1974. Title: A novel low-dose self-amplifying mRNA vaccine (GRT-R910) induces strong and broad boost in cellular and humoral immune response following primary series with a chimpanzee adenovirus SARS-CoV-2 vaccination

Disclosures

Ciaran Scallan, PhD, Gritstone Bio: Salaried employee of Gritstone|Gritstone Bio: Stocks/Bonds Andrew Ustianowski, MD, PhD, Gilead: Advisor/Consultant|Gilead: Board Member|Gilead: Honoraria|Gilead: Speaker fees|Pfizer: Honoraria|Pfizer: Speaker fees|Vir/GlaxoSmithKline: Advisor/Consultant|Vir/GlaxoSmithKline: Board Member.

Background

The SARS-CoV-2 pandemic continues, with new variants of concern fueling periodic increases in COVID-19 cases. Authorized vaccines have provided protection against severe disease but less so for incident cases. Boosts with these vaccines have demonstrated waning protection. New vaccines, including those which induce immunity against more conserved regions outside of Spike, may improve upon these and be key to long-term protection and may be a useful approach against novel coronaviruses.

Methods

GO-009 (CORAL-Boost, NCT05148962) is an open-label study, conducted in the UK, of a self-amplifying mRNA vaccine encoding for Wuhan Spike (S) and highly conserved non-S T cell epitopes (GRT-R910; R910). R910 is given as 1 or 2 doses after vaccination with an authorized adenovirus or mRNA SARS-CoV-2 vaccine. The first two cohorts assessed 10µg and 30µg doses of R910 in older (≥60y) adults who had previously received ChAdOx1. Subsequent cohorts assess two boost doses in older and younger adults who have received an adenovirus or mRNA vaccine. Primary objectives are safety and reactogenicity and secondary objectives include cellular and humoral immunogenicity.

Results

Ten and seven adults received 10 or 30µg (cohorts 1 and 2) of R910, respectively. Reactogenicity and unsolicited adverse events were mostly mild/moderate and transient. The majority of severe events (malaise, fatigue, myalgia, Inj. site pain/tenderness/swelling) after dose 1 were experienced by 1 subject in cohort 2. Analysis of both IgG binding and neutralizing antibodies demonstrated a boost of anti-S antibodies after one dose of R910; geomean ID50 titers from 92 to 2370 and 99 to 1553 for 10 and 30µg, respectively. ELISpot analyses demonstrated that R910 boosted and broadened T cell responses to S and non-S T cell epitopes.

Conclusion

R910 was well tolerated. One R910 boost vaccination increased existing humoral and cellular immunity against S while inducing a broad T cell response against non-S SARS-CoV-2 proteins. A 10µg R910 boost increased neutralizing antibody titers comparable to a 10-fold higher dose (100µg) with authorized mRNA vaccines in a similar population (Munro et al 2021). A 10µg dose was selected for further study. Data post mRNA primary series will also be presented.

Long-term predictive models of risk factors for early chronic kidney disease: a longitudinal study

Background

The high incidence and prevalence of chronic kidney disease (CKD) in Taiwan have produced tremendous burdens on health care resources. The work environment of air force special operations personnel engenders high psychological stress, and the resulting increased blood pressure can lead to glomerular hypertension and accelerated glomerular injury in the long term. The aim of the study was to establish the predictive models to define the predictors of CKD.

Results

The results indicated that the prevalence of CKD over 4 consecutive years was 3.8%, 9.4%, 9.0%, and 9.4%. The capability of using occult blood in urine to predict the risk of CKD after 1, 2, and 3 years was statistically significant. The age-adjusted odds ratio (OR) and 95% confidence interval (CI) were 7.94 (95% CI: 2.61–24.14), 12.35 (95% CI: 4.02–37.94) and 4.25 (95% CI: 1.32–13.70), respectively.

Discussion

The predictive power of occult blood in urine for the risk of CKD in each model was statistically significant. Future investigations can explore the feasibility of implementing simple and accurate urine dipsticks for preliminary testing besides annual aircrew physical examinations to facilitate early detection and treatment.

Methods

This study was a longitudinal study, in which air force special operations personnel who received physical examinations at military hospitals between 2004 and 2010 were selected. CKD was determined based on the definition provided by the US National Kidney Foundation. Overall, 212 participants that could be followed continuously for 4 years were analyzed.

Clinical stage and risk of recurrence and mortality: interaction of DNA methylation factors in patients with colorectal cancer

Aberrant DNA methylation plays a crucial role in cancer development; however, prospective evidence of an interaction between molecular biomarkers and cancer staging for predicting the prognosis of colorectal cancer (CRC) is still limited. We examined DNA methylation in tumors and adjacent normal tissues from patients who underwent CRC surgical resection, and evaluated the interaction between cancer staging (advanced vs local) and DNA methylation to predict the prognosis of CRC. We recruited 132 patients with CRC from Tri-Service General Hospital in Taiwan and used the candidate gene approach to select 3 tumor suppressor genes involved in carcinogenesis pathways. ORs and 95% CIs were computed using logistic regression analyses while adjusting for potential covariates. Advanced cancer stage was correlated with cancer recurrence (OR 7.22, 95% CI 2.82 to 18.45; p<0.001). In addition, after stratification by promoter methylation in 3 combined genes in the matched normal tissues, we observed a joint effect after adjusting for sex, age at surgery, and adjuvant chemotherapy, yielding a significant OR of 20.35 (95% CI 4.16 to 99.57; p<0.001). DNA methylation status would significantly increase the recurrence risk of CRC with a significant impact on joint effect between DNA methylation and clinical stage, particularly in matched normal tissues. This was attributed to molecular changes that could not be examined on the basis of clinical pathology. Our interaction results may serve as a reference marker for evaluating the risk of recurrence in future studies.

Abstract A32: PBX1, a transcriptional regulator, promotes stemness and chemoresistance in ovarian cancer

Background: Cancer recurrence and chemoresistance contribute greatly to the high mortality of ovarian cancers; however, molecular players involved in these processes remain under-determined. Several theories have been proposed to account for the development of resistance to chemotherapeutic agents. One of the emerging concepts is tumor heterogeneity, which argues for the presence of different cell subpopulations in bulk tumor with varying degrees of tumor initiating potential and drug sensitivity. The fractions of cells with enhanced tumor initiating potential are referred to as cancer stem-like cells (CSC). These cells have defining “stemness” phenotypes, including unlimited cell division, repopulation by a minimum cell number and resistance to cytotoxic agents and irradiation.

New Findings: To identify embryonic stem cell factors that are potentially involved in tumor recurrence and chemoresistance, we have screened expression levels of four of these factors by immunohistochemistry in pairs of matched recurrent and primary tumor tissues from 41 patients. Our data demonstrated that PBX1 is significantly up-regulated in recurrent/chemoresistant ovarian tumors. Moreover, PBX1 overexpression in ascites tumors correlates with shorter overall survival in post-chemotherapy ovarian cancer patients. When PBX1 is ectopically expressed, it promotes cancer stem cell-like phenotypes, including increased side population and ALDH1 activity, enhanced tumorigenicity at low cell density, and increased resistance to platinum-based therapy. In platinum-resistant cell lines that overexpress PBX1, silencing PBX1 expression using RNA interference sensitizes cells to platinum treatment and reduces their stem cell-like phenotypes. Gene expression and chromatin immunoprecipitation analyses identified PBX1 direct target genes involved in multi-drug resistance, stem cell maintenance, immunomodulation, and DNA damage response. In the TCGA ovarian cancer recurrent series, expression of several PBX1 direct target genes, including ABCA1, Nanog, BMP3, and ATM, is tightly associated with PBX1 expression, further supporting the tissue-level transcriptional regulation of these genes by PBX1.

Conclusion: The above findings establish PBX1 as an upstream regulator of key functional networks that mediate cancer stem-like and drug resistant phenotypes. Studies on the hematopoietic system have indicated that PBX1 maintains a viable pool of quiescent stem cells. Recently, in a renal cell carcinoma system, chemotherapy has been shown to induce damage signaling and to stimulate cell division and repopulation of quiescent CSCs. We speculate that chemotherapy in ovarian cancer may induce comparable injury responses and trigger PBX1 signaling, which in turn may activate downstream networks that support CSC survival and create a microenvironment niche that is essential for CSC repopulation at the tissue level. Collectively, the association between PBX1 and a cascade of stemness pathways points to a potential Achilles's heel critical to responding to chemotherapy and developing chemoresistance and argues for the development of antagonists of PBX1 signaling as anticancer agents.

Citation Format: Jin-Gyoung Jung, Tae-Hoen Kim, Emily Gerry, Jen-Chun Kuan, Ayse Ayhan, Ben Davidson, Ie-Ming Shih, Tian-Li Wang. PBX1, a transcriptional regulator, promotes stemness and chemoresistance in ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: Exploiting Vulnerabilities; Oct 17-20, 2015; Orlando, FL. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(2 Suppl):Abstract nr A32.

MOLECULAR DETECTION OF HUMAN BOCAVIRUS 1 AND 2 IN CHILDREN WITH ACUTE GASTROENTERITIS IN TAIWAN

Human bocaviruses (HBoVs) have been detected in human gastrointestinal infections worldwide. Although HBoV global prevalence and strains diversity have been reported, but epidemiological data from Taiwan is largely unavailable to date. A total of 110 fecal samples from stools of diarrheic children at a general hospital, Taiwan, obtained from August 2012 to July 2013, were analyzed by nested PCR targeting a partial fragment (576 bp) of HBoV VP1/VP2 gene, which revealed 4 positive fecal samples. Clinical symptoms of HBoV-associated acute gastroenteritis (AGE) were not different from those without HBoV. HBoV infection was seen only during the fall and winter seasons. This is the first description of HBoV infection in children with AGE in Taiwan. Systematic surveillance and evidence-based studies are required to determine the transmission pathways and spread of HBoV in Taiwan.

Mevalonate Pathway Antagonist Suppresses Formation of Serous Tubal Intraepithelial Carcinoma and Ovarian Carcinoma in Mouse Models

PURPOSE

Statins are among the most frequently prescribed drugs because of their efficacy and low toxicity in treating hypercholesterolemia. Recently, statins have been reported to inhibit the proliferative activity of cancer cells, especially those with TP53 mutations. Because TP53 mutations occur in almost all ovarian high-grade serous carcinoma (HGSC), we determined whether statins suppressed tumor growth in animal models of ovarian cancer.

EXPERIMENTAL DESIGN

Two ovarian cancer mouse models were used. The first one was a genetically engineered model, mogp-TAg, in which the promoter of oviduct glycoprotein-1 was used to drive the expression of SV40 T-antigen in gynecologic tissues. These mice spontaneously developed serous tubal intraepithelial carcinomas (STICs), which are known as ovarian cancer precursor lesions. The second model was a xenograft tumor model in which human ovarian cancer cells were inoculated into immunocompromised mice. Mice in both models were treated with lovastatin, and effects on tumor growth were monitored. The molecular mechanisms underlying the antitumor effects of lovastatin were also investigated.

RESULTS

Lovastatin significantly reduced the development of STICs in mogp-TAg mice and inhibited ovarian tumor growth in the mouse xenograft model. Knockdown of prenylation enzymes in the mevalonate pathway recapitulated the lovastatin-induced antiproliferative phenotype. Transcriptome analysis indicated that lovastatin affected the expression of genes associated with DNA replication, Rho/PLC signaling, glycolysis, and cholesterol biosynthesis pathways, suggesting that statins have pleiotropic effects on tumor cells.

CONCLUSIONS

The above results suggest that repurposing statin drugs for ovarian cancer may provide a promising strategy to prevent and manage this devastating disease.

Predictive value of serum apolipoprotein B/apolipoprotein A-I ratio in metabolic syndrome risk: a Chinese cohort study

The purpose of this study was to evaluate whether the apolipoprotein B/apolipoprotein A-I (apoB/apoA-I) ratio is a promising risk predictor of metabolic syndrome (MetS) and to determine the optimal cut-off value of this ratio in detecting subjects with MetS in a Chinese population. A prospective study was conducted using a representative sample of non-institutionized people in Taiwan. A total of 3,343 participants with mean age (±SD) of 39.86 (±15.61) years old were followed up from 2002 to 2007. The primary outcome was the incidence of MetS. The MetS was defined according to a unified criterion established by several major organizations. There were 462 cases of incident MetS during a mean follow-up period of 5.26 years. A significantly stepwise increase in the incidence of MetS across quartiles of the apoB/apoA-I ratio was noted in both sexes after adjustment for potential confounders (p for trend <0.001). Compared with the lowest quartile of apoB/apoA-I ratio, participants in the highest quartile had a significantly higher risk of MetS in both men [adjusted hazard ratio (HR) = 6.29, 95 % confidence interval (CI) = 2.79-9.13] and women (adjusted HR = 3.82, 95 % CI = 1.06-6.63). Comparisons of receiver operating characteristics curves indicated that the predictive ability of apoB/apoA-I ratio to detect MetS was better than conventional lipid ratio measurements. Furthermore, the optimal cut-off value of apoB/apoA-I ratio for MetS diagnosis was 0.71 in men and 0.56 in women. These results suggest that an elevated apoB/apoA-I ratio might constitute a potentially crucial measure linked to the risk of developing MetS.

Turmeric improves post-prandial working memory in pre-diabetes independent of insulin

BACKGROUND AND OBJECTIVES

Cognitive impairment develops with pre-diabetes and dementia is a complication of diabetes. Natural products like turmeric and cinnamon may ameliorate the underlying pathogenesis.

METHODS

People ≥ 60 years (n=48) with newly-recognised untreated pre-diabetes were randomised to a double-blind metabolic study of placebo, turmeric (1 g), cinnamon (2 g) or both (1 g & 2 g respectively), ingested at a white bread (119 g) breakfast. Observations were made over 6 hours for pre- and post-working memory (WM), glycaemic and insulin responses and biomarkers of Alzheimer's disease (AD)(0, 2, 4 and 6 hours): amyloid precursor protein (APP), γ-secretase subunits presenilin-1 (PS1), presenilin-2 (PS2), and glycogen synthase kinase (GSK-3β). Differences between natural product users and non-users were determined by Students t and chi square tests; and between pre-test and post-test WM by Wilcoxon signed rank tests. Interaction between turmeric and cinnamon was tested by 2-way ANOVA. Multivariable linear regression (MLR) took account of BMI, glycaemia, insulin and AD biomarkers in the WM responses to turmeric and cinnamon.

RESULTS

No interaction between turmeric and cinnamon was detected. WM increased from 2.6 to 2.9 out of 3.0 (p=0.05) with turmeric, but was unchanged with cinnamon. WM improvement was inversely associated with insulin resistance (r=-0.418, p<0.01), but not with AD biomarkers. With MLR, the WM responses to turmeric were best predicted with an R2 of 34.5%; and with significant turmeric, BMI and insulin/glucose AUC beta-coefficients.

CONCLUSIONS

Co-ingestion of turmeric with white bread increases working memory independent of body fatness, glycaemia, insulin, or AD biomarkers.

Elevated uric acid level as a significant predictor of chronic kidney disease: a cohort study with repeated measurements

BACKGROUND

Cohort studies evaluating increased serum uric acid (SUA) level as a chronic kidney disease (CKD) risk factor have yielded variable results. We aimed to assess the association between the pattern of longitudinal changes in SUA and incident CKD [estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2)].

METHODS

A population-based cohort study was conducted on 3,605 participants who were followed prospectively for a mean of 5.18 years. The longitudinal changes in SUA were categorized into three subgroups: persistently low, fluctuated (reduced or elevated), and persistently high. The primary outcome of interest was the development of CKD at a follow-up examination. Cox proportional hazards analysis was used to test the hypothesis.

RESULTS

After adjustment for potential confounders, participants with fluctuated SUA with progressively elevated level and persistently high SUA level had significantly higher risk of developing CKD compared to subjects with persistently low SUA level: adjusted hazard ratio (95% confidence interval) was 2.05 (1.24-3.38) vs. 1.90 (1.34-2.71). This longitudinal relationship was independent of sex, age, body mass index, and hypertension status.

CONCLUSIONS

Longitudinally elevated SUA independently predicts the risk of new-onset CKD.

Predicting the progress of colon cancer by DNA methylation markers of the p16 gene in feces - Evidence from an animal model

A new noninvasive screening tool for colorectal neoplasia detects epigenetic alterations exhibited by gastrointestinal tumor cells shed into stool. There is insufficient existing data to determine temporal associations between colorectal cancer (CRC) progression and aberrant DNA methylation. To evaluate the feasibility of using fecal DNA methylation status to determine CRC progression, we collected stool samples from 14 male SD rats aged six weeks, and administered subcutaneous injections of either 1,2-dimethylhydrazine or saline weekly. p16 DNA methylation statuses in tumorous and normal colon tissue, and from stool samples were determined using methylation-specific PCR. Additionally, p16 methylation was detected in stool DNA from 85.7% of the CRC rats. The earliest change in p16 methylation status in the DMH-treated group stool samples occurred during week nine; repeatabilities were 57.1% in week 19 (p = 0.070) and 85.7% in week 34 (p = 0.005). A temporal correlation was evidenced between progression of CRC and p16 methylation status, as evidenced by DMH-induced rat feces. Using fecal DNA methylation status to determine colorectal tissue methylation status can reveal CRC progression. Our data suggests that p16 promoter methylation is a feasible epigenetic marker for the detection and may be useful for CRC screening.

Simplified method to quantify geosmin and 2-methylisoborneol concentrations in water and microbiological cultures

A simple and rapid method for the extraction and quantification of geosmin and 2-methylisoborneol is described. Using methylene chloride extraction and gas chromatography, the procedure eliminates costly stripping devices. Recovery efficiency of the procedure is approximately 65% with a sensitivity equal to the human threshold for these two important off-flavor compounds.

Bile acid synthesis by cultured hepatocytes. Inhibition by mevinolin, but not by bile acids

The ability of cultured hepatocytes to maintain a constant rate of bile acid synthesis and secretion in a chemically defined serum-free culture medium allowed us to examine the direct effects of bile acids on their synthesis. Mass quantitation of bile acids by gas liquid chromatography showed that adding taurochenodeoxycholate at concentrations which were from 2 to 20 times the concentration of bile acids found in rat portal blood increased rather than decreased the secretion of cholic acid. Using a more direct approach to measure relative rates of bile acid synthesis and secretion, we determined the rate of de novo 14C-bile acid synthesis. Adding taurocholate at concentrations ranging from 2 to 60 times the concentration found in rat portal blood did not inhibit 14C-bile acid synthesis. Furthermore, free and conjugated di- and tri-hydroxy bile acids did not inhibit bile acid synthesis. In contrast, mevinolin, a potent inhibitor of cholesterol biosynthesis, inhibited 14C-bile acid synthesis by 63%. Since previous demonstration of bile acid negative feedback regulation was achieved in vivo by infusing taurocholate into the intestines of bile-diverted rats, we examined the possibility that bile acid synthesis must be induced in order for bile acids to inhibit their synthesis. Hepatocytes obtained from bile-diverted rats exhibited a 5-fold increase in the synthesis and secretion of 14C-bile acids. However, taurocholate did not inhibit bile acid synthesis by cells from bile-diverted rats. These data show that bile acids do not interact directly with the hepatocyte to inhibit their synthesis.

An alternative method for the determination of uric acid in serum

A novel fluorometric method for the determination of uric acid based on the coupled reactions of uric acid with uricase and peroxidase to form highly fluorescent 2,2'dihydroxy-3,3'-dimethoxy-biphenyl-5,5'-diacetic acid is described. The calibration curve was constructed from a series of standard uric acid solutions vs. the corresponding relative fluorescence. It was linear up to 15 mg/dl (0.9 mmol/l). The serum or plasma samples must be deproteinated with (absolute) ethanol before assay and its uric acid content can be obtained from the calibration curve. This method is rather simple, having good precision and accuracy. High level ascorbic acid in the sample falsely elevates uric acid concentration. Comparison of the results obtained on the patient sera with a colorimetric phosphotungstate method and a standard enzymatic spectrophotometric method gave coefficients of correlation of 0.908 and 0.986, respectively.

Enzymatic determination of serum urea on the surface of silicone-rubber pads

An enzymatic, fluorometric method is described for determination of serum urea on silicone-rubber pads. In this method, the reagents are lyophilized on the surface of the pads, NADH on one side and a mixture of urease, glutamate dehydrogenase, and alpha-ketoglutarate on the other. The rate of disappearance of NADH fluorescence at 460nm (excitation wavelength, 340 nm) is monitored and related to serum urea concentration. The calibration curve is linear to 250 mg of urea per liter. The method affords a rapid, simple, and inexpensive means for urea assay, the results of which correlate well with automatic diacetyl monoxime method (correlation coefficient, 0.998).