuschel EL, Tingey C, Flingai S, Villarreal DO, Wise M, Patel A, Izmirly A, Aljuaid A, Seliga AM, Soule G, Morrow M, Kraynyak KA, Khan AS, Scott DP, Feldmann F, LaCasse R, Meade-White K, Okumura A, Ugen KE, Sardesai NY, Kim JJ, Kobinger G, Feldmann H, Weiner DB. A synthetic consensus anti-spike protein DNA vaccine induces protective immunity against Middle East respiratory syndrome coronavirus in nonhuman primates. Sci Transl Med 2016; 7:301ra132. [PMID: 26290414 DOI: 10.1126/scitranslmed.aac7462] [Citation(s) in RCA: 188] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
First identified in 2012, Middle East respiratory syndrome (MERS) is caused by an emerging human coronavirus, which is distinct from the severe acute respiratory syndrome coronavirus (SARS-CoV), and represents a novel member of the lineage C betacoronoviruses. Since its identification, MERS coronavirus (MERS-CoV) has been linked to more than 1372 infections manifesting with severe morbidity and, often, mortality (about 495 deaths) in the Arabian Peninsula, Europe, and, most recently, the United States. Human-to-human transmission has been documented, with nosocomial transmission appearing to be an important route of infection. The recent increase in cases of MERS in the Middle East coupled with the lack of approved antiviral therapies or vaccines to treat or prevent this infection are causes for concern. We report on the development of a synthetic DNA vaccine against MERS-CoV. An optimized DNA vaccine encoding the MERS spike protein induced potent cellular immunity and antigen-specific neutralizing antibodies in mice, macaques, and camels. Vaccinated rhesus macaques seroconverted rapidly and exhibited high levels of virus-neutralizing activity. Upon MERS viral challenge, all of the monkeys in the control-vaccinated group developed characteristic disease, including pneumonia. Vaccinated macaques were protected and failed to demonstrate any clinical or radiographic signs of pneumonia. These studies demonstrate that a consensus MERS spike protein synthetic DNA vaccine can induce protective responses against viral challenge, indicating that this strategy may have value as a possible vaccine modality against this emerging pathogen.
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Affiliation(s)
- Karuppiah Muthumani
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Darryl Falzarano
- Laboratory of Virology, Division of Intramural Research, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - Emma L Reuschel
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Colleen Tingey
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Seleeke Flingai
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Daniel O Villarreal
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Megan Wise
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Ami Patel
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Abdullah Izmirly
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Abdulelah Aljuaid
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Alecia M Seliga
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA
| | - Geoff Soule
- Special Pathogens Program, University of Manitoba and Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Matthew Morrow
- Inovio Pharmaceuticals Inc., Plymouth Meeting, PA 19462, USA
| | | | - Amir S Khan
- Inovio Pharmaceuticals Inc., Plymouth Meeting, PA 19462, USA
| | - Dana P Scott
- Rocky Mountain Veterinary Branch, Division of Intramural Research, NIAID, NIH, Hamilton, MT 59840, USA
| | - Friederike Feldmann
- Rocky Mountain Veterinary Branch, Division of Intramural Research, NIAID, NIH, Hamilton, MT 59840, USA
| | - Rachel LaCasse
- Rocky Mountain Veterinary Branch, Division of Intramural Research, NIAID, NIH, Hamilton, MT 59840, USA
| | - Kimberly Meade-White
- Rocky Mountain Veterinary Branch, Division of Intramural Research, NIAID, NIH, Hamilton, MT 59840, USA
| | - Atsushi Okumura
- Department of Microbiology, University of Washington, Seattle, WA 98195, USA
| | - Kenneth E Ugen
- Department of Molecular Medicine, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA
| | | | - J Joseph Kim
- Inovio Pharmaceuticals Inc., Plymouth Meeting, PA 19462, USA
| | - Gary Kobinger
- Special Pathogens Program, University of Manitoba and Public Health Agency of Canada, Winnipeg, Manitoba R3E 3R2, Canada
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Hamilton, MT 59840, USA
| | - David B Weiner
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA 19104, USA.
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Reuschel EL, Muthumani K, Kraynyak K, Tingey C, Kudchodkar SB, Khan AS, Sardesai NY, Kim JJ, Maslow J, Park YK, Kobinger G, Falzarano D, Feldman H, Weiner DB. 436. Developing a Synthetic DNA Vaccine for an Emerging Pathogen - Middle East Respiratory Syndrome. Mol Ther 2016. [PMCID: PMC7129814 DOI: 10.1016/s1525-0016(16)33245-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Muthumani K, Block P, Flingai S, Muruganantham N, Chaaithanya IK, Tingey C, Wise M, Reuschel EL, Chung C, Muthumani A, Sarangan G, Srikanth P, Khan AS, Vijayachari P, Sardesai NY, Kim JJ, Ugen KE, Weiner DB. Rapid and Long-Term Immunity Elicited by DNA-Encoded Antibody Prophylaxis and DNA Vaccination Against Chikungunya Virus. J Infect Dis 2016; 214:369-78. [PMID: 27001960 PMCID: PMC4936642 DOI: 10.1093/infdis/jiw111] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 03/11/2016] [Indexed: 12/14/2022] Open
Abstract
Background. Vaccination and passive antibody therapies are critical for controlling infectious diseases. Passive antibody administration has limitations, including the necessity for purification and multiple injections for efficacy. Vaccination is associated with a lag phase before generation of immunity. Novel approaches reported here utilize the benefits of both methods for the rapid generation of effective immunity. Methods. A novel antibody-based prophylaxis/therapy entailing the electroporation-mediated delivery of synthetic DNA plasmids encoding biologically active anti–chikungunya virus (CHIKV) envelope monoclonal antibody (dMAb) was designed and evaluated for antiviral efficacy, as well as for the ability to overcome shortcomings inherent with conventional active vaccination and passive immunotherapy. Results. One intramuscular injection of dMAb produced antibodies in vivo more rapidly than active vaccination with an anti-CHIKV DNA vaccine. This dMAb neutralized diverse CHIKV clinical isolates and protected mice from viral challenge. Combination of dMAb and the CHIKV DNA vaccine afforded rapid and long-lived protection. Conclusions. A DNA-based dMAb strategy induced rapid protection against an emerging viral infection. This method can be combined with DNA vaccination as a novel strategy to provide both short- and long-term protection against this emerging infectious disease. These studies have implications for pathogen treatment and control strategies.
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Affiliation(s)
- Karuppiah Muthumani
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania The Wistar Institute, Philadelphia, Pennsylvania
| | - Peter Block
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania
| | - Seleeke Flingai
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania The Wistar Institute, Philadelphia, Pennsylvania
| | - Nagarajan Muruganantham
- Regional Medical Research Centers, Indian Council of Medical Research, Port Blair, Andaman & Nicobar Islands
| | - Itta Krishna Chaaithanya
- Regional Medical Research Centers, Indian Council of Medical Research, Port Blair, Andaman & Nicobar Islands
| | - Colleen Tingey
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania
| | - Megan Wise
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania The Wistar Institute, Philadelphia, Pennsylvania
| | - Emma L Reuschel
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania The Wistar Institute, Philadelphia, Pennsylvania
| | - Christopher Chung
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania The Wistar Institute, Philadelphia, Pennsylvania
| | - Abirami Muthumani
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania
| | - Gopalsamy Sarangan
- Department of Microbiology, Sri Ramachandra Medical College & Research Institute, Chennai, India
| | - Padma Srikanth
- Department of Microbiology, Sri Ramachandra Medical College & Research Institute, Chennai, India
| | - Amir S Khan
- Inovio Pharmaceutics Inc., Plymouth Meeting, Pennsylvania
| | - Paluru Vijayachari
- Regional Medical Research Centers, Indian Council of Medical Research, Port Blair, Andaman & Nicobar Islands
| | | | - J Joseph Kim
- Inovio Pharmaceutics Inc., Plymouth Meeting, Pennsylvania
| | - Kenneth E Ugen
- Department of Molecular Medicine, University of South Florida Morsani College of Medicine, Tampa
| | - David B Weiner
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania The Wistar Institute, Philadelphia, Pennsylvania
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Lee II, Maniar K, Lydon JP, Kim JJ. Akt regulates progesterone receptor B-dependent transcription and angiogenesis in endometrial cancer cells. Oncogene 2016; 35:5191-201. [PMID: 26996671 PMCID: PMC5031502 DOI: 10.1038/onc.2016.56] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 09/25/2015] [Revised: 01/20/2016] [Accepted: 02/08/2016] [Indexed: 12/14/2022]
Abstract
Progestins have long been used clinically for the treatment of endometrial cancers, however, the response rates to progestin therapy vary and the molecular mechanisms behind progestin insensitivity are poorly understood. We hypothesized that in PTEN mutated endometrial cancers, hyperactive Akt signaling downregulates Progesterone Receptor B (PRB) transcriptional activity, leading to overall impaired progestin responses. We report that inhibition of Akt with the Akt inhibitor, MK-2206 (MK), in conjunction with progestin (R5020) treatment, is sufficient to upregulate a subset of PRB target genes in Ishikawa cells stably expressing PRB (PRB-Ishikawa). Through gene ontology analysis of Akt-regulated PRB target genes, angiogenesis was found to be the principle process regulated by Akt-PRB. To further interrogate the mechanism by which Akt modulates PRB transcriptional activity, ChIP-Mass Spectrometry was performed to identify potential cofactors that differentially interact with PRB in the presence of the R5020 and MK+R5020. 14-3-3σ was identified as a protein enriched in the MK+R5020 dataset, and it was demonstrated that 14-3-3σ is required for the upregulation in PRB target gene expression following inhibition of Akt. In order to determine the ramifications of MK+R5020 treatment on angiogenesis, in vitro assays were performed and combinatorial MK+R5020 treatment significantly decreased endothelial cell invasion and tube formation more than MK or R5020 treatment alone. Furthermore, we found that combinatorial MK-2206+Progesterone treatments decreased angiogenesis and proliferation in the Ptend/d conditional mouse model of endometrial cancer. Taken together, these findings suggest that a combinatorial therapeutic approach utilizing Akt inhibitors with progestins may improve the efficacy of progestin therapy for the treatment of endometrial cancer.
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Affiliation(s)
- I I Lee
- Division of Reproductive Science in Medicine, Department of Obstetrics and Gynecology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - K Maniar
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - J P Lydon
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - J J Kim
- Division of Reproductive Science in Medicine, Department of Obstetrics and Gynecology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Kim CW, Park SN, Lee SB, Kim JJ, Lee HW, Kim YK, Yoon SS. Blue Emitters Based on Aryl End-Capped Pyrene Groups for OLEDs. J Nanosci Nanotechnol 2016; 16:2912-2915. [PMID: 27455733 DOI: 10.1166/jnn.2016.11092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We have synthesized four pyrene-derived blue emitting materials using Suzuki cross coupling reactions. All OLED devices using these materials as emitting materials showed efficient blue electroluminescence (EL). Particularly, a device using 1,1'-(9,9-dimethyl-9H-fluorene-2,7-diyl)bis-pyrene (1) showed best EL properties with the luminous efficiency of 4.32 cd/A, the power efficiency of 3.98 lm/W and the external quantum efficiency of 2.48% at 500 cd/m2.
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Lee ES, Jung SY, Kim JY, Kim JJ, Yoo TK, Kim YG, Lee KS, Lee ES, Kim EK, Min JW, Han W, Noh DY, Moon HG. Identifying the potential long-term survivors among breast cancer patients with distant metastasis. Ann Oncol 2016; 27:828-33. [PMID: 26823524 DOI: 10.1093/annonc/mdw036] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 01/15/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND We aimed to develop a prediction model to identify long-term survivors after developing distant metastasis from breast cancer. PATIENTS AND METHODS From the institution's database, we collected data of 547 patients who developed distant metastasis during their follow-ups. We developed a model that predicts the post-metastasis overall survival (PMOS) based on the clinicopathologic factors of the primary tumors and the characteristics of the distant metastasis. For validation, the survival data of 254 patients from four independent institutions were used. RESULTS The median duration of the PMOS was 31.0 months. The characteristics of the initial primary tumor, such as tumor stage, hormone receptor status, and Ki-67 expression level, and the characteristics of the distant metastasis presentation including the duration of disease-free interval, the site of metastasis, and the presence of metastasis-related symptoms were independent prognostic factors determining the PMOS. The association between tumor stage and the PMOS was only seen in tumors with early relapses. The PMOS score, which was developed based on the above six factors, successfully identified patients with superior survival after metastasis. The median PMOS for patients with a PMOS score of <2 and for patients with a PMOS score of >5 were 71.0 and 12 months, respectively. The clinical significance of the PMOS score was further validated using independent multicenter datasets. CONCLUSIONS We have developed a novel prediction model that can classify breast cancer patients with distant metastasis according to their survival after metastasis. Our model can be a valuable tool to identify long-term survivors who can be potential candidates for more intensive multidisciplinary approaches. Furthermore, our model can provide a more reliable survival information for both physicians and patients during their informed decision-making process.
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Affiliation(s)
- E S Lee
- Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - S Y Jung
- Center for Breast Cancer, National Cancer Center, Goyang
| | - J Y Kim
- Department of Surgery, College of Medicine, Gyeongsang National University, Jinju
| | - J J Kim
- Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - T K Yoo
- Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - Y G Kim
- Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - K S Lee
- Center for Breast Cancer, National Cancer Center, Goyang
| | - E S Lee
- Center for Breast Cancer, National Cancer Center, Goyang
| | - E K Kim
- Department of Surgery, Breast Cancer Center, Seoul National University Bundang Hospital, Seongnam
| | - J W Min
- Department of Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - W Han
- Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - D Y Noh
- Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul
| | - H G Moon
- Department of Surgery, Seoul National University College of Medicine, Laboratory of Breast Cancer Biology, Cancer Research Institute, Seoul National University College of Medicine, Seoul
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Affiliation(s)
- J J Kim
- Division of Gastroenterology, Loma Linda University Medical Center, Loma Linda, CA, USA.
| | - F Lee
- Division of Gastroenterology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - L Laine
- Section of Digestives Diseases, Yale University School of Medicine, New Haven, CT, USA.,VA Connecticut Healthcare System, West Haven, CT, USA
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Kim ER, Lee H, Min BH, Lee JH, Rhee PL, Kim JJ, Kim KM, Kim S. Effect of rescue surgery after non-curative endoscopic resection of early gastric cancer. Br J Surg 2015; 102:1394-401. [PMID: 26313295 DOI: 10.1002/bjs.9873] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 12/23/2014] [Accepted: 05/15/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Whether rescue surgery confers a survival benefit in patients undergoing non-curative endoscopic resection of early gastric cancer remains controversial. METHODS This was a retrospective review of patients who underwent non-curative endoscopic resection of at least one lesion of differentiated-type early gastric cancer between 2000 and 2011. Patients with a positive lateral resection margin as the only non-curative factor were excluded. Outcome was investigated by univariable (Kaplan-Meier) and multivariable (Cox proportional hazards) analysis. RESULTS Some 341 patients underwent non-curative endoscopic resection for at least one lesion of differentiated-type early gastric cancer. Sixty-seven patients with a positive lateral resection margin as the only non-curative factor were excluded, leaving 274 patients for analysis; 194 had rescue surgery and 80 had no additional treatment. The median duration of follow-up was 60·5 months. Patients who had rescue surgery were younger, had a lower Charlson co-morbidity index score, smaller tumours and a higher lymphovascular invasion rate than patients with no treatment. Among 194 patients who had rescue surgery, intragastric local residual tumours were found in ten (5·2 per cent) and lymph node metastases in 11 (5·7 per cent). Patients with lymph node metastasis were significantly older than those without metastasis; no other significant differences were found. Univariable analysis showed that patients aged less than 65 years, those with a Charlson co-morbidity index score below 4 and patients undergoing rescue surgery had significantly longer overall survival. Five-year overall survival rates in the rescue surgery and no-treatment groups were 94·3 and 85 per cent respectively. In multivariable analysis, rescue surgery was identified as the only independent predictor of overall survival after non-curative endoscopic resection of early gastric cancer. CONCLUSION Rescue surgery confers a survival benefit after non-curative endoscopic resection of early gastric cancer.
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Affiliation(s)
- E R Kim
- Departments of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Lee
- Departments of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B-H Min
- Departments of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J H Lee
- Departments of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - P-L Rhee
- Departments of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J J Kim
- Departments of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K-M Kim
- Departments of Pathology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Kim
- Departments of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
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