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Lin JB, Pepple KL, Concepcion C, Korshunova Y, Paley MA, Paley GL, Laurent J, Apte RS, Hassman LM. Aqueous Macrophages Contribute to Conserved CCL2 and CXCL10 Gradients in Uveitis. Ophthalmol Sci 2024; 4:100453. [PMID: 38650614 PMCID: PMC11033188 DOI: 10.1016/j.xops.2023.100453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 04/25/2024]
Abstract
Purpose Uveitis is a heterogenous group of inflammatory eye disease for which current cytokine-targeted immune therapies are effective for only a subset of patients. We hypothesized that despite pathophysiologic nuances that differentiate individual disease states, all forms of eye inflammation might share common mechanisms for immune cell recruitment. Identifying these mechanisms is critical for developing novel, broadly acting therapeutic strategies. Design Experimental study. Subjects Biospecimens from patients with active or inactive uveitis and healthy controls. Methods Protein concentration and single cell gene expression were assessed in aqueous fluid biopsies and plasma samples from deidentified patients with uveitis or healthy controls. Main Outcome Measures The concentration of 31 inflammatory proteins was measured in all aqueous samples, as well as plasma samples from patients with active uveitis. Chemokine and cytokine ligand and receptor expression were assessed in individual cell types from aqueous biopsies obtained from patients with active uveitis. Results We identified 6 chemokines that were both elevated in active uveitis compared with controls and enriched in aqueous compared with plasma during active uveitis (C-C motif chemokine ligand [CCL]2, C-X-C motif chemokine ligand [CXCL]10, CXCL9, CXCL8, CCL3, and CCL14), forming potential gradients for migration of immune cells from the blood to the eye. Of these, CCL2 and CXCL10 were consistently enriched in the aqueous of all patients in our cohort, as well as in a larger cohort of patients from a previously published study. These data suggest that CCL2 and CXCL10 are key mediators in immune cell migration to the eye during uveitis. Next, single cell RNA sequencing suggested that macrophages contribute to aqueous enrichment of CCL2 and CXCL10 during human uveitis. Finally, using chemokine ligand and receptor expression mapping, we identified a broad signaling network for macrophage-derived CCL2 and CXCL10 in human uveitis. Conclusions These data suggest that ocular macrophages may play a central role, via CCL2 and CXCL10 production, in recruiting inflammatory cells to the eye in patients with uveitis. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Joseph B. Lin
- John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
- Neurosciences Graduate Program, Roy and Diana Vagelos Division of Biology and Biomedical Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Kathryn L. Pepple
- Department of Ophthalmology, Roger and Angie Karalis Johnson Retina Center, University of Washington, Seattle, Washington
| | - Christian Concepcion
- John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Yulia Korshunova
- John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Michael A. Paley
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Grace L. Paley
- John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer Laurent
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Rajendra S. Apte
- John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri
- Center for Regenerative Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Lynn M. Hassman
- John F. Hardesty, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
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2
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Pawar N, Taylor KE, Yang M, Deepak P, Kim W, Paley MA, Matloubian M, Carvidi A, Ciorba MA, Demissie E, El‐Qunni A, Huang K, Kinnett B, McMorrow LE, Paez D, Poole M, Rose A, Schriefer RE, Kim AH, Nakamura M, Katz P, Gensler LS. Sleep Disturbance and SARS-CoV-2 Vaccinations in Patients With Chronic Inflammatory Disease. Arthritis Care Res (Hoboken) 2023; 75:1849-1856. [PMID: 36479599 PMCID: PMC9877722 DOI: 10.1002/acr.25065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/26/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Immunocompromised patients with chronic inflammatory disease (CID) may have experienced additional psychosocial burden during the COVID-19 pandemic due to their immunocompromised status. This study was undertaken to determine if vaccination would result in improved patient-reported outcomes longitudinally among individuals with CID undergoing SARS-CoV-2 vaccination regardless of baseline anxiety. METHODS Data are from a cohort of individuals with CID from 2 sites who underwent SARS-CoV-2 vaccination. Participants completed 3 study visits before and after 2 messenger RNA vaccine doses in the initial vaccination series when clinical data were collected. Patient-reported outcomes were measured using the Patient-Reported Outcomes Measurement Information System 29-item Health Profile and expressed as T scores, with 2 groups stratified by high and low baseline anxiety. Mixed-effects models were used to examine longitudinal changes, adjusting for age, sex, and study site. RESULTS A total of 72% of the cohort was female with a mean ± SD age of 48.1 ± 15.5 years. Overall, sleep disturbance improved following both doses of SARS-CoV-2 vaccinations, and anxiety decreased after the second dose. Physical function scores worsened but did not meet the minimally important difference threshold. When stratifying by baseline anxiety, improvement in anxiety, fatigue, and social participation were greater in the high anxiety group. Physical function worsened slightly in both groups, and sleep disturbance improved significantly in the high anxiety group. CONCLUSION Sleep disturbance decreased in a significant and meaningful way in patients with CID upon vaccination. In patients with higher baseline anxiety, social participation increased, and anxiety, fatigue, and sleep disturbance decreased. Overall, results suggest that SARS-CoV-2 vaccination may improve mental health and well-being, particularly among those with greater anxiety.
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Affiliation(s)
- Niti Pawar
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Kimberly E. Taylor
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Monica Yang
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Parakkal Deepak
- Division of Gastroenterology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Wooseob Kim
- Division of Immunobiology, Department of Pathology & ImmunologyWashington University School of Medicine
| | - Michael A. Paley
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Mehrdad Matloubian
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Alex Carvidi
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Matthew A. Ciorba
- Division of Gastroenterology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Emanuel Demissie
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Alia El‐Qunni
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Katherine Huang
- Division of Gastroenterology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Baylee Kinnett
- Division of Gastroenterology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Lily E. McMorrow
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Diana Paez
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Mackenzie Poole
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Abigail Rose
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Rebecca E. Schriefer
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Alfred H.J. Kim
- Division of Rheumatology, Department of MedicineWashington University in St. Louis School of MedicineSt. LouisMO
| | - Mary Nakamura
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Patricia Katz
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
| | - Lianne S. Gensler
- University of California, School of Medicine Division of RheumatologySan FranciscoCA
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3
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Greene SE, Huang Y, Kim W, Liebeskind MJ, Chandrasekaran V, Liu Z, Deepak P, Paley MA, Lew D, Yang M, Matloubian M, Gensler LS, Nakamura MC, O'Hallaran JA, Presti RM, Whelan SPJ, Buchser WJ, Kim AHJ, Weil GJ. A simple point-of-care assay accurately detects anti-spike antibodies after SARS-CoV-2 vaccination. J Clin Virol Plus 2023; 3:100135. [PMID: 36644774 PMCID: PMC9831968 DOI: 10.1016/j.jcvp.2023.100135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
Objective Lateral flow assays (LFA) are sensitive for detecting antibodies to SARS-CoV-2 proteins within weeks after infection. This study tested samples from immunocompetent adults, and those receiving treatments for chronic inflammatory diseases (CID), before and after mRNA SARS-CoV-2 vaccination. Methods We compared results obtained with the COVIBLOCK Covid-19 LFA to those obtained by anti-spike (S) ELISA. Results The LFA detected anti-S antibodies in 29 of 29 (100%) of the immunocompetent and 110 of 126 (87.3%) of the CID participants after vaccination. Semiquantitative LFA scores were statistically significantly lower in samples from immunosuppressed participants, and were significantly correlated with anti-S antibody levels measured by ELISA. Conclusions This simple LFA test is a practical alternative to laboratory-based assays for detecting anti-S antibodies after infection or vaccination. This type of test may be most useful for testing people in outpatient or resource-limited settings.
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Affiliation(s)
- Sarah E Greene
- Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, 4444 Forest Park Avenue, Rm 4184 , St. Louis, MO 63110, United States
| | - Yuefang Huang
- Division of Infectious Diseases, Department of Medicine, Washington University, St. Louis, MO, United States
| | - Wooseob Kim
- Division of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Mariel J Liebeskind
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, United States
| | - Vinay Chandrasekaran
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, United States
| | - Zhuoming Liu
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Parakkal Deepak
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Michael A Paley
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Daphne Lew
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, United States
| | - Monica Yang
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Mehrdad Matloubian
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Lianne S Gensler
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States.,San Francisco VA Health Care System, San Francisco, CA, United States
| | - Mary C Nakamura
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, United States.,San Francisco VA Health Care System, San Francisco, CA, United States
| | - Jane A O'Hallaran
- Division of Infectious Diseases, Department of Medicine, Washington University, St. Louis, MO, United States
| | - Rachel M Presti
- Division of Infectious Diseases, Department of Medicine, Washington University, St. Louis, MO, United States
| | - Sean P J Whelan
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, United States
| | - William J Buchser
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, United States
| | - Alfred H J Kim
- Division of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States.,Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Gary J Weil
- Division of Infectious Diseases, Department of Medicine, Washington University, St. Louis, MO, United States
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4
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Yang X, Garner LI, Zvyagin IV, Paley MA, Komech EA, Jude KM, Zhao X, Fernandes RA, Hassman LM, Paley GL, Savvides CS, Brackenridge S, Quastel MN, Chudakov DM, Bowness P, Yokoyama WM, McMichael AJ, Gillespie GM, Garcia KC. Autoimmunity-associated T cell receptors recognize HLA-B*27-bound peptides. Nature 2022; 612:771-777. [PMID: 36477533 PMCID: PMC10511244 DOI: 10.1038/s41586-022-05501-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 11/01/2022] [Indexed: 12/12/2022]
Abstract
Human leucocyte antigen B*27 (HLA-B*27) is strongly associated with inflammatory diseases of the spine and pelvis (for example, ankylosing spondylitis (AS)) and the eye (that is, acute anterior uveitis (AAU))1. How HLA-B*27 facilitates disease remains unknown, but one possible mechanism could involve presentation of pathogenic peptides to CD8+ T cells. Here we isolated orphan T cell receptors (TCRs) expressing a disease-associated public β-chain variable region-complementary-determining region 3β (BV9-CDR3β) motif2-4 from blood and synovial fluid T cells from individuals with AS and from the eye in individuals with AAU. These TCRs showed consistent α-chain variable region (AV21) chain pairing and were clonally expanded in the joint and eye. We used HLA-B*27:05 yeast display peptide libraries to identify shared self-peptides and microbial peptides that activated the AS- and AAU-derived TCRs. Structural analysis revealed that TCR cross-reactivity for peptide-MHC was rooted in a shared binding motif present in both self-antigens and microbial antigens that engages the BV9-CDR3β TCRs. These findings support the hypothesis that microbial antigens and self-antigens could play a pathogenic role in HLA-B*27-associated disease.
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Affiliation(s)
- Xinbo Yang
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Lee I Garner
- NDM Research Building, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Centre for Immuno-oncology, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Ivan V Zvyagin
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Institute of Translational Medicine, Pirogov Russian National Research Medical University, Moscow, Russian Federation
- Genomics of Adaptive Immunity Department, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russian Federation
| | - Michael A Paley
- Rheumatology Division, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Ekaterina A Komech
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Institute of Translational Medicine, Pirogov Russian National Research Medical University, Moscow, Russian Federation
- Genomics of Adaptive Immunity Department, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russian Federation
| | - Kevin M Jude
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Xiang Zhao
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Ricardo A Fernandes
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Lynn M Hassman
- Department of Ophthalmology, Washington University School of Medicine, St Louis, MO, USA
| | - Grace L Paley
- Department of Ophthalmology, Washington University School of Medicine, St Louis, MO, USA
| | - Christina S Savvides
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, USA
| | - Simon Brackenridge
- NDM Research Building, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Centre for Immuno-oncology, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Max N Quastel
- NDM Research Building, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Centre for Immuno-oncology, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Dmitriy M Chudakov
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Institute of Translational Medicine, Pirogov Russian National Research Medical University, Moscow, Russian Federation
- Genomics of Adaptive Immunity Department, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russian Federation
| | - Paul Bowness
- Nuffield Department of Orthopaedics Rheumatology and Muscuoskeletal Science (NDORMS), Botnar Research Center, University of Oxford, Oxford, UK
| | - Wayne M Yokoyama
- Rheumatology Division, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
- Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St Louis, MO, USA.
| | - Andrew J McMichael
- NDM Research Building, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Centre for Immuno-oncology, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Geraldine M Gillespie
- NDM Research Building, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Centre for Immuno-oncology, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - K Christopher Garcia
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Structural Biology, Stanford University School of Medicine, Stanford, CA, USA.
- Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, CA, USA.
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5
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Yang MM, Taylor KE, Paez D, Carividi A, Demissie E, Pawar N, El-Qunni AA, McMorrow LE, Schriefer RE, Huang K, Kinnett B, Klebert M, Haile A, O'Halloran JA, Presti RM, Kim W, Ellebedy AH, Ciorba MA, Paley MA, Deepak P, Kim AHJ, Katz P, Matloubian M, Nakamura M, Gensler LS. Reactogenicity of the Messenger RNA SARS-CoV-2 Vaccines Associated With Immunogenicity in Patients With Autoimmune and Inflammatory Disease. Arthritis Care Res (Hoboken) 2022; 74:1953-1960. [PMID: 35412029 PMCID: PMC9073989 DOI: 10.1002/acr.24894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 03/21/2022] [Accepted: 04/07/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Little is known regarding the reactogenicity and related SARS-CoV-2 vaccine response in patients with chronic inflammatory disease (CID). Our objective was to characterize the adverse event profile of CID patients following SARS-CoV-2 vaccination and understand the relationship between reactogenicity and immunogenicity of SARS-CoV-2 vaccines. METHODS CID patients and healthy controls eligible to receive messenger RNA (mRNA) SARS-CoV-2 vaccines participated in 3 study visits (pre-vaccine, after dose 1, and after dose 2) in which blood and clinical data were collected. Assessment of adverse events were solicited within 7 days of receiving each dose. Serum anti-SARS-CoV-2 spike IgG ± antibody titers were quantified following vaccination. Statistical analysis was performed utilizing mixed models and tobit regressions, with adjustment for covariates. RESULTS The present study included 441 participants (322 CID patients and 119 control subjects). Compared to controls, CID patients reported greater symptom severity after dose 1 (P = 0.0001), including more myalgia and fatigue (P < 0.05). For immunogenicity, a higher symptom severity after dose 1 and a higher number of symptoms after dose 2 was associated with higher antibody titers (P ≤ 0.05). Each increase of 1 symptom was associated with a 15.1% increase in antibody titer. Symptom association was strongest with site pain after dose 1 (105%; P = 0.03) and fatigue after dose 2 (113%; P = 0.004). CONCLUSION Patients with CID have a distinct reactogenicity profile following SARS-CoV-2 vaccination compared to controls. Furthermore, there is an association between increased reactogenicity and increased vaccine response. This finding may speak to the more variable immunogenicity in CID patients and may be an important indicator of vaccine response to the novel SARS-CoV-2 vaccines.
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Affiliation(s)
| | | | | | | | | | | | - Alia A El-Qunni
- Washington University School of Medicine, St. Louis, Missouri
| | - Lily E McMorrow
- Washington University School of Medicine, St. Louis, Missouri
| | | | - Katherine Huang
- Washington University School of Medicine, St. Louis, Missouri
| | - Baylee Kinnett
- Washington University School of Medicine, St. Louis, Missouri
| | - Michael Klebert
- Washington University School of Medicine, St. Louis, Missouri
| | - Alem Haile
- Washington University School of Medicine, St. Louis, Missouri
| | | | - Rachel M Presti
- Washington University School of Medicine, St. Louis, Missouri
| | - Wooseob Kim
- Washington University School of Medicine, St. Louis, Missouri
| | - Ali H Ellebedy
- Washington University School of Medicine, St. Louis, Missouri
| | | | - Michael A Paley
- Washington University School of Medicine, St. Louis, Missouri
| | - Parakkal Deepak
- Washington University School of Medicine, St. Louis, Missouri
| | - Alfred H J Kim
- Washington University School of Medicine, St. Louis, Missouri
| | | | | | - Mary Nakamura
- University of California, San Francisco and San Francisco Veterans Administration Health Care System, San Francisco, California
| | - Lianne S Gensler
- University of California, San Francisco and San Francisco Veterans Administration Health Care System, San Francisco, California
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Sultan H, Rajagopal R, Rao PK, Piggott KD, Paley MA, Hassman LM, Li AS, Marshall B, Apte RS. Vitreous microparticles contain apoptotic signals suggesting a diabetic vitreopathy. Int J Ophthalmol 2022; 15:89-97. [PMID: 35047362 DOI: 10.18240/ijo.2022.01.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate differences in microparticle profiles in vitreous samples between diabetic and non-diabetic eyes undergoing vitrectomy. METHODS Un-masked cross-sectional series of 34 eyes undergoing vitrectomy. Vitreous specimens were collected and processed to evaluate for membrane integrity (DAPI), apoptosis (Annexin-V), and endothelial-cell origin (V-Cadherin). A BD LSR II flow cytometer was used for analysis and standardized sub-micron-sized beads were used for size comparison. RESULTS Thirty-four specimens underwent analysis. Greater levels of Annexin-V were found on microparticles from specimens in which blood had entered the vitreous (n=12) compared to those without blood (n=22; 52.3%±30.7% vs 19.6%±27.2%, P=0.002). Patients with diabetes having surgery with hemorrhage (n=7) had greater expression of Annexin-V than those without hemorrhage (n=8; 62.1%±31.7% vs 18.9%±20.9%, P=0.009). However, in patients with non-diabetic vitreous hemorrhage, the level of Annexin-V expression was not significantly different compared to other disease processes (38.6%±25.7%, n=5 vs 20.0%±30.9%, n=14, P=0.087). CONCLUSION Increased expression of the apoptotic marker, Annexin-V is detected on vitreous microparticles in diabetes-related vitreous hemorrhage. When evaluating vitreous hemorrhage in patients without diabetes, the apoptotic signal is not significantly different. Vitrectomy in patients with diabetes, and improvement in visual outcomes, may be related to the removal of a serum-derived, pro-apoptotic vitreous. Further investigation is warranted in order to identify the molecular characteristics of microparticles that regulate disease.
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Affiliation(s)
- Harris Sultan
- John Hardesty Department of Ophthalmology, Washington University, St. Louis, MO 63110, USA
| | - Rithwick Rajagopal
- John Hardesty Department of Ophthalmology, Washington University, St. Louis, MO 63110, USA
| | - Prabakar Kumar Rao
- John Hardesty Department of Ophthalmology, Washington University, St. Louis, MO 63110, USA
| | - Kisha Deslee Piggott
- John Hardesty Department of Ophthalmology, Washington University, St. Louis, MO 63110, USA
| | - Michael A Paley
- Department of Medicine, Division of Rheumatology, Washington University, St. Louis, MO 63110, USA
| | - Lynn Marisa Hassman
- John Hardesty Department of Ophthalmology, Washington University, St. Louis, MO 63110, USA
| | - Albert S Li
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Brigid Marshall
- John Hardesty Department of Ophthalmology, Washington University, St. Louis, MO 63110, USA
| | - Rajendra Shridhar Apte
- John Hardesty Department of Ophthalmology, Washington University, St. Louis, MO 63110, USA
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7
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Chen RE, Gorman MJ, Zhu DY, Carreño JM, Yuan D, VanBlargan LA, Burdess S, Lauffenburger DA, Kim W, Turner JS, Droit L, Handley SA, Chahin S, Deepak P, O'Halloran JA, Paley MA, Presti RM, Wu GF, Krammer F, Alter G, Ellebedy AH, Kim AHJ, Diamond MS. Reduced antibody activity against SARS-CoV-2 B.1.617.2 delta virus in serum of mRNA-vaccinated individuals receiving tumor necrosis factor-α inhibitors. Med 2021; 2:1327-1341.e4. [PMID: 34812429 PMCID: PMC8599018 DOI: 10.1016/j.medj.2021.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/27/2021] [Accepted: 11/11/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although vaccines effectively prevent coronavirus disease 2019 (COVID-19) in healthy individuals, they appear to be less immunogenic in individuals with chronic inflammatory disease (CID) or receiving chronic immunosuppression therapy. METHODS Here we assessed a cohort of 77 individuals with CID treated as monotherapy with chronic immunosuppressive drugs for antibody responses in serum against historical and variant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viruses after immunization with the BNT162b2 mRNA vaccine. FINDINGS Longitudinal analysis showed the greatest reductions in neutralizing antibodies and Fc effector function capacity in individuals treated with tumor necrosis factor alpha (TNF-α) inhibitors (TNFi), and this pattern appeared to be worse against the B.1.617.2 delta virus. Within 5 months of vaccination, serum neutralizing titers of all TNFi-treated individuals tested fell below the presumed threshold correlate for antibody-mediated protection. However, TNFi-treated individuals receiving a third mRNA vaccine dose boosted their serum neutralizing antibody titers by more than 16-fold. CONCLUSIONS Vaccine boosting or administration of long-acting prophylaxis (e.g., monoclonal antibodies) will likely be required to prevent SARS-CoV-2 infection in this susceptible population. FUNDING This study was supported by grants and contracts from the NIH (R01 AI157155, R01AI151178, and HHSN75N93019C00074; NIAID Centers of Excellence for Influenza Research and Response (CEIRR) contracts HHSN272201400008C and 75N93021C00014; and Collaborative Influenza Vaccine Innovation Centers [CIVIC] contract 75N93019C00051).
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Affiliation(s)
- Rita E Chen
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Daniel Y Zhu
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dansu Yuan
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Laura A VanBlargan
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Samantha Burdess
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Wooseob Kim
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jackson S Turner
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Lindsay Droit
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Scott A Handley
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Salim Chahin
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Parakkal Deepak
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jane A O'Halloran
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael A Paley
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel M Presti
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO, USA
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO, USA
| | - Gregory F Wu
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Ali H Ellebedy
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
- Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO, USA
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO, USA
| | - Alfred H J Kim
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO, USA
| | - Michael S Diamond
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
- Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, Saint Louis, MO, USA
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, Saint Louis, MO, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA
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Deepak P, Kim W, Paley MA, Yang M, Carvidi AB, Demissie EG, El-Qunni AA, Haile A, Huang K, Kinnett B, Liebeskind MJ, Liu Z, McMorrow LE, Paez D, Pawar N, Perantie DC, Schriefer RE, Sides SE, Thapa M, Gergely M, Abushamma S, Akuse S, Klebert M, Mitchell L, Nix D, Graf J, Taylor KE, Chahin S, Ciorba MA, Katz P, Matloubian M, O'Halloran JA, Presti RM, Wu GF, Whelan SPJ, Buchser WJ, Gensler LS, Nakamura MC, Ellebedy AH, Kim AHJ. Effect of Immunosuppression on the Immunogenicity of mRNA Vaccines to SARS-CoV-2 : A Prospective Cohort Study. Ann Intern Med 2021; 174:1572-1585. [PMID: 34461029 PMCID: PMC8407518 DOI: 10.7326/m21-1757] [Citation(s) in RCA: 220] [Impact Index Per Article: 73.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Patients with chronic inflammatory disease (CID) treated with immunosuppressive medications have increased risk for severe COVID-19. Although mRNA-based SARS-CoV-2 vaccination provides protection in immunocompetent persons, immunogenicity in immunosuppressed patients with CID is unclear. OBJECTIVE To determine the immunogenicity of mRNA-based SARS-CoV-2 vaccines in patients with CID. DESIGN Prospective observational cohort study. SETTING Two U.S. CID referral centers. PARTICIPANTS Volunteer sample of adults with confirmed CID eligible for early COVID-19 vaccination, including hospital employees of any age and patients older than 65 years. Immunocompetent participants were recruited separately from hospital employees. All participants received 2 doses of mRNA vaccine against SARS-CoV-2 between 10 December 2020 and 20 March 2021. Participants were assessed within 2 weeks before vaccination and 20 days after final vaccination. MEASUREMENTS Anti-SARS-CoV-2 spike (S) IgG+ binding in all participants, and neutralizing antibody titers and circulating S-specific plasmablasts in a subset to assess humoral response after vaccination. RESULTS Most of the 133 participants with CID (88.7%) and all 53 immunocompetent participants developed antibodies in response to mRNA-based SARS-CoV-2 vaccination, although some with CID developed numerically lower titers of anti-S IgG. Anti-S IgG antibody titers after vaccination were lower in participants with CID receiving glucocorticoids (n = 17) than in those not receiving them; the geometric mean of anti-S IgG antibodies was 357 (95% CI, 96 to 1324) for participants receiving prednisone versus 2190 (CI, 1598 to 3002) for those not receiving it. Anti-S IgG antibody titers were also lower in those receiving B-cell depletion therapy (BCDT) (n = 10). Measures of immunogenicity differed numerically between those who were and those who were not receiving antimetabolites (n = 48), tumor necrosis factor inhibitors (n = 39), and Janus kinase inhibitors (n = 11); however, 95% CIs were wide and overlapped. Neutralization titers seemed generally consistent with anti-S IgG results. Results were not adjusted for differences in baseline clinical factors, including other immunosuppressant therapies. LIMITATIONS Small sample that lacked demographic diversity, and residual confounding. CONCLUSION Compared with nonusers, patients with CID treated with glucocorticoids and BCDT seem to have lower SARS-CoV-2 vaccine-induced antibody responses. These preliminary findings require confirmation in a larger study. PRIMARY FUNDING SOURCE The Leona M. and Harry B. Helmsley Charitable Trust, Marcus Program in Precision Medicine Innovation, National Center for Advancing Translational Sciences, and National Institute of Arthritis and Musculoskeletal and Skin Diseases.
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Affiliation(s)
- Parakkal Deepak
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Wooseob Kim
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Michael A Paley
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Monica Yang
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Alexander B Carvidi
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Emanuel G Demissie
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Alia A El-Qunni
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Alem Haile
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Katherine Huang
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Baylee Kinnett
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Mariel J Liebeskind
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Zhuoming Liu
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Lily E McMorrow
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Diana Paez
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Niti Pawar
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Dana C Perantie
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Rebecca E Schriefer
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Shannon E Sides
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Mahima Thapa
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Maté Gergely
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Suha Abushamma
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Sewuese Akuse
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Michael Klebert
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Lynne Mitchell
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Darren Nix
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Jonathan Graf
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Kimberly E Taylor
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Salim Chahin
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Matthew A Ciorba
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Patricia Katz
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Mehrdad Matloubian
- University of California San Francisco, San Francisco, California (M.Y., A.B.C., E.G.D., D.P., N.P., J.G., K.E.T., P.K., M.M.)
| | - Jane A O'Halloran
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Rachel M Presti
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Gregory F Wu
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Sean P J Whelan
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - William J Buchser
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Lianne S Gensler
- University of California San Francisco and San Francisco VA Health Care System, San Francisco, California (L.S.G., M.C.N.)
| | - Mary C Nakamura
- University of California San Francisco and San Francisco VA Health Care System, San Francisco, California (L.S.G., M.C.N.)
| | - Ali H Ellebedy
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
| | - Alfred H J Kim
- Washington University School of Medicine, St. Louis, Missouri (P.D., W.K., M.A.P., A.A.E., A.H., K.H., B.K., M.J.L., Z.L., L.E.M., D.C.P., R.E.S., S.E.S., M.T., M.G., S.A., S.A., M.K., L.M., D.N., S.C., M.A.C., J.A.O., R.M.P., G.F.W., S.P.W., W.J.B., A.H.E., A.H.K.)
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Rosenbaum JT, Harrington CA, Searles RP, Fei SS, Zaki A, Arepalli S, Paley MA, Hassman LM, Vitale AT, Conrady CD, Keath P, Mitchell C, Watson L, Planck SR, Martin TM, Choi D. Identifying RNA Biomarkers and Molecular Pathways Involved in Multiple Subtypes of Uveitis. Am J Ophthalmol 2021; 226:226-234. [PMID: 33503442 DOI: 10.1016/j.ajo.2021.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Uveitis is a heterogeneous collection of diseases. We tested the hypothesis that despite the diversity of uveitides, there could be common mechanisms shared by multiple subtypes, and that evidence of these common mechanisms may be detected as gene expression profiles in whole blood. DESIGN Cohort study. METHODS Ninety subjects with uveitis including axial spondyloarthritis (n = 17), sarcoidosis (n = 13), inflammatory bowel disease (n = 12), tubulointerstitial nephritis with uveitis (n = 10), or idiopathic uveitis (n = 38) as well as 18 healthy controls were enrolled, predominantly at Oregon Health & Science University. RNA-Seq data generated from peripheral, whole blood identified 19,859 unique transcripts. We analyzed gene expression pathways via Kyoto Encyclopedia of Genes and Genomes and Gene Ontology (GO). We validated our list of upregulated genes by comparison to a previously published study on peripheral blood gene expression among 50 subjects with diverse forms of uveitis. RESULTS Both the Kyoto Encyclopedia of Genes and Genomes and GO analysis identified multiple shared pathways or GO terms with a P value of <.0001. Almost all pathways related to the immune response and/or response to an infection. A total of 119 individual transcripts were upregulated by at least 1.5-fold and false discovery rate <.05, and 61 were downregulated by similar criteria. Comparing mRNA from our study with a false discovery rate <.05 and the prior report, we identified 10 common gene transcripts: ICAM1, IL15RA, IL15, IRF1, IL10RB, GSK3A, TYK2, MEF2A, MEF2B, and MEF2D. CONCLUSIONS Many forms of uveitis share overlapping mechanisms. These data support the concept that a single therapeutic approach could benefit diverse forms of this disease.
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James H, Paley GL, Brasington R, Custer PL, Margolis TP, Paley MA. Tofacitinib for refractory ocular mucous membrane pemphigoid. Am J Ophthalmol Case Rep 2021; 22:101104. [PMID: 34007952 PMCID: PMC8111584 DOI: 10.1016/j.ajoc.2021.101104] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 01/18/2021] [Accepted: 04/11/2021] [Indexed: 12/30/2022] Open
Abstract
Purpose To report the successful use of tofacitinib in the treatment of refractory ocular mucous membrane pemphigoid (MMP). Observations Two patients with ocular MMP presented with refractory disease after failure of multiple therapies. Treatment with tofacitinib led to durable control of conjunctival inflammation within 8 weeks and no apparent progression of sub-conjunctival fibrosis. One patient maintained absence of apparent disease activity over 16 months of follow-up. Cessation of tofacitinib in the other patient led to disease relapse which was reversed by re-initiation of therapy. Conclusions and importance Small molecule inhibitors of Janus kinases, such as tofacitinib, may offer an effective treatment option for refractory ocular MMP.
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Affiliation(s)
- Hayley James
- Department of Ophthalmology and Visual Sciences, Washington University in Saint Louis, Center for Outpatient Health, 6th floor, 4901 Forest Park Avenue, Saint Louis, MO, 63110, USA
| | - Grace L Paley
- Department of Ophthalmology and Visual Sciences, Washington University in Saint Louis, Center for Outpatient Health, 6th floor, 4901 Forest Park Avenue, Saint Louis, MO, 63110, USA
| | - Richard Brasington
- Department of Ophthalmology and Visual Sciences, Washington University in Saint Louis, Center for Outpatient Health, 6th floor, 4901 Forest Park Avenue, Saint Louis, MO, 63110, USA.,Division of Rheumatology, Department of Medicine, Washington University in Saint Louis, Center for Advanced Medicine, 5th floor Suite C, 4921 Parkview Place, Saint Louis, MO, 63110, USA
| | - Philip L Custer
- Department of Ophthalmology and Visual Sciences, Washington University in Saint Louis, Center for Outpatient Health, 6th floor, 4901 Forest Park Avenue, Saint Louis, MO, 63110, USA
| | - Todd P Margolis
- Department of Ophthalmology and Visual Sciences, Washington University in Saint Louis, Center for Outpatient Health, 6th floor, 4901 Forest Park Avenue, Saint Louis, MO, 63110, USA
| | - Michael A Paley
- Division of Rheumatology, Department of Medicine, Washington University in Saint Louis, Center for Advanced Medicine, 5th floor Suite C, 4921 Parkview Place, Saint Louis, MO, 63110, USA
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11
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Deepak P, Kim W, Paley MA, Yang M, Carvidi AB, El-Qunni AA, Haile A, Huang K, Kinnett B, Liebeskind MJ, Liu Z, McMorrow LE, Paez D, Perantie DC, Schriefer RE, Sides SE, Thapa M, Gergely M, Abushamma S, Klebert M, Mitchell L, Nix D, Graf J, Taylor KE, Chahin S, Ciorba MA, Katz P, Matloubian M, O'Halloran JA, Presti RM, Wu GF, Whelan SPJ, Buchser WJ, Gensler LS, Nakamura MC, Ellebedy AH, Kim AHJ. Glucocorticoids and B Cell Depleting Agents Substantially Impair Immunogenicity of mRNA Vaccines to SARS-CoV-2. medRxiv 2021:2021.04.05.21254656. [PMID: 33851176 PMCID: PMC8043473 DOI: 10.1101/2021.04.05.21254656] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Individuals with chronic inflammatory diseases (CID) are frequently treated with immunosuppressive medications that can increase their risk of severe COVID-19. While novel mRNA-based SARS-CoV-2 vaccination platforms provide robust protection in immunocompetent individuals, the immunogenicity in CID patients on immunosuppression is not well established. Therefore, determining the effectiveness of SARS-CoV-2 vaccines in the setting of immunosuppression is essential to risk-stratify CID patients with impaired protection and provide clinical guidance regarding medication management. METHODS We conducted a prospective assessment of mRNA-based vaccine immunogenicity in 133 adults with CIDs and 53 immunocompetent controls. Blood from participants over 18 years of age was collected before initial immunization and 1-2 weeks after the second immunization. Serum anti-SARS-CoV-2 spike (S) IgG + binding, neutralizing antibody titers, and circulating S-specific plasmablasts were quantified to assess the magnitude and quality of the humoral response following vaccination. RESULTS Compared to immunocompetent controls, a three-fold reduction in anti-S IgG titers (P=0.009) and SARS-CoV-2 neutralization (p<0.0001) were observed in CID patients. B cell depletion and glucocorticoids exerted the strongest effect with a 36- and 10-fold reduction in humoral responses, respectively (p<0.0001). Janus kinase inhibitors and antimetabolites, including methotrexate, also blunted antibody titers in multivariate regression analysis (P<0.0001, P=0.0023, respectively). Other targeted therapies, such as TNF inhibitors, IL-12/23 inhibitors, and integrin inhibitors, had only modest impacts on antibody formation and neutralization. CONCLUSIONS CID patients treated with immunosuppressive therapies exhibit impaired SARS-CoV-2 vaccine-induced immunity, with glucocorticoids and B cell depletion therapy more severely impeding optimal responses.
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Affiliation(s)
- Parakkal Deepak
- Inflammatory Bowel Diseases Center, Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Wooseob Kim
- Division of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael A Paley
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Monica Yang
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Alexander B Carvidi
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Alia A El-Qunni
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Alem Haile
- Clinical Trials Unit, Washington University School of Medicine, St. Louis, MO, USA
| | - Katherine Huang
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Baylee Kinnett
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Mariel J Liebeskind
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Zhuoming Liu
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Lily E McMorrow
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Diana Paez
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Dana C Perantie
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rebecca E Schriefer
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Shannon E Sides
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Mahima Thapa
- Division of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Maté Gergely
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Suha Abushamma
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael Klebert
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Lynne Mitchell
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Darren Nix
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jonathan Graf
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Kimberly E Taylor
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Salim Chahin
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Matthew A Ciorba
- Inflammatory Bowels Diseases Center, Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Patricia Katz
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Mehrdad Matloubian
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jane A O'Halloran
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel M Presti
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Gregory F Wu
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Division of Immunobiology, Department of Pathology and Immunology, Washington, University School of Medicine, St. Louis, MO, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA
| | - Sean P J Whelan
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, USA
| | - William J Buchser
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Lianne S Gensler
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Arthritis/Immunology Section, San Francisco Veterans Administration Health Care System, San Francisco, CA, USA
| | - Mary C Nakamura
- Division of Rheumatology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Arthritis/Immunology Section, San Francisco Veterans Administration Health Care System, San Francisco, CA, USA
| | - Ali H Ellebedy
- Division of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA
| | - Alfred H J Kim
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA; Division of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA; The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St. Louis, MO, USA
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12
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Hassman LM, Paley MA, Esaulova E, Paley GL, Ruzycki PA, Linskey N, Laurent J, Feigl-Lenzen L, Springer L, Montana CL, Hong K, Enright J, James H, Artyomov MN, Yokoyama WM. Clinicomolecular Identification of Conserved and Individualized Features of Granulomatous Uveitis. Ophthalmol Sci 2021; 1:100010. [PMID: 35937550 PMCID: PMC9352144 DOI: 10.1016/j.xops.2021.100010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/17/2021] [Accepted: 03/08/2021] [Indexed: 12/17/2022]
Abstract
Objective To identify molecular features that distinguish individuals with shared clinical features of granulomatous uveitis. Design Cross-sectional, observational study. Participants Four eyes from patients with active granulomatous uveitis. Methods We performed single-cell RNA-sequencing with antigen-receptor sequence analysis to obtain an unbiased gene expression survey of ocular immune cells and identify clonally expanded lymphocytes. Main Outcomes Measures For each inflamed eye, we measured the proportion of distinct immune cell types, the amount of B or T cell clonal expansion, and the transcriptional profile of T and B cells. Results Each individual had robust clonal expansion arising from a single T or B cell lineage, suggesting distinct, antigen-driven pathogenic processes in each patient. This variability in clonal expansion was mirrored by individual variability in CD4 T cell populations, whereas ocular CD8 T cells and B cells were more transcriptionally similar between patients. Finally, ocular B cells displayed evidence of class-switching and plasmablast differentiation within the ocular microenvironment, providing additional support for antigen-driven immune responses in granulomatous uveitis. Conclusions Collectively, our study identified both conserved and individualized features of granulomatous uveitis, illuminating parallel pathophysiologic mechanisms, and suggesting that future personalized therapeutic approaches may be warranted.
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Affiliation(s)
- Lynn M. Hassman
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Michael A. Paley
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Ekaterina Esaulova
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Grace L. Paley
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Philip A. Ruzycki
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Nicole Linskey
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer Laurent
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Lacey Feigl-Lenzen
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Luke Springer
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Cynthia L. Montana
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Karen Hong
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Jennifer Enright
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Hayley James
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
| | - Maxim N. Artyomov
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Wayne M. Yokoyama
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
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13
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Rosenbaum JT, Harrington CA, Searles RP, Fei SS, Zaki A, Arepalli S, Paley MA, Hassman LM, Vitale AT, Conrady CD, Keath P, Mitchell C, Watson L, Planck SR, Martin TM, Choi D. Revising the Diagnosis of Idiopathic Uveitis by Peripheral Blood Transcriptomics. Am J Ophthalmol 2021; 222:15-23. [PMID: 32941857 DOI: 10.1016/j.ajo.2020.09.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To test the hypothesis that idiopathic uveitis can be categorized into subtypes based on gene expression from blood. DESIGN Case control study. METHODS We applied RNA-Seq to peripheral blood from patients with uveitis associated with 1 of 4 systemic diseases, including axial spondyloarthritis (n = 17), sarcoidosis (n = 13), inflammatory bowel disease (n = 12), tubulo-interstitial nephritis with uveitis (n = 10), or idiopathic uveitis (n = 38) as well as 18 healthy control subjects evaluated predominantly at Oregon Health and Science University. A high-dimensional negative binomial regression model implemented in the edgeR R package compared each disease group with the control subjects. The 20 most distinctive genes for each diagnosis were extracted. Of 80 genes, there were 75 unique genes. A classification algorithm was developed by fitting a gradient boosting tree with 5-fold cross-validation. Messenger RNA from subjects with idiopathic uveitis were analyzed to see if any fit clinically and by gene expression pattern with one of the diagnosable entities. RESULTS For uveitis associated with a diagnosable systemic disease, gene expression profiling achieved an overall accuracy of 85% (balanced average of sensitivity plus specificity, P < .001). Although most patients with idiopathic uveitis presumably have none of these 4 associated systemic diseases, gene expression profiles helped to reclassify 11 of 38 subjects. CONCLUSIONS Peripheral blood gene expression profiling is a potential adjunct in accurate differential diagnosis of the cause of uveitis. Validation of these results and characterization of the gene expression profile from additional discrete diagnoses could enhance the value of these observations.
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Affiliation(s)
- James T Rosenbaum
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA; Department of Medicine, Oregon Health and Science University, Portland, Oregon, USA; Department of Cell Biology, Oregon Health and Science University, Portland, Oregon, USA; Legacy Devers Eye Institute, Portland, Oregon, USA.
| | - Christina A Harrington
- Integrated Genomics Laboratory, Oregon Health and Science University, Portland, Oregon, USA; Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon, USA
| | - Robert P Searles
- Integrated Genomics Laboratory, Oregon Health and Science University, Portland, Oregon, USA
| | - Suzanne S Fei
- Bioinformatics and Biostatistics Core, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Oregon, USA
| | - Amr Zaki
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Sruthi Arepalli
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Michael A Paley
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Lynn M Hassman
- Department of Ophthalmology, Washington University, St Louis, Missouri, USA
| | - Albert T Vitale
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Christopher D Conrady
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Puthyda Keath
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Claire Mitchell
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Lindsey Watson
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Stephen R Planck
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA
| | - Tammy M Martin
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA; Department of Molecular Microbiology and Immunology, Oregon Health and Science University, Portland, Oregon, USA
| | - Dongseok Choi
- Department of Ophthalmology/Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, USA; Department of Medicine, Oregon Health and Science University, Portland, Oregon, USA; Oregon Health and Science University-Portland State University School of Public Health, Oregon Health and Science University, Portland, Oregon, USA; Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
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14
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Johnnidis JB, Muroyama Y, Ngiow SF, Chen Z, Manne S, Cai Z, Song S, Platt JM, Schenkel JM, Abdel-Hakeem M, Beltra JC, Greenplate AR, Ali MAA, Nzingha K, Giles JR, Harly C, Attanasio J, Pauken KE, Bengsch B, Paley MA, Tomov VT, Kurachi M, Vignali DAA, Sharpe AH, Reiner SL, Bhandoola A, Johnson FB, Wherry EJ. Inhibitory signaling sustains a distinct early memory CD8 + T cell precursor that is resistant to DNA damage. Sci Immunol 2021; 6:6/55/eabe3702. [PMID: 33452106 DOI: 10.1126/sciimmunol.abe3702] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/10/2020] [Indexed: 12/16/2022]
Abstract
The developmental origins of memory T cells remain incompletely understood. During the expansion phase of acute viral infection, we identified a distinct subset of virus-specific CD8+ T cells that possessed distinct characteristics including expression of CD62L, T cell factor 1 (TCF-1), and Eomesodermin; relative quiescence; expression of activation markers; and features of limited effector differentiation. These cells were a quantitatively minor subpopulation of the TCF-1+ pool and exhibited self-renewal, heightened DNA damage surveillance activity, and preferential long-term recall capacity. Despite features of memory and somewhat restrained proliferation during the expansion phase, this subset displayed evidence of stronger TCR signaling than other responding CD8+ T cells, coupled with elevated expression of multiple inhibitory receptors including programmed cell death 1 (PD-1), lymphocyte activating gene 3 (LAG-3), cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), CD5, and CD160. Genetic ablation of PD-1 and LAG-3 compromised the formation of this CD62Lhi TCF-1+ subset and subsequent CD8+ T cell memory. Although central memory phenotype CD8+ T cells were formed in the absence of these cells, subsequent memory CD8+ T cell recall responses were compromised. Together, these results identify an important link between genome integrity maintenance and CD8+ T cell memory. Moreover, the data indicate a role for inhibitory receptors in preserving key memory CD8+ T cell precursors during initial activation and differentiation. Identification of this rare subpopulation within the memory CD8+ T cell precursor pool may help reconcile models of the developmental origin of long-term CD8+ T cell memory.
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Affiliation(s)
- Jonathan B Johnnidis
- Department of Biology, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yuki Muroyama
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Shin Foong Ngiow
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA.,Parker Institute for Cancer Immunotherapy, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zeyu Chen
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sasikanth Manne
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zhangying Cai
- Division of Biology and Biomedical Sciences, Washington University, St. Louis, MO 63110, USA
| | - Shufei Song
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jesse M Platt
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.,Whitehead Institute for Biomedical Research, Cambridge, MA 02142, USA
| | - Jason M Schenkel
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA.,David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Mohamed Abdel-Hakeem
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jean-Christophe Beltra
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA.,Parker Institute for Cancer Immunotherapy, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Allison R Greenplate
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mohammed-Alkhatim A Ali
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kito Nzingha
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Josephine R Giles
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA.,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA.,Parker Institute for Cancer Immunotherapy, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christelle Harly
- T-Cell Biology and Development Unit, Laboratory of Genome Integrity, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA.,Université de Nantes, INSERM, CNRS, CRCINA, Nantes, France.,LabEx IGO 'Immunotherapy, Graft, Oncology', Nantes, France
| | - John Attanasio
- Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kristen E Pauken
- Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA.,Evergrande Center for Immunologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Bertram Bengsch
- Department of Medicine II, Gastroenterology, Hepatology, Endocrinology, and Infectious Diseases, University Medical Center Freiburg, Germany.,Signaling Research Centers BIOSS and CIBSS, University of Freiburg, Freiburg, Germany
| | - Michael A Paley
- Department of Medicine, Washington University in Saint Louis School of Medicine, St. Louis, MO 63110, USA
| | - Vesselin T Tomov
- Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA.,Department of Medicine, Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Makoto Kurachi
- Department of Molecular Genetics, Graduate School of Medicine, Kanazawa University, Kanazawa, Japan
| | - Dario A A Vignali
- Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.,Tumor Microenvironment Center, UPMC Hillman Cancer Center, Pittsburgh PA 15232, USA.,Cancer Immunology and Immunotherapy Program, UPMC Hillman Cancer Center, Pittsburgh, PA 15232, USA
| | - Arlene H Sharpe
- Department of Immunology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA.,Evergrande Center for Immunologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Steven L Reiner
- Department of Microbiology and Immunology and Department of Pediatrics, Columbia University, New York, NY 10032, USA
| | - Avinash Bhandoola
- T-Cell Biology and Development Unit, Laboratory of Genome Integrity, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA
| | - F Bradley Johnson
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - E John Wherry
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA. .,Institute for Immunology, University of Pennsylvania, Philadelphia, PA 19104, USA.,Parker Institute for Cancer Immunotherapy, University of Pennsylvania, Philadelphia, PA 19104, USA
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15
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Paley MA, Edrees F, Kudose S, Gaut JP, Ranganathan P, Vijayan A. Successful use of rituximab for hydralazine-induced anti-neutrophil cytoplasmic antibodies-associated vasculitis. Saudi J Kidney Dis Transpl 2019; 30:226-230. [PMID: 30804286 PMCID: PMC6435256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Hydralazine is a commonly used anti-hypertensive medication. It can, however, contribute to the development of autoimmunity, in the form of drug-induced lupus and anti-neutrophil cytoplasmic antibodies-associated vasculitis. We report a 45-year-old patient with hypertension managed with hydralazine for four years who presented with rapidly progressive glomerulonephritis (RPGN), requiring hemodialysis, and diffuse alveolar hemorrhage (DAH), requiring mechanical ventilation, and extracorporeal membrane oxygenation. The patient's autoantibody profile was consistent with a drug-induced autoimmune process and renal histology revealed focal necrotizing crescentic GN. She was treated with high-dose steroids, plasma exchange and rituximab. DAH resolved and her renal function improved, allowing discontinuation of hemodialysis. This case reveals that rituximab can be successfully used in the setting of hydralazine-induced vasculitis, including critically ill patients with severe DAH and acute kidney injury from RPGN.
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Affiliation(s)
- Michael A. Paley
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine
| | - Fahad Edrees
- Department of Medicine, Division of Pulmonary and Critical Care, Washington University School of Medicine
| | - Satoru Kudose
- Department of Pathology and Immunology, Division of Anatomic and Molecular Pathology, Washington University School of Medicine
| | - Joseph P. Gaut
- Department of Pathology and Immunology, Division of Anatomic and Molecular Pathology, Washington University School of Medicine
| | - Prabha Ranganathan
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine
| | - Anitha Vijayan
- Department of Medicine, Division of Nephrology, Washington University School of Medicine, St. Louis, MO, USA
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16
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Lauron EJ, Yang L, Harvey IB, Sojka DK, Williams GD, Paley MA, Bern MD, Park E, Victorino F, Boon ACM, Yokoyama WM. Viral MHCI inhibition evades tissue-resident memory T cell formation and responses. J Exp Med 2018; 216:117-132. [PMID: 30559127 PMCID: PMC6314518 DOI: 10.1084/jem.20181077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/14/2018] [Accepted: 11/07/2018] [Indexed: 01/06/2023] Open
Abstract
Lauron et al. demonstrate that viral MHCI inhibition within infected cells reduces local antigen-driven generation of resident memory CD8+ T cells. Additionally, resident memory CD8+ T cells are insufficient in controlling peripheral infection in the context of viral MHCI evasion. Tissue-resident memory CD8+ T cells (TRMs) confer rapid protection and immunity against viral infections. Many viruses have evolved mechanisms to inhibit MHCI presentation in order to evade CD8+ T cells, suggesting that these mechanisms may also apply to TRM-mediated protection. However, the effects of viral MHCI inhibition on the function and generation of TRMs is unclear. Herein, we demonstrate that viral MHCI inhibition reduces the abundance of CD4+ and CD8+ TRMs, but its effects on the local microenvironment compensate to promote antigen-specific CD8+ TRM formation. Unexpectedly, local cognate antigen enhances CD8+ TRM development even in the context of viral MHCI inhibition and CD8+ T cell evasion, strongly suggesting a role for in situ cross-presentation in local antigen-driven TRM differentiation. However, local cognate antigen is not required for CD8+ TRM maintenance. We also show that viral MHCI inhibition efficiently evades CD8+ TRM effector functions. These findings indicate that viral evasion of MHCI antigen presentation has consequences on the development and response of antiviral TRMs.
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Affiliation(s)
- Elvin J Lauron
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Liping Yang
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Ian B Harvey
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Dorothy K Sojka
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Graham D Williams
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO
| | - Michael A Paley
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Michael D Bern
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Eugene Park
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Francisco Victorino
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Adrianus C M Boon
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO.,Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO
| | - Wayne M Yokoyama
- Division of Rheumatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO .,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
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17
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Paley MA, Karacal H, Rao PK, Margolis TP, Miner JJ. Tofacitinib for refractory uveitis and scleritis. Am J Ophthalmol Case Rep 2018; 13:53-55. [PMID: 30582071 PMCID: PMC6288302 DOI: 10.1016/j.ajoc.2018.12.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/12/2018] [Accepted: 12/03/2018] [Indexed: 12/14/2022] Open
Abstract
Purpose To report the successful use of tofacitinib in the treatment of refractory uveitis and scleritis. Observations Two patients, one with scleritis and another with anterior and intermediate uveitis, presented with refractory disease after failure of multiple steroid-sparing therapies. Treatment with tofacitinib led to durable resolution of uveitis and scleritis. Conclusions and importance Tofacitinib is a potential novel treatment option for refractory, noninfectious inflammatory eye disease.
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Affiliation(s)
- Michael A. Paley
- Department of Medicine, Saint Louis, MO, 63110, USA
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, 63110, USA
| | - Humeyra Karacal
- Department of Ophthalmology and Visual Sciences, Saint Louis, MO, 63110, USA
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, 63110, USA
| | - P. Kumar Rao
- Department of Ophthalmology and Visual Sciences, Saint Louis, MO, 63110, USA
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, 63110, USA
| | - Todd P. Margolis
- Department of Ophthalmology and Visual Sciences, Saint Louis, MO, 63110, USA
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, 63110, USA
| | - Jonathan J. Miner
- Department of Medicine, Saint Louis, MO, 63110, USA
- Department of Molecular Microbiology, Saint Louis, MO, 63110, USA
- Department of Pathology and Immunology, Saint Louis, MO, 63110, USA
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, 63110, USA
- Corresponding author. Departments of Medicine, Molecular Microbiology, and Pathology and Immunology, Washington University School of Medicine, 660 South Euclid Ave. Box 8045, Saint Louis, MO, 63110, USA.
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18
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Bengsch B, Johnson AL, Kurachi M, Odorizzi PM, Pauken KE, Attanasio J, Stelekati E, McLane LM, Paley MA, Delgoffe GM, Wherry EJ. Bioenergetic Insufficiencies Due to Metabolic Alterations Regulated by the Inhibitory Receptor PD-1 Are an Early Driver of CD8(+) T Cell Exhaustion. Immunity 2016; 45:358-73. [PMID: 27496729 DOI: 10.1016/j.immuni.2016.07.008] [Citation(s) in RCA: 501] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 04/16/2016] [Accepted: 05/11/2016] [Indexed: 01/23/2023]
Abstract
Dynamic reprogramming of metabolism is essential for T cell effector function and memory formation. However, the regulation of metabolism in exhausted CD8(+) T (Tex) cells is poorly understood. We found that during the first week of chronic lymphocytic choriomeningitis virus (LCMV) infection, before severe dysfunction develops, virus-specific CD8(+) T cells were already unable to match the bioenergetics of effector T cells generated during acute infection. Suppression of T cell bioenergetics involved restricted glucose uptake and use, despite persisting mechanistic target of rapamycin (mTOR) signaling and upregulation of many anabolic pathways. PD-1 regulated early glycolytic and mitochondrial alterations and repressed transcriptional coactivator PGC-1α. Improving bioenergetics by overexpression of PGC-1α enhanced function in developing Tex cells. Therapeutic reinvigoration by anti-PD-L1 reprogrammed metabolism in a subset of Tex cells. These data highlight a key metabolic control event early in exhaustion and suggest that manipulating glycolytic and mitochondrial metabolism might enhance checkpoint blockade outcomes.
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Affiliation(s)
- Bertram Bengsch
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - Andy L Johnson
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - Makoto Kurachi
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - Pamela M Odorizzi
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - Kristen E Pauken
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - John Attanasio
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - Erietta Stelekati
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - Laura M McLane
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - Michael A Paley
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA
| | - Greg M Delgoffe
- Tumor Microenvironment Center, Department of Immunology, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15232, USA
| | - E John Wherry
- Department of Microbiology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA; Institute for Immunology, University of Pennsylvania Perelman School Medicine, Philadelphia, PA 19104, USA.
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19
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Barnett BE, Staupe RP, Odorizzi PM, Palko O, Tomov VT, Mahan AE, Gunn B, Chen D, Paley MA, Alter G, Reiner SL, Lauer GM, Teijaro JR, Wherry EJ. Cutting Edge: B Cell-Intrinsic T-bet Expression Is Required To Control Chronic Viral Infection. J Immunol 2016; 197:1017-22. [PMID: 27430722 DOI: 10.4049/jimmunol.1500368] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 05/18/2016] [Indexed: 12/31/2022]
Abstract
The role of Ab and B cells in preventing infection is established. In contrast, the role of B cell responses in containing chronic infections remains poorly understood. IgG2a (IgG1 in humans) can prevent acute infections, and T-bet promotes IgG2a isotype switching. However, whether IgG2a and B cell-expressed T-bet influence the host-pathogen balance during persisting infections is unclear. We demonstrate that B cell-specific loss of T-bet prevents control of persisting viral infection. T-bet in B cells controlled IgG2a production, as well as mucosal localization, proliferation, glycosylation, and a broad transcriptional program. T-bet controlled a broad antiviral program in addition to IgG2a because T-bet in B cells was important, even in the presence of virus-specific IgG2a. Our data support a model in which T-bet is a universal controller of antiviral immunity across multiple immune lineages.
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Affiliation(s)
- Burton E Barnett
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104; Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Ryan P Staupe
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104; Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Pamela M Odorizzi
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104; Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Olesya Palko
- Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104; Division of Gastroenterology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Vesselin T Tomov
- Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104; Division of Gastroenterology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Alison E Mahan
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139
| | - Bronwyn Gunn
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139
| | - Diana Chen
- Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115
| | - Michael A Paley
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104; Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA 02139
| | - Steven L Reiner
- Department of Microbiology and Immunology, College of Physicians and Surgeons, Columbia University, New York, NY 10032; Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY 10032; and
| | - Georg M Lauer
- Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115
| | - John R Teijaro
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA 92037
| | - E John Wherry
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104; Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104;
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20
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Odorizzi PM, Pauken KE, Paley MA, Sharpe A, Wherry EJ. Genetic absence of PD-1 promotes accumulation of terminally differentiated exhausted CD8+ T cells. ACTA ACUST UNITED AC 2015; 212:1125-37. [PMID: 26034050 PMCID: PMC4493417 DOI: 10.1084/jem.20142237] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/08/2015] [Indexed: 12/16/2022]
Abstract
Programmed Death-1 (PD-1) has received considerable attention as a key regulator of CD8(+) T cell exhaustion during chronic infection and cancer because blockade of this pathway partially reverses T cell dysfunction. Although the PD-1 pathway is critical in regulating established "exhausted" CD8(+) T cells (TEX cells), it is unclear whether PD-1 directly causes T cell exhaustion. We show that PD-1 is not required for the induction of exhaustion in mice with chronic lymphocytic choriomeningitis virus (LCMV) infection. In fact, some aspects of exhaustion are more severe with genetic deletion of PD-1 from the onset of infection. Increased proliferation between days 8 and 14 postinfection is associated with subsequent decreased CD8(+) T cell survival and disruption of a critical proliferative hierarchy necessary to maintain exhausted populations long term. Ultimately, the absence of PD-1 leads to the accumulation of more cytotoxic, but terminally differentiated, CD8(+) TEX cells. These results demonstrate that CD8(+) T cell exhaustion can occur in the absence of PD-1. They also highlight a novel role for PD-1 in preserving TEX cell populations from overstimulation, excessive proliferation, and terminal differentiation.
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Affiliation(s)
- Pamela M Odorizzi
- Department of Microbiology and Penn Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 Department of Microbiology and Penn Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Kristen E Pauken
- Department of Microbiology and Penn Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 Department of Microbiology and Penn Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Michael A Paley
- Department of Microbiology and Penn Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 Department of Microbiology and Penn Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Arlene Sharpe
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA 02115 Evergrande Center for Immunological Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115 Broad Institute of MIT and Harvard, Cambridge, MA 02142 Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115
| | - E John Wherry
- Department of Microbiology and Penn Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 Department of Microbiology and Penn Institute for Immunology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
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21
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Paley MA, Kroy DC, Odorizzi PM, Johnnidis JB, Dolfi DV, Barnett BE, Bikoff EK, Robertson EJ, Lauer GM, Reiner SL, Wherry EJ. Progenitor and terminal subsets of CD8+ T cells cooperate to contain chronic viral infection. Science 2012. [PMID: 23197535 DOI: 10.1126/science.1229620] [Citation(s) in RCA: 660] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Chronic infections strain the regenerative capacity of antiviral T lymphocyte populations, leading to failure in long-term immunity. The cellular and molecular events controlling this regenerative capacity, however, are unknown. We found that two distinct states of virus-specific CD8(+) T cells exist in chronically infected mice and humans. Differential expression of the T-box transcription factors T-bet and Eomesodermin (Eomes) facilitated the cooperative maintenance of the pool of antiviral CD8(+) T cells during chronic viral infection. T-bet(hi) cells displayed low intrinsic turnover but proliferated in response to persisting antigen, giving rise to Eomes(hi) terminal progeny. Genetic elimination of either subset resulted in failure to control chronic infection, which suggests that an imbalance in differentiation and renewal could underlie the collapse of immunity in humans with chronic infections.
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Affiliation(s)
- Michael A Paley
- Department of Microbiology and Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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22
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Paley MA, Gordon SM, Bikoff EK, Robertson EJ, Wherry EJ, Reiner SL. Technical Advance: Fluorescent reporter reveals insights into eomesodermin biology in cytotoxic lymphocytes. J Leukoc Biol 2012. [PMID: 23192430 DOI: 10.1189/jlb.0812400] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The T-box transcription factor Eomes is expressed in cytotoxic immune cells and plays an important role in development, maintenance, and function of these cell types. Identification and separation of cells with differential Eomes expression would allow for better understanding of the transcriptional program governing these cytotoxic lymphocytes. Here, we report the use of an Eomes(gfp)-targeted mouse allele that displays robust fidelity to Eomes protein expression in NK and T cells. Use of this reporter mouse revealed that Eomes expression in antiviral effector cells did not correlate with enhanced cytotoxicity but rather was associated with more efficient central memory differentiation. Weakening of reporter activity in Eomes-deficient CD8(+) T cells revealed a critical role for Eomes protein in maintaining central memory cells that have activated the Eomes locus. Characterization of reporter activity in NK lineage cells also permitted identification of a novel intermediate of NK cell maturation. Thus, the murine Eomes(gfp)-targeted allele provides a novel opportunity to explore Eomes biology in cytotoxic lymphocytes.
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Affiliation(s)
- Michael A Paley
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
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23
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Doering TA, Crawford A, Angelosanto JM, Paley MA, Ziegler CG, Wherry EJ. Network analysis reveals centrally connected genes and pathways involved in CD8+ T cell exhaustion versus memory. Immunity 2012; 37:1130-44. [PMID: 23159438 DOI: 10.1016/j.immuni.2012.08.021] [Citation(s) in RCA: 390] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 08/06/2012] [Indexed: 02/07/2023]
Abstract
Exhausted CD8(+) T cells function poorly and are negatively regulated by inhibitory receptors. Transcriptional profiling has identified gene expression changes associated with exhaustion. However, the transcriptional pathways critical to the differences between exhausted and functional memory CD8(+) T cells are unclear. We thus defined transcriptional coexpression networks to define pathways centrally involved in exhaustion versus memory. These studies revealed differences between exhausted and memory CD8(+) T cells including the following: lack of coordinated transcriptional modules of quiescence during exhaustion, centrally connected hub genes, pathways such as transcription factors, genes involved in regulation of immune responses, and DNA repair genes, as well as differential connectivity for genes including T-bet, Eomes, and other transcription factors. These data identify pathways involved in CD8(+) T cell exhaustion, and highlight the context-dependent nature of transcription factors in exhaustion versus memory.
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Affiliation(s)
- Travis A Doering
- Department of Microbiology and Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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24
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Kao C, Oestreich KJ, Paley MA, Crawford A, Angelosanto JM, Ali MAA, Intlekofer AM, Boss JM, Reiner SL, Weinmann AS, Wherry EJ. Transcription factor T-bet represses expression of the inhibitory receptor PD-1 and sustains virus-specific CD8+ T cell responses during chronic infection. Nat Immunol 2011; 12:663-71. [PMID: 21623380 PMCID: PMC3306165 DOI: 10.1038/ni.2046] [Citation(s) in RCA: 367] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Accepted: 05/02/2011] [Indexed: 01/09/2023]
Abstract
T cell exhaustion plays a major role in failure to control chronic infections. High expression of inhibitory receptors, including PD-1, and the inability to sustain functional T cell responses contribute to exhaustion. However, the transcriptional control of these processes remains unclear. Here we demonstrate that the transcription factor T-bet regulates CD8+ T cell exhaustion and inhibitory receptor expression. T-bet directly repressed Pdcd1 transcription and decreased the expression of other inhibitory receptors. While elevated T-bet promoted terminal differentiation following acute infection, high T-bet expression sustained exhausted CD8+ T cells and repressed inhibitory receptor expression during chronic viral infection. Persisting antigenic stimulation caused T-bet downregulation, which resulted in more severe exhaustion of CD8+ T cells. These observations suggest therapeutic opportunities involving increasing T-bet expression during chronic infection.
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Affiliation(s)
- Charlly Kao
- Department of Microbiology and Institute for Immunology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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25
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Banerjee A, Gordon SM, Intlekofer AM, Paley MA, Mooney EC, Lindsten T, Wherry EJ, Reiner SL. Cutting edge: The transcription factor eomesodermin enables CD8+ T cells to compete for the memory cell niche. J Immunol 2010; 185:4988-92. [PMID: 20935204 DOI: 10.4049/jimmunol.1002042] [Citation(s) in RCA: 305] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
CD8(+) T cells responding to intracellular infection give rise to cellular progeny that become terminally differentiated effector cells and self-renewing memory cells. T-bet and eomesodermin (Eomes) are key transcription factors of cytotoxic lymphocyte lineages. We show in this study that CD8(+) T cells lacking Eomes compete poorly in contributing to the pool of Ag-specific central memory cells. Eomes-deficient CD8(+) T cells undergo primary clonal expansion but are defective in long-term survival, populating the bone marrow niche and re-expanding postrechallenge. The phenotype of Eomes-deficient CD8(+) T cells supports the hypothesis that T-bet and Eomes can act redundantly to induce effector functions, but can also act to reciprocally promote terminal differentiation versus self-renewal of Ag-specific memory cells.
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Affiliation(s)
- Arnob Banerjee
- Abramson Family Cancer Research Institute, University of Pennsylvania, Philadelphia, PA 19104, USA
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26
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Foulds KE, Rotte MJ, Paley MA, Singh B, Douek DC, Hill BJ, O'Shea JJ, Watford WT, Seder RA, Wu CY. IFN-gamma mediates the death of Th1 cells in a paracrine manner. J Immunol 2008; 180:842-9. [PMID: 18178823 DOI: 10.4049/jimmunol.180.2.842] [Citation(s) in RCA: 20] [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] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Th1 cells have different capacities to develop into memory cells based on their production of IFN-gamma. In this study, the mechanism by which a homogenous population of IFN-gamma-producing CD4 T cells was eliminated in vivo was assessed. When such cells were transferred into naive mice and activated with Ag, a striking decrease in the frequency of cells in the spleen and lung was observed. However, administration of neutralizing anti-IFN-gamma Ab at the time of Ag challenge largely prevented the elimination of such cells. To determine whether IFN-gamma was mediating its effects directly and/or indirectly, the ability of IFN-gamma to effectively signal in such cells was assessed in vitro. Indeed, there was reduced phosphorylation of STAT1 in response to IFN-gamma as well as markedly reduced expression of the IFN-gammaR beta-chain. Furthermore, transfer of such cells into IFN-gammaR-deficient mice limited their death following activation with Ag. Together, these data suggest that IFN-gamma acts in a paracrine manner to mediate the death of activated IFN-gamma-producing Th1 cells. In contrast to Ag stimulation, administration of CpG alone resulted in the elimination of Th1 cells in IFN-gammaR-/- mice. These results show that in response to Ag stimulation, the death of IFN-gamma-producing effector Th1 cells is controlled in an IFN-gamma-dependent manner, whereas in response to innate activation, the death of IFN-gamma-producing Th1 cells can occur through an IFN-gamma-independent pathway. Collectively, these data show the multiple mechanisms by which Th1 effector cells are efficiently eliminated in vivo.
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Affiliation(s)
- Kathryn E Foulds
- Cellular Immunology Section, Human Immunology Laboratory, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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27
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Bucove B, Putnam WJ, McNerney WJ, Metcalf GR, Paley MA. Public-private partnership: its influence upon official and nonofficial health agencies. Bull N Y Acad Med 1969; 45:1223-49. [PMID: 5260076 PMCID: PMC1750487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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28
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Paley MA. Areawide planning. Hospitals 1968; 42:33-6. [PMID: 4966960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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29
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Paley MA. Federal legislation and the smaller health care facility. Areawide planning: tool for orderly development. Hospitals 1966; 40:79-82. [PMID: 5934417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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