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Xue M, Turpin W, Haim L, Lee SH, Neustaeter A, Mei D, Xu W, Espin-Garcia O, Madsen KL, Guttman DS, Griffiths AM, Huynh H, Turner D, Panancionne R, Steinhart H, Aumais G, Bitton A, Jacobson K, Mack D, Croitoru K. A198 THE LONG-TERM IMPACT OF ENVIRONMENTAL EXPOSURES ON HOST HEALTH AND THE RISK FACTORS OF CROHN'S DISEASE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991169 DOI: 10.1093/jcag/gwac036.198] [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: 03/09/2023] Open
Abstract
Background Several environmental factors are associated with Crohn’s disease (CD) in large case-control studies; however, it is not clear how these factors maybe be influenced by age of exposure and if they are related to alterations in pre-disease biological markers of CD risk. Purpose To investigate the association between environmental factors in different age groups with future risk of CD onset and assess their relation to other pre-disease biomarkers. Method We used an environmental risk assessment questionnaire (ERA) to collect information from healthy first-degree relatives(FDR) of CD enrolled in the CCC-GEM project. ERA was a multi-item questionnaire querying 69 questions under 7 section headings: background, cultural/ethnic, smoking history, medical history, family history, environmental history and pet history. For the environmental and pet sections, current and historical (<1, 2-4, 5-15 years old) data was captured at the time of recruitment. We used Cox proportional hazard models to identify exposures associated with future CD onset. Next, we used regression models to identify the relationship of exposures with biological factors associated with CD risk previously identified by our group i.e.: i) intestinal permeability using urinary fractional excretion of lactulose to mannitol ratio (LMR) with LMR≥0.025 defined as abnormal; ii) subclinical inflammation using fecal calprotectin (FCP) with FCP≥100µg/g; and iii) fecal microbiome composition and diversity using 16S rDNA sequencing. Two-sided p<0.05 (or false discovery rate corrected p<0.05) were considered significant. Result(s) A total of 4289 FDRs were recruited, 47% were male, median recruitment age was 17.0 years[6-35]. After a median follow-up of 5.6-years (IQR=3.42-8.67), 86 FDRs developed CD. Living with a dog between age 5-15 (Hazard Ratio (HR)=0.61; 95% confidence interval (CI)=0.39-0.95), and a large family size (>3) in the first year of life (HR=0.41; 95% CI=0.22-0.89) were protective against CD onset. Conversely, having a bird at time of survey (HR=2.84; CI=1.37-5.90), and having a sibling with CD (HR=2.07; 95% CI=1.18-3.63) were risk factors for CD onset. We found that owning a dog between age of 5-15 (Odd Ratio(OR)=0.77, 95% CI=0.65-0.90) was significantly associated with LMR, nine taxa bacterial and higher chao1 diversity index. Having a bird at time of survey was significantly associated with FCP (OR=2.04, 95% CI=1.33-3.11). There was no association between large family size and having a CD sibling with gut microbiome, FCP or LMR. Conclusion(s) The study identified four environmental factors associated with future development of CD. Among them, exposure to dogs during early life was protective against CD onset and might be explained by its association with normal gut permeability and microbiome. We also identified that having a bird at recruitment increased risk of CD onset which might be mediated by an increase in subclinical inflammation. Submitted on behalf of the CCC-GEM consortium Disclosure of Interest None Declared
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Affiliation(s)
- M Xue
- Lunenfeld-Tanenbaum Research Institute
| | - W Turpin
- Lunenfeld-Tanenbaum Research Institute
| | - L Haim
- Lunenfeld-Tanenbaum Research Institute
| | - S -H Lee
- Lunenfeld-Tanenbaum Research Institute
| | | | - D Mei
- Dalla Lana School of Public Health, University of Toronto, Toronto
| | - W Xu
- Dalla Lana School of Public Health, University of Toronto, Toronto
| | - O Espin-Garcia
- Dalla Lana School of Public Health, University of Toronto, Toronto
| | | | - D S Guttman
- Department of Cell & Systems Biology, University of Toronto
| | - A M Griffiths
- Paediatrics, The Hospital for Sick Children, Toronto, Canada
| | - H Huynh
- University of Alberta, Alberta
| | - D Turner
- The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | | | | | | - K Jacobson
- University of British Columbia, Vancouver
| | - D Mack
- Children’s Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada
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Olivera P, Martinez-Lozano H, Leibovitzh H, Xue M, Xu W, Espin-Garcia O, Madsen K, Meddings J, Guttman D, Griffiths A, Huynh H, Turner D, Panancionne R, Steinhart H, Aumais G, Jacobson K, Mack D, Marshall J, Moayyedi P, Lee SH, Turpin W, Croitoru K. A39 HEALTHY FIRST-DEGREE RELATIVES FROM MULTIPLEX FAMILIES VERSUS SIMPLEX HARBOR A HIGHER RISK OF DEVELOPING CROHN'S DISEASE AND ARE ASSOCIATED WITH SUBCLINICAL INFLAMMATION AND ALTERED MICROBIOME COMPOSITION. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991131 DOI: 10.1093/jcag/gwac036.039] [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: 03/09/2023] Open
Abstract
Background Healthy individuals within families with multiple affected members (multiplex families) with Crohn’s disease (CD) have a notably high risk of developing CD. No large prospective pre-disease cohort has assessed differences in preclinical intestinal inflammation, permeability, fecal microbiome, and genetics in healthy at-risk subjects from multiplex families. Purpose We aimed to assess differences in subclinical gut inflammation, genetic risk, gut barrier function, and fecal microbiota composition between first-degree relatives (FDRs) from families with 2 or more affected members (multiplex) and families with only one affected member (simplex). Also, we aimed to assess the risk of future CD onset in subjects from multiplex versus simplex families. Method We utilized the GEM Project cohort of healthy FDRs of CD patients. Subclinical gut inflammation was assessed using fecal calprotectin (FCP) at recruitment. Gut barrier function was assessed using the lactulose-to-mannitol ratio (LMR). For assessment of the CD-related genetic risk, CD-polygenic risk scores (CD-PRS) were calculated. Microbiome composition was assessed by sequencing fecal 16S ribosomal RNA. Generalized estimating equations logistic regression and LEfSe (PMID: 21702898) were used to assess the associations between multiplex status and different outcomes. A Cox proportional hazards model was used to assess time-related risk of future onset of CD. Result(s) 4385 subjects were included. Median age was 17 [IQR 12-24] years, 52.9% were female, 69.4% were siblings and 30.6% were offspring. 4052 (92.4%) and 333 (7.6 %) were simplex and multiplex subjects, respectively. After adjusting for age, sex, family size, and relation to proband, multiplex status was significantly associated with higher baseline FCP (p=0.038), but was not associated with either baseline LMR or CD-PRS (p=0.19 and p=0.33, respectively). We found no significant differences in alpha diversity (Shannon index) (p=0.57) between simplex and multiplex subjects. Beta diversity analysis assessed by the Bray-Curtis dissimilarity index did not reveal significant differences (R2=3e-04, p=0.607). The genera Eisenbergiella, Eggerthellaceae uncultured, and Morganella, were significantly more abundant in multiplex subjects, whereas Lachnospira, Sutterella, Lachnospiraceae_NK4A136_group, and Lachnospiraceae_UCG_004 less abundant. The risk of CD onset was significantly higher in multiplex subjects. In multivariable analysis, multiplex status at recruitment was associated with increased risk of CD onset (adjusted HR 3.41, 95% CI 1.70-6.87, p=0.00055), after adjusting for demographics, FCP, LMR, and CD-PRS. Conclusion(s) Multiplex status compared to simplex is associated with a 3.4-fold increased risk of CD onset, a higher FCP, and fecal bacterial composition. A comprehensive assessment of environmental factors that increase CD risk in multiplex families remains to be elucidated in future studies. Disclosure of Interest None Declared
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Affiliation(s)
- P Olivera
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - H Martinez-Lozano
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - H Leibovitzh
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - M Xue
- Temerty Faculty of Medicine
| | - W Xu
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto
| | - O Espin-Garcia
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto
| | | | - J Meddings
- Department of Medicine, Cumming School of Medicine, Calgary
| | - D Guttman
- Department of Cell & Systems Biology,Centre for the Analysis of Genome Evolution & Function
| | - A Griffiths
- IBD Center, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto
| | - H Huynh
- Division of Gastroenterology and Nutrition, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - D Turner
- The Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - R Panancionne
- Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology of Gastroenterology, University of Calgary, Calgary
| | - H Steinhart
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - G Aumais
- Department of Medicine, Hôpital Maisonneuve-Rosemont, Montreal University, Montreal
| | - K Jacobson
- British Columbia Children's Hospital, British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver
| | - D Mack
- Division of Gastroenterology, Hepatology & Nutrition, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa
| | - J Marshall
- Department of Medicine, McMaster University, Hamilton, Canada
| | - P Moayyedi
- Department of Medicine, McMaster University, Hamilton, Canada
| | - S -H Lee
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - W Turpin
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
| | - K Croitoru
- Division of Gastroenterology & Hepatology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital,Temerty Faculty of Medicine
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Neustaeter A, Lee SH, Xue M, Leibovitzh H, Madsen K, Meddings JB, Espin-Garcia O, Griffiths AM, Moayyedi P, Steinhart AH, Panancionne R, Huynh H, Jacobson K, Aumais G, Mack D, Bernstein C, Marshall JK, Xu W, Turpin W, Croitoru K. A218 ASSOCIATIONS BETWEEN ADHERENCE TO LITERATURE-DERIVED DIETARY INDICES AND PRE-DISEASE BIOMARKERS: IMPLICATIONS FOR CROHN’S DISEASE PREVENTION. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991210 DOI: 10.1093/jcag/gwac036.218] [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: 03/09/2023] Open
Abstract
Background The incidence of Crohn’s disease (CD) is increasing globally, indicating a significant environmental influence such as diet. A plethora of dietary adherence (DA) patterns exist in the literature: the Mediterranean Diet (MD), Empirical Dietary Inflammatory Pattern (EDIP), Specific Carbohydrate Diet (SCD), and low Fermentable Oligosaccharide, Disaccharide, Monosaccharide, or Polyol diet (FODMAP) are all potential candidates to maintain a reduced level of inflammation, improving gastrointestinal function. Contrary, the Westernized diet (WD) is generally reported as a diet promoting inflammation in humans. Purpose To determine if DA to literature-derived dietary indices in a cohort of first-degree relatives (FDRs) of CD patients can modulate pre-disease biomarkers. Method We used food frequency questionnaire (FFQ) data from 2,696 healthy FDR subjects of the Crohn’s Colitis Canada- Genes, Environment, Microbial (CCC-GEM) project. We rederived each of the following scores using our FFQ data, utilizing originally described methods for the MD, EDIP, SCD, low FODMAP, and WD to obtain DA. Each diet was correlated pairwise via Kendall’s Tau. We fit multivariable regression models to identify the association of DA (top quintile vs remaining) and: i) intestinal permeability using urinary fractional excretion of lactulose to mannitol ratio (LMR), LMR≥0.03 defined abnormal; ii) subclinical inflammation using fecal calprotectin (FCP) measured with BÜHLMANN fCAL® ELISA, FCP≥250µg/g defined inflammation; and iii) fecal microbiome richness and composition using 16S rRNA sequencing. Two-sided p<0.05 for primary and q<0.05 for secondary analysis defined significance. Result(s) There were positive correlations between the MD, SCD, and low FODMAP, these diets negatively correlated with the WD. The EDIP negatively correlated with the SCD and low FODMAP, did not correlate with the MD, and positively correlated with the WD. No diet was associated with abnormal LMR or FCP. Only the SCD was associated with increased microbial richness (q=0.03). All diets were associated with microbial genera: the MD (n=18 taxa, (2.0-7<q-values< 0.04), EDIP (n=9, [2.8-4-0.05]), SCD (n=13, [3.7-11-0.05]), low FODMAP (n=14, [1.3-7-0.05]), and WD (n=1, [0.03]). Conclusion(s) This study shows that literature-derived dietary indices correlate generally with each other, yet none were not associated with abnormal LMR or FCP. However, we found that diet can impact microbiome richness and composition. Thus, it is tempting to speculate that diet is a possible intervention capable of maintain microbiome homeostasis to reduce future risk of CD. Submitted on behalf of the CCC-GEM consortium. Funding Crohn’s and Colitis Canada Genetics Environment Microbial (CCC-GEM) III The Leona M. and Harry B. Helmsley Charitable Trust Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Disease Disclosure of Interest None Declared
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Affiliation(s)
| | | | - M Xue
- University of Toronto, Toronto
| | | | | | | | | | | | | | | | | | - H Huynh
- University of Alberta, Calgary
| | - K Jacobson
- University of British Columbia, Vancouver
| | | | - D Mack
- University of Ottawa, Ottawa
| | | | | | - W Xu
- University of Toronto, Toronto
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4
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Neustaeter A, Shao J, Xue M, Antonio Hernández Rocha C, Lee SH, Leibovitzh H, Madsen K, Meddings JB, Espin-Garcia O, Griffiths AM, Moayyedi P, Steinhart AH, Panancionne R, Huynh H, Jacobson K, Aumais G, Mack D, Bernstein C, Marshall JK, Xu W, Turpin W, Croitoru K. A238 BILE ACID COMPOSITION AND DIETARY FAT: IMPLICATIONS FOR CROHN’S DISEASE IN A COHORT OF HEALTHY FIRST-DEGREE RELATIVES. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991268 DOI: 10.1093/jcag/gwac036.238] [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: 03/09/2023] Open
Abstract
Background Crohn’s disease (CD) is a chronic relapsing inflammatory disease of the gastrointestinal tract. The etiology of CD may arise from complex interactions including host genetics, diet, and the intestinal microbiome. Increased consumption of saturated fats, characteristic of the Western diet, is a known risk factor for CD. Dietary fat (DF) is absorbed by the host through the release of primary bile acids (PBAs) and bio-transformed by the microbiome into secondary bile acids (SBAs). Altogether, bile acids (BAs) can act as signaling molecules involved in host immune regulation and potentially in CD onset. Purpose To investigate the relationship between CD risk, BAs, and DF, and evaluate the predictive performance of CD onset of these factors by developing machine learning models. Method We used samples healthy first-degree relatives (FDRs) recruited as part of the Crohn’s Colitis Canada- Genes, Environment, Microbial (GEM) project. Those who developed CD (n=87) were matched 1:4 by age, sex, follow-up time, and geographic location with control FDRs remaining healthy (n=347). Serum, urine, and stool BA were measured using ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy. DF types were derived from food frequency questionnaire data. We used conditional logistic regressions to identify associations between CD onset, BAs (n=93), and DFs (n=9). We further explored the relationships of significant CD-related BAs and DF via Generalized Estimation Equations. Finally, we used a tree-based machine-learning algorithm (XGBoost) with 5-fold cross-validation to assess the prediction performance of CD onset using BA from all sources as well as DF. Two-sided p<0.05 was considered significant. Result(s) In total, 10 of 93 BAs, and two of nine DFs were significantly associated with increased odds of CD onset (p<0.05). Additionally, five BAs were significantly associated with DF (p<0.05). Serum-derived BAs had the best predictive performance for CD, with a mean AUC of 0.70 [95% CI: 0.63;0.76], followed by stool derived BAs with a mean AUC= 0.65 [0.55;0.75], and followed by urine derived Bas with a mean AUC= 0.57 [0.48;0.66]. Lastly DF was not a predictive marker of CD onset with a mean AUC= 0.50 [0.41;0.60]. Conclusion(s) This study suggests that BAs are associated with the pathogenesis of CD and the effects may be influenced by DF. Serum-derived BAs may be able to better predict the risk of CD than other stool or urine derived BA, while DF is not directly implicated in CD risk. Submitted on behalf of the CCC-GEM consortium. Funding Crohn’s and Colitis Canada Genetics Environment Microbial (CCC-GEM) III The Leona M. and Harry B. Helmsley Charitable Trust Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Diseases The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) Jingcheng Shao is the recipient of a Data Science Institute Summer Undergraduate Data Science award Disclosure of Interest None Declared
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Affiliation(s)
| | - J Shao
- University of Toronto, Toronto
| | - M Xue
- University of Toronto, Toronto
| | | | | | | | | | | | | | | | | | | | | | - H Huynh
- University of Alberta, Calgary
| | - K Jacobson
- University of British Columbia, Vancouver
| | | | - D Mack
- University of Ottawa, Ottawa
| | | | | | - W Xu
- University of Toronto, Toronto
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5
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Leibovitzh H, Lee S, Xue M, Raygoza Garay J, Hernandez-Rocha C, Madsen K, Meddings J, Guttmen DS, Espin Garcia O, Goethel A, Griffiths A, Moayyedi P, Huynh HQ, Jacobson K, Mack DR, Abreu M, Bernstein CN, Marshall J, Turner D, Xu W, Turpin W, Croitoru K. A238 ALTERED GUT MICROBIOME COMPOSITION AND FUNCTION ARE ASSOCIATED WITH GUT BARRIER DYSFUNCTION IN HEALTHY RELATIVES OF CROHN’S DISEASE PATIENTS. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859348 DOI: 10.1093/jcag/gwab049.237] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The gut microbiome may play a role in gut barrier homeostasis including epithelial barrier function, but data are scarce and limited to animal studies Aims To assess if alterations in gut microbiome are associated with gut barrier function Methods We utilized the Genetic Environmental Microbial (CCC GEM) cohort of healthy first-degree relatives (FDRs) of Crohn’s disease (CD) patients. Gut barrier function was assessed using the ratio of urinary fractional excretion of lactulose to mannitol (LMR). Stool bacterial DNA was extracted and sequenced for the V4 hypervariable region of the 16S rRNA gene using MiSeq and processed using QIIME2. Microbial functions were imputed using PICRUSt2. The cohort was divided into a North American discovery cohort (n=2,472) and non-North American external validation cohort (n=655). LMR>0.025 was defined as abnormal. LMR-microbiome associations were assessed using multivariable regression model and Random Forest (RF) classifier algorithm. q<0.05 was considered significant when multiple tests were performed Results The median age of the entire cohort was 17.0 years [IQR 12.0; 24.0], 52.6% were females and 25.4% had LMR>0.025. In the discovery cohort, subjects with LMR>0.025 had markedly reduced alpha diversity (Chao1 index, estimate= -0.0037, p=4.0e-04) and altered beta diversity (Bray-Curtis dissimilarity index, PERMANOVA: pseudo-F statistic = 2.99, p=1.0e-03). We identified eight bacterial genera and 52 microbial pathways associated with LMR>0.025 (q<0.05). Four genera (decreased Adlercreutzia [odds ratio(OR)=0.74, 95% confidence interval (CI) 0.6–0.91], Clostridia-UCG-014 [OR=0.71, 95%CI 0.59–0.86], and Clostridium-sensu-stricto-1 [OR=0.75, 95%CI 0.61–0.92] and increased Colidextribacter [OR=1.65, 95%CI 1.2–2.26]) and eight pathways (including decreased biosynthesis of glutamate [OR=0.4, 95%CI 0.21–0.74], tryptophan [OR=0.06, 95%CI 0.01–0.27] and threonine [OR=0.038, 95%CI 0.003–0.41]) were replicated. Bacterial community composition was associated with gut barrier homeostasis as defined by the RF analysis (p= 1.4e-6) Conclusions Gut microbiome community and pathways are associated with gut barrier function. These findings may identify potential microbial targets to modulate barrier function Submitted on behalf of the CCC-GEM Consortium Funding Agencies CCC, CIHRCrohn’s and Colitis Canada Genetics Environment Microbial (CCC-GEM) III; The Leona M. and Harry B. Helmsley Charitable Trust; Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Diseases
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Affiliation(s)
- H Leibovitzh
- University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
| | - S Lee
- University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
| | - M Xue
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, ON, Canada
| | - J Raygoza Garay
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, ON, Canada
| | - C Hernandez-Rocha
- University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
| | - K Madsen
- University of Alberta, Edmonton, AB, Canada
| | - J Meddings
- University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - D S Guttmen
- University of Toronto Department of Cell and Systems Biology, Toronto, ON, Canada
| | - O Espin Garcia
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada
| | - A Goethel
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, ON, Canada
| | - A Griffiths
- The Hospital for Sick Children, Toronto, ON, Canada
| | - P Moayyedi
- McMaster University Department of Medicine, Hamilton, ON, Canada
| | - H Q Huynh
- University of Alberta, Edmonton, AB, Canada
| | - K Jacobson
- BC Children’s Hospital, Vancouver, BC, Canada
| | - D R Mack
- University of Ottawa, Ottawa, ON, Canada
| | - M Abreu
- University of Miami School of Medicine, Miami, FL
| | | | - J Marshall
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - D Turner
- Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel
| | - W Xu
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada
| | - W Turpin
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, ON, Canada
| | - K Croitoru
- University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
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6
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Neustaeter A, Timpano J, Lee S, Xue M, Leibovitzh H, Madsen K, Meddings J, Espin-Garcia O, Goethel A, Griffiths A, Moayyedi P, Steinhart H, Panaccione R, Huynh HQ, Jacobson K, Aumais G, Mack DR, Bernstein CN, Marshall J, Xu W, Turpin W, Croitoru K. A157 DEFINITIONS OF MEDITERRANEAN DIET INCONSISTENTLY ASSOCIATE WITH MARKERS OF GUT BARRIER FUNCTION OR SUBCLINICAL INFLAMMATION IN A POPULATION-BASED COHORT. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859210 DOI: 10.1093/jcag/gwab049.156] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Mediterranean Diet (MD) is proposed to reduce the risk of Crohn’s disease (CD) onset in cohort studies, with inconsistent results. This inconsistency may be due to heterogeneity in defining MD scores. Additionally, relationships between MD compliance and intestinal permeability or sub-clinical inflammation are not defined.
Aims
We examined correlations between different MD scores, and determined associations between MD compliance and intestinal permeability or subclinical inflammation in a cohort of first degree relatives of CD patients.
Methods
We used food frequency questionnaire data from 2,112 subjects of the Crohn’s Colitis Canada- Genes, Environment, Microbial (CCC-GEM) project. We obtained 12 MD definitions from the literature and calculated daily percent compliance, we further compared MD scores via pairwise correlations (Kendall’s Tau). We measured intestinal permeability via urinary fractional excretion ratio of lactulose to mannitol (LMR) (LMR≥0.03 defined abnormal), and subclinical inflammation via fecal calprotectin (FCP) measured with BÜHLMANN fCAL® ELISA (FCP≥250 defined abnormal). We fit multivariable regression models between MD compliance and abnormal LMR and FCP, respectively. Two-sided p<0.05 defined significance.
Results
There was large variation in cross-correlations among MD scores, from nil (t=0.0, p=0.54) to highly significant (t=0.97, p<2.2e-16). Associations of MD compliance and abnormal LMR or FCP were in both directions of effect, largely non-significant. Of the 12 MD scores, none associated with abnormal LMR, while 4 associated with abnormal FCP-Odds Ratios =1.22, 1.23, 1.24, and 1.30; p=0.02, 0.02, 0.01, and 0.009, and 95% Confidence Intervals = [1.03,1.45], [1.04,1.45], [1.05,1.47], and [1.07,1.59] respectively. No diet remained significant after correcting for multiple testing.
Conclusions
Currently MD definitions vary widely. Despite discrepancies, we expected consistent directions of effect for MD compliance on LMR or FCP. The largely non-significant associations between MDs suggest limitations in definition, interpretation, and relation to biological outcomes.
Submitted on behalf of the CCC-GEM consortium.
Funding Agencies
CIHRCrohn’s and Colitis Canada Genetics Environment Microbial (CCC-GEM) III;The Leona M. and Harry B. Helmsley Charitable Trust; Justine Timpano is a recipient of a fellowship award from Mount Sinai Hospital; Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Diseases
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Affiliation(s)
- A Neustaeter
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Zane Cohen Centre for Digestive Diseases, Toronto, ON, Canada
| | - J Timpano
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Zane Cohen Centre for Digestive Diseases, Toronto, ON, Canada
| | - S Lee
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Zane Cohen Centre for Digestive Diseases, Toronto, ON, Canada
| | - M Xue
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Zane Cohen Centre for Digestive Diseases, Toronto, ON, Canada
| | - H Leibovitzh
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Zane Cohen Centre for Digestive Diseases, Toronto, ON, Canada
| | - K Madsen
- University of Alberta, Edmonton, AB, Canada
| | - J Meddings
- Medicine, University of Calgary, Calgary, AB, Canada
| | - O Espin-Garcia
- Immunology, University of Toronto, Faculty of Medicine, Toronto, ON, Canada
| | - A Goethel
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Zane Cohen Centre for Digestive Diseases, Toronto, ON, Canada
| | - A Griffiths
- Hospital for Sick Children, Toronto, ON, Canada
| | - P Moayyedi
- McMaster University, Hamilton, ON, Canada
| | - H Steinhart
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
| | - R Panaccione
- Medicine, University of Calgary, Calgary, AB, Canada
| | - H Q Huynh
- Pediatrics, University of alberta, Edmonton, AB, Canada
| | - K Jacobson
- BC Children’s Hospital, Vancouver, BC, Canada
| | - G Aumais
- Hopital Maisonneuve-Rosemont, Montreal, QC, Canada
| | - D R Mack
- Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - C N Bernstein
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - J Marshall
- Immunology, University of Toronto, Faculty of Medicine, Toronto, ON, Canada
| | - W Xu
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Zane Cohen Centre for Digestive Diseases, Toronto, ON, Canada
| | - W Turpin
- Mount Sinai Hospital, Joseph and Wolf Lebovic Health Complex, Zane Cohen Centre for Digestive Diseases, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
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7
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Lee S, Raygoza Garay J, Turpin W, Smith MI, Goethel A, Griffiths A, Moayyedi P, Espin-Garcia O, Aumais G, Bernstein CN, Avni-Biron I, Cino M, Deslandres C, Dotan I, El-Matary W, Feagan BG, Guttmen DS, Huynh HQ, Hyams J, Jacobson K, Mack DR, Marshall J, Otley A, Panaccione R, Silverberg MS, Steinhart H, Turner D, Xu W, Croitoru K. A236 ASSOCIATION OF STOOL METABOLOMIC PROFILE AND MICROBIOME COMPOSITION RISK SCORE WITH FUTURE ONSET OF CROHN’S DISEASE. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859353 DOI: 10.1093/jcag/gwab049.235] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Microbial composition-based risk score (MRS) was recently developed and validated to predict future risk of developing Crohn’s disease (CD) among healthy first-degree relatives (FDR) of CD patients. We hypothesized that stool metabolomic profiles, some of which are linked to the gut microbiome, are associated with future risk of CD.
Aims
To assess the association of stool metabolomic profile with onset of CD and to determine the correlation between stool metabolites and the MRS
Methods
Healthy FDR of CD patients were recruited as part of the nested case-control cohort of the CCC-GEM Project. Healthy FDRs who later developed CD (n=56) were matched approximately 1:1 by age, sex, follow-up duration, and geographical location with control FDRs remaining healthy (n=66). Stool metabolomics were assessed using the Metabolon’s DiscoveryHD4™ platform, and the stool microbiome characterised by 16s rDNA amplicon sequencing. We fitted a multivariable conditional logistic regression model on the disease status as a function of individual stool metabolites. We additionally performed Spearman correlation between each stool metabolite and the MRS.
Results
Among 1,029 stool metabolites that were analyzed, 79 were associated with future risk of CD (p<0.05); however, none remained significant after multiple testing correction (FDR correction). Considering the exploratory nature of this study with limited sample size, we focused on the top seven metabolites associated with CD onset (p<0.01). Of these, two stool metabolites (dimethylglycine, methylmyristate) were associated with increased risk of CD onset while five (cytosine, guanine, cytidine, hydroxyglutarate, nervonate) were associated with decreased risk of developing CD. The two metabolites positively associated with CD onset were positively correlated with the MRS, while the five metabolites negatively associated with CD onset, were negatively correlated with the MRS. Meanwhile, 24 stool metabolites had significant correlation with MRS (FDR-corrected p<0.2). Among those, a total of four stool metabolites (cytosine, guanine, methymyristate, cytidine) overlapped with the top seven stool metabolites associated with CD onset.
Conclusions
Stool metabolite profiles may predict future risk of CD. A subset of these metabolites have significant correlation with the MRS with consistent direction of effect. This may suggest that stool metabolites mediate the putative effect of the gut microbiome on CD risk. Further validation in the full GEM cohort is warranted.
Funding Agencies
CCC, CIHRThe Leona M. and Harry B. Helmsley Charitable Trust; Kenneth Croitoru is the recipient of the Canada Research Chair in Inflammatory Bowel Diseases; Sun-Ho Lee is a recipient of the Imagine/ CIHR/CAG Fellowship Award; Sun-Ho Lee, Juan Antonio Raygoza Garay, and Williams Turpin are recipients of fellowship awards from the Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
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Affiliation(s)
- S Lee
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
| | - J Raygoza Garay
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
| | - W Turpin
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
| | - M I Smith
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
| | - A Goethel
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
| | - A Griffiths
- Hospital for Sick Children, Toronto, ON, Canada
| | - P Moayyedi
- McMaster University, Hamilton, ON, Canada
| | - O Espin-Garcia
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada
| | - G Aumais
- Hopital Maisonneuve-Rosemont, Montreal, QC, Canada
| | | | | | - M Cino
- Toronto Western Hospital, Toronto, ON, Canada
| | - C Deslandres
- Service de gastro-entérologie, CHU Sainte-Justine, Montréal, QC, Canada
| | - I Dotan
- Rabin Medical Center, Petah Tikva, Israel
| | | | - B G Feagan
- Western University Schulich School of Medicine & Dentistry, London, ON, Canada
| | | | - H Q Huynh
- Pediatrics, University of alberta, Edmonton, AB, Canada
| | - J Hyams
- Connecticut Children’s Medical Center, Hartford, CT
| | - K Jacobson
- BC Children’s Hospital, Vancouver, BC, Canada
| | - D R Mack
- Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - J Marshall
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - A Otley
- Pediatrics, Dalhousie University, Halifax, NS, Canada
| | | | - M S Silverberg
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
| | - H Steinhart
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
| | - D Turner
- Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel
| | - W Xu
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada
| | - K Croitoru
- Department of Gastroenterology, Mount Sinai Hospital, Toronto, ON, Canada
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8
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Galipeau HJ, CAMINERO FERNANDEZ A, Turpin W, Bermudez-Brito M, Santiago A, Libertucci J, Constante M, Raygoza Garay J, Rueda GH, Clarizio AV, Smith MI, Surette M, Bercik P, Croitoru K, Verdu E. A29 NOVEL FECAL BIOMARKERS THAT PRECEDE CLINICAL DIAGNOSIS OF ULCERATIVE COLITIS. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.028] [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
Altered gut microbiota composition and function has been associated with inflammatory bowel diseases (IBD) including ulcerative colitis (UC), but causality and mechanisms remain unknown. Most studies have examined patients with active or treated disease and little is known about microbial compositional or functional changes that occur before disease onset.
Aims
We studied a longitudinal cohort of subjects at risk for IBD to define the fecal microbial composition and function in subjects prior to UC onset (pre-UC) and at diagnosis (post-UC), and in matched at-risk subjects that remained healthy.
Methods
Fecal samples were collected from healthy individuals at-risk for IBD (pre-UC; n=13) and subjects were followed longitudinally until UC diagnosis (post-UC, n=9), at which point another fecal sample was collected. Fecal samples from a cohort of matched at-risk individuals that did not develop UC were used as healthy controls (n=48). We applied 16S rRNA gene sequencing, next generation shotgun sequencing, in vitro proteolytic assays and gnotobiotic colonizations to define the microbial composition and proteolytic function in fecal samples.
Results
The microbiota of post-UC subjects clustered separately from pre-UC and HC subjects, based on bray-curtis and unweighted UniFrac, had reduced alpha-diversity, and had reduced abundance of Aldercreutzia compared to pre-UC and HC. In vitro functional analysis revealed increased fecal proteolytic and elastase activity in pre-UC and post-UC samples compared to HC. Metagenomics identified pathways and gene families related to protein metabolism and proteases/peptides that were significantly different between HC and pre-UC samples, suggesting a bacterial component to the pre-UC proteolytic signature. Elastase activity inversely correlated with the relative abundance of Adlercreutzia, and other potentially beneficial taxa, and directly correlated with Bacteroides vulgatus, a known proteolytic taxon. High elastase activity was confirmed in Bacteroides isolates from fecal samples. Bacterial contribution and functional significance of the proteolytic signature was investigated in germ-free adults and litters born from dams colonized with HC, pre-UC or post-UC microbiota. Mice colonized with pre-UC microbiota at adulthood or neonatally developed higher fecal proteolytic activity and an inflammatory immune tone compared with HC colonized mice.
Conclusions
We have identified increased fecal proteolytic activity that precedes clinical diagnosis of UC and associates with gut microbiota changes. This may constitute a non-invasive biomarker of inflammation to monitor at-risk populations that can be targeted therapeutically with anti-proteases.
Funding Agencies
CAG, CCC, CIHR
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Affiliation(s)
- H J Galipeau
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - A CAMINERO FERNANDEZ
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - W Turpin
- University of Toronto, Toronto, ON, Canada
| | - M Bermudez-Brito
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - A Santiago
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - J Libertucci
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - M Constante
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | | | - G H Rueda
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - A V Clarizio
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - M I Smith
- Zane Cohen Centre for Digestive Diseases, Mount Sinai, Toronto, ON, Canada
| | - M Surette
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - P Bercik
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - K Croitoru
- Zane Cohen Centre for Digestive Diseases, Mount Sinai, Toronto, ON, Canada
| | - E Verdu
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
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9
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Gryfe MD, Croitoru K, Goethel A, Luchak A. A235 THE INFLUENCE OF IL10 ON COLITIS DEVELOPMENT IN NOD2 DEFICIENT MICE. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.234] [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
Inflammatory bowel disease (IBD) risk genes include interleukin-10 (IL10) and nucleotide-binding oligomerization domain-containing protein 2 (NOD2). Although their specific roles in intestinal inflammation are unclear, these proteins are involved in modulating host-microbe interactions and intestinal homeostasis.
Aims
Since IL10 is an anti-inflammatory cytokine that maintains intestinal homeostasis, we hypothesized that mice deficient for both IL10 and NOD2 would be more susceptible to colitis than mice with only the NOD2 deletion.
Methods
In-house generated NOD2-/- x IL10-/- (double knockout) and NOD2-/- x IL10+/+ littermate mice of varying ages (3–20 weeks of age) were weighed and stools samples were collected at weekly intervals. Lipocalin-2 (LCN-2) levels were quantified in stool by ELISA. A subset of mice from each genotype received 3.5% dextran sulfate sodium (DSS) supplemented water for 5 days starting at eight weeks of age. Mice were sacrificed after two days of regular water, on day 8.
Results
Untreated NOD2-/- x IL10+/+ mice showed higher fecal LCN-2 compared to NOD2-/- x IL10-/- mice at all ages, although this trend was not significant. Within DSS-treated mice, LCN-2 levels in stool collected at sacrifice (on day 8) were significantly higher in NOD2-/- x IL10+/+ mice, compared to NOD2-/- x IL10-/- mice. Moreover, only 50% (2 of 4) of the NOD2-/- x IL10+/+ DSS-treated mice survived to day 8, whereas all four NOD2-/- x IL10-/- DSS-treated mice survived.
Conclusions
Fecal LCN-2 indicates the extent of neutrophil infiltration, which is reflective of the severity of intestinal inflammation. As such, LCN-2 levels suggest that NOD2-/- x IL10+/+ mice have higher baseline inflammation and are more susceptible to DSS-induced colitis than double knockout NOD2-/- x IL10-/- mice. These results are contrary to our hypothesis that combining IL10 and NOD2 deficiency would increase colitis susceptibility as compared to NOD2 deficiency alone. This suggests that the absence of IL10 may actually reduce the severity of DSS-induced colitis in NOD2 deficient mice. The role of IL10 in modulating the gut microbiome using this model remains to be assessed.
Funding Agencies
CAG
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Affiliation(s)
- M D Gryfe
- Science, Western University, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
| | - A Goethel
- University of Toronto, Toronto, ON, Canada
| | - A Luchak
- University of Toronto, Toronto, ON, Canada
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10
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Santiago Badenas A, Libertucci J, Turpin W, Galipeau HJ, Croitoru K, Caminero Fernandez A, Verdu E. A210
ADLERCREUTZIA IS DEPLETED IN UC PATIENTS, EVEN BEFORE CLINICAL DIAGNOSIS, AND INVERSELY CORRELATES WITH FECAL ELASTOLYTIC ACTIVITY. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.209] [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
A combination of genetics, environmental, and immune factors contribute to the development of ulcerative colitis (UC). Host proteolytic imbalance has been reported in active UC. Preliminary results from our lab suggest microbial proteolytic activity is increased before as well as after onset of UC, and transfer of this activity to mice contributes to inflammation.
Aims
Our aim was to correlate the elastolytic activity of fecal samples from individuals at risk for IBD, before and after onset of ulcerative colitis, with their fecal microbiota profiles
Methods
We first investigated proteolytic activity in fecal samples from individuals at risk to develop UC (pre-UC, n=12) prior to disease onset and after UC diagnosis (post-UC, n=7) and matched healthy controls (n=66). Microbial community analysis was performed by sequencing the V4 region of the 16S rRNA gene region using Illumina MiSeq platform. Sequences were analyzed with QIIMEv1.9.0. We measured bacterial proteolytic activity, using a FITC-elastin assay.
Results
Microbial community analysis revealed that the overall diversity (both richness and evenness) in UC patients was decreased compared to healthy controls as well as pre-UC patients. The relative abundance of the genus Adlercreutzia was decreased by 3.1 fold in pre-UC patients compared to healthy controls and was further decreased in post-UC (3.8 fold). The presence of Adlercreutzia was also found to be negatively correlated (r=-0.47, p<0.0001) with elastolytic activity in stool supernatant, suggesting a possible protective role in the disease.
Conclusions
We found novel potentially protective bacteria, Adlercreutzia, which was depleted in UC patients, even before clinical diagnosis and correlated negatively with proinflammatory elastolytic activity described previously in IBD. The protective mechanisms are under investigation.
On behalf of the CCC-GEM Project consortiumand Supported by a CCC GIA to EFV
Funding Agencies
CCC
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Affiliation(s)
| | - J Libertucci
- Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - W Turpin
- University of Toronto, Toronto, ON, Canada
| | - H J Galipeau
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
| | - A Caminero Fernandez
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - E Verdu
- McMaster University, Hamilton, ON, Canada
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11
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Lee S, Shestopaloff K, Espin-Garcia O, Turpin W, Raygoza Garay J, Power N, Smith M, Silverberg M, Xu W, Paterson AD, Croitoru K. A221 CROHN’S DISEASE POLYGENIC RISK SCORE IS ASSOCIATED WITH FECAL CALPROTECTIN CONCENTRATION IN ASYMPTOMATIC FIRST-DEGREE RELATIVES OF CROHN’S DISEASE PATIENTS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.220] [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
Fecal calprotectin concentration (FC), a measure of gut inflammation is reported to be significantly higher in healthy first-degree relatives (FDR) of Crohn’s disease (CD) patients compared to healthy controls. In contrast, FC in spouses of CD patients was not significantly different from controls, suggesting that a genetic predisposition rather than a shared environmental factor affects FC.
Aims
We investigated the genetic association with FC in healthy FDRs of CD patients. Notably, these subjects are known to be enriched with CD risk alleles.
Methods
We investigated 1455 healthy Caucasian FDRs of CD patients from the GEM Project. Subjects were genotyped by HumanCoreEXOME chip and ImmunoChip platforms and then imputed by the Haplotype Reference Consortium v1.1 panel (Michigan Imputation Server). SNPs with a minor allele frequency<5% were removed. FC was measured using BUHLMANN ELISA kit. Heritability was estimated using a pedigree based SOLAR program and a SNP-based GCTA software. Genome wide association of FC was tested using the GEE framework that accounts for family clusters, age, sex, first 3 genetic principal components and multiplex family status (≥2 FDRs diagnosed with CD). In addition, CD-polygenic risk scores were derived based on summary statistics and imputed SNPs from a recent GWAS by pruning and thresholding (P+T) and LDPred algorithm (PMID:31002795).
Results
Among 1455 subjects, 45.2% were male, median age was 19 years (IQR 13–26), 8.8% were from multiplex families, and median FC was 52 mg/kg (IQR 31–87; 20.8% had FC>100). We estimated the heritability of FC to be 27% (27.1%, standard error=9%, p<0.001 by pedigree approach; 27.9%, SE=12%, p<0.001 by SNP approach). An untargeted GWAS failed to show any significant association with FC (i.e. p<5x10-8). The lowest p value was obtained for rs224631 (p=5x10-7). Strikingly, an increase in CD polygenic risk scores was significantly associated with an increase of FC (p=5.2x10-5 with P+T method).
Conclusions
We demonstrate that FC concentration is a heritable trait in unaffected FDRs of CD patients. Although the association between genetic variants with FC did not reach GWAS significance, CD-polygenic risk score, which incorporates small effect size CD-associated SNPs, was significantly associated with FC concentrationin this cohort. Our results suggest that FC concentration is influenced genetically with contributions from CD-associated SNPs in unaffected FDRs of CD probands. It remains to be determined if the genetic influence to FC concentration is dependent/independent with the future development of CD.
Submitted on behalf of The CCC-GEM Project research team
Funding Agencies
CCCHelmsley Charitable Trust/ Mount Sinai Hospital Fellowship Award
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Affiliation(s)
- S Lee
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - K Shestopaloff
- Division of Biostatistics, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - O Espin-Garcia
- Division of Biostatistics, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - W Turpin
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - J Raygoza Garay
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - N Power
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - M Smith
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - M Silverberg
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - W Xu
- Division of Biostatistics, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - A D Paterson
- Division of Biostatistics, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - K Croitoru
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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12
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Raygoza Garay J, Turpin W, Smith M, Goethel A, Guttman DS, Croitoru K. A17 ASSOCIATION BETWEEN HOST INFLAMMATION-RELATED PROTEOMICS AND GUT MICROBIOME IN HEALTHY FIRST-DEGREE RELATIVES OF CROHN’S DISEASE PATIENTS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.016] [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
Crohn’s disease (CD) is a chronic inflammatory condition of the gastrointestinal tract. It has been suggested that the cause of CD is due to microbial and environmental factors that induce an imbalance of the immune system in genetically susceptible individuals. The Genetic Environmental Microbial (GEM) Project is a prospective study of asymptomatic first-degree relatives (FDR) of CD patients, recruited to understand the biological and environmental determinants of disease development.
Aims
Here, we aim to define the relationships between the host inflammation-related proteomics and gut microbiome composition in a cohort of 320 healthy CD FDRs at the time of recruitment.
Methods
We measured 92 inflammation-related serum proteins using the Olink® ’Inflammation’ proteomics panel. Stool microbial composition was determined by sequencing the V4 region of the 16S rRNA. To assess the relationship between serum protein levels and the relative abundance of microbial taxa, we used a zero-inflated two-part regression model corrected for multiple-comparisons (significant association at p< 2.75 × 10–4).
Results
We found fifteen serum proteins that were each significantly associated with the relative abundances of one to five genera or families, depending on the analyte. Of particular interest to CD, the relative abundance of both TNF-β and LIGHT (TNFSF14) were negatively associated with the relative abundance of bacteria in the Parabacteroides genus. Both TNF-β and LIGHT are members of the Tumor Necrosis Factor (TNF) family of cytokines with roles in mucosal healing, IgA production, and in control of innate lymphoid cells (ILCs). These processes have been hypothesized to have critical roles in CD pathology. Interestingly, prior work also demonstrates that Parabacteroides distasonis enhanced colitis in a mouse model and was isolated from a gut wall-cavitating microlesion in a patient with severe CD. Other inflammation-related proteins with significant taxa associations include IL-2, IL-33, OSM, 4E_BP1, IL-1α, ARTN, AXIN1, and CDCP1.
Conclusions
This study highlights the associations between inflammation associated proteomics and gut microbial taxa in asymptomatic FDRs of CD patients. The mechanisms explaining this association will require further analysis.
Funding Agencies
CCC The Leona M. and Harry B. Helmsley Charitable Trust
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Affiliation(s)
| | - W Turpin
- University of Toronto, Toronto, ON, Canada
| | - M Smith
- Medicine, University of Toronto, Toronto, ON, Canada
| | - A Goethel
- Immunology, University of Toronto, Faculty of Medicine, Toronto, ON, Canada
| | - D S Guttman
- Medicine, University of Toronto, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
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13
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Galipeau HJ, Turpin W, Caminero Fernandez A, Santiago A, Libertucci J, Bermudez-Brito M, Armstrong S, Bedrani L, Croitoru K, Verdu E. A35 MICROBIAL PROTEOLYTIC SIGNATURE IN ULCERATIVE COLITIS INDUCES AN INFLAMMATORY SIGNATURE IN MICROBIOTA-HUMANIZED MICE. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.034] [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
Altered gut microbiota composition has been associated with inflammatory bowel diseases (IBD) including ulcerative colitis (UC), but causality and bacterially-driven mechanisms, are unclear. Proteases within the gastrointestinal tract play a critical role in maintaining homeostasis and are tightly regulated by anti-proteases. Host-derived proteolytic imbalances have been described in IBD, including UC, however, the role of intestinal microbiota as a source of proteases and anti-proteases has largely been ignored.
Aims
To study microbial proteolytic activity and intestinal microbiota profiles in a cohort of individuals at-risk for IBD, and in those individuals that develop UC at follow-up.
Methods
Fecal samples were collected from healthy individuals at-risk for IBD and who went on to develop UC (pre-UC; n=14) and again after UC diagnosis (post-UC, n=10). Fecal samples from matched at-risk individuals that did not develop UC were used as healthy controls (n=52). Overall fecal proteolytic and elastolytic activity was measured. We performed metagenomics sequencing in 4 UC subjects (pre and post) and 4 matched HC using Illumina Hi-Seq from stool DNA. To investigate bacterial origin and functional significance, pregnant germ-free (GF) mice were colonized with a fecal sample from a selected UC subject (pre and post) and a matched HC. Naturally colonized litters were followed for 12 weeks, after which proteolytic activities and signs of inflammation were measured.
Results
Fecal proteolytic and elastase activity was increased in pre- and post-UC samples compared to HCs. Metagenomics revealed over 20k genes were significantly different between HC and pre-UC samples, and of these, 440 related to proteases and peptidases. Increased fecal proteolytic activity, higher lipocalin levels, and increased colonic polymorphonuclear cells in colonic H&E sections was observed in pre- and post-UC colonized mice compared to HC colonized mice. Mice colonized with pre-UC microbiota showed increased mRNA expression of genes linked to immunological disease, antimicrobial and inflammatory responses (ie. Tlr2, Tlr5, Nod2, and Il1b) as compared to HC colonized mice.
Conclusions
These results suggest increased fecal proteolytic activity is observed prior to the onset and clinical diagnosis of UC in patients at-risk for IBD, and upon transfer to mice born from colonized GF dams, low-grade inflammation develops. These pathways could be developed as novel non-invasive biomarkers to monitor at-risk populations. Submitted on behalf of the CCC-GEM Project consortium. Supported by CCC GIA to EF Verdu
Funding Agencies
CCC
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Affiliation(s)
- H J Galipeau
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - W Turpin
- University of Toronto, Toronto, ON, Canada
| | - A Caminero Fernandez
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - A Santiago
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - J Libertucci
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - M Bermudez-Brito
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - S Armstrong
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - L Bedrani
- University of Toronto, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
| | - E Verdu
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
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14
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Goethel A, Turpin W, Rouquier S, Zanello G, Robertson SJ, Streutker CJ, Philpott DJ, Croitoru K. Nod2 influences microbial resilience and susceptibility to colitis following antibiotic exposure. Mucosal Immunol 2019; 12:720-732. [PMID: 30651577 DOI: 10.1038/s41385-018-0128-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 12/05/2018] [Accepted: 12/16/2018] [Indexed: 02/04/2023]
Abstract
Inflammatory bowel disease (IBD) etiology involves genetic susceptibility, environmental triggers, and the gut microbiome. Antibiotic exposure is associated with IBD, both in early life and adulthood. Here, we investigated whether Nod2-deficiency influenced response of the gut microbiota to antibiotics and subsequent colitis susceptibility. Wild-type and Nod2-/- littermate mice were treated with amoxicillin as adults or neonates, and fecal samples were collected for 16S rRNA sequencing. Five weeks after antibiotic exposure, dextran sulfate sodium (DSS) colitis was induced. Antibiotic treatment altered the microbiota of adult WT and Nod2-/- mice, but recovery was delayed in Nod2-/- mice. Neonatal antibiotic treatment significantly changed the microbiota at weaning in WT and Nod2-/- littermates; however, Nod2-/- mice maintained reduced microbial diversity 14 days after cessation of antibiotics. Although treatment of adult mice did not influence susceptibility to colitis, neonatally treated Nod2-/- mice developed a more severe colitis. Moreover, the colitis phenotype was transferable through fecal transplantation into germ-free Nod2-/- recipients, and was associated with changes in intestinal T cells and the cytokine milieu following inflammation. These data demonstrate that neonatal antibiotic exposure has long-lasting influence on the microbiota and mucosal immunity, and may explain how NOD2 contributes to the risk of intestinal inflammation.
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Affiliation(s)
- A Goethel
- Department of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada.,Zane Cohen Centre for Digestive Diseases, The Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5T 3L9, Canada
| | - W Turpin
- Zane Cohen Centre for Digestive Diseases, The Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5T 3L9, Canada.,Department of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - S Rouquier
- Department of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - G Zanello
- Department of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - S J Robertson
- Department of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - C J Streutker
- St. Michael's Hospital, Toronto, ON, M5B 1W8, Canada
| | - D J Philpott
- Department of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - K Croitoru
- Department of Immunology, University of Toronto, Toronto, ON, M5S 1A8, Canada. .,Zane Cohen Centre for Digestive Diseases, The Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5T 3L9, Canada. .,Department of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada. .,Division of Gastroenterology, Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada.
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15
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Hernandez Rocha CA, Borowski K, Turpin W, Kabakchiev B, Boland K, Bedrani L, Stempak J, Smith M, Nguyen GC, Steinhart H, Croitoru K, Silverberg MS. A5 ASSOCIATION ANALYSIS BETWEEN BILE ACID-METABOLIZING MICROBIOTA ABUNDANCE AND ENDOSCOPIC INFLAMMATION IN INFLAMMATORY BOWEL DISEASE PATIENTS. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.004] [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)
- C A Hernandez Rocha
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - K Borowski
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - W Turpin
- Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - B Kabakchiev
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - K Boland
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - L Bedrani
- Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - J Stempak
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - M Smith
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - G C Nguyen
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - H Steinhart
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - K Croitoru
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
| | - M S Silverberg
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital , Toronto, ON, Canada
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16
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Marshall K, Goethel A, Croitoru K. A103 COMBINATORIAL EFFECT OF EARLY LIFE ANTIBIOTIC EXPOSURE AND HIGH-FAT DIET ON COLITIS SUSCEPTIBILITY. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.102] [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)
- K Marshall
- Immunology, University of Toronto, Faculty of Medicine, Toronto, ON, Canada
| | - A Goethel
- Immunology, University of Toronto, Faculty of Medicine, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
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17
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Power N, Jeyalingam T, Filice M, Smith M, Silverberg MS, Steinhart A, Nguyen GC, Zezos P, Croitoru K. A66 CHARACTERIZATION OF PERIPHERAL BLOOD AND LAMINA PROPRIA LYMPHOCYTES IN CROHN’S DISEASE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.066] [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)
- N Power
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
| | - T Jeyalingam
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
| | - M Filice
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
| | - M Smith
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
| | - M S Silverberg
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
| | - A Steinhart
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
| | - G C Nguyen
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
| | - P Zezos
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital Centre for Inflammatory Bowel Disease, Toronto, ON, Canada
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18
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Turpin W, Bedrani L, Espin-Garcia O, Smith M, Guttman D, Madsen K, Griffiths A, Moayyedi P, Panaccione R, Huynh HQ, Dieleman LA, Steinhart A, Aumais G, Silverberg MS, Wei X, Paterson A, Croitoru K. A35 GENOME WIDE ASSOCIATION STUDY OF ABNORMAL INTESTINAL PERMEABILITY IN HEALTHY FIRST DEGREE RELATIVES OF CROHN’S PATIENTS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.035] [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)
- W Turpin
- University of Toronto, Toronto, ON, Canada
| | - L Bedrani
- University of Toronto, Toronto, ON, Canada
| | - O Espin-Garcia
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - M Smith
- University of Toronto, Toronto, ON, Canada
| | - D Guttman
- University of Toronto, Toronto, ON, Canada
| | - K Madsen
- University of Alberta, Edmonton, AB, Canada
| | - A Griffiths
- Hospital for Sick Children, Toronto, ON, Canada
| | - P Moayyedi
- McMaster University, Hamilton, ON, Canada
| | | | - H Q Huynh
- Pediatrics, University of alberta, Edmonton, AB, Canada
| | - L A Dieleman
- Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - G Aumais
- Montreal University, Montreal, QC, Canada
| | | | - X Wei
- Dalla Lana School of Public Health, Toronto, ON, Canada
| | - A Paterson
- Dalla Lana School of Public Health, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
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19
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Zezos P, Kabakchiev B, Weizman AV, Nguyen GC, Narula N, Croitoru K, Steinhart H, Silverberg MS. A133 EFFECTIVENESS AND SAFETY OF VEDOLIZUMAB INDUCTION THERAPY IN PATIENTS WITH ULCERATIVE COLITIS: REAL-WORLD EXPERIENCE IN A TERTIARY IBD CENTRE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.134] [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)
- P Zezos
- Mount Sinai Hospital, Toronto, ON, Canada
| | - B Kabakchiev
- Lunenfeld Tannenbaum Research Institute, Toronto, ON, Canada
| | | | - G C Nguyen
- Mount Sinai Hospital, Toronto, ON, Canada
| | - N Narula
- Mount Sinai Hospital, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
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20
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Marshall K, Goethel A, Croitoru K. A91 T CELL-SPECIFIC DELETION OF NOD2 DOES NOT INFLUENCE MICROBIAL RESILIENCE FOLLOWING ANTIBIOTIC EXPOSURE OR MUCOSAL DAMAGE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.091] [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)
- K Marshall
- Immunology, University of Toronto, Faculty of Medicine, Toronto, ON, Canada
| | - A Goethel
- Immunology, University of Toronto, Faculty of Medicine, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
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21
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Bedrani L, Turpin W, Smith M, Guttman D, Silverberg MS, Xu W, Paterson A, Croitoru K. A135 MICROBIOME IN CROHN’S DISEASE PATIENTS: A COMPILATION OF PUBLICLY AVAILABLE DATASETS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.136] [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: 11/15/2022] Open
Affiliation(s)
- L Bedrani
- University of Toronto, Toronto, ON, Canada
| | - W Turpin
- University of Toronto, Toronto, ON, Canada
| | - M Smith
- Mount Sinai Hospital, Toronto, ON, Canada
| | - D Guttman
- University of Toronto, Toronto, ON, Canada
| | | | - W Xu
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - A Paterson
- University of Toronto, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
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22
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Bermudez-Brito M, Galipeau HJ, CAMINERO FERNANDEZ A, Turpin W, Bedrani L, Croitoru K, Verdu E. A276 CHARACTERIZING MICROBIOTA COMPOSITION AND FUNCTION THAT PRECEDE DEVELOPMENT OF CLINICALLY RELEVANT INFLAMMATION IN UC PATIENTS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.276] [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)
| | - H J Galipeau
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada
| | | | - W Turpin
- University of Toronto, Toronto, ON, Canada
| | - L Bedrani
- University of Toronto, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
| | - E Verdu
- McMaster University, Hamilton, ON, Canada
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23
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Bedrani L, Turpin W, Espin-Garcia O, Smith M, Guttman D, Xu W, Croitoru K. A111 ANALYSIS OF GUT MICROBIOME OF HEALTHY INDIVIDUALS THAT GO ON TO DEVELOP CELIAC DISEASE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.111] [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)
- L Bedrani
- University of Toronto, Toronto, ON, Canada
| | - W Turpin
- University of Toronto, Toronto, ON, Canada
| | | | - M Smith
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - D Guttman
- University of Toronto, Toronto, ON, Canada
| | - W Xu
- University of Toronto, Toronto, ON, Canada
| | - K Croitoru
- Mount Sinai Hospital, Toronto, ON, Canada
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24
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Rivas MA, Graham D, Sulem P, Stevens C, Desch AN, Goyette P, Gudbjartsson D, Jonsdottir I, Thorsteinsdottir U, Degenhardt F, Mucha S, Kurki MI, Li D, D'Amato M, Annese V, Vermeire S, Weersma RK, Halfvarson J, Paavola-Sakki P, Lappalainen M, Lek M, Cummings B, Tukiainen T, Haritunians T, Halme L, Koskinen LLE, Ananthakrishnan AN, Luo Y, Heap GA, Visschedijk MC, MacArthur DG, Neale BM, Ahmad T, Anderson CA, Brant SR, Duerr RH, Silverberg MS, Cho JH, Palotie A, Saavalainen P, Kontula K, Färkkilä M, McGovern DPB, Franke A, Stefansson K, Rioux JD, Xavier RJ, Daly MJ, Barrett J, de Lane K, Edwards C, Hart A, Hawkey C, Jostins L, Kennedy N, Lamb C, Lee J, Lees C, Mansfield J, Mathew C, Mowatt C, Newman B, Nimmo E, Parkes M, Pollard M, Prescott N, Randall J, Rice D, Satsangi J, Simmons A, Tremelling M, Uhlig H, Wilson D, Abraham C, Achkar JP, Bitton A, Boucher G, Croitoru K, Fleshner P, Glas J, Kugathasan S, Limbergen JV, Milgrom R, Proctor D, Regueiro M, Schumm PL, Sharma Y, Stempak JM, Targan SR, Wang MH. A protein-truncating R179X variant in RNF186 confers protection against ulcerative colitis. Nat Commun 2016; 7:12342. [PMID: 27503255 PMCID: PMC4980482 DOI: 10.1038/ncomms12342] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/24/2016] [Indexed: 01/05/2023] Open
Abstract
Protein-truncating variants protective against human disease provide in vivo validation of therapeutic targets. Here we used targeted sequencing to conduct a search for protein-truncating variants conferring protection against inflammatory bowel disease exploiting knowledge of common variants associated with the same disease. Through replication genotyping and imputation we found that a predicted protein-truncating variant (rs36095412, p.R179X, genotyped in 11,148 ulcerative colitis patients and 295,446 controls, MAF=up to 0.78%) in RNF186, a single-exon ring finger E3 ligase with strong colonic expression, protects against ulcerative colitis (overall P=6.89 × 10(-7), odds ratio=0.30). We further demonstrate that the truncated protein exhibits reduced expression and altered subcellular localization, suggesting the protective mechanism may reside in the loss of an interaction or function via mislocalization and/or loss of an essential transmembrane domain.
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Affiliation(s)
- Manuel A. Rivas
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Daniel Graham
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | | | - Christine Stevens
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - A. Nicole Desch
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Philippe Goyette
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada H1T1C8
| | - Daniel Gudbjartsson
- deCODE Genetics, Amgen Inc., 101 Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, 101 Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE Genetics, Amgen Inc., 101 Reykjavik, Iceland
- Department of Immunology, Landspitali, the National University Hospital of Iceland, 101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE Genetics, Amgen Inc., 101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Frauke Degenhardt
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany
| | - Sören Mucha
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany
| | - Mitja I. Kurki
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Dalin Li
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
- Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California 90048 USA
| | - Mauro D'Amato
- Department of Biosciences and Nutrition, Karolinska Institutet, 14183 Stockholm, Sweden
- BioCruces Health Research Institute and IKERBASQUE, Basque Foundation for Science, 48903 Bilbao, Spain
| | - Vito Annese
- Unit of Gastroenterology, Istituto di Ricovero e Cura a Carattere Scientifico-Casa Sollievo della Sofferenza (IRCCS-CSS) Hospital, 71013 San Giovanni Rotondo, Italy
- Strutture Organizzative Dipartimentali (SOD) Gastroenterologia 2, Azienda Ospedaliero Universitaria (AOU) Careggi, 50134 Florence, Italy
| | - Severine Vermeire
- Department of Clinical and Experimental Medicine, Translational Research in GastroIntestinal Disorders (TARGID), Katholieke Universiteit (KU) Leuven, Leuven 3000, Belgium
- Division of Gastroenterology, University Hospital Gasthuisberg, BE-3000 Leuven, Belgium
| | - Rinse K. Weersma
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Jonas Halfvarson
- Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, SE 701 82 Örebro, Sweden
| | - Paulina Paavola-Sakki
- Department of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Helsinki University Hospital, 00100 Helsinki, Finland
- Clinic of Gastroenterology, Helsinki University Hospital, 00100 Helsinki, Finland
| | - Maarit Lappalainen
- Department of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Helsinki University Hospital, 00100 Helsinki, Finland
- Research Programs Unit, Immunobiology, and Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland
| | - Monkol Lek
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Beryl Cummings
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Taru Tukiainen
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Talin Haritunians
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
- Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California 90048 USA
| | - Leena Halme
- Department of Transplantation and Liver Surgery, University of Helsinki, 00100 Helsinki, Finland
| | - Lotta L. E. Koskinen
- Research Programs Unit, Immunobiology, and Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland
- Department of Medical Genetics, Biomedicum Helsinki, University of Helsinki, 00100 Helsinki, Finland
| | - Ashwin N. Ananthakrishnan
- Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Division of Medical Sciences, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Yang Luo
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
| | - Graham A. Heap
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - Marijn C. Visschedijk
- Department of Gastroenterology and Hepatology, University of Groningen and University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Daniel G. MacArthur
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Benjamin M. Neale
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Tariq Ahmad
- Peninsula College of Medicine and Dentistry, Exeter PL6 8BU, UK
| | - Carl A. Anderson
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
| | - Steven R. Brant
- Meyerhoff Inflammatory Bowel Disease Center, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, 21205, USA
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, 21205, USA
| | - Richard H. Duerr
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - Mark S. Silverberg
- Department of Medicine, Inflammatory Bowel Disease Centre, Mount Sinai Hospital, Toronto, Ontario, Canada M5G 1X5
| | - Judy H Cho
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut 06510, USA
| | - Aarno Palotie
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
- Institute for Molecular Medicine Finland, University of Helsinki, 00100 Helsinki, Finland
- Massachusetts General Hospital, Center for Human Genetic Research, Psychiatric and Neurodevelopmental Genetics Unit, Boston, Massachusetts 02114, USA
| | - Päivi Saavalainen
- Research Programs Unit, Immunobiology, University of Helsinki, 00100 Helsinki, Finland
| | - Kimmo Kontula
- Department of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Helsinki University Hospital, 00100 Helsinki, Finland
| | - Martti Färkkilä
- Department of Medicine, University of Helsinki, 00100 Helsinki, Finland
- Helsinki University Hospital, 00100 Helsinki, Finland
- Clinic of Gastroenterology, Helsinki University Hospital, 00100 Helsinki, Finland
| | - Dermot P. B. McGovern
- F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
- Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, California 90048 USA
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany
| | - Kari Stefansson
- deCODE Genetics, Amgen Inc., 101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - John D. Rioux
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada H1T1C8
- Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada H3T 1J4
| | - Ramnik J. Xavier
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Mark J. Daly
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - J. Barrett
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - K. de Lane
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - C. Edwards
- Department of Gastroenterology, Torbay Hospital, Devon, UK
| | - A. Hart
- Department of Medicine, St. Mark's Hospital, Middlesex, UK
| | - C. Hawkey
- Nottingham Digestive Disease Centre, Queens Medical Centre, Nottingham, UK
| | - L. Jostins
- Wellcome Trust Centre for Human Genetics, University of Oxford, Headington, UK
- Christ Church, University of Oxford, Oxford, UK
| | - N. Kennedy
- Gastrointestinal Unit, Wester General Hospital, University of Edinburgh, Edinburgh, UK
| | - C. Lamb
- Newcastle University, Newcastle upon Tyne, UK
| | - J. Lee
- Inflammatory Bowel Disease Research Group, Addenbrooke's Hospital, Cambridge, UK
| | - C. Lees
- Gastrointestinal Unit, Wester General Hospital, University of Edinburgh, Edinburgh, UK
| | | | - C. Mathew
- Department of Medical and Molecular Genetics, Guy's Hospital, London, UK
- Department of Medical and Molecular Genetics, King's College London School of Medicine, Guy's Hospital, London, UK
| | - C. Mowatt
- Department of Medicine, Ninewells Hospital and Medical School, Dundee, UK
| | - B. Newman
- Genetic Medicine, Manchester Academic Health Science Centre, Manchester, UK
- The Manchester Centre for Genomic Medicine, University of Manchester, Manchester, UK
| | - E. Nimmo
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - M. Parkes
- Inflammatory Bowel Disease Research Group, Addenbrooke's Hospital, Cambridge, UK
| | - M. Pollard
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - N. Prescott
- Department of Medical and Molecular Genetics, Guy's Hospital, London, UK
- Department of Medical and Molecular Genetics, King's College London School of Medicine, Guy's Hospital, London, UK
| | - J. Randall
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - D. Rice
- IBD Pharmacogenetics, Royal Devon and Exeter NHS Trust, Exeter EX2 5DW, UK
| | - J. Satsangi
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - A. Simmons
- Translational Gastroenterology Unit, John Radcliffe Hospital, University of Oxford, Oxford, UK
- Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - M. Tremelling
- Gastroenterology & General Medicine, Norfolk and Norwich University Hospital, Norwich, UK
| | - H. Uhlig
- Translational Gastroenterology Unit and the Department of Pediatrics, University of Oxford, Oxford, UK
| | - D. Wilson
- Pediatric Gastroenterology and Nutrition, Royal Hospital for Sick Children, Edinburgh, UK
- Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - C. Abraham
- Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - J. P. Achkar
- Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - A. Bitton
- Division of Gastroenterology, Royal Victoria Hospital, Montréal, Québec, Canada
| | - G. Boucher
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada H1T1C8
| | - K. Croitoru
- Inflammatory Bowel Disease Group, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - P. Fleshner
- Department of Transplantation and Liver Surgery, University of Helsinki, 00100 Helsinki, Finland
| | - J. Glas
- Division of Gastroenterology, Royal Victoria Hospital, Montréal, Québec, Canada
| | - S. Kugathasan
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J. V. Limbergen
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, Toronto, Ontario, Canada
| | - R. Milgrom
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut 06510, USA
| | - D. Proctor
- Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - M. Regueiro
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261, USA
| | - P. L. Schumm
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Y. Sharma
- Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - J. M. Stempak
- Department of Genetics, Yale School of Medicine, New Haven, Connecticut 06510, USA
| | - S. R. Targan
- Department of Transplantation and Liver Surgery, University of Helsinki, 00100 Helsinki, Finland
| | - M. H. Wang
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA
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Zittan E, Kabakchiev B, Milgrom R, Nguyen GC, Croitoru K, Steinhart AH, Silverberg MS. Higher Adalimumab Drug Levels are Associated with Mucosal Healing in Patients with Crohn's Disease. J Crohns Colitis 2016; 10:510-5. [PMID: 26783345 PMCID: PMC4957459 DOI: 10.1093/ecco-jcc/jjw014] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 12/28/2015] [Accepted: 01/04/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS The current approach to managing the loss of response to anti-tumour necrosis factor (TNF) agents is generally empirical. Prior studies have suggested that adalimumab levels of >4.9 µg/mL are required to achieve clinical remission. Our aim was to identify an optimal adalimumab level to achieve endoscopic healing in Crohn's disease (CD). METHODS A cohort of 60 CD patients treated with adalimumab between 2005 and 2013 were reviewed for the study. Demographic and clinical information was obtained from chart review and patient interview. Disease activity was determined using the Harvey-Bradshaw index (HBI), ileocolonoscopy reports and C-reactive protein (CRP) levels. Clinical remission was defined as HBI <5. Endoscopic remission/mucosal healing (MH) was defined as the absence of any ulceration in all ileocolonic segments. Trough adalimumab levels and adalimumab antibody levels were tested using a liquid-phase mobility shift assay. RESULTS Lower median CRP was significantly associated with MH 1.2mg/dl vs no MH 14.4mg/dl (p = 6.93×10(-6)). Higher adalimumab trough level was significantly associated with MH (median 14.7 µg/mL in those with MH vs 3.4 µg/mL in those without, p = 6.25×10(-5)). Higher adalimumab trough level was also significantly associated with the combined outcome of clinical and endoscopic remission (median 13.0 vs 4.8 µg/mL, p = 5.36×10(-3)). A cut-off of 8.14 µg/ml best discriminated subjects with MH from those without MH, with sensitivity and specificity of 91.4 and 76.0%, respectively (positive and negative predictive values 84.2 and 86.4%, respectively). CONCLUSIONS Higher adalimumab levels were significantly associated with MH. This study suggests that attaining MH alone or a combined outcome of clinical and endoscopic remission is more likely to occur in those patients who achieve an adalimumab trough level of at least 8.14 μg/mL.
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Affiliation(s)
- E Zittan
- Mount Sinai Hospital, Zane Cohen Centre for Digestive Diseases; Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Canada Institute of Gastroenterology and Liver Diseases, Emek Medical Center, Afula, Israel
| | - B Kabakchiev
- Mount Sinai Hospital, Zane Cohen Center, Toronto, Canada
| | - R Milgrom
- Mount Sinai Hospital, Zane Cohen Center, Toronto, Canada
| | - G C Nguyen
- Mount Sinai Hospital, Zane Cohen Centre for Digestive Diseases; Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Canada
| | - K Croitoru
- Mount Sinai Hospital, Zane Cohen Centre for Digestive Diseases; Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Canada
| | - A H Steinhart
- Mount Sinai Hospital, Zane Cohen Centre for Digestive Diseases; Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Canada
| | - M S Silverberg
- Mount Sinai Hospital, Zane Cohen Centre for Digestive Diseases; Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Canada
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Hirsh V, Blais N, Burkes R, Verma S, Croitoru K. Management of diarrhea induced by epidermal growth factor receptor tyrosine kinase inhibitors. Curr Oncol 2014; 21:329-36. [PMID: 25489260 PMCID: PMC4257116 DOI: 10.3747/co.21.2241] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Treatment for non-small-cell lung cancer (nsclc) is moving away from traditional chemotherapy toward personalized medicine. The reversible tyrosine kinase inhibitors (tkis) erlotinib and gefitinib were developed to target the epidermal growth factor receptor (egfr). Afatinib, an irreversible ErbB family blocker, was developed to block egfr (ErbB1), human epidermal growth factor receptor 2 (ErbB2), and ErbB4 signalling, and transphosphorylation of ErbB3. All of the foregoing agents are efficacious in treating nsclc, and their adverse event profile is different from that of chemotherapy. Two of the most common adverse events with egfr tkis are rash and diarrhea. Here, we focus on diarrhea. The key to successful management of diarrhea is to treat early and aggressively using patient education, diet, and antidiarrheal medications such as loperamide. We also present strategies for the effective assessment and management of egfr tki-induced diarrhea.
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Affiliation(s)
- V. Hirsh
- Hematology–Oncology Services, Santa Cabrini Hospital, and Department of Oncology, Faculty of Medicine, McGill University, Montreal, QC
| | - N. Blais
- Department of Medicine, University of Montreal, Montreal, QC
| | - R. Burkes
- Division of Hematology/Medical Oncology, University of Toronto, Mount Sinai Hospital, and The Princess Margaret Hospital Cancer Centre, Toronto, ON
| | - S. Verma
- University of Toronto and Medical Oncology/Hematology, Sunnybrook Health Sciences Centre, Toronto, ON
| | - K. Croitoru
- University of Toronto, and Division of Gastroenterology, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, ON
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Weizman AV, Ahn E, Thanabalan R, Leung W, Croitoru K, Silverberg MS, Steinhart AH, Nguyen GC. Characterisation of complementary and alternative medicine use and its impact on medication adherence in inflammatory bowel disease. Aliment Pharmacol Ther 2012; 35:342-9. [PMID: 22176478 DOI: 10.1111/j.1365-2036.2011.04956.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [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: 12/12/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) use among inflammatory bowel disease (IBD) patients is common. We characterised CAM utilisation and assessed its impact on medical adherence in the IBD population. AIM To characterise CAM utilisation and assess its impact on medical adherence in the IBD population. METHODS Inflammatory bowel disease patients recruited from an out-patient clinic at a tertiary centre were asked to complete a questionnaire on CAM utilisation, conventional IBD therapy, demographics and communication with their gastroenterologist. Adherence was measured using the self-reported Morisky scale. Demographics, clinical characteristics and self-reported adherence among CAM and non-CAM users were compared. RESULTS We recruited prospectively 380 IBD subjects (57% Crohn's disease; 35% ulcerative colitis, and 8% indeterminate colitis). The prevalence of CAM use was 56% and did not significantly vary by type of IBD. The most common reason cited for using CAM was ineffectiveness of conventional IBD therapy (40%). The most popular form of CAM was probiotics (53%). CAM users were younger than non-CAM users at diagnosis (21.2 vs. 26.2, P < 0.0001) and more likely than non-CAM users to have a University-level education or higher (75% vs. 62% P = 0.006). There was no overall difference in adherence between CAM and non-CAM users (Morisky score: 1.0 vs. 0.9, P = 0.26). CONCLUSIONS The use of complementary and alternative medicine is widely prevalent among IBD patients, and is more frequent among those with experience of adverse effects of conventional medications. From this cross-sectional analysis, complementary and alternative medicine use does not appear to be associated with reduced overall adherence to medical therapy.
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Affiliation(s)
- A V Weizman
- Division of Gastroenterology, Department of Medicine, Mount Sinai Hospital, Toronto, ON, Canada
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28
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Chatterjee A, Swain MG, Lee SS, Bain VG, Peltekian K, Croitoru K, Adams PC, Kaita K, Teitel J, Heathcote EJ. Induction versus noninduction antiviral therapy for chronic hepatitis C virus in patients with congenital coagulation disorders: a Canadian multicentre trial. Can J Gastroenterol 2007; 21:91-5. [PMID: 17299612 PMCID: PMC2657667 DOI: 10.1155/2007/817198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Patients with congenital coagulation disorders and chronic hepatitis C virus (HCV) infection have multiple risk factors (ie, infection predominantly with genotype-1 HCV, long duration of the disease, HIV coinfection and male sex) for poor response to antiviral therapy. The present study compared induction therapy with interferon-alpha (IFN-alpha)-2b with standard IFN-alpha2b therapy. Pegylated IFN was not available at the time that the study was initiated. PATIENTS AND METHODS A randomized study was performed comparing the efficacy of traditional IFN-alpha2b therapy (group A -- three million units, three times weekly for 24 to 48 weeks) and daily ribavirin (1.0 g to 1.2 g according to weight for 24 to 48 weeks), with induction IFN-alpha2b therapy (group B -- three million units, daily for eight weeks followed by the same dose administered three times a week for a further 16 to 40 weeks) and daily ribavirin (same dose as above) in IFN-naive patients with congenital coagulation disorders and chronic HCV infection. RESULTS Between 2000 and 2003, 54 HIV-negative patients were recruited and randomly assigned to group A or B (n=27 each). Both groups were comparable in terms of age, sex, ethnicity, body mass index, baseline HCV RNA titre, viral genotype, liver fibrosis stage and type of coagulation disorder. Induction therapy did not significantly alter sustained virological response rates (group A 50%, group B 50%; P=1.0). Multiple logistic regression analysis indicated that induction therapy did not benefit individuals with difficult-to-treat infection (ie, those infected with genotypes 1 and 4, or those with high baseline viral loads). CONCLUSIONS There was no benefit with induction antiviral therapy for HCV infection in individuals with congenital coagulation disorders.
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Affiliation(s)
- A Chatterjee
- Department of Medicine, University of Toronto, Toronto, Ontario
| | - MG Swain
- University of Calgary, Calgary, Alberta
| | - SS Lee
- University of Calgary, Calgary, Alberta
| | - VG Bain
- University of Alberta, Edmonton, Alberta
| | | | | | - PC Adams
- University of Western Ontario, London, Ontario
| | - K Kaita
- University of Manitoba, Winnipeg, Manitoba
| | - J Teitel
- Department of Medicine, University of Toronto, Toronto, Ontario
| | - EJ Heathcote
- Department of Medicine, University of Toronto, Toronto, Ontario
- Correspondence: Dr EJ Heathcote, Toronto Western Hospital, Fell Pavilion, Floor 6B – Room 156, University Health Network, 399 Bathurst Street, Toronto, Ontario M5T 2S8. Telephone 416-603-5914, fax 416-603-6281, e-mail
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29
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Söderholm JD, Streutker C, Yang PC, Paterson C, Singh PK, McKay DM, Sherman PM, Croitoru K, Perdue MH. Increased epithelial uptake of protein antigens in the ileum of Crohn's disease mediated by tumour necrosis factor alpha. Gut 2004; 53:1817-24. [PMID: 15542521 PMCID: PMC1774309 DOI: 10.1136/gut.2004.041426] [Citation(s) in RCA: 122] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS The exact nature of the epithelial barrier defect in Crohn's disease remains to be elucidated. Previously we showed increased permeability to proteins in ileal Crohn's disease. Our aims were to study if this barrier defect (a) involves endocytotic uptake of antigens and (b) is related to low grade inflammation not detectable by histology. METHODS Macroscopically normal segments of distal ileum of Crohn's disease patients (n = 10) were subgrouped into non-inflamed (histologically unaffected) and slightly inflamed tissues and studied in Ussing chambers, with normal ileal specimens from colon cancer patients (n = 9) as controls. Endocytotic uptake into enterocytes of the protein antigen horseradish peroxidase was assessed by measuring the area of horseradish peroxidase containing endosomes in electron photomicrographs. Mucosal tumour necrosis factor alpha (TNF-alpha) mRNA was quantified using real time polymerase chain reaction. For comparison, the effects of low doses of TNF-alpha on endosomal uptake of horseradish peroxidase were studied in cultured T84 cells grown on filter supports. RESULTS The area of horseradish peroxidase containing endosomes was increased (p<0.001) in enterocytes of non-inflamed ileum of Crohn's disease (2.8 (0.7) mum(2)/300 mum(2)) compared with control ileum (0.6 (0.06)). In non-inflamed mucosa, a significant association between endosomal uptake and mucosal expression of TNF-alpha mRNA (p = 0.03) was found. Low concentrations of TNF-alpha (0.25-1.0 ng/ml) enhanced the endosomal uptake of horseradish peroxidase in polarised T84 cells, without affecting transepithelial electrical resistance. CONCLUSIONS Our findings suggest increased endosomal uptake of antigens in ileal Crohn's disease that may be mediated by TNF-alpha. These data highlight the transcellular route of antigen uptake in barrier dysfunction and implicate the interaction between epithelial cells and the innate immune system in the development of mucosal inflammation.
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Affiliation(s)
- J D Söderholm
- Department of Surgery, University Hospital, SE-581 85 Linköping, Sweden.
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30
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Streutker CJ, Bernstein CN, Chan VL, Riddell RH, Croitoru K. Detection of species-specific helicobacter ribosomal DNA in intestinal biopsy samples from a population-based cohort of patients with ulcerative colitis. J Clin Microbiol 2004; 42:660-4. [PMID: 14766833 PMCID: PMC344456 DOI: 10.1128/jcm.42.2.660-664.2004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The inflammatory bowel diseases are considered an abnormal host immune response to an environmental stimulus. Evidence suggests a role for intestinal bacteria in initiating and/or providing an ongoing stimulus for inflammation in inflammatory bowel disease. Helicobacter pylori is the major cause of active chronic gastritis and peptic ulcers in humans and has been linked to gastric carcinoma and lymphoma. Studies in various animal models, particularly mice, have identified enterohepatic Helicobacter species that are capable of causing hepatitis and enterocolitis. We hypothesize that Helicobacter species may have a role in maintaining inflammation in humans with inflammatory bowel disease. In order to investigate this, biopsy specimens were obtained from patients with and without inflammatory bowel disease. DNA was extracted from the tissues and subjected to PCR with primers designed to detect the ribosomal DNA of members of the Helicobacter species. DNA from six biopsy samples from 60 inflammatory bowel disease patients tested positive. This included 5 of 33 ulcerative colitis patients that were positive compared to 0 of 29 age-matched controls (P < 0.04). Sequencing of the bands produced by PCR amplification revealed >or=99% homology with H. pylori. These results indicate that a member of the Helicobacter species may be involved in some cases of ulcerative colitis.
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Affiliation(s)
- C J Streutker
- Department of Laboratory and Molecular Medicine, McMaster University, Hamilton, Canada.
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31
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Merger M, Viney JL, Borojevic R, Steele-Norwood D, Zhou P, Clark DA, Riddell R, Maric R, Podack ER, Croitoru K. Defining the roles of perforin, Fas/FasL, and tumour necrosis factor alpha in T cell induced mucosal damage in the mouse intestine. Gut 2002; 51:155-63. [PMID: 12117872 PMCID: PMC1773316 DOI: 10.1136/gut.51.2.155] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS Mucosal flattening and epithelial cell apoptosis are typical features of T cell induced inflammatory diseases of the bowel, such as coeliac disease and graft versus host disease. Mice injected with a T cell activating anti-CD3 antibody develop a severe diarrhoeal illness. We describe the histological features of this enteropathy and define the effector mechanisms involved in T cell induced mucosal injury in this in vivo model. METHODS Wild-type and genetically modified mice were injected with the anti-CD3 antibody 3C11 (50 microg). Changes in the murine intestine were characterised by light microscopy analysis and terminal uridine nick-end labelling (TUNEL) assay. The role of perforin, Fas/Fas ligand (FasL), tumour necrosis factor alpha (TNF-alpha), and interferon gamma (IFN-gamma) in T cell induced mucosal damage was assessed using selected immunodeficient mouse strains. RESULTS T cell activation caused severe damage, including small intestinal mucosal flattening and apoptosis of crypt epithelial cells. Mucosal damage was unaltered in anti-CD3 treated mice lacking IFN-gamma, Fas, or TNF-alpha receptors. In mice lacking TNF-alpha receptors and Fas (TNF-R1xR2 lpr/lpr strain), enterocyte apoptosis was diminished but there was no significant reduction in tissue damage. Apoptosis and mucosal injury were significantly reduced in perforin knockout mice. Abrogation of both FasL and perforin (perforin KOxgld mice) further significantly reduced tissue damage and apoptotic bodies. CONCLUSIONS T cell induced mucosal injury is mediated by the combined effect of multiple pathways but predominantly by perforin. The redundancy of the mechanisms of tissue damage will have significant impact on therapeutic strategies aimed at specific and targeted inhibition of inflammatory processes.
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MESH Headings
- Animals
- Antibodies, Monoclonal/pharmacology
- Antigens, CD/genetics
- Apoptosis
- CD3 Complex/immunology
- Epithelium/pathology
- Fas Ligand Protein
- In Situ Nick-End Labeling
- Interferon-gamma/genetics
- Intestinal Mucosa/immunology
- Intestinal Mucosa/pathology
- Intestine, Small/immunology
- Lymphocyte Activation
- Membrane Glycoproteins/genetics
- Membrane Glycoproteins/physiology
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Mice, Knockout
- Mice, SCID
- Models, Animal
- Perforin
- Pore Forming Cytotoxic Proteins
- Receptors, Tumor Necrosis Factor/genetics
- Receptors, Tumor Necrosis Factor, Type I
- Receptors, Tumor Necrosis Factor, Type II
- T-Lymphocytes/immunology
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/physiology
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Affiliation(s)
- M Merger
- Intestinal Disease Research Program, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
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Clark DA, Croitoru K. TH1/TH2,3 imbalance due to cytokine-producing NK, gammadelta T and NK-gammadelta T cells in murine pregnancy decidua in success or failure of pregnancy. Am J Reprod Immunol 2001; 45:257-65. [PMID: 11432400 DOI: 10.1111/j.8755-8920.2001.450501.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PROBLEM Recurrent spontaneous abortion in DBA/2-mated CBA/J mice has been attributed to the production of Th1 cytokines (tumor necrosis factor [TNF]-alpha and interferon [IFN]-gamma) by asialoGM1+ natural killer (NK) cells and Vgamma1.1delta6.3+ T cells that infiltrate decidua by day 6.5, during the peri-implantation period. Abortions can be prevented by a second population of Vgamma1.1delta6.3 cells, which infiltrate on day 8.5 of gestation, and produce the Th2 cytokine interleukin (IL)-10 and Th3 cytokine transforming growth factor (TGF)-beta2. In low abortion rate immunocompetent mice, most of the TGF-beta2 is derived from gammadelta T cells. However, TGF-beta2-producing cells are present in the decidua of pregnant severe combined immune deficient (SCID) mice, which lack gammadelta T cells. METHODS The cells in day 13.5 decidua of CBA x DBA/2 matings and SCID x SCID matings were identified using flow cytometry and combined surface staining for gammadelta and/or asialoGM1, and intracellular cytokine staining for TNF-alpha, IFN-gamma, and TGF-beta2,3. RESULTS TGF-beta2 and TNF-alpha were found in asialoGM1+ NK cells in SCID mouse decidua. In CBA x DBA/2 mated mice, two major and one minor subsets of cytokine-positive cells were identified: -gammadelta-only T cells, double positive asialoGM1+ gammadelta+ (NK-gammadelta T) cells, and a small number of asialoGM1 +gammadelta- NK-only cells. The NK-only and NK-gammadelta T subsets showed a greater Th1/Th2,3 pattern of intracellular staining compared with the gammadelta-only subset. In the CBA x DBA/2 and SCID x SCID systems, Th1/Th2,3 ratios could not predict actual observed abortion rates but did correlate with susceptibility to abortions (if exposed to an additional stimulus such as stress). The known effect of in vivo administration of anti-asialoGM1 antibody on abortion rates within groups of mice exposed to such stresses could also be predicted. CONCLUSION gammadelta+ cells in decidua (e.g. Vgamma1+ cells which can recognize trophoblasts) differ based on the presence or absence of the NK marker-asialo-GM1. NK-gammadelta T cells may be quite important in the Th1 response in early pregnancy that predisposes to abortions in CBA x DBA/2 matings, whereas gammadelta T-only cells appear to be protective. In pregnant SCID mice, the TNF-alpha+/TGF-beta2+ NK population is greatly expanded. An activating stimulus (such as stress or endotoxin) appears to be as important in triggering abortions, as is the Th1/Th2,3 ratio at the feto maternal interface.
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MESH Headings
- Abortion, Habitual/immunology
- Animals
- Cytokines/biosynthesis
- Decidua/immunology
- Female
- Interferon-gamma/biosynthesis
- Interleukin-10/biosynthesis
- Killer Cells, Natural/metabolism
- Male
- Mice
- Mice, Inbred C3H
- Mice, Inbred CBA
- Mice, Inbred DBA
- Mice, SCID
- Pregnancy
- Receptors, Antigen, T-Cell, gamma-delta/metabolism
- Species Specificity
- T-Lymphocyte Subsets/immunology
- T-Lymphocytes, Helper-Inducer/immunology
- Th1 Cells/immunology
- Th2 Cells/immunology
- Transforming Growth Factor beta/biosynthesis
- Tumor Necrosis Factor-alpha/biosynthesis
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Affiliation(s)
- D A Clark
- Department of Molecular Medicine & Pathology, Obstetrics/Gynecology, McMaster University, Hamilton, Ont, Canada.
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Abstract
At the fetomaternal interface, maternal effector cells come in intimate contact with fetal trophoblast cells which express paternal antigens. Failure of fetal trophoblast cells to activate maternal Th1 immune responses has been attributed in part to the absence of classical Class I and Class II major histocompatibilty complex (MHC) antigen expression and elaboration of factors which reduce TcR expression and shift any immune responses which may occur to Th2. Classical TcR alphabeta(+) T cells have not been found to be able to respond to trophoblasts. Recently, TcR gammadelta(+) T cells have been characterized in the low-abortion-rate pregnant C57Bl/10 mouse decidua, and the Vgamma1(+) subset may be able to respond to trophoblasts in a non-MHC-dependent manner. Trophoblast-recognizing T cells with Vgamma1 receptors are also present in the decidua of CBA/J mice pregnant by DBA/2, an abortion-prone mating combination. To test the role of the Vgamma1 subset of decidual gammadelta T cells in abortion-prone pregnancies, we altered this subset by injecting monoclonal anti-Vgamma1.1 antibody on gestation day 5.5, 1 day after implantation. This reduced detectability of a Vgammadelta subset producing TNF-alpha and reduced the abortion rate. Anti-Vgamma2, which reacts with a similar proportion of decidual gammadelta T cells as anti-Vgamma1.1, failed to prevent abortions. Vdelta6.3(+) cells are prominent at the fetomaternal interface, and anti-Vdelta6 antibody injected on day 5.5 prevented abortions. TGF-beta2(+) gammadelta cells first appear on day 8.5 of pregnancy; anti-Vgamma1.1 antibody injection on day 8.5 depleted these cells and boosted abortions; anti-Vdelta6.3 given on day 8.5 boosted abortions to the same level. These results suggest that two populations of Vgamma1.1(+)delta6.3(+) T cells may arise in the decidua: an early population that is Th1, abortogenic, and present during the time of implantation, and a Th2/3 cell subset that is present in the decidua later during pregnancy and which is pregnancy-protective.
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MESH Headings
- Abortion, Spontaneous/etiology
- Abortion, Spontaneous/immunology
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/toxicity
- Crosses, Genetic
- Cytokines/physiology
- Decidua/immunology
- Female
- Fetal Resorption/immunology
- Flow Cytometry
- H-2 Antigens/immunology
- Male
- Mice
- Mice, Inbred CBA
- Mice, Inbred DBA
- Pregnancy
- Pregnancy Complications
- Pregnancy Outcome
- Pregnancy, Animal/immunology
- Receptors, Antigen, T-Cell, gamma-delta/analysis
- Stress, Physiological/complications
- T-Lymphocyte Subsets/immunology
- Th1 Cells/immunology
- Th2 Cells/immunology
- Trophoblasts/immunology
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Affiliation(s)
- P C Arck
- Medizinische Fakultat der Humbolt, Universitat zu Berlin, Augustenburger Platz, Berlin, 13353, Germany
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Jiang B, Jordana M, Xing Z, Smaill F, Snider DP, Borojevic R, Steele-Norwood D, Hunt RH, Croitoru K. Replication-defective adenovirus infection reduces Helicobacter felis colonization in the mouse in a gamma interferon- and interleukin-12-dependent manner. Infect Immun 1999; 67:4539-44. [PMID: 10456897 PMCID: PMC96775 DOI: 10.1128/iai.67.9.4539-4544.1999] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Helicobacter infection leads to chronic inflammation of the stomach. Although the infection persists in spite of an immune response, animal studies have shown that adjuvant-based oral vaccines can protect against infection and even eliminate established infection. These vaccines are thought to induce a Th2 immune response, counterbalancing the Th1 response seen with natural infections. As a prelude to using adenovirus vectors carrying cytokine genes to modulate the immune response to established Helicobacter felis infection, we first examined the effect of the replication-defective adenovirus (RDA) vector itself. C57BL/6 mice chronically infected with H. felis (8 to 10 weeks) received intramuscular injections of RDA. The effect of RDA on the severity of H. felis colonization and the degree of gastric inflammation was assessed 2 weeks later. RDA caused a significant decrease in H. felis colonization without significantly altering the associated inflammation. RDA did not alter the H. felis-specific immunoglobulin G1 (IgG1), IgG2a, and IgA responses in the serum but was associated with an increase in gamma interferon (IFN-gamma)-producing CD8(+) spleen cells. To determine if IFN-gamma or Th1 cytokines were involved in the response to RDA, we examined RDA treatment of H. felis infection in mice lacking either IFN-gamma or interleukin-12 (IL-12). RDA failed to alter H. felis colonization in either of these two mouse strains. Thus, viral infection of mice chronically infected with H. felis led to a significant decrease in H. felis colonization in an IFN-gamma- and IL-12-dependent manner. These results demonstrate that Th1 responses associated with systemic viral infection can influence an established H. felis infection.
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Affiliation(s)
- B Jiang
- Intestinal Diseases Research and Immunology and Infection Programs, Departments of Medicine and Pathology, McMaster University, Hamilton, Ontario, Canada
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35
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Sherman PM, Croitoru K. Pathobiology of Helicobacter pylori infection. Can J Gastroenterol 1999; 13:212. [PMID: 10331930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- P M Sherman
- Research Institute, The Hospital for Sick Children, University of Toronto, Canada
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36
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Abstract
Helicobacter pylori leads to a chronic infection in humans that is associated with gastric inflammation and a vigorous immune response. Despite the humoral and cellular responses that can be detected in both human and animal models of helicobacter infection, the immune response fails to eliminate the organism. Eradication failure may be due to the niche in which H pylori confines itself, well away from direct contact with elements of the immune system. Alternatively, the general tendency of the intestinal immune response to down- regulate reactivity to noninvasive luminal bacteria also may contribute to the failure to eliminate helicobacter infection. Results of vaccine studies in mouse models indicate that modulating the helper T cell response from a T helper cell type 1 to a T helper cell type 2 response likely is required for the prevention and elimination of helicobacter infection. Understanding the mechanisms by which the immune response controls bacterial infections will allow for the design of novel strategies of immune modulation and the development of vaccines for both the treatment and prevention of H pylori.
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Affiliation(s)
- K Croitoru
- Intestinal Diseases Research Program, Department of Medicine, Division of Gastroenterology, McMaster University, Hamilton, Ontario.
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Radojevic N, McKay DM, Merger M, Vallance BA, Collins SM, Croitoru K. Characterization of enteric functional changes evoked by in vivo anti-CD3 T cell activation. Am J Physiol 1999; 276:R715-23. [PMID: 10070131 DOI: 10.1152/ajpregu.1999.276.3.r715] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Specific in vivo T cell activation initiated by treatment with anti-CD3 antibodies leads to diarrhea and structural damage of the intestinal mucosa. In this study, the effect of T cell-induced mucosal damage on jejunal epithelial ion transport, muscle contractility, and neuronal ACh release was assessed in Ussing chambers, organ baths, and a specialized perfusion apparatus, respectively. Time-matched control mice received hamster serum containing irrelevant antibodies. Jejunal segments from anti-CD3-treated mice displayed a significantly elevated epithelial baseline short-circuit current (which indicates increased ion transport) and a concomitant reduction in responsiveness to prosecretory stimuli (nerve stimulation, carbachol, and forskolin). Longitudinal smooth muscle displayed altered spontaneous contractile activity, length-tension relationships, and carbachol-stimulated contraction in tissues excised from mice 20 and 40 h posttreatment. Anti-CD3 treatment did not affect stimulated ACh release from myenteric plexus neurons. We conclude that specific T cell activation via anti-CD3 antibody results in dramatic alterations in jejunal epithelial and smooth muscle function. Such T cell-induced changes in intestinal function may contribute to the symptomatology of T cell-mediated enteropathies, including graft-versus-host disease, celiac disease, and idiopathic inflammatory bowel disease.
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Affiliation(s)
- N Radojevic
- Intestinal Disease Research Programme, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
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Abstract
BACKGROUND Recent epidemiological studies have suggested that exposure to certain viruses and bacteria influences the development of allergy and allergic diseases, such as asthma. However, there is a paucity of experimental evidence examining the consequences of concurrent exposure to allergen and infectious agents, and the potential mechanisms by which allergic disease might be averted as a result. OBJECTIVE To model this situation experimentally, we investigated whether a virally induced immune response, elicited by a replication-deficient human type 5 adenovirus (RDA) administered at a site distant from the airways, could inhibit ovalbumin (OVA)-induced airways eosinophilic inflammation. METHODS C57BL/6 mice were infected intramuscularly with RDA 16h prior to intraperitoneal OVA sensitization. Cellular and cytokine responses in the lung/airways were examined after an OVA aerosol challenge. RESULTS RDA infection significantly inhibited the inflammatory response in the lung tissue after antigen challenge. In the bronchoalveolar lavage (BAL), total cell number, eosinophils and lymphocytes were decreased by 70, 85 and 65%, respectively, after antigen challenge in RDA-treated, compared with untreated, mice. RDA infection had no effect on IgE synthesis. The levels of IL-5, IL-4 and IFNgamma in the BAL after antigen challenge were significantly lower in RDA-treated mice. In vitro production of cytokines by splenocytes in response to OVA restimulation revealed a shift from IL-4 in sensitized, PBS-treated mice, to IFNgamma in sensitized mice treated with RDA. Flow cytometric analysis revealed that RDA infection increased the proportion of CD8 T cells in the BAL; this change in T-cell subsets was accompanied by an increase in both CD4 and CD8 T cells positive for intracellular IFNgamma. Inhibition of antigen-induced airways inflammation was IFNgamma-dependent but did not require IL-12, as RDA-treatment inhibited airways inflammation in IL-12 but not IFNgamma knock-out mice. CONCLUSION This study demonstrates that an immune response against a replication-deficient adenovirus during the initial exposure to OVA inhibits the development of airways inflammation after antigen aerosol challenge.
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Affiliation(s)
- M R Stämpfli
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
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Abstract
Mice deficient in CD8 T cells demonstrated levels of Th1 cytokines and granulomatous responses in the lungs very similar to those demonstrated by normal control mice and were fully capable of controlling pulmonary mycobacterial infection by Mycobacterium bovis BCG as assessed at day 37 postinfection. In comparison, mice deficient in CD4 T cells had similar levels of interleukin-12 (IL-12) and tumor necrosis factor alpha but lower levels of gamma interferon in the lungs and were still able to mount tissue granulomatous responses and control pulmonary mycobacterial infection. In contrast, IL-12(-/-) mice with impaired CD4 and CD8 T-cell responses had a markedly weakened control of infection, whereas SCID mice deficient in all T cells succumbed to such pulmonary mycobacterial infections.
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Affiliation(s)
- Z Xing
- Department of Pathology and Division of Infectious Diseases, Centre for Gene Therapeutics, McMaster University, Hamilton, Ontario, Canada.
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Vallance BA, Croitoru K, Collins SM. T lymphocyte-dependent and -independent intestinal smooth muscle dysfunction in the T. spiralis-infected mouse. Am J Physiol 1998; 275:G1157-65. [PMID: 9815046 DOI: 10.1152/ajpgi.1998.275.5.g1157] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We examined the profile of increased intestinal muscle contractility after primary infection with Trichinella spiralis in the mouse, correlating it with parasite expulsion. We also examined the extent to which the changes in muscle contraction were T lymphocyte dependent, by infecting athymic and SCID mice. Infection was accompanied by increased tension development by intestinal muscle. Two components of this response were identified, a rapid peak increase in tension generation observed on day 6 postinfection, and a smaller but sustained increase in tension evident thereafter in euthymic BALB/c mice. The peak muscle response was significantly delayed in infected athymic and SCID mice, along with a corresponding reduction in the magnitude of the sustained component. These changes were accompanied by reduced parasite expulsion in athymic and SCID mice, compared with euthymic mice. Reconstitution of T cell function in athymic mice restored both the acute and sustained profile of muscle contraction seen in euthymic mice, and this was accompanied by faster expulsion of the worms. These results identify T cell-dependent and -independent components of the muscle response to nematode infection in the mouse and suggest that the onset of the peak contractile response, as well as the magnitude of the sustained muscle response, contributes to parasite eviction from the gut.
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Affiliation(s)
- B A Vallance
- Intestinal Diseases Research Program, Health Sciences Center, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
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Lei XF, Ohkawara Y, Stämpfli MR, Gauldie J, Croitoru K, Jordana M, Xing Z. Compartmentalized transgene expression of granulocyte-macrophage colony-stimulating factor (GM-CSF) in mouse lung enhances allergic airways inflammation. Clin Exp Immunol 1998; 113:157-65. [PMID: 9717963 PMCID: PMC1905049 DOI: 10.1046/j.1365-2249.1998.00652.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To investigate the role of GM-CSF in asthmatic airways inflammation, we have targeted GM-CSF transgene to the airway cells in a mouse model of ovalbumin (OVA)-induced allergic airways inflammation, a model in which there is marked induction of endogenous IL-5 and IL-4 but not GM-CSF. Following intranasal delivery of a replication-deficient adenoviral gene transfer vector (Ad), transgene expression was found localized primarily to the respiratory epithelial cells. Intranasal delivery of 0.03 x 10(9) plaque-forming units (PFU) of AdGM-CSF into naive BALB/c mice resulted in prolonged and compartmentalized release of GM-CSF transgene protein with a peak concentration of approximately 80 pg/ml detected in bronchoalveolar lavage fluid (BALF) at day 7, but little in serum. These levels of local GM-CSF expression per se resulted in no eosinophilia and only a minimum of tissue inflammatory responses in the lung of naive mice, similar to those induced by the control vector. However, such GM-CSF expression in the airways of OVA-sensitized mice resulted in a much greater and sustained accumulation of various inflammatory cell types, most noticeably eosinophils, both in BALF and airway tissues for 15-21 days post-OVA aerosol challenge, at which times airways inflammation had largely resolved in control mice. While the levels of IL-5 and IL-4 in BALF and the rate of eosinophil apoptosis were found similar between different treatments, there was an increased number of proliferative leucocytes in the lung receiving GM-CSF gene transfer. Our results thus provide direct experimental evidence that GM-CSF can significantly contribute to the development of allergic airways inflammation through potentiating and prolonging inflammatory infiltration induced by cytokines such as IL-5 and IL-4.
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Affiliation(s)
- X F Lei
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
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Wakeham J, Wang J, Magram J, Croitoru K, Harkness R, Dunn P, Zganiacz A, Xing Z. Lack of both types 1 and 2 cytokines, tissue inflammatory responses, and immune protection during pulmonary infection by Mycobacterium bovis bacille Calmette-Guérin in IL-12-deficient mice. J Immunol 1998; 160:6101-11. [PMID: 9637527] [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: 02/07/2023]
Abstract
Understanding of key cytokines and the nature of protective immune responses in pulmonary mycobacterial diseases remains a task of paramount importance. In this study, both wild-type (wt) and IL-12-deficient (IL-12(-/-)) mice were infected by airways inoculation of live Mycobacterium bovis bacille Calmette-Guérin (BCG). The type 1 cytokines IL-12, IFN-gamma, and TNF-alpha, but not the type 2 cytokines IL-4 and granulocyte macrophage (GM)-CSF, markedly increased in the lung and peripheral blood of wt mice postinfection, which resulted in the development of intense granulomatous responses and the effective control of mycobacterial infection in the lung. In contrast, IL-12(-/-) mice demonstrated a lack of both types 1 and 2 cytokines in the lung and blood and a severely impaired tissue immune-inflammatory response lacking not only macrophages and neutrophils but CD4 and CD8 T cells and NK cells in the lung throughout the entire course of study. Total lung mononuclear cells isolated from these mice, in contrast to wt mice, had an impaired recall immune response to Ag challenge in vitro. These impaired responses resulted in an uncontrolled local growth and systemic spread of bacilli. Our findings reveal that IL-12 plays an irreplaceable role in the initiation of Th1 responses, and the loss of its function cannot be compensated for by alternative mechanisms in the lung. This cytokine, together with IFN-gamma and TNF-alpha, and granulomatous inflammation are critically required for the effective control of pulmonary mycobacterial infection. Our results also indicate that the absence of type 1 cytokines does not necessarily favor a Th2 response.
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Affiliation(s)
- J Wakeham
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
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Abstract
In chronic inflammatory bowel disease, self-destructive, exaggerated inflammation seems to occur in the absence of a well defined pathogen. However, epidemiological data strongly suggests that development of disease does not depend on endogenous factors alone. In this review, we summarize how a possible role for microbial factors can be reconciled with the current understanding of etiology and pathogenesis of IBD. The data presented does not support that IBD is an infectious disease nor that it is a self-antigen-specific autoimmune disease, however, recent findings increasingly suggest that tissue damage might be caused by a non-specific autoaggressive inflammation which is driven by common, ubiquitous microbial agents derived from the bacterial flora in the intestinal lumen.
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Affiliation(s)
- M Merger
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Arck PC, Ferrick DA, Steele-Norwood D, Croitoru K, Clark DA. Murine T cell determination of pregnancy outcome: I. Effects of strain, alphabeta T cell receptor, gammadelta T cell receptor, and gammadelta T cell subsets. Am J Reprod Immunol 1997; 37:492-502. [PMID: 9228307 DOI: 10.1111/j.1600-0897.1997.tb00265.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PROBLEM T cells bearing alphabeta T cell receptor (TcR) and gammadelta TcR are present at the fetomaternal interface, and the latter, which express surface activation markers, can react with fetal trophoblast cell antigens. What is the role of these cells? METHOD Using stress-abortion-prone DBA/2-mated CBA/J and abortion-resistant C57/B16 mice, alphabeta, gammadelta, and CD8+/- T cell subsets were measured in spleen and uterine decidua. The effect of immunization against abortion and administration of anti-TcR antibody in vivo was examined. Cytokine synthesis was measured by intracellular staining of Brefeldin A-treated cells. RESULTS Abortion-prone matings showed an unexpected accumulation of gammadelta T cells beginning in the peri-implantation period and this was suppressed by immunization against abortion. The immunization deleted gammadelta T cells producing the abortogenic cytokines, TNF-alpha and gamma-interferon, and increased production of the anti-abortive cytokines, IL-10 and transforming growth factor-beta2 (TGF-beta2). Immunization also boosted the number of alphabeta T cells which were present in the decidua as early as 2 days after implantation. In vivo injection of GL4 (anti-delta) depleted gammadelta T cells producing Th1 cytokines in the peri-implantation period, and prevented abortions, whereas H57 (anti-beta) decreased the number of alphabeta T cells and led to 100% abortions. CD8+ T cells present in peri-implant decidua before onset of abortions were mostly alphabeta TcR+, although some were gammadelta+. Changes in gammadelta and alphabeta T cells in pregnancy were most dramatic in uterine tissue. CONCLUSION Although decidual gammadelta T cells after formation of a distinct placenta and fetus produce anti-abortive TGF-beta2-like molecules and IL-10, prior events can lead to abortion. High local production of TNF-alpha and gamma-interferon develop during the peri-implantation phase because of an excessive increase in the Th1 cytokine+ subset of gammadelta cells; these cytokines may be contributed by other tissues in decidua, and the contribution of bioactive factors by gammadelta T cells may augment the cytokine pool. In contrast, alphabeta T cells (which may be inactivated by stress that causes abortions) may mediate the anti-abortive effect of alloimmunization. Alloimmunization involves a shift from a Th1 to a Th2 pattern in the gammadelta T cells in decidua.
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MESH Headings
- Abortion, Spontaneous/etiology
- Abortion, Spontaneous/immunology
- Abortion, Spontaneous/prevention & control
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/therapeutic use
- Decidua/immunology
- Decidua/pathology
- Disease Susceptibility
- Female
- H-2 Antigens/immunology
- Interferon-gamma/metabolism
- Male
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Mice, Inbred CBA
- Mice, Inbred DBA
- Pregnancy
- Pregnancy Outcome
- Pregnancy, Animal/immunology
- Receptors, Antigen, T-Cell, alpha-beta/immunology
- Receptors, Antigen, T-Cell, gamma-delta/immunology
- Spleen/immunology
- Stress, Physiological/complications
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/metabolism
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- P C Arck
- Department of Medicine, McMaster University Hamilton, Ontario, Canada
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Clark DA, Merali FS, Hoskin DW, Steel-Norwood D, Arck PC, Croitoru K, Murgita RA, Hirte H. Decidua-associated suppressor cells in abortion-prone DBA/2-mated CBA/J mice that release bioactive transforming growth factor beta2-related immunosuppressive molecules express a bone marrow-derived natural suppressor cell marker and gamma delta T-cell receptor. Biol Reprod 1997; 56:1351-60. [PMID: 9160738 DOI: 10.1095/biolreprod56.5.1351] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The decidua of allopregnant mice contains a novel population of Thy1 Lyt1 CD4 CD8 asialoGM1- non-B small lymphocytic suppressor cells that release transforming growth factor (TGF) SS2-related suppressor molecules. The "null" phenotype of this cell population is similar to some bone marrow-derived natural suppressor cell (NSC) populations, and the latter may release TGF(beta)s. We now report that the TGF beta2-producing suppressor cells in the uterine decidua of DBA/2-mated CBA/J female mice-linked to prevention of abortions-are inactivated effectively by 1E5/B5.1 but not by 2C1.1 rat monoclonal antibodies to murine pregnancy-associated splenic NSC in the presence of complement. Immunostaining of a subpopulation of cells in decidua with 1E5/B5.1 but not with 2C1.1 was shown by flow cytometry. Release of suppressor factor was also abrogated by 1E5/B5.1 + complement but not by 2C1.1 + complement, and the suppressor factor was specifically neutralized by anti-TGF beta2 and not by anti-TGF beta3. Splenic pregnancy NSC are susceptible to 2C1.1, produce TGF beta1, and express CD3 and alpha beta T-cell receptor (TcR) chains. Release of suppressor factor by the decidual NSC was abrogated by treatment with anti-CD3 (145 2C11) and anti-TcR gamma delta (GL4) monoclonal antibodies + complement, but not by anti-TcR alpha beta (H57) + complement; and cells sorted using anti-TcR gamma delta (GL3) released suppressive activity in vitro. Slightly more suppressive activity was released by implantation-site decidua where there was no epithelium than from epithelialized inter-implantation-site decidua; no significant activity was released from placental tissue, but combining implantation-site tissue with placental tissue led to release of enhanced levels of immunosuppressive activity. There appear to be subtypes of bone marrow-derived TcR+ NSC with different phenotypes and tissue localization patterns in pregnancy. The previously reported dependence of decidual NSC activity on the presence of soluble signals from fetal trophoblast may be explainable by the ability of cells bearing TcR gamma delta to recognize and react to placental trophoblast cell antigen.
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MESH Headings
- Abortion, Veterinary/etiology
- Abortion, Veterinary/immunology
- Abortion, Veterinary/pathology
- Animals
- Biomarkers
- Decidua/immunology
- Decidua/pathology
- Female
- Flow Cytometry
- Immunosuppressive Agents/metabolism
- Male
- Mice
- Mice, Inbred CBA
- Mice, Inbred DBA
- Pregnancy
- Rats
- Receptors, Antigen, T-Cell, gamma-delta/metabolism
- T-Lymphocytes, Regulatory/immunology
- T-Lymphocytes, Regulatory/pathology
- Transforming Growth Factor beta/metabolism
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Affiliation(s)
- D A Clark
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Abstract
PROBLEM T cells are present at the feto-maternal interface, but their function during pregnancy has not been fully elucidated. T cells bearing gamma delta T-cell receptor (TCR) may be particularly important, as some subsets can react to trophoblast cells by producing cytokines, such as interleukin-2 (IL-2). METHOD We depleted T cells bearing the gamma delta receptor by injecting monoclonal antibodies (mAb) into females of the abortion-prone animal model CBA x DBA/2. We investigated the percentage and number of gamma delta T-cell receptor positive (TCR)+ cells in decidua and spleen during pregnancy in control and gamma delta-depleted female mice. Pregnant females were also exposed to ultrasonic sound stress to boost the abortion rate. RESULTS Stress failed to increase the abortion rate in the gamma delta TCR-depleted mice. FACScan analysis show that the ratio of cells bearing the gamma delta TCR dramatically decreased after injection of mAB to the gamma delta TCR in spleen and decidua, these cells recovered six days after depletion, showing a change in cytokine pattern. Levels of TNF-alpha in decidual gamma delta T cells decreased; similar effects of decreasing Th1 cytokines could be observed in splenic gamma delta T cells. We further identified increased levels of intracellular TNF-alpha in the V delta 4 subset in the decidua, compared to spleen. CONCLUSIONS Trophoblast recognition by the V delta 4 T-cell subset in the decidua may cause the release of abortogenic cytokines such as TNF-alpha. Depletion of such gamma delta TCR T cells during early pregnancy may promote successful pregnancy outcome in normal pregnancy and prevent stress-induced abortions.
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Affiliation(s)
- P C Arck
- McMaster University, Dept. of Medicine, Hamilton, Ontario, Canada
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47
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Braciak TA, Bacon K, Xing Z, Torry DJ, Graham FL, Schall TJ, Richards CD, Croitoru K, Gauldie J. Overexpression of RANTES using a recombinant adenovirus vector induces the tissue-directed recruitment of monocytes to the lung. J Immunol 1996; 157:5076-84. [PMID: 8943417] [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: 02/03/2023]
Abstract
RANTES (regulated on activation, normal T cell expressed and secreted) is a member of the C-C superfamily of chemokines and is reported to function as a potent chemoattractant for monocytes, eosinophils, and a subpopulation of CD4+ T cells. Using a recombinant human type 5 adenovirus containing the murine RANTES cDNA (Ad5E3 mRANTES), which is capable of expressing biologically active cytokine upon infection, we initiated a study to characterize the biologic functions of RANTES cytokine in vivo. Intratracheal administration of Ad5E3 mRANTES targeted transient RANTES expression to the bronchial epithelium of the lung in Sprague-Dawley rats. Bronchoalveolar lavage fluids (BAL) collected at 24 h had increased chemotactic activity vs controls as measured in a murine CD4+ T cell Boyden chamber microchemotaxis assay. There was a dramatic increase in the number of cells (macrophage, monocytes, and neutrophils) recovered from BAL samples taken from Ad5E3 mRANTES-treated animals at 24 h, with a >50-fold increase in monocytes, indicating a proinflammatory effect for this cytokine in vivo. This effect on monocytes was transient, decreasing by 7 days, with evidence of increased eosinophils and lymphocytes at this time. Histologic examination of lung sections at 24 h revealed greatly increased numbers of mononuclear cells, primarily monocytes, within the lungs of Ad5E3 mRANTES-treated animals, with increased extravasation of monocytes around blood vessels, indicating an ongoing process of peripheral blood monocyte recruitment. This study provides further evidence for RANTES to be a monocyte chemoattractant in vivo.
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Affiliation(s)
- T A Braciak
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
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48
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Braciak TA, Bacon K, Xing Z, Torry DJ, Graham FL, Schall TJ, Richards CD, Croitoru K, Gauldie J. Overexpression of RANTES using a recombinant adenovirus vector induces the tissue-directed recruitment of monocytes to the lung. The Journal of Immunology 1996. [DOI: 10.4049/jimmunol.157.11.5076] [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: 01/01/2023]
Abstract
Abstract
RANTES (regulated on activation, normal T cell expressed and secreted) is a member of the C-C superfamily of chemokines and is reported to function as a potent chemoattractant for monocytes, eosinophils, and a subpopulation of CD4+ T cells. Using a recombinant human type 5 adenovirus containing the murine RANTES cDNA (Ad5E3 mRANTES), which is capable of expressing biologically active cytokine upon infection, we initiated a study to characterize the biologic functions of RANTES cytokine in vivo. Intratracheal administration of Ad5E3 mRANTES targeted transient RANTES expression to the bronchial epithelium of the lung in Sprague-Dawley rats. Bronchoalveolar lavage fluids (BAL) collected at 24 h had increased chemotactic activity vs controls as measured in a murine CD4+ T cell Boyden chamber microchemotaxis assay. There was a dramatic increase in the number of cells (macrophage, monocytes, and neutrophils) recovered from BAL samples taken from Ad5E3 mRANTES-treated animals at 24 h, with a >50-fold increase in monocytes, indicating a proinflammatory effect for this cytokine in vivo. This effect on monocytes was transient, decreasing by 7 days, with evidence of increased eosinophils and lymphocytes at this time. Histologic examination of lung sections at 24 h revealed greatly increased numbers of mononuclear cells, primarily monocytes, within the lungs of Ad5E3 mRANTES-treated animals, with increased extravasation of monocytes around blood vessels, indicating an ongoing process of peripheral blood monocyte recruitment. This study provides further evidence for RANTES to be a monocyte chemoattractant in vivo.
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Affiliation(s)
- T A Braciak
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - K Bacon
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - Z Xing
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - D J Torry
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - F L Graham
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - T J Schall
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - C D Richards
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - K Croitoru
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - J Gauldie
- Molecular Virology and Immunology Program, Department of Pathology, McMaster University, Hamilton, Ontario, Canada
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49
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Abstract
The mechanism whereby the intestinal microenvironment promotes T cell development in the absence of the thymus is unknown. We show that the murine intestine-derived epithelial cell line, MODE-K, can induce T cell differentiation marker expression in vitro on bone marrow (BM) T cell precursors. Three-color flow cytometry analysis of T-cell-depleted C3H BM mononuclear cells (MNC) after 4 days of coculture on monolayers of MODE-K indicated that approximately 25% of MNC expressed CD3 and TCR alpha beta. Of these CD3+ cells, 36% were CD3loCD4-CD8- double negative (DN), 34% were CD3loCD4+CD8 alpha beta+ double positive (DP), and the remainder were CD3hiCD4+CD8- or CD3hiCD4-CD8 alpha beta+ single positive (SP). In addition, the T cells which developed in coculture with MODE-K expressed the early T cell differentiation marker CD24 (heat-stable antigen). These T cells subsets did not develop when BM was cocultured with the LTA fibroblast cell line or in medium alone. Interestingly, preventing cell contact between MODE-K and BM by culturing in Transwell plates did not interfere with the development of T cells expressing the DN, DP, or SP phenotypes. Double-positive T cells did not develop if splenic MNC were cocultured with MODE-K. These results suggest that the intestinal epithelial environment can induce and support the T cell development from bone marrow precursors.
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Affiliation(s)
- D Maric
- Intestinal Disease Research Programme, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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50
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Gupta AA, Leal-Berumen I, Croitoru K, Marshall JS. Rat peritoneal mast cells produce IFN-gamma following IL-12 treatment but not in response to IgE-mediated activation. The Journal of Immunology 1996. [DOI: 10.4049/jimmunol.157.5.2123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Mast cells have been reported to secrete a wide range of immunoregulatory cytokines following IgE-mediated activation and to play an important role in allergic inflammation. We have previously demonstrated that mast cells can also produce certain cytokines following activation with bacterial LPS or prostanoids without preformed mediator release. IL-12 is a potent inducer of IFN-gamma production by T cells and NK cells, and is thought to play a critical role in determining the nature of the local immune response to infection. We here report that highly purified peritoneal mast cells from Brown Norway rats will produce IFN-gamma in response to IL-12 without significant histamine release. IFN-gamma protein was detected by ELISA in supernatants of mast cells cultured with 2 U/ml recombinant mouse IL-12 for between 6 and 24 h. The production of IFN-gamma was dependent on the dose of IL-12 and was significantly inhibited by concurrent treatment with IL-10 or PGE2. Supernatants from IL-12-stimulated mast cells induced MHC class II expression on the mouse epithelial cell line, MODE-K, by an IFN-gamma-dependent mechanism. Peritoneal mast cells cultured following activation with anti-IgE or LPS, under conditions that will induce the production of IL-6, demonstrated no detectable protein production of IFN-gamma. We conclude that mast cells are capable of contributing to the IFN-gamma response to IL-12, but substantial mast cell IFN-gamma production does not occur as a result of IgE-mediated activation. These observations have important implications for the role of the mast cell in local immune regulation.
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Affiliation(s)
- A A Gupta
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - I Leal-Berumen
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - K Croitoru
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
| | - J S Marshall
- Department of Pathology, McMaster University, Hamilton, Ontario, Canada
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