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Woodall MNJ, Cujba AM, Worlock KB, Case KM, Masonou T, Yoshida M, Polanski K, Huang N, Lindeboom RGH, Mamanova L, Bolt L, Richardson L, Cakir B, Ellis S, Palor M, Burgoyne T, Pinto A, Moulding D, McHugh TD, Saleh A, Kilich E, Mehta P, O'Callaghan C, Zhou J, Barclay W, DeCoppi P, Butler CR, Cortina-Borja M, Vinette H, Roy S, Breuer J, Chambers RC, Heywood WE, Mills K, Hynds RE, Teichmann SA, Meyer KB, Nikolić MZ, Smith CM. Age-specific nasal epithelial responses to SARS-CoV-2 infection. Nat Microbiol 2024; 9:1293-1311. [PMID: 38622380 PMCID: PMC11087271 DOI: 10.1038/s41564-024-01658-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 03/04/2024] [Indexed: 04/17/2024]
Abstract
Children infected with SARS-CoV-2 rarely progress to respiratory failure. However, the risk of mortality in infected people over 85 years of age remains high. Here we investigate differences in the cellular landscape and function of paediatric (<12 years), adult (30-50 years) and older adult (>70 years) ex vivo cultured nasal epithelial cells in response to infection with SARS-CoV-2. We show that cell tropism of SARS-CoV-2, and expression of ACE2 and TMPRSS2 in nasal epithelial cell subtypes, differ between age groups. While ciliated cells are viral replication centres across all age groups, a distinct goblet inflammatory subtype emerges in infected paediatric cultures and shows high expression of interferon-stimulated genes and incomplete viral replication. In contrast, older adult cultures infected with SARS-CoV-2 show a proportional increase in basaloid-like cells, which facilitate viral spread and are associated with altered epithelial repair pathways. We confirm age-specific induction of these cell types by integrating data from in vivo COVID-19 studies and validate that our in vitro model recapitulates early epithelial responses to SARS-CoV-2 infection.
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Affiliation(s)
| | | | - Kaylee B Worlock
- UCL Respiratory, Division of Medicine, University College London, London, UK
| | | | - Tereza Masonou
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Masahiro Yoshida
- UCL Respiratory, Division of Medicine, University College London, London, UK
| | | | - Ni Huang
- Wellcome Sanger Institute, Cambridge, UK
| | | | | | - Liam Bolt
- Wellcome Sanger Institute, Cambridge, UK
| | | | | | - Samuel Ellis
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Machaela Palor
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Thomas Burgoyne
- UCL Institute of Ophthalmology, University College London, London, UK
- Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Andreia Pinto
- Royal Brompton Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Dale Moulding
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Timothy D McHugh
- UCL Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Aarash Saleh
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - Eliz Kilich
- UCL Respiratory, Division of Medicine, University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Puja Mehta
- UCL Respiratory, Division of Medicine, University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Jie Zhou
- Department of Infectious Disease, Imperial College London, London, UK
| | - Wendy Barclay
- Department of Infectious Disease, Imperial College London, London, UK
| | - Paolo DeCoppi
- Great Ormond Street UCL Institute of Child Health, London, UK
- Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Colin R Butler
- Great Ormond Street Hospital NHS Foundation Trust, London, UK
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, Developmental Biology and Cancer Department, Great Ormond Street UCL Institute of Child Health, University College London, London, UK
| | | | - Heloise Vinette
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Sunando Roy
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Judith Breuer
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Rachel C Chambers
- UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Wendy E Heywood
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Kevin Mills
- Great Ormond Street UCL Institute of Child Health, London, UK
| | - Robert E Hynds
- Epithelial Cell Biology in ENT Research (EpiCENTR) Group, Developmental Biology and Cancer Department, Great Ormond Street UCL Institute of Child Health, University College London, London, UK
- UCL Cancer Institute, University College London, London, UK
| | - Sarah A Teichmann
- Wellcome Sanger Institute, Cambridge, UK.
- Theory of Condensed Matter, Cavendish Laboratory/Dept Physics, University of Cambridge, Cambridge, UK.
| | | | - Marko Z Nikolić
- UCL Respiratory, Division of Medicine, University College London, London, UK.
- University College London Hospitals NHS Foundation Trust, London, UK.
| | - Claire M Smith
- Great Ormond Street UCL Institute of Child Health, London, UK.
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Bhandarkar K, DeCoppi P, Cross K, Blackburn S, Curry J. Long-term functional outcomes and multidisciplinary management after ileorectal Duhamel pull-through for total colonic aganglionosis- 20-year experience in a tertiary surgical center. Eur J Pediatr Surg 2023. [PMID: 37748721 DOI: 10.1055/a-2181-2065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Introduction Management of patients with total colonic aganglionosis (TCA) is challenging for paediatric surgeons. The purpose of this study was to review our institution's 20-year experience regarding long-term outcomes and multidisciplinary team management of these patients after an Ileorectal Duhamel pull-through procedure. Materials and Methods Retrospective review was conducted for all patients diagnosed with TCA in our tertiary institution. Data was collected on demographics, clinical presentation, complications, need for additional surgery and long-term effects on bowel function. Results Of a total of 202 patients with Hirschsprung's disease (HSCR), 13 were diagnosed with TCA (6.4 %). Clinical presentation was variable. 11 presented in neonatal period with distal bowel obstruction and 2 presented with constipation in early infancy. Ileorectal Duhamel pull-through was performed in all patients. Median follow up was 13 years. 11 are toilet trained, of whom 5 are fully continent. 6 continue to have problems with bowel continence or constipation. 1 developed recurrent episode of Hirschsprung's associated enterocolitis (HAEC). 2 patients had stoma re-established. Patients experiencing difficulties in bowel function are jointly managed by a multidisciplinary team consisting of surgeons, gastroenterologists, paediatric psychologists, and clinical nurse specialists. Conclusions TCA can be associated with significant long-term morbidity. Nearly half of the patients in this series have ongoing problems with bowel continence requiring a permanent stoma in some. Diligent follow-up coupled with inputs of a multidisciplinary team has greatly helped manage these complex patients in our institution.
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Affiliation(s)
- Kailas Bhandarkar
- department of paediatric surgery, Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain and Northern Ireland
| | - Paolo DeCoppi
- department of paediatric surgery, Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain and Northern Ireland
| | - Kate Cross
- department of paediatric surgery, Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain and Northern Ireland
| | - Simon Blackburn
- department of paediatric surgery, Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain and Northern Ireland
| | - Joe Curry
- paediatric surgery, Great Ormond Street Hospital for Children, London, United Kingdom of Great Britain and Northern Ireland
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Elliott MJ, Roebuck D, Muthialu N, Hewitt R, Wallis C, DeCoppi P, Macintyre D, McLaren CA. Teamwork in Airway Surgery. Front Pediatr 2021; 9:621449. [PMID: 33718299 PMCID: PMC7943849 DOI: 10.3389/fped.2021.621449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/20/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | - Nagarajan Muthialu
- The Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Richard Hewitt
- The Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Colin Wallis
- The Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | | | - Denise Macintyre
- The Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
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Zhao L, Sundaram S, Le AV, Huang AH, Zhang J, Hatachi G, Beloiartsev A, Caty MG, Yi T, Leiby K, Gard A, Kural MH, Gui L, Rocco KA, Sivarapatna A, Calle E, Greaney A, Urbani L, Maghsoudlou P, Burns A, DeCoppi P, Niklason LE. Engineered Tissue-Stent Biocomposites as Tracheal Replacements. Tissue Eng Part A 2017; 22:1086-97. [PMID: 27520928 DOI: 10.1089/ten.tea.2016.0132] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Here we report the creation of a novel tracheal construct in the form of an engineered, acellular tissue-stent biocomposite trachea (TSBT). Allogeneic or xenogeneic smooth muscle cells are cultured on polyglycolic acid polymer-metal stent scaffold leading to the formation of a tissue comprising cells, their deposited collagenous matrix, and the stent material. Thorough decellularization then produces a final acellular tubular construct. Engineered TSBTs were tested as end-to-end tracheal replacements in 11 rats and 3 nonhuman primates. Over a period of 8 weeks, no instances of airway perforation, infection, stent migration, or erosion were observed. Histological analyses reveal that the patent implants remodel adaptively with native host cells, including formation of connective tissue in the tracheal wall and formation of a confluent, columnar epithelium in the graft lumen, although some instances of airway stenosis were observed. Overall, TSBTs resisted collapse and compression that often limit the function of other decellularized tracheal replacements, and additionally do not require any cells from the intended recipient. Such engineered TSBTs represent a model for future efforts in tracheal regeneration.
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Affiliation(s)
- Liping Zhao
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Sumati Sundaram
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut.,2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Andrew V Le
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Angela H Huang
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Jiasheng Zhang
- 3 Department of Internal Medicine Cardiology, Yale University , New Haven, Connecticut
| | - Go Hatachi
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Arkadi Beloiartsev
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Michael G Caty
- 4 Section of Pediatric Surgery, Yale University , New Haven, Connecticut
| | - Tai Yi
- 5 Nationwide Children's Hospital Research Institute , Columbus, Ohio
| | - Katherine Leiby
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Ashley Gard
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Mehmet H Kural
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Liqiong Gui
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Kevin A Rocco
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Amogh Sivarapatna
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Elizabeth Calle
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Allison Greaney
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Luca Urbani
- 6 UCL Institute of Child Health and Great Ormond Street Hospital , UCL, London, United Kingdom
| | - Panagiotis Maghsoudlou
- 6 UCL Institute of Child Health and Great Ormond Street Hospital , UCL, London, United Kingdom
| | - Alan Burns
- 6 UCL Institute of Child Health and Great Ormond Street Hospital , UCL, London, United Kingdom .,7 Department of Clinical Genetics, Erasmus Medical Center , Rotterdam, The Netherlands
| | - Paolo DeCoppi
- 6 UCL Institute of Child Health and Great Ormond Street Hospital , UCL, London, United Kingdom
| | - Laura E Niklason
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut.,2 Department of Anesthesiology, Yale University , New Haven, Connecticut
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Pachl M, Eaton S, Kiely EM, Drake D, Cross K, Curry JI, Pierro A, DeCoppi P. Esophageal atresia and malrotation: what association? Pediatr Surg Int 2015; 31:181-5. [PMID: 25403487 DOI: 10.1007/s00383-014-3641-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Esophageal atresia/tracheo-esophageal fistula (EA/TEF) has an incidence of approximately 1:3,500. The incidence of malrotation is thought to be 1:200-500. We attempted to define the incidence of a combination and discuss the implications. METHODS This was a retrospective review of all patients admitted to a single institution with a diagnosis of EA or EA/TEF or TEF between April 1981 and January 2013. Patients were included if the position of the duodeno-jejunal flexure (DJF) was determined by upper GI contrast study (UGIS), surgery or post-mortem. RESULTS Case notes were reviewed for 235 patients. In the EA type A group, 3/28 (11 %; 95 % CI 3.7-27.2 %) had malrotation, significantly higher than the reported incidence of malrotation in the general population (p = 0.0008). All three patients in this group were symptomatic with one patient found to have a volvulus at emergency surgery. In the type C group, 6/196 (3 %, 95 % CI 1.4-6.5 %) had malrotation, significantly higher than the incidence reported for the general population (p = 0.0033) but not significantly different to that of the type A group (p = 0.0878). There were no patients with malrotation identified in any other EA/TEF type. In total, 9/235 (3.8 %; 95 % CI 2.0-7.2 %) patients with EA had malrotation, significantly higher than the 5/1,050 (0.48 %) reported for the general population (p = 0.0002). CONCLUSION There is a high incidence of malrotation in patients with pure EA. In the type A group an attempt to identify the DJF position at gastrostomy siting and/or performance of UGIS in the neonatal period should be undertaken. There should also be a low threshold for UGIS in all EA/TEF patients.
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Affiliation(s)
- M Pachl
- Department of Paediatric Surgery, Institute of Child Health and Great Ormond Street Hospital, London, UK,
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Mukherjee S, Pipino C, David AL, DeCoppi P, Thrasher AJ. Emerging Neuronal Precursors from Amniotic Fluid–Derived Down Syndrome Induced Pluripotent Stem Cells. Hum Gene Ther 2014; 25:682-3. [DOI: 10.1089/hum.2014.074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sayandip Mukherjee
- Department of Biological Sciences, School of Natural Sciences, Bangalore University, Bangalore 560056, Karnataka, India
- Molecular Immunology Unit, Centre for Immunodeficiency, Institute of Child Health, University College London, London WC1N 1EH, United Kingdom
| | - Caterina Pipino
- Surgery Unit, Institute of Child Health, University College London, London WC1N 1EH, United Kingdom
- Department of Experimental and Clinical Sciences, University “G. d'Annunzio,” and Aging Research Center, Ce.S.I., “G. d'Annunzio University Foundation,” Stem-TeCh Group, Chieti 66013, Italy
| | - Anna L. David
- Prenatal Cell and Gene Therapy Group, Institute for Women's Health, University College London, London WC1E 6HX, United Kingdom
| | - Paolo DeCoppi
- Surgery Unit, Institute of Child Health, University College London, London WC1N 1EH, United Kingdom
| | - Adrian J. Thrasher
- Molecular Immunology Unit, Centre for Immunodeficiency, Institute of Child Health, University College London, London WC1N 1EH, United Kingdom
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Carnaghan H, Roberts T, Savery D, Norris FC, McCann CJ, Copp AJ, Scambler PJ, Lythgoe MF, Greene ND, DeCoppi P, Burns AJ, Pierro A, Eaton S. Novel exomphalos genetic mouse model: the importance of accurate phenotypic classification. J Pediatr Surg 2013; 48:2036-42. [PMID: 24094954 PMCID: PMC4030649 DOI: 10.1016/j.jpedsurg.2013.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 04/18/2013] [Accepted: 04/21/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Rodent models of abdominal wall defects (AWD) may provide insight into the pathophysiology of these conditions including gut dysfunction in gastroschisis, or pulmonary hypoplasia in exomphalos. Previously, a Scribble mutant mouse model (circletail) was reported to exhibit gastroschisis. We further characterise this AWD in Scribble knockout mice. METHOD Homozygous Scrib knockout mice were obtained from heterozygote matings. Fetuses were collected at E17.5-18.5 with intact amniotic membranes. Three mutants and two control fetuses were imaged by in amnio micro-MRI. Remaining fetuses were dissected, photographed and gut length/weight measured. Ileal specimens were stained for interstitial cells of Cajal (ICC), imaged using confocal microscopy and ICC quantified. RESULTS 127 fetuses were collected, 15 (12%) exhibited AWD. Microdissection revealed 3 mutants had characteristic exomphalos phenotype with membrane-covered gut/liver herniation into the umbilical cord. A further 12 exhibited extensive AWD, with eviscerated abdominal organs and thin covering membrane (intact or ruptured). Micro-MRI confirmed these phenotypes. Gut was shorter and heavier in AWD group compared to controls but morphology/number of ICC was not different. DISCUSSION The Scribble knockout fetus exhibits exomphalos (intact and ruptured), in contrast to the original published phenotype of gastroschisis. Detailed dissection of fetuses is essential ensuring accurate phenotyping and result reporting.
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Affiliation(s)
| | - Tom Roberts
- Centre for Advanced Biomedical Imaging, University College London, London, UK,Centre for Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, London, UK
| | | | - Francesca C. Norris
- Centre for Advanced Biomedical Imaging, University College London, London, UK,Centre for Mathematics and Physics in the Life Sciences and Experimental Biology, University College London, London, UK
| | | | | | | | - Mark F. Lythgoe
- Centre for Advanced Biomedical Imaging, University College London, London, UK
| | | | | | | | - Agustino Pierro
- UCL Institute of Child Health, London, UK,Division of Paediatric Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Simon Eaton
- UCL Institute of Child Health, London, UK,Corresponding author.
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