1
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Ravichandar JD, Rutherford E, Chow CET, Han A, Yamamoto ML, Narayan N, Kaplan GG, Beck PL, Claesson MJ, Dabbagh K, Iwai S, DeSantis TZ. Strain level and comprehensive microbiome analysis in inflammatory bowel disease via multi-technology meta-analysis identifies key bacterial influencers of disease. Front Microbiol 2022; 13:961020. [PMID: 36312950 PMCID: PMC9614153 DOI: 10.3389/fmicb.2022.961020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/12/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Inflammatory bowel disease (IBD) is a heterogenous disease in which the microbiome has been shown to play an important role. However, the precise homeostatic or pathological functions played by bacteria remain unclear. Most published studies report taxa-disease associations based on single-technology analysis of a single cohort, potentially biasing results to one clinical protocol, cohort, and molecular analysis technology. To begin to address this key question, precise identification of the bacteria implicated in IBD across cohorts is necessary. Methods We sought to take advantage of the numerous and diverse studies characterizing the microbiome in IBD to develop a multi-technology meta-analysis (MTMA) as a platform for aggregation of independently generated datasets, irrespective of DNA-profiling technique, in order to uncover the consistent microbial modulators of disease. We report the largest strain-level survey of IBD, integrating microbiome profiles from 3,407 samples from 21 datasets spanning 15 cohorts, three of which are presented for the first time in the current study, characterized using three DNA-profiling technologies, mapping all nucleotide data against known, culturable strain reference data. Results We identify several novel IBD associations with culturable strains that have so far remained elusive, including two genome-sequenced but uncharacterized Lachnospiraceae strains consistently decreased in both the gut luminal and mucosal contents of patients with IBD, and demonstrate that these strains are correlated with inflammation-related pathways that are known mechanisms targeted for treatment. Furthermore, comparative MTMA at the species versus strain level reveals that not all significant strain associations resulted in a corresponding species-level significance and conversely significant species associations are not always re-captured at the strain level. Conclusion We propose MTMA for uncovering experimentally testable strain-disease associations that, as demonstrated here, are beneficial in discovering mechanisms underpinning microbiome impact on disease or novel targets for therapeutic interventions.
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Affiliation(s)
| | | | | | - Andrew Han
- Second Genome Inc., Brisbane, CA, United States
| | | | | | - Gilaad G. Kaplan
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Paul L. Beck
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | | | | | - Shoko Iwai
- Second Genome Inc., Brisbane, CA, United States
| | - Todd Z. DeSantis
- Second Genome Inc., Brisbane, CA, United States
- Todd Z. DeSantis,
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2
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Ueno A, Jijon HB, Peng R, Sparksman S, Mainoli B, Filyk A, Li Y, Wilson S, Novak K, Panaccione R, Hirota S, Dufour A, Lu C, Beck PL. Association of Circulating Fibrocytes With Fibrostenotic Small Bowel Crohn's Disease. Inflamm Bowel Dis 2022; 28:246-258. [PMID: 34428284 DOI: 10.1093/ibd/izab157] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fibrocytes are hematopoietic cells with features of mesenchymal cells found in the circulation and inflammatory sites implicated in promoting fibrosis in many fibroinflammatory diseases. However, their role(s) in the development of intestinal fibrosis is poorly understood. Here, we investigated a potential role of fibrocytes in the development of fibrosis in Crohn's disease (CD) and sought factors that may impact their development and function. METHODS Plasma and mononuclear cells were collected from patients with and without fibrostenotic CD. Fibrocytes defined as CD11b+, CD34+, and Collagen 1+ were correlated with clinical assessments of fibrosis, including evaluation using intestinal ultrasound. We measured the levels of relevant circulating molecules via Luminex and studied the effect of patient plasma proteins on fibrocyte differentiation. RESULTS Fibrocyte numbers were increased in CD patients with stricturing Crohn's disease compared with patients with an inflammatory phenotype (P = .0013), with strong correlation between fibrocyte numbers and acoustic radiation force impulse (ARFI), a measure of bowel elasticity on intestinal ultrasound (R = .8383, P = .0127). Fibrostenotic plasma was a more potent inducer of fibrocyte differentiation in both primary human monocytes and cell line and contained increased levels of cytokines implicated in fibrocyte differentiation compared with plasma from inflammatory patients. Interestingly, increased fibrocyte numbers at time of ultrasound were associated with escalation of medical therapy and endoscopic/surgical management of small bowel strictures at 30 months follow-up. CONCLUSIONS Circulating fibrocytes strongly correlate with fibrostenotic disease in CD, and they may serve as predictors for escalation of medical +/- surgical therapy.
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Affiliation(s)
- Aito Ueno
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Humberto B Jijon
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Richard Peng
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Steven Sparksman
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Barbara Mainoli
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Alexis Filyk
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Yan Li
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Stephanie Wilson
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Kerri Novak
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Remo Panaccione
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Simon Hirota
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Antoine Dufour
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cathy Lu
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Paul L Beck
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
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3
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Shifa I, Hazlewood GS, Durand C, Barr SG, Mydlarski PR, Beck PL, Burton JM, Khan FM, Jamani K, Osman M, Storek J. Efficacy of Allogeneic Hematopoietic Cell Transplantation for Autoimmune Diseases. Transplant Cell Ther 2021; 27:489.e1-489.e9. [PMID: 33775907 DOI: 10.1016/j.jtct.2021.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/04/2021] [Revised: 03/06/2021] [Accepted: 03/21/2021] [Indexed: 12/29/2022]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) may be efficacious for autoimmune diseases (AIDs), but its efficacy for individual AIDs is unknown. Factors influencing the likelihood of relapse for each AID are also unknown. This study aimed to determine the likelihood of relapse for each common AID and to generate hypotheses about factors influencing the likelihood of relapse. We reviewed charts of adult patients with nonhematologic AIDs who had undergone HCT in Alberta (n = 21) and patients described in the literature (n = 67). We used stringent inclusion criteria to minimize the inclusion of patients whose AID may have been cured before transplantation. We also used stringent definitions of AID relapse and remission. AID relapsed in 2 of 9 patients (22%) with lupus, in 4 of 12 (33%) with rheumatoid arthritis (RA), in 0 of 4 (0%) with systemic sclerosis (SSc), in 3 of 16 (19%) with psoriasis, in 1 of 12 (8%) with Behçet's disease (BD), in 1 of 15 (7%) with Crohn's disease (CD), in 0 of 5 (0%) with ulcerative colitis (UC), in 4 of 8 (50%) with multiple sclerosis (MS), and in 3 of 3 (100%) with type 1 diabetes mellitus (T1DM). Among highly informative patients (followed for >1 year after discontinuation of immunosuppressive therapy if no relapse, or donor AID status known if relapse), relapse occurred in 0 of 3 patients with lupus, in 2 of 7 with RA, in 0 of 2 with SSc, in 3 of 6 with psoriasis, in 0 of 3 with BD, in 0 of 10 with CD, in 0 of 3 with UC, in 2 of 3 with MS, and in 2 of 2 with T1DM. There appeared to be no associations between AID relapse and low intensity of pretransplantation chemoradiotherapy, multiple lines of AID therapy (surrogate for AID refractoriness) except perhaps for lupus, absence of serotherapy for graft-versus-host disease (GVHD) prophylaxis, lack of GVHD except perhaps for lupus, or incomplete donor chimerism. Even though remission commonly occurs after HCT in lupus, RA, SSc, psoriasis, BD, CD, and UC, HCT is efficacious for only a subset of patients. The efficacy appears to be unrelated to pretransplantation therapy, GVHD, or chimerism. Large studies are needed to determine the characteristics of patients likely to benefit from HCT for each AID.
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Affiliation(s)
- Iman Shifa
- Division of Hematology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Glen S Hazlewood
- Division of Rheumatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Caylib Durand
- Division of Rheumatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan G Barr
- Division of Rheumatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - P Régine Mydlarski
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul L Beck
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jodie M Burton
- Department of Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Faisal M Khan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kareem Jamani
- Division of Hematology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mohamed Osman
- Division of Rheumatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jan Storek
- Division of Hematology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
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4
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Bracey NA, Platnich JM, Lau A, Chung H, Hyndman ME, MacDonald JA, Chun J, Beck PL, Girardin SE, Gordon PM, Muruve DA. Tissue-selective alternate promoters guide NLRP6 expression. Life Sci Alliance 2020; 4:4/3/e202000897. [PMID: 33376129 PMCID: PMC7772780 DOI: 10.26508/lsa.202000897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/28/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 12/14/2022] Open
Abstract
The NLRP6 innate immune sensor is regulated by tissue-selective alternate promoters that facilitate translational gene silencing outside of the intestinal epithelium in both humans and mice. The pryin domain (PYD) domain is involved in protein interactions that lead to assembly of immune-sensing complexes such as inflammasomes. The repertoire of PYD-containing genes expressed by a cell type arms tissues with responses against a range of stimuli. The transcriptional regulation of the PYD gene family however is incompletely understood. Alternative promoter utilization was identified as a mechanism regulating the tissue distribution of human PYD gene family members, including NLRP6 that is translationally silenced outside of intestinal tissue. Results show that alternative transcriptional promoters mediate NLRP6 silencing in mice and humans, despite no upstream genomic synteny. Human NLRP6 contains an internal alternative promoter within exon 2 of the PYD, resulting in a truncated mRNA in nonintestinal tissue. In mice, a proximal promoter was used that expanded the 5′ leader sequence restricting nuclear export and abolishing translational efficiency. Nlrp6 was dispensable in disease models targeting the kidney, which expresses noncanonical isoforms. Thus, alternative promoter use is a critical mechanism not just for isoform modulation but for determining expression profile and function of PYD family members.
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Affiliation(s)
- Nathan A Bracey
- Department of Medicine, University of Calgary, Calgary, Canada.,Snyder Institute for Chronic Disease, University of Calgary, Calgary, Canada
| | - Jaye M Platnich
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Arthur Lau
- Department of Medicine, University of Calgary, Calgary, Canada.,Snyder Institute for Chronic Disease, University of Calgary, Calgary, Canada
| | - Hyunjae Chung
- Department of Medicine, University of Calgary, Calgary, Canada.,Snyder Institute for Chronic Disease, University of Calgary, Calgary, Canada
| | - M Eric Hyndman
- Department of Surgery, University of Calgary, Calgary, Canada
| | - Justin A MacDonald
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Canada
| | - Justin Chun
- Department of Medicine, University of Calgary, Calgary, Canada.,Snyder Institute for Chronic Disease, University of Calgary, Calgary, Canada
| | - Paul L Beck
- Department of Medicine, University of Calgary, Calgary, Canada.,Snyder Institute for Chronic Disease, University of Calgary, Calgary, Canada
| | - Stephen E Girardin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Paul Mk Gordon
- Centre for Health Genomics and Informatics, University of Calgary, Calgary, Canada
| | - Daniel A Muruve
- Department of Medicine, University of Calgary, Calgary, Canada .,Snyder Institute for Chronic Disease, University of Calgary, Calgary, Canada
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5
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Yin X, Altman T, Rutherford E, West KA, Wu Y, Choi J, Beck PL, Kaplan GG, Dabbagh K, DeSantis TZ, Iwai S. A Comparative Evaluation of Tools to Predict Metabolite Profiles From Microbiome Sequencing Data. Front Microbiol 2020; 11:595910. [PMID: 33343536 PMCID: PMC7746778 DOI: 10.3389/fmicb.2020.595910] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/16/2020] [Indexed: 12/26/2022] Open
Abstract
Metabolomic analyses of human gut microbiome samples can unveil the metabolic potential of host tissues and the numerous microorganisms they support, concurrently. As such, metabolomic information bears immense potential to improve disease diagnosis and therapeutic drug discovery. Unfortunately, as cohort sizes increase, comprehensive metabolomic profiling becomes costly and logistically difficult to perform at a large scale. To address these difficulties, we tested the feasibility of predicting the metabolites of a microbial community based solely on microbiome sequencing data. Paired microbiome sequencing (16S rRNA gene amplicons, shotgun metagenomics, and metatranscriptomics) and metabolome (mass spectrometry and nuclear magnetic resonance spectroscopy) datasets were collected from six independent studies spanning multiple diseases. We used these datasets to evaluate two reference-based gene-to-metabolite prediction pipelines and a machine-learning (ML) based metabolic profile prediction approach. With the pre-trained model on over 900 microbiome-metabolome paired samples, the ML approach yielded the most accurate predictions (i.e., highest F1 scores) of metabolite occurrences in the human gut and outperformed reference-based pipelines in predicting differential metabolites between case and control subjects. Our findings demonstrate the possibility of predicting metabolites from microbiome sequencing data, while highlighting certain limitations in detecting differential metabolites, and provide a framework to evaluate metabolite prediction pipelines, which will ultimately facilitate future investigations on microbial metabolites and human health.
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Affiliation(s)
| | - Tomer Altman
- Altman Analytics LLC, San Francisco, CA, United States
| | | | | | - Yonggan Wu
- Second Genome Inc., Brisbane, CA, United States
| | | | - Paul L. Beck
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Gilaad G. Kaplan
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | | | | | - Shoko Iwai
- Second Genome Inc., Brisbane, CA, United States
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6
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Jayme TS, Leung G, Wang A, Workentine ML, Rajeev S, Shute A, Callejas BE, Mancini N, Beck PL, Panaccione R, McKay DM. Human interleukin-4-treated regulatory macrophages promote epithelial wound healing and reduce colitis in a mouse model. Sci Adv 2020; 6:eaba4376. [PMID: 32548267 PMCID: PMC7274799 DOI: 10.1126/sciadv.aba4376] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/08/2020] [Indexed: 05/10/2023]
Abstract
Murine alternatively activated macrophages can exert anti-inflammatory effects. We sought to determine if IL-4-treated human macrophages [i.e., hM(IL4)] would promote epithelial wound repair and can serve as a cell transfer treatment for inflammatory bowel disease (IBD). Blood monocytes from healthy volunteers and patients with active and inactive IBD were converted to hM(IL4)s. IL-4 treatment of blood-derived macrophages from healthy volunteers and patients with inactive IBD resulted in a characteristic CD206+CCL18+CD14low/- phenotype (RNA-seq revealed IL-4 affected expression of 996 genes). Conditioned media from freshly generated or cryopreserved hM(IL4)s promoted epithelial wound healing in part by TGF, and reduced cytokine-driven loss of epithelial barrier function in vitro. Systemic delivery of hM(IL4) to dinitrobenzene sulphonic acid (DNBS)-treated Rag1-/- mice significantly reduced disease. These findings from in vitro and in vivo analyses provide proof-of-concept support for the development of autologous M(IL4) transfer as a cellular immunotherapy for IBD.
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Affiliation(s)
- Timothy S. Jayme
- Gastrointestinal Research Group and Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Joan and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Gabriella Leung
- Gastrointestinal Research Group and Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Joan and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
- Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Arthur Wang
- Gastrointestinal Research Group and Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Joan and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | | | - Sruthi Rajeev
- Gastrointestinal Research Group and Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Joan and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Adam Shute
- Gastrointestinal Research Group and Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Joan and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Blanca E. Callejas
- Gastrointestinal Research Group and Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Joan and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Nicole Mancini
- Gastrointestinal Research Group and Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Joan and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Paul L. Beck
- Gastrointestinal Research Group, Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Remo Panaccione
- Gastrointestinal Research Group, Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Derek M. McKay
- Gastrointestinal Research Group and Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Joan and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Alberta, Canada
- Corresponding author.
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7
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Pang JXQ, Kheirkhahrahimabadi H, Bindra S, Bindra G, Panaccione R, Eksteen B, Kaplan GG, Nasser Y, Beck PL, Jijon HB. Differential Effect of Genetic Burden on Disease Phenotypes in Crohn's Disease and Ulcerative Colitis in a Canadian Cohort. J Can Assoc Gastroenterol 2020; 4:65-72. [PMID: 33855263 PMCID: PMC8023832 DOI: 10.1093/jcag/gwaa002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/12/2019] [Accepted: 01/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background and Aims Crohn’s disease (CD) and ulcerative colitis (UC) demonstrate considerable phenotypic heterogeneity and course. Accurate predictors of disease behaviour are lacking. The contribution of genetics and specific polymorphisms is widely appreciated; however, their cumulative effect(s) upon disease behaviour remains poorly understood. Here, we investigate the relationship between genetic burden and disease phenotype in a Canadian inflammatory bowel disease (IBD) Cohort. Methods We retrospectively examined a cohort of CD and UC patients recruited from a single tertiary referral center genotyped using a Goldengate Illumina platform. A genetic risk score (GRS) incorporating strength of association (log odds ratio) and allele dose for 151 IBD-risk loci was calculated and evaluated for phenotypic associations. Results Among CD patients, higher GRS was associated with earlier onset of disease (regression coefficient −2.19, 95% confidence interval [CI] −3.77 to −0.61, P = 0.007), ileal disease (odds ratio [OR] 1.45), stricturing/penetrating disease (OR 1.72), perianal disease (OR 1.57) and bowel resection (OR 1.66). Higher GRS was associated with use of anti-tumor necrosis factor (TNF) (P < 0.05) but not immunomodulators. Interestingly, we could not demonstrate an association between higher GRS and family history of IBD (OR 1.27, P = 0.07). Onset of disease remained statistically significant for never smokers (P = 0.03) but not ever smokers (P = 0.13). For UC, having a higher GRS did not predict the age of diagnosis nor was it predictive of UC disease extent (P = 0.18), the need for surgery (P = 0.74), nor medication use (immunomodulators P = 0.53, anti-TNF P = 0.49). We could not demonstrate an association between increased GRS and having a family history of IBD in the UC group. Conclusions Increasing genetic burden is associated with early age of diagnosis in CD and may be useful in predicting disease behaviour in CD but not UC.
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Affiliation(s)
- Jack X Q Pang
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | | | - Sunint Bindra
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | - Gurmeet Bindra
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | - Remo Panaccione
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | - Bertus Eksteen
- Current Address: Aspen Woods Clinic, Calgary, Alberta, Canada
| | - Gilaad G Kaplan
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | - Yasmin Nasser
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | - Paul L Beck
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | - Humberto B Jijon
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
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8
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Thornton CS, Wang Y, Köebel M, Bernard K, Burdz T, Maitland A, Ferraz JG, Beck PL, Ferland A. Another Whipple's triad? Pericardial, myocardial and valvular disease in an unusual case presentation from a Canadian perspective. BMC Cardiovasc Disord 2019; 19:312. [PMID: 31870305 PMCID: PMC6929430 DOI: 10.1186/s12872-019-1257-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 11/13/2019] [Indexed: 12/16/2022] Open
Abstract
Background Whipple’s disease is a clinically relevant multi-system disorder that is often undiagnosed given its elusive nature. We present an atypical case of Whipple’s disease involving pan-valvular endocarditis and constrictive pericarditis, requiring cardiac intervention. A literature review was also performed assessing the prevalence of atypical cases of Whipple’s disease. Case presentation A previously healthy 56-year-old male presented with a four-year history of congestive heart failure with weight loss and fatigue. Notably, he had absent gastrointestinal symptoms. He went on to develop pan-valvular endocarditis and constrictive pericarditis requiring urgent cardiac surgery. A clinical diagnosis of Whipple’s disease was suspected, prompting duodenal biopsy sampling which was unremarkable, Subsequently, Tropheryma whipplei was identified by 16S rDNA PCR on the cardiac valvular tissue. He underwent prolonged antibiotic therapy with recovery of symptoms. Conclusions Our study reports the first known case of Whipple’s disease involving pan-valvular endocarditis and constrictive pericarditis. A literature review also highlights this presentation of atypical Whipple’s with limited gastrointestinal manifestations. Duodenal involvement was limited and the gold standard of biopsy was not contributory. We also highlight the Canadian epidemiology of the disease from 2012 to 2016 with an approximate 4% prevalence rate amongst submitted samples. Routine investigations for Whipple’s disease, including duodenal biopsy, in this case may have missed the diagnosis. A high degree of suspicion was critical for diagnosis of unusual manifestations of Whipple’s disease.
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Affiliation(s)
- Christina S Thornton
- Division of Respirology, Department of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
| | - Yinong Wang
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.,Calgary Laboratory Services, Calgary, AB, Canada
| | - Martin Köebel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.,Calgary Laboratory Services, Calgary, AB, Canada
| | - Kathryn Bernard
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada.,Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada
| | - Tamara Burdz
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Andrew Maitland
- Division of Cardiac Surgery, University of Calgary, Calgary, AB, Canada
| | - Jose G Ferraz
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Paul L Beck
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Andre Ferland
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada
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9
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Platnich JM, Chung H, Lau A, Sandall CF, Bondzi-Simpson A, Chen HM, Komada T, Trotman-Grant AC, Brandelli JR, Chun J, Beck PL, Philpott DJ, Girardin SE, Ho M, Johnson RP, MacDonald JA, Armstrong GD, Muruve DA. Shiga Toxin/Lipopolysaccharide Activates Caspase-4 and Gasdermin D to Trigger Mitochondrial Reactive Oxygen Species Upstream of the NLRP3 Inflammasome. Cell Rep 2019; 25:1525-1536.e7. [PMID: 30404007 DOI: 10.1016/j.celrep.2018.09.071] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 06/04/2018] [Accepted: 09/21/2018] [Indexed: 01/11/2023] Open
Abstract
The non-canonical caspase-4 and canonical NLRP3 inflammasomes are both activated by intracellular lipopolysaccharide (LPS), but the crosstalk between these two pathways remains unclear. Shiga toxin 2 (Stx2)/LPS complex, from pathogenic enterohemorrhagic Escherichia coli, activates caspase-4, gasdermin D (GSDMD), and the NLRP3 inflammasome in human THP-1 macrophages, but not mouse macrophages that lack the Stx receptor CD77. Stx2/LPS-mediated IL-1β secretion and pyroptosis are dependent on mitochondrial reactive oxygen species (ROS) downstream of the non-canonical caspase-4 inflammasome and cleaved GSDMD, which is enriched at the mitochondria. Blockade of caspase-4 activation and ROS generation as well as GSDMD deficiency significantly reduces Stx2/LPS-induced IL-1β production and pyroptosis. The NLRP3 inflammasome plays a significant role in amplifying Stx2/LPS-induced GSDMD cleavage and pyroptosis, with significant reduction of these responses in NLRP3-deficient THP-1 cells. Together, these data show that Stx2/LPS complex activates the non-canonical inflammasome and mitochondrial ROS upstream of the NLRP3 inflammasome to promote cytokine maturation and pyroptosis.
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Affiliation(s)
- Jaye M Platnich
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Hyunjae Chung
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Arthur Lau
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Christina F Sandall
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, AB, Canada
| | - Adom Bondzi-Simpson
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Huey-Miin Chen
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, AB, Canada
| | - Takanori Komada
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | | | - Jeremy R Brandelli
- Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Justin Chun
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Paul L Beck
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Dana J Philpott
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | - Stephen E Girardin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - May Ho
- Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Roger P Johnson
- Public Health Agency of Canada, National Microbiology Laboratory, Guelph, ON, Canada
| | - Justin A MacDonald
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, AB, Canada
| | - Glen D Armstrong
- Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - Daniel A Muruve
- Department of Medicine, University of Calgary, Calgary, AB, Canada; Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada.
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10
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Logan LM, Jensen SK, Singh N, Peplowski MA, Rabi D, Yipp BG, Hollenberg MD, Beck PL. Proceedings from the 8th Annual University of Calgary Leaders in Medicine Research Symposium. ACTA ACUST UNITED AC 2019; 41:E165-E185. [PMID: 30737977 DOI: 10.25011/cim.v41i4.32220] [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] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Indexed: 11/03/2022]
Abstract
On November 14, 2016, the Leaders in Medicine (LIM) program at the Cumming School of Medicine, University of Calgary hosted its 8th Annual Research Symposium. Professor Stephen Sawcer, Professor of Neurological Genetics at the University of Cambridge and an Honorary Consultant Neurologist at Addenbrooke's Hospital, was the keynote speaker and presented a lecture entitled, "Multiple sclerosis genetics - prospects and pitfalls". This was not only a cutting edge address on genetics but also a thoughtful overview on Dr. Sawcer's career and career choices. We were extremely grateful for the opportunity to have Dr. Sawcer participate in our annual symposium.
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Affiliation(s)
- Lindsey M Logan
- Cumming School of Medicine University of Calgary, Calgary AB.
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11
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Reyes JL, Lopes F, Leung G, Jayme TS, Matisz CE, Shute A, Burkhard R, Carneiro M, Workentine ML, Wang A, Petri B, Beck PL, Geuking MB, McKay DM. Macrophages treated with antigen from the tapeworm Hymenolepis diminuta condition CD25 + T cells to suppress colitis. FASEB J 2019; 33:5676-5689. [PMID: 30668930 DOI: 10.1096/fj.201802160r] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Macrophages play central roles in immunity as early effectors and modulating adaptive immune reponses; we implicated macrophages in the anticolitic effect of infection with the tapeworm Hymenolepis diminuta. Here, gene arrays revealed that H. diminuta antigen (HdAg) evoked a program in murine macrophages distinct from that elicited by IL-4. Further, HdAg suppressed LPS-evoked release of TNF-α and IL-1β from macrophages via autocrine IL-10 signaling. In assessing the ability of macrophages treated in vitro with an extract of H. diminuta [M(HdAg)] to affect disease, intravenous, but not peritoneal, injection of M(HdAg) protected wild-type but not RAG1-/- mice from dinitrobenzene sulphonic acid (DNBS)-induced colitis. Administration of splenic CD4+ T cells from in vitro cocultures with M(HdAg), but not those cocultured with M(IL-4) cells, inhibited DNBS-induced colitis; fractionation of the T-cell population indicated that the CD4+CD25+ T cells from cocultures with M(HdAg) drove the suppression of DNBS-induced colitis. Use of IL-4-/- or IL-10-/- CD4+ T cells revealed that neither cytokine alone from the donor cells was essential for the anticolitic effect. These data illustrate that HdAg evokes a unique regulatory program in macrophages, identifies HdAg-evoked IL-10 suppression of macrophage activation, and reveals the ability of HdAg-treated macrophages to educate ( i.e., condition) and mobilize CD4+CD25+ T cells, which could be deployed to treat colonic inflammation.-Reyes, J. L., Lopes, F., Leung, G., Jayme, T. S., Matisz, C. E., Shute, A., Burkhard, R., Carneiro, M., Workentine, M. L., Wang, A., Petri, B., Beck, P. L., Geuking, M. B., McKay, D. M., Macrophages treated with antigen from the tapeworm Hymenolepis diminuta condition CD25+ T cells to suppress colitis.
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Affiliation(s)
- José L Reyes
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada.,Laboratorio de Inmunología Experimental y Regulación de la Inflamación Hepato-Intestinal, Unidad de Investigación en Biomedicina (UBIMED), Facultad de Estudios Superiores (FES) Iztacala, Universidad Nacional Autónoma de México (UNAM), Tlalnepantla de Baz, México
| | - Fernando Lopes
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada
| | - Gabriella Leung
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada
| | - Timothy S Jayme
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada
| | - Chelsea E Matisz
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada
| | - Adam Shute
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada
| | - Regula Burkhard
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada.,Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Matheus Carneiro
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | | | - Arthur Wang
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada
| | - Björn Petri
- Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada.,Mouse Phenomics Resource Laboratory, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul L Beck
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Markus B Geuking
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada.,Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Derek M McKay
- Department of Physiology and Pharmacology, Calvin, Joan, and Phoebe Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary Alberta, Canada
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12
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Abstract
The epithelial lining of the gastrointestinal tract serves as the interface for digestion and absorption of nutrients and water and as a defensive barrier. The defensive functions of the intestinal epithelium are remarkable considering that the gut lumen is home to trillions of resident bacteria, fungi and protozoa (collectively, the intestinal microbiota) that must be prevented from translocation across the epithelial barrier. Imbalances in the relationship between the intestinal microbiota and the host lead to the manifestation of diseases that range from disorders of motility and sensation (IBS) and intestinal inflammation (IBD) to behavioural and metabolic disorders, including autism and obesity. The latest discoveries shed light on the sophisticated intracellular, intercellular and interkingdom signalling mechanisms of host defence that involve epithelial and enteroendocrine cells, the enteric nervous system and the immune system. Together, they maintain homeostasis by integrating luminal signals, including those derived from the microbiota, to regulate the physiology of the gastrointestinal tract in health and disease. Therapeutic strategies are being developed that target these signalling systems to improve the resilience of the gut and treat the symptoms of gastrointestinal disease.
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Affiliation(s)
- Keith A Sharkey
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. .,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada. .,Gastrointestinal Research Group, University of Calgary, Calgary, Alberta, Canada. .,Department of Physiology & Pharmacology, University of Calgary, Calgary, Alberta, Canada.
| | - Paul L Beck
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.,Gastrointestinal Research Group, University of Calgary, Calgary, Alberta, Canada.,Inflammation Research Network, University of Calgary, Calgary, Alberta, Canada.,Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Derek M McKay
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.,Gastrointestinal Research Group, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology & Pharmacology, University of Calgary, Calgary, Alberta, Canada.,Inflammation Research Network, University of Calgary, Calgary, Alberta, Canada
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13
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Fang X, Monk JM, Nurk S, Akseshina M, Zhu Q, Gemmell C, Gianetto-Hill C, Leung N, Szubin R, Sanders J, Beck PL, Li W, Sandborn WJ, Gray-Owen SD, Knight R, Allen-Vercoe E, Palsson BO, Smarr L. Metagenomics-Based, Strain-Level Analysis of Escherichia coli From a Time-Series of Microbiome Samples From a Crohn's Disease Patient. Front Microbiol 2018; 9:2559. [PMID: 30425690 PMCID: PMC6218438 DOI: 10.3389/fmicb.2018.02559] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022] Open
Abstract
Dysbiosis of the gut microbiome, including elevated abundance of putative leading bacterial triggers such as E. coli in inflammatory bowel disease (IBD) patients, is of great interest. To date, most E. coli studies in IBD patients are focused on clinical isolates, overlooking their relative abundances and turnover over time. Metagenomics-based studies, on the other hand, are less focused on strain-level investigations. Here, using recently developed bioinformatic tools, we analyzed the abundance and properties of specific E. coli strains in a Crohns disease (CD) patient longitudinally, while also considering the composition of the entire community over time. In this report, we conducted a pilot study on metagenomic-based, strain-level analysis of a time-series of E. coli strains in a left-sided CD patient, who exhibited sustained levels of E. coli greater than 100X healthy controls. We: (1) mapped out the composition of the gut microbiome over time, particularly the presence of E. coli strains, and found that the abundance and dominance of specific E. coli strains in the community varied over time; (2) performed strain-level de novo assemblies of seven dominant E. coli strains, and illustrated disparity between these strains in both phylogenetic origin and genomic content; (3) observed that strain ST1 (recovered during peak inflammation) is highly similar to known pathogenic AIEC strains NC101 and LF82 in both virulence factors and metabolic functions, while other strains (ST2-ST7) that were collected during more stable states displayed diverse characteristics; (4) isolated, sequenced, experimentally characterized ST1, and confirmed the accuracy of the de novo assembly; and (5) assessed growth capability of ST1 with a newly reconstructed genome-scale metabolic model of the strain, and showed its potential to use substrates found abundantly in the human gut to outcompete other microbes. In conclusion, inflammation status (assessed by the blood C-reactive protein and stool calprotectin) is likely correlated with the abundance of a subgroup of E. coli strains with specific traits. Therefore, strain-level time-series analysis of dominant E. coli strains in a CD patient is highly informative, and motivates a study of a larger cohort of IBD patients.
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Affiliation(s)
- Xin Fang
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States
| | - Jonathan M Monk
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States
| | - Sergey Nurk
- Center for Algorithmic Biotechnology, Institute for Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Margarita Akseshina
- St. Petersburg Academic University, Russian Academy of Sciences, St. Petersburg, Russia
| | - Qiyun Zhu
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
| | - Christopher Gemmell
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Connor Gianetto-Hill
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Nelly Leung
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Richard Szubin
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States
| | - Jon Sanders
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Paul L Beck
- Division of Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - Weizhong Li
- Human Longevity Inc., San Diego, CA, United States.,J. Craig Venter Institute, La Jolla, CA, United States
| | - William J Sandborn
- Department of Medicine, University of California, San Diego, La Jolla, CA, United States.,Inflammatory Bowel Disease Center, University of California, San Diego, La Jolla, CA, United States
| | - Scott D Gray-Owen
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Rob Knight
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States.,Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA, United States.,Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States
| | - Emma Allen-Vercoe
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Bernhard O Palsson
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, United States.,Center for Algorithmic Biotechnology, Institute for Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia.,Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States.,The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Lyngby, Denmark
| | - Larry Smarr
- Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA, United States.,Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, United States.,California Institute for Telecommunications and Information Technology, University of California, San Diego, La Jolla, CA, United States
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14
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Barton KI, Capozzi LC, Aker G, Yipp BG, Hollenberg MD, Rabi DM, Beck PL. The Need for an Executive Leadership Curriculum in Scientist-Clinician Training Programs. ACTA ACUST UNITED AC 2018; 41:E144-E147. [PMID: 30315750 DOI: 10.25011/cim.v41i3.30855] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 09/30/2018] [Indexed: 11/03/2022]
Abstract
The health of Canadians depends on effective leadership among health care providers to facilitate the translation of new health discoveries into clinical practice. Clinician-scientists play an important role in bridging the gap between research and clinical practice, and require effective leadership skills to advance clinical practice successfully. To accelerate the leadership development in clinician scientist trainees, with the aim of developing strong leaders in administration and health advocacy, the Leaders in Medicine (LIM) training program at the University of Calgary created an Executive Leadership Coaching Program involving three phases: 1) an evidence-based evaluation tool, the Core Values IndexTM (CVI), that was used to identify the key drivers behind how individuals can be most effective in making their contribution; 2) small group workshops to debrief the results of the CVI assessment; and 3) one-on-one executive coaching sessions to facilitate the discovery, development and deployment of individual leadership capabilities. Coaching in leadership strategies enables clinician-scientist trainees to lead, influence, manage and deliver science-based improvements into the practice of medicine. We strongly recommend that other Canadian scientist-clinician training programs consider opportunities like the ones we offer to our LIM trainees. This training has important implications for the delivery of healthcare in Canada.
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Affiliation(s)
- Kristen I Barton
- Leaders in Medicine Program, Cumming School of Medicine, University of Calgary; Undergraduate Medical Education, Cumming School of Medicine, University of Calgary.
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15
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Fernando EH, Gordon MH, Beck PL, MacNaughton WK. Inhibition of Intestinal Epithelial Wound Healing through Protease-Activated Receptor-2 Activation in Caco2 Cells. J Pharmacol Exp Ther 2018; 367:382-392. [DOI: 10.1124/jpet.118.249524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 08/31/2018] [Indexed: 01/01/2023] Open
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16
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Motta JP, Allain T, Green-Harrison LE, Groves RA, Feener T, Ramay H, Beck PL, Lewis IA, Wallace JL, Buret AG. Iron Sequestration in Microbiota Biofilms As A Novel Strategy for Treating Inflammatory Bowel Disease. Inflamm Bowel Dis 2018; 24:1493-1502. [PMID: 29788224 PMCID: PMC5995063 DOI: 10.1093/ibd/izy116] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Indexed: 12/12/2022]
Abstract
Significant alterations of intestinal microbiota and anemia are hallmarks of inflammatory bowel disease (IBD). It is widely accepted that iron is a key nutrient for pathogenic bacteria, but little is known about its impact on microbiota associated with IBD. We used a model device to grow human mucosa-associated microbiota in its physiological anaerobic biofilm phenotype. Compared to microbiota from healthy donors, microbiota from IBD patients generate biofilms ex vivo that were larger in size and cell numbers, contained higher intracellular iron concentrations, and exhibited heightened virulence in a model of human intestinal epithelia in vitro and in the nematode Caenorhabditis elegans. We also describe an unexpected iron-scavenging property for an experimental hydrogen sulfide-releasing derivative of mesalamine. The findings demonstrate that this new drug reduces the virulence of IBD microbiota biofilms through a direct reduction of microbial iron intake and without affecting bacteria survival or species composition within the microbiota. Metabolomic analyses indicate that this drug reduces the intake of purine nucleosides (guanosine), increases the secretion of metabolite markers of purine catabolism (urate and hypoxanthine), and reduces the secretion of uracil (a pyrimidine nucleobase) in complex multispecies human biofilms. These findings demonstrate a new pathogenic mechanism for dysbiotic microbiota in IBD and characterize a novel mode of action for a class of mesalamine derivatives. Together, these observations pave the way towards a new therapeutic strategy for treatment of patients with IBD.
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Affiliation(s)
- Jean-Paul Motta
- Department of Biological Sciences, University of Calgary, University Drive NW, Calgary, Alberta, Canada,Department of Physiology & Pharmacology, University of Calgary, Hospital Drive NW, Calgary, Alberta, Canada
| | - Thibault Allain
- Department of Biological Sciences, University of Calgary, University Drive NW, Calgary, Alberta, Canada
| | - Luke E Green-Harrison
- Department of Biological Sciences, University of Calgary, University Drive NW, Calgary, Alberta, Canada
| | - Ryan A Groves
- Department of Biological Sciences, University of Calgary, University Drive NW, Calgary, Alberta, Canada
| | - Troy Feener
- Department of Physiology & Pharmacology, University of Calgary, Hospital Drive NW, Calgary, Alberta, Canada
| | - Hena Ramay
- International Microbiome Centre, University of Calgary, Hospital Drive NW, Calgary, Alberta, Canada
| | - Paul L Beck
- Department of Medicine, University of Calgary, Hospital Drive NW, Calgary, Alberta, Canada
| | - Ian A Lewis
- Department of Biological Sciences, University of Calgary, University Drive NW, Calgary, Alberta, Canada
| | - John L Wallace
- Department of Physiology & Pharmacology, University of Calgary, Hospital Drive NW, Calgary, Alberta, Canada
| | - Andre G Buret
- Department of Biological Sciences, University of Calgary, University Drive NW, Calgary, Alberta, Canada,Address correspondence to: Andre G. Buret, PhD, Department of Biological Sciences, Faculty of Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 4N1, Canada. E-mail:
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17
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Beatty J, Peplowski M, Singh N, Beers C, Beck EM, Hollenberg M, Yipp B, Beck PL. Combining the Love of Art, Science, Business and Medicine to Innovate and Enhance Patient Health. Highlights from the 7th Annual Leaders in Medicine Symposium of the Cummings School of Medicine, Calgary, AB. ACTA ACUST UNITED AC 2018; 41:E51-E54. [PMID: 29959883 DOI: 10.25011/cim.v41i2.29915] [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] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Indexed: 11/03/2022]
Abstract
The Leader in Medicine (LIM) Program of the Cumming School of Medicine, University of Calgary, hosted its 7th Annual LIM Research Symposium on October 30, 2015 and participation grew once again, with a total of six oral and 99 posters presentations! Over 45 of our Faculty members also participated in the symposium. This year's LIM Symposium theme was "Innovations in Medicine" and the invited guest speaker was our own Dr. Breanne Everett (MD/MBA). She completed her residency in plastic surgery at University of Calgary and holds both a medical degree and an MBA from the University of Calgary. In her inspiring talk, entitled "Marrying Business and Medicine: Toe-ing a Fine Line", she described how she dealt with a clinical problem (diabetic foot ulcers), came up with an innovation that optimized patient care, started her own company and delivered her product to market to enhance the health of the community. She clearly illustrated how to complete the full circle, from identifying a clinical problem to developing and providing a solution that both enhances clinical care and patient health as well as reduces health care costs and hospital admissions. The research symposium was an outstanding success and the abstracts are included in companion article in CIM.
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Affiliation(s)
- Jennifer Beatty
- Cumming School of Medicine, University of Calgary, Calgary AB.
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18
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Frolkis A, Beatty J, Peplowski M, Singh N, Beers C, Beck EM, Hollenberg M, Yipp B, Beck PL. Proceedings from the 7th Annual University of Calgary Leaders in Medicine Research Symposium. ACTA ACUST UNITED AC 2018; 41:E55-E126. [PMID: 29959884 DOI: 10.25011/cim.v41i2.29916] [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] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Indexed: 11/03/2022]
Abstract
TOn October 30th, 2015, the Leaders in Medicine (LIM) program at the Cumming School of Medicine, University of Calgary hosted its 7th Annual Research Symposium. Dr. Breanne Everett, President and CEO of Orpyx Medical Technologies and holder both of medical and MBA degrees from the University of Calgary, presented a lecture entitled "Marrying Business and Medicine: Toe-ing a Fine Line". The LIM symposium also provides a forum for both LIM and non-LIM medical students to present their research work in oral and poster presentation formats. This year over 100 students submitted their work and six oral presentations and 99 posters were presented. The oral presentations were as follows: Ryan Lewinson, Prediction of wedged insole-induced changes to knee joint moments during walkingLindsey Logan, Robotic measures provide insight on sensorimotor and cognitive impairments following traumatic brain injury Jackie Mann, What medication information do community doctors want to receive in discharge summaries for safer transfers? Ashley Jensen, Increased mortality associated with resident handoff periods at ten veterans administration medical centers Jason Bau, Keratinocyte growth factor protects against C. difficile-induced cell injury and death Michael Keough, A novel drug class promotes regeneration of central nervous system myelin by overcoming inhibitory scar molecules in vitro and in vivo For further details on the University of Calgary Leaders in Medicine Program see "A Prescription that Addresses the Decline of Basic Science Education in Medical School" (Clinical and Investigative Medicine. 2014;37(5):E29). The LIM Symposium has the following objectives: (1) to showcase the variety of projects undertaken by students in the LIM Program as well as University of Calgary medical students; (2) to encourage medical student participation in research and special projects; (3) to inform students and faculty about the diversity of opportunities available for research and special projects during medical school and beyond; and, (4) to enhance student and staff interactions, with the ultimate goal being to enhance translational medicine improve health.
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19
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Lau A, Chung H, Komada T, Platnich JM, Sandall CF, Choudhury SR, Chun J, Naumenko V, Surewaard BG, Nelson MC, Ulke-Lemée A, Beck PL, Benediktsson H, Jevnikar AM, Snelgrove SL, Hickey MJ, Senger DL, James MT, Macdonald JA, Kubes P, Jenne CN, Muruve DA. Renal immune surveillance and dipeptidase-1 contribute to contrast-induced acute kidney injury. J Clin Invest 2018; 128:2894-2913. [PMID: 29863495 DOI: 10.1172/jci96640] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 04/10/2018] [Indexed: 01/04/2023] Open
Abstract
Radiographic contrast agents cause acute kidney injury (AKI), yet the underlying pathogenesis is poorly understood. Nod-like receptor pyrin containing 3-deficient (Nlrp3-deficient) mice displayed reduced epithelial cell injury and inflammation in the kidney in a model of contrast-induced AKI (CI-AKI). Unexpectedly, contrast agents directly induced tubular epithelial cell death in vitro that was not dependent on Nlrp3. Rather, contrast agents activated the canonical Nlrp3 inflammasome in macrophages. Intravital microscopy revealed diatrizoate (DTA) uptake within minutes in perivascular CX3CR1+ resident phagocytes in the kidney. Following rapid filtration into the tubular luminal space, DTA was reabsorbed and concentrated in tubular epithelial cells via the brush border enzyme dipeptidase-1 in volume-depleted but not euvolemic mice. LysM-GFP+ macrophages recruited to the kidney interstitial space ingested contrast material transported from the urine via direct interactions with tubules. CI-AKI was dependent on resident renal phagocytes, IL-1, leukocyte recruitment, and dipeptidase-1. Levels of the inflammasome-related urinary biomarkers IL-18 and caspase-1 were increased immediately following contrast administration in patients undergoing coronary angiography, consistent with the acute renal effects observed in mice. Taken together, these data show that CI-AKI is a multistep process that involves immune surveillance by resident and infiltrating renal phagocytes, Nlrp3-dependent inflammation, and the tubular reabsorption of contrast via dipeptidase-1.
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Affiliation(s)
- Arthur Lau
- Department of Medicine.,Snyder Institute for Chronic Diseases
| | - Hyunjae Chung
- Department of Medicine.,Snyder Institute for Chronic Diseases
| | - Takanori Komada
- Department of Medicine.,Snyder Institute for Chronic Diseases
| | - Jaye M Platnich
- Department of Medicine.,Snyder Institute for Chronic Diseases
| | - Christina F Sandall
- Department of Biochemistry and Molecular Biology.,Libin Cardiovascular Institute of Alberta
| | | | - Justin Chun
- Department of Medicine.,Snyder Institute for Chronic Diseases
| | - Victor Naumenko
- Snyder Institute for Chronic Diseases.,Department of Microbiology, Immunology, and Infectious Diseases, and
| | - Bas Gj Surewaard
- Snyder Institute for Chronic Diseases.,Department of Microbiology, Immunology, and Infectious Diseases, and
| | | | - Annegret Ulke-Lemée
- Department of Biochemistry and Molecular Biology.,Libin Cardiovascular Institute of Alberta
| | - Paul L Beck
- Department of Medicine.,Snyder Institute for Chronic Diseases
| | - Hallgrimur Benediktsson
- Snyder Institute for Chronic Diseases.,Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anthony M Jevnikar
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Sarah L Snelgrove
- Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
| | - Michael J Hickey
- Centre for Inflammatory Diseases, Monash University Department of Medicine, Monash Medical Centre, Clayton, Victoria, Australia
| | - Donna L Senger
- Department of Oncology.,Arnie Charbonneau Cancer Institute
| | - Matthew T James
- Department of Medicine.,Libin Cardiovascular Institute of Alberta
| | - Justin A Macdonald
- Department of Biochemistry and Molecular Biology.,Libin Cardiovascular Institute of Alberta
| | - Paul Kubes
- Snyder Institute for Chronic Diseases.,Department of Microbiology, Immunology, and Infectious Diseases, and
| | - Craig N Jenne
- Snyder Institute for Chronic Diseases.,Department of Microbiology, Immunology, and Infectious Diseases, and
| | - Daniel A Muruve
- Department of Medicine.,Snyder Institute for Chronic Diseases
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20
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Flannigan KL, Taylor MR, Pereira SK, Rodriguez-Arguello J, Moffat AW, Alston L, Wang X, Poon KK, Beck PL, Rioux KP, Jonnalagadda M, Chelikani PK, Galipeau HJ, Lewis IA, Workentine ML, Greenway SC, Hirota SA. An intact microbiota is required for the gastrointestinal toxicity of the immunosuppressant mycophenolate mofetil. J Heart Lung Transplant 2018; 37:1047-1059. [PMID: 30173823 DOI: 10.1016/j.healun.2018.05.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [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: 02/19/2018] [Revised: 04/04/2018] [Accepted: 05/07/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Mycophenolate mofetil (MMF) is commonly prescribed after transplantation and has major advantages over other immunosuppressive drugs, but frequent gastrointestinal (GI) side-effects limit its use. The mechanism(s) underlying MMF-related GI toxicity have yet to be elucidated. METHODS To investigate MMF-related GI toxicity, experimental mice were fed chow containing MMF (0.563%) and multiple indices of toxicity, including weight loss and colonic inflammation, were measured. Changes in intestinal microbial composition were detected using 16S rRNA Illumina sequencing, and downstream PICRUSt analysis was used to predict metagenomic pathways involved. Germ-free (GF) mice and mice treated with orally administered broad-spectrum antibiotics (ABX) were utilized to interrogate the importance of the microbiota in MMF-induced GI toxicity. RESULTS Mice treated with MMF exhibited significant weight loss, related to loss of body fat and muscle, and marked colonic inflammation. MMF exposure was associated with changes in gut microbial composition, as demonstrated by a loss of overall diversity, expansion of Proteobacteria (specifically Escherichia/Shigella), and enrichment of genes involved in lipopolysaccharide (LPS) biosynthesis, which paralleled increased levels of LPS in the feces and serum. MMF-related GI toxicity was dependent on the intestinal microbiota, as MMF did not induce weight loss or colonic inflammation in GF mice. Furthermore, ABX prevented and reversed MMF-induced weight loss and colonic inflammation. CONCLUSIONS An intact intestinal microbiota is required to initiate and sustain the GI toxicity of MMF. MMF treatment causes dynamic changes in the composition of the intestinal microbiota that may be a targetable driver of the GI side-effects of MMF.
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Affiliation(s)
- Kyle L Flannigan
- Department of Physiology and Pharmacology, Cumming School of Medicine; Snyder Institute for Chronic Diseases.
| | - Michael R Taylor
- Department of Paediatrics and Alberta Children's Hospital Research Institute, Cumming School of Medicine
| | - Sheldon K Pereira
- Snyder Institute for Chronic Diseases; Department of Paediatrics and Alberta Children's Hospital Research Institute, Cumming School of Medicine
| | - Jimena Rodriguez-Arguello
- Department of Paediatrics and Alberta Children's Hospital Research Institute, Cumming School of Medicine
| | - Andrew W Moffat
- Department of Paediatrics and Alberta Children's Hospital Research Institute, Cumming School of Medicine
| | - Laurie Alston
- Department of Physiology and Pharmacology, Cumming School of Medicine; Snyder Institute for Chronic Diseases
| | - Xuemei Wang
- Department of Paediatrics and Alberta Children's Hospital Research Institute, Cumming School of Medicine; Department of Cardiac Sciences and the Libin Cardiovascular Institute of Alberta, Cumming School of Medicine
| | - Karen K Poon
- Snyder Institute for Chronic Diseases; Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine
| | - Paul L Beck
- Department of Physiology and Pharmacology, Cumming School of Medicine; Snyder Institute for Chronic Diseases; Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kevin P Rioux
- Snyder Institute for Chronic Diseases; Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine; Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mahesh Jonnalagadda
- Laboratory of Animal Medical Services, University of Cincinnati, Cincinnati, Ohio, USA
| | - Prasanth K Chelikani
- Department of Production, Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Heather J Galipeau
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Steven C Greenway
- Department of Paediatrics and Alberta Children's Hospital Research Institute, Cumming School of Medicine; Department of Cardiac Sciences and the Libin Cardiovascular Institute of Alberta, Cumming School of Medicine; Department of Biochemistry & Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Simon A Hirota
- Department of Physiology and Pharmacology, Cumming School of Medicine; Snyder Institute for Chronic Diseases; Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine
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21
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Reyes JL, Vannan DT, Vo T, Gulamhusein A, Beck PL, Reimer RA, Eksteen B. Neutralization of IL-15 abrogates experimental immune-mediated cholangitis in diet-induced obese mice. Sci Rep 2018; 8:3127. [PMID: 29449577 PMCID: PMC5814438 DOI: 10.1038/s41598-018-21112-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 01/29/2018] [Indexed: 12/26/2022] Open
Abstract
Obesity is a global epidemic affecting chronic inflammatory diseases. Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease that can occur as an extraintestinal manifestation of inflammatory bowel disease (IBD). Previously we reported that patients with PSC who are obese have a higher risk of advanced liver disease. Currently it is unknown how obesity accelerates or worsens PSC. We evaluated the progression of PSC in an antigen-driven cholangitis mouse model of diet-induced obesity. Obesity was induced in our murine model of immune-mediated cholangitis (OVAbil). OVAbil mice were fed standard chow or high-fat/sucrose diet for twelve weeks followed by induction of biliary inflammation by OVA-specific T cell transfer. Histopathological damage in portal tracts was scored and serum collected. Neutralizing antibodies against IL-15 were administered daily until study termination. Obese mice developed exacerbated liver inflammation and damage. Immune cell phenotyping in liver revealed greater numbers of neutrophils and CD8+ T cells in obese mice. Higher levels of cytokines and chemokines were found in obese mice with cholangitis. Immuno-neutralizing antibodies against IL-15 greatly attenuated cholangitis in obese mice. Obesity exacerbated experimental PSC in part by overproduction of IL-15. Timely targeting of IL-15 may slow the progression of PSC.
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Affiliation(s)
- José L Reyes
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Laboratorio de Inmunología Experimental y Regulación de la Inflamación Hepato-Intestinal, UBIMED, FES Iztacala UNAM, Estado de México, Mexico
| | - Danielle T Vannan
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Aspen Woods Clinic, Calgary, Alberta, Canada
| | - Tina Vo
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aliya Gulamhusein
- Genomic Hepatobiology Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul L Beck
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raylene A Reimer
- Department of Biochemistry & Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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22
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Komada T, Chung H, Lau A, Platnich JM, Beck PL, Benediktsson H, Duff HJ, Jenne CN, Muruve DA. Macrophage Uptake of Necrotic Cell DNA Activates the AIM2 Inflammasome to Regulate a Proinflammatory Phenotype in CKD. J Am Soc Nephrol 2018; 29:1165-1181. [PMID: 29439156 DOI: 10.1681/asn.2017080863] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/19/2017] [Indexed: 11/03/2022] Open
Abstract
Nonmicrobial inflammation contributes to CKD progression and fibrosis. Absent in melanoma 2 (AIM2) is an inflammasome-forming receptor for double-stranded DNA. AIM2 is expressed in the kidney and activated mainly by macrophages. We investigated the potential pathogenic role of the AIM2 inflammasome in kidney disease. In kidneys from patients with diabetic or nondiabetic CKD, immunofluorescence showed AIM2 expression in glomeruli, tubules, and infiltrating leukocytes. In a mouse model of unilateral ureteral obstruction (UUO), Aim2 deficiency attenuated the renal injury, fibrosis, and inflammation observed in wild-type (WT) littermates. In bone marrow chimera studies, UUO induced substantially more tubular injury and IL-1β cleavage in Aim2-/- or WT mice that received WT bone marrow than in WT mice that received Aim2-/- bone marrow. Intravital microscopy of the kidney in LysM(gfp/gfp) mice 5-6 days after UUO demonstrated the significant recruitment of GFP+ proinflammatory macrophages that crawled along injured tubules, engulfed DNA from necrotic cells, and expressed active caspase-1. DNA uptake occurred in large vacuolar structures within recruited macrophages but not resident CX3CR1+ renal phagocytes. In vitro, macrophages that engulfed necrotic debris showed AIM2-dependent activation of caspase-1 and IL-1β, as well as the formation of AIM2+ ASC specks. ASC specks are a hallmark of inflammasome activation. Cotreatment with DNaseI attenuated the increase in IL-1β levels, confirming that DNA was the principal damage-associated molecular pattern in this process. Therefore, the activation of the AIM2 inflammasome by DNA from necrotic cells drives a proinflammatory phenotype that contributes to chronic injury in the kidney.
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Affiliation(s)
- Takanori Komada
- Departments of Medicine.,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Hyunjae Chung
- Departments of Medicine.,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Arthur Lau
- Departments of Medicine.,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Jaye M Platnich
- Departments of Medicine.,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Paul L Beck
- Departments of Medicine.,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Hallgrimur Benediktsson
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.,Pathology and Laboratory Medicine
| | | | - Craig N Jenne
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.,Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada; and
| | - Daniel A Muruve
- Departments of Medicine, .,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
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23
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Nguyen HH, Beck PL. Not Your Ordinary Ulcer: A Cautionary Tale of an Uncommon Condition. Gastroenterology 2017; 153:1484-1485. [PMID: 29104099 DOI: 10.1053/j.gastro.2017.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 04/05/2017] [Indexed: 12/02/2022]
Affiliation(s)
- Henry H Nguyen
- Division of Gastroenterology and Hepatology, University of Calgary, Calgary AB Canada
| | - Paul L Beck
- Division of Gastroenterology and Hepatology, University of Calgary, Calgary AB Canada
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24
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Peplowski MA, Vegso AJ, Iablokov V, Dicay M, Zaheer RS, Renaux B, Proud D, Hollenberg MD, Beck PL, MacNaughton WK. Tumor necrosis factor α decreases aquaporin 3 expression in intestinal epithelial cells through inhibition of constitutive transcription. Physiol Rep 2017; 5:5/19/e13451. [PMID: 29038361 PMCID: PMC5641937 DOI: 10.14814/phy2.13451] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 05/18/2017] [Revised: 08/21/2017] [Accepted: 08/24/2017] [Indexed: 01/08/2023] Open
Abstract
Inflammatory diseases of the gut are associated with altered electrolyte and water transport, leading to the development of diarrhea. Epithelially expressed aquaporins (AQPs) are downregulated in inflammation, although the mechanisms involved are not known. We hypothesized that AQP3 expression in intestinal epithelial cells is altered in intestinal inflammation and that these changes are driven by tumor necrosis factor (TNF) α. Human colonic adenocarcinoma (HT‐29) cells were treated with TNFα to investigate signaling mechanisms in vitro. AQP3 expression was assessed by real‐time PCR and radiolabeled glycerol uptake, with select inhibitors and a luciferase reporter construct used to further elucidate intracellular signaling. AQP3 expression was downregulated in HT‐29 cells treated with TNFα. Luciferase reporter construct experiments revealed that TNFα downregulated constitutive transcriptional activity of the AQP3 promoter, and inhibition of MEK/ERK and nuclear factor κB (NF‐κB) signaling prevented the decrease in AQP3 mRNA expression. Constitutive AQP3 expression was suppressed by specificity protein (Sp) 3, and knockdown of this transcription factor bound to the AQP3 promoter was able to partially prevent the TNFα‐induced downregulation of AQP3. TNFα signals through MEK/ERK and NF‐κB to enhance the negative transcriptional control of AQP3 expression exerted by Sp3. Similar mechanisms regulate numerous ion channels, suggesting a common mechanism by which both ion and water transport are altered in inflammation.
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Affiliation(s)
- Michael A Peplowski
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Andrew J Vegso
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Vadim Iablokov
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Michael Dicay
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Raza S Zaheer
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Bernard Renaux
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - David Proud
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Morley D Hollenberg
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Paul L Beck
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Wallace K MacNaughton
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
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25
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Li J, Yan Y, Meng Z, Liu S, Beck PL, Ghosh S, Qian J, Gui X. Microscopic Colitis Evolved Into Inflammatory Bowel Diseases Is Characterized by Increased Th1/Tc1 Cells in Colonic Mucosal Lamina Propria. Dig Dis Sci 2017; 62:2755-2767. [PMID: 28597107 DOI: 10.1007/s10620-017-4636-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/26/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND An association between microscopic colitis (MC), i.e., lymphocytic colitis (LC) and collagenous colitis (CC), and inflammatory bowel diseases (IBD) has been noticed. A subset of MC cases may evolve into IBD, and IBD in remission may present as MC in a histologic pattern. Moreover, MC and IBD may coexist in different regions of the bowel. A link between MC and IBD in their pathogenesis is, therefore, suggested. Abnormal mucosal immunity is likely the key. METHODS We reviewed 2324 MC cases in Calgary over 14 years and identified 20 cases evolved into IBD (IBD transformers). 13 of them were further investigated for colonic mucosal lamina propria mononuclear cells (LPMNCs), as opposed to 22 cases whose MC resolved. On their index colonic biopsy immunohistochemistry was performed to detect major T cell subsets characterized by key cytokines and master transcription factors (IFNγ and T-bet for Th1/Tc1, GATA-3 for Th2/Tc2, IL-17 and RORc for Th17/Tc17, FoxP3 for Treg/Tcreg) as well as TNFα+ cells (partly representing Th1). LPMNCs positive for each marker were counted (average number per high-power field). RESULTS IBD transformers had increased IFNγ+, T-bet+, TNF-α+, and GATA-3+ LPMNCs compared to the MC-resolved cases. The LC-to-IBD subgroup had increased IFNγ+ and GATA-3+ cells compared to the LC-resolved subgroup. The CC-to-IBD subgroup had increased T-bet+, TNF-α+, and GATA-3+ cells compared to the CC-resolved subgroup. Among MC-resolved patients, more TNF-α+ and RORc+ cells were seen in LC than in CC. CONCLUSION Th1/Tc1- and TNFα-producing cells, and likely a subset of Th2/Tc2 cells as well, may be involved in the MC-to-IBD transformation.
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Affiliation(s)
- Ji Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Yuchu Yan
- Calgary Laboratory Services, Calgary, AB, Canada
| | - Ziran Meng
- Calgary Laboratory Services, Calgary, AB, Canada
| | - Shuhong Liu
- Calgary Laboratory Services, Calgary, AB, Canada
| | - Paul L Beck
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Subrata Ghosh
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, AB, Canada
- Institute of Translational Medicine, University of Birmingham, Birmingham, UK
| | - Jiaming Qian
- Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China
| | - Xianyong Gui
- Calgary Laboratory Services, Calgary, AB, Canada.
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Pathology, Foothills Medical Centre, 1403 29 Street NW, Calgary, AB, T2N 2T9, Canada.
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26
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Li J, Ueno A, Iacucci M, Fort Gasia M, Jijon HB, Panaccione R, Kaplan GG, Beck PL, Luider J, Barkema HW, Qian J, Gui X, Ghosh S. Crossover Subsets of CD4 + T Lymphocytes in the Intestinal Lamina Propria of Patients with Crohn's Disease and Ulcerative Colitis. Dig Dis Sci 2017; 62:2357-2368. [PMID: 28573508 DOI: 10.1007/s10620-017-4596-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/26/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Hovhannisyan et al. first showed evidence of plasticity between Treg and Th17 in the inflamed intestine of Crohn's disease (CD) patients. Our previous report suggests that the inflammatory cytokine milieu generates IL-17+ Foxp3+ CD4+ T lymphocytes which is a crossover population converting Treg subset to Th17 in the peripheral blood of IBD patients. This is considered as an evidence of Treg/Th17 plasticity. AIM The aim of this study was to characterize a variety of helper T cell crossover population, not limited to IL-17+ Foxp3+ CD4+ T lymphocytes, in the lamina propria (LP) of IBD patients. METHODS Fresh colonoscopic biopsies were obtained from patients with CD (n = 50) and ulcerative colitis (UC, n = 32) and from healthy controls (HC, n = 25). LP mononuclear cells were assessed for intracellular cytokines and transcription factors such as IFNγ, IL-13, IL-17, IL-22, T-bet, Gata-3, RORγt, and Foxp3 using multicolor flow cytometry to detect subsets of LP CD4+ T lymphocytes. RESULTS Patients with IBD demonstrated increased crossover populations in IL-17+ Foxp3+, T-bet+ Foxp3+, Gata3+ Foxp3+, RORγt+ Foxp3+ populations compared to HC. There was an inverse correlation of Harvey-Bradshaw index with Gata3+ Foxp3+ population in CD patients, while IL-13+ Foxp3+ population was directly correlated with Mayo clinical scores in UC patients. Furthermore, total IL-22 expressing cells as well as Th22 and IL-22+ Th1 populations were decreased in UC compared to CD and HC. CONCLUSION IBD patients exhibit the increased crossover populations in LP Treg cells toward Th2 and Th17 compared to HC. The prevalence of Treg/Th2 crossover populations is associated with clinical disease score of IBD.
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Affiliation(s)
- Ji Li
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada.,Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China
| | - Aito Ueno
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada.
| | - Marietta Iacucci
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada.,Institute of Translational Medicine, University of Birmingham, Birmingham, UK
| | - Miriam Fort Gasia
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada
| | - Humberto B Jijon
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada
| | - Remo Panaccione
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada
| | - Gilaad G Kaplan
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada
| | - Paul L Beck
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada
| | | | - Herman W Barkema
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada
| | - Jiaming Qian
- Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China
| | - Xianyong Gui
- Calgary Laboratory Services, Calgary, AB, Canada.,Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Subrata Ghosh
- Gastrointestinal Research Group/Department of Medicine, HSC1838, University of Calgary, 2500 University Dr. NW, Calgary, AB, Canada.,Institute of Translational Medicine, University of Birmingham, Birmingham, UK
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27
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Kuenzig ME, Yim J, Coward S, Eksteen B, Seow CH, Barnabe C, Barkema HW, Silverberg MS, Lakatos PL, Beck PL, Fedorak R, Dieleman LA, Madsen K, Panaccione R, Ghosh S, Kaplan GG. The NOD2-Smoking Interaction in Crohn's Disease is likely Specific to the 1007fs Mutation and may be Explained by Age at Diagnosis: A Meta-Analysis and Case-Only Study. EBioMedicine 2017; 21:188-196. [PMID: 28668336 PMCID: PMC5514403 DOI: 10.1016/j.ebiom.2017.06.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/13/2017] [Accepted: 06/14/2017] [Indexed: 12/23/2022] Open
Abstract
Background NOD2 and smoking are risk factors for Crohn's disease. We meta-analyzed NOD2-smoking interactions in Crohn's disease (Phase 1), then explored the effect of age at diagnosis on NOD2-smoking interactions (Phase 2). Methods Phase 1: MEDLINE and EMBASE were searched for studies (n = 18) providing data on NOD2 and smoking in Crohn's disease. NOD2-smoking interactions were estimated using odds ratios (ORs) and 95% confidence intervals (CIs) calculated using random effects models. Phase 2: A case-only study compared the proportion of smokers and carriers of the 1007 fs variant across ages at diagnosis (≤ 16, 17–40, > 40 years). Findings Phase 1: Having ever smoked was less common among carriers of the 1007 fs variant of NOD2 (OR 0.74, 95%CI:0.66–0.83). There was no interaction between smoking and the G908R (OR 0.96, 95%CI:0.82–1.13) or the R702W variant (OR 0.89, 95%CI:0.76–1.05). Phase 2: The proportion of patients (n = 627) carrying the 1007 fs variant decreased with age at diagnosis (≤ 16 years: 15%; 17–40: 12%; > 40: 3%; p = 0.003). Smoking was more common in older patients (≤ 16 years: 4%; 17–40: 48%; > 40: 71%; p < 0.001). Interpretation The negative NOD2-smoking interaction in Crohn's disease is specific to the 1007 fs variant. However, opposing rates of this variant and smoking across age at diagnosis may explain this negative interaction. There is a negative interaction between NOD2 smoking in Crohn's disease and it is specific to the 1007fs variant. With increasing age, the prevalence of the 1007fs variant decreases and exposure to cigarette smoke increases. Contrasting trends in the 1007fs variant and cigarette smoking may explain the negative NOD2-smoking interaction.
We reviewed 18 studies evaluating NOD2-smoking interactions in Crohn's disease. Only the 1007fs variant interacted with smoking. Smokers with this mutation were less likely to develop Crohn's disease. We then conducted a study of 627 patients with Crohn's disease, which showed that the 1007fs variant was common in young patients and rare in older patients, whereas smoking was more common among older patients. The decreasing prevalence of 1007fs mutation and increasing exposure to smoking as age of diagnosis advances may explain the negative interaction between NOD2 and smoking observed in our meta-analysis. Our study highlights the challenges of identifying gene-environment interactions.
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Affiliation(s)
- M Ellen Kuenzig
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Jeff Yim
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Stephanie Coward
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Bertus Eksteen
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Cynthia H Seow
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl Barnabe
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Herman W Barkema
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Mark S Silverberg
- Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Peter L Lakatos
- McGill University, Montreal General Hospital, Montreal, Quebec, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Paul L Beck
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Richard Fedorak
- Department of Medicine, Division of Gastroenterology and CEGIIR, University of Alberta, Edmonton, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Levinus A Dieleman
- Department of Medicine, Division of Gastroenterology and CEGIIR, University of Alberta, Edmonton, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Karen Madsen
- Department of Medicine, Division of Gastroenterology and CEGIIR, University of Alberta, Edmonton, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Remo Panaccione
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Subrata Ghosh
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada
| | - Gilaad G Kaplan
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada; Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada; (i)Alberta Inflammatory Bowel Disease Consortium, University of Calgary, Calgary, Alberta, Canada.
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Bau JT, Frolkis AD, Nathoo N, Yipp BG, Hollenberg MD, Beck PL. Career and research outcomes of the physician-scientist training program at the University of Calgary: a retrospective cohort study. CMAJ Open 2017; 5:E395-E401. [PMID: 28506972 PMCID: PMC5498177 DOI: 10.9778/cmajo.20160103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Physician-scientists are integral to medical research, with medical programs throughout Canada invested in training hybrid physician-scientists. Few data exist as to whether these programs are generating the diversity, gender equity and numbers of trainees essential for the future of medical research and teaching. We aimed to identify factors that contribute to research productivity, diversity and retention of individuals as physician-scientists. METHODS We completed a retrospective cohort study, for the period 1973 to 2015, of the University of Calgary Leaders in Medicine Program in Calgary, Alberta. Participants were coregistered in graduate (master's or PhD) and medical degree programs. Primary outcomes included number of publications and the eventual career paths of graduates, with individuals characterized as physicians or physician-scientists on the basis of these metrics. RESULTS Of the 307 individuals who were coregistered in or had completed a joint graduate and medical degree, 125 (40.7%) were PhD students/graduates, and 182 (59.3%) were master's trainees/graduates. While in the joint program, male PhD students consistently published more frequently than female PhD students. There was no significant difference in publication records between male and female master's students. Of the 172 individuals who were 5 years or more beyond graduation, 47 (27.3%) were classified as physician-scientists; these individuals consisted of 28 (40.6%) of the 69 PhD graduates and 19 (18.4%) of the 103 master's graduates. INTERPRETATION Overall, our study shows that graduates receiving both clinical and research training, through master's or PhD programs, continue to be involved in research in their subsequent careers.
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Affiliation(s)
- Jason T Bau
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Alexandra D Frolkis
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Nabeela Nathoo
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Bryan G Yipp
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Morley D Hollenberg
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Paul L Beck
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
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Seow CH, Leung Y, Vande Casteele N, Ehteshami Afshar E, Tanyingoh D, Bindra G, Stewart MJ, Beck PL, Kaplan GG, Ghosh S, Panaccione R. The effects of pregnancy on the pharmacokinetics of infliximab and adalimumab in inflammatory bowel disease. Aliment Pharmacol Ther 2017; 45:1329-1338. [PMID: 28318043 DOI: 10.1111/apt.14040] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [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] [Received: 12/30/2016] [Revised: 01/26/2017] [Accepted: 02/21/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Transplacental transfer of infliximab and adalimumab results in detectable drug levels in the cord blood and infant. AIM To determine if pregnancy influenced the pharmacokinetics of anti-TNF agents in women with inflammatory bowel disease. METHODS Twenty-five women from the University of Calgary inflammatory bowel disease(IBD) pregnancy clinic on maintenance infliximab or adalimumab were recruited prospectively with serum bio-banking performed each trimester. Infliximab trough and adalimumab steady-state levels were the outcomes of interest and were analysed using the ANSER infliximab and adalimumab assays. Multivariate linear mixed-effects models were constructed to assess infliximab and adalimumab drug levels during pregnancy adjusting for the clinical covariates of albumin, BMI and CRP. RESULTS Fifteen women (eight Crohn's disease, seven ulcerative colitis) received infliximab and 10 women with 11 pregnancies were treated with adalimumab. Median age was 29.6 years (IQR: 27.6-31.2 years). Median disease duration was 9.2 years (IQR: 3.16-15.0 years). Median trough infliximab concentrations were 8.50 μg/mL (IQR: 7.23-10.07 μg/mL), 10.31 μg/mL (IQR: 7.66-15.63 μg/mL) and 21.02 μg/mL (IQR: 16.01-26.70 μg/mL) at trimesters 1, 2 and 3 respectively. Significant changes in albumin and BMI (P < 0.05) but not CRP (P > 0.05) were documented throughout pregnancy. After adjusting for albumin, BMI and CRP, infliximab trough levels increased during pregnancy, by 4.2 μg/mL per trimester (P = 0.02), while adalimumab drug levels remained stable (P > 0.05). CONCLUSIONS Infliximab levels rise during pregnancy, whereas adalimumab levels remain stable after accounting for changes in albumin, BMI and CRP. Therapeutic drug monitoring in the second trimester may be useful in guiding dosing in the third trimester.
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Affiliation(s)
- C H Seow
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Y Leung
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada
| | - N Vande Casteele
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - E Ehteshami Afshar
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada
| | - D Tanyingoh
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada
| | - G Bindra
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada
| | - M J Stewart
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada
| | - P L Beck
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada
| | - G G Kaplan
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - S Ghosh
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada
| | - R Panaccione
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Canada
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Beatty JK, Akierman SV, Motta JP, Muise S, Workentine ML, Harrison JJ, Bhargava A, Beck PL, Rioux KP, McKnight GW, Wallace JL, Buret AG. Giardia duodenalis induces pathogenic dysbiosis of human intestinal microbiota biofilms. Int J Parasitol 2017; 47:311-326. [PMID: 28237889 DOI: 10.1016/j.ijpara.2016.11.010] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/12/2016] [Accepted: 11/17/2016] [Indexed: 02/07/2023]
Abstract
Giardia duodenalis is a prevalent cause of acute diarrheal disease worldwide. However, recent outbreaks in Italy and Norway have revealed a link between giardiasis and the subsequent development of chronic post-infectious irritable bowel syndrome. While the mechanisms underlying the causation of post-infectious irritable bowel syndrome remain obscure, recent findings suggest that alterations in gut microbiota communities are linked to the pathophysiology of irritable bowel syndrome. In the present study, we use a laboratory biofilm system to culture and enrich mucosal microbiota from human intestinal biopsies. Subsequently, we show that co-culture with Giardia induces disturbances in biofilm species composition and biofilm structure resulting in microbiota communities that are intrinsically dysbiotic - even after the clearance of Giardia. These microbiota abnormalities were mediated in part by secretory-excretory Giardia cysteine proteases. Using in vitro cell culture and germ-free murine infection models, we show that Giardia-induced disruptions of microbiota promote bacterial invasion, resulting in epithelial apoptosis, tight junctional disruption, and bacterial translocation across an intestinal epithelial barrier. Additionally, these dysbiotic microbiota communities resulted in increased activation of the Toll-like receptor 4 signalling pathway, and overproduction of the pro-inflammatory cytokine IL-1beta in humanized germ-free mice. Previous studies that have sought explanations and risk factors for the development of post-infectious irritable bowel syndrome have focused on features of enteropathogens and attributes of the infected host. We propose that polymicrobial interactions involving Giardia and gut microbiota may cause persistent dysbiosis, offering a new interpretation of the reasons why those afflicted with giardiasis are predisposed to gastrointestinal disorders post-infection.
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Affiliation(s)
- Jennifer K Beatty
- Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Sarah V Akierman
- Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Jean-Paul Motta
- Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Physiology & Pharmacology, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Stacy Muise
- Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Matthew L Workentine
- Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Joe J Harrison
- Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Amol Bhargava
- Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Paul L Beck
- Department of Medicine, Division of Gastroenterology, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Kevin P Rioux
- Department of Medicine, Division of Gastroenterology, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Gordon Webb McKnight
- Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada
| | - John L Wallace
- Department of Physiology & Pharmacology, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Andre G Buret
- Department of Biological Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 4N1, Canada; Department of Physiology & Pharmacology, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada.
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Medlicott SAC, Brown HA, Roland B, Beck PL, Auer I, Mansoor A. Multiple Lymphomatous Diverticulosis and Comorbid Chronic Lymphocytic Leukemia: Novel Manifestations of Ileocolic Mantle Cell Lymphoma. Int J Surg Pathol 2016; 15:408-13. [PMID: 17913952 DOI: 10.1177/1066896907302372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mantle cell lymphoma (MCL) has tropism for the gastrointestinal tract (GIT) identifiable as multiple polyps and mass lesions throughout the GIT. We describe 2 novel manifestations of MCL. A 60-year-old woman with known chronic lymphocytic leukemia (CLL) had an exophytic mass of the appendiceal orifice. Multiple polypoid masses of the distal ileum were identified in the right hemicolectomy specimen (multiple lymphomatous polyposis). Ancillary studies confirmed the coexistence of the 2 independent lymphoproliferative disorders. A 69-year-old man had recurrent urinary tract infections and pneumatouria caused by a colovesicular fistula complicating diverticulosis coli. Segmental resections of the sigmoid and ileocecum confirmed diverticulosis of the left and right colon. Histology identified infiltrates of MCL confined to the penetrating aspects of colonic diverticula. MCL has not been documented to coexist with CLL. An invaginating morphology of lymphoma, multiple lymphomatous diverticulosis is also a novel presentation. These 2 scenarios expand MCL's known manifestations within the GIT.
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MESH Headings
- Aged
- Biomarkers, Tumor/metabolism
- Bone Marrow Cells/pathology
- Colonic Neoplasms/metabolism
- Colonic Neoplasms/pathology
- Colonic Neoplasms/surgery
- Combined Modality Therapy
- Diverticulum/complications
- Diverticulum/metabolism
- Diverticulum/pathology
- Female
- Humans
- Ileal Neoplasms/metabolism
- Ileal Neoplasms/pathology
- Ileal Neoplasms/surgery
- In Situ Hybridization, Fluorescence
- Intestinal Fistula/complications
- Intestinal Fistula/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Lymphoma, Mantle-Cell/metabolism
- Lymphoma, Mantle-Cell/pathology
- Lymphoma, Mantle-Cell/therapy
- Male
- Middle Aged
- Neoplasms, Multiple Primary/metabolism
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/therapy
- Treatment Outcome
- Urinary Bladder Fistula/complications
- Urinary Bladder Fistula/pathology
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Affiliation(s)
- Shaun A C Medlicott
- Department of Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
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Beck PL, Cotton JA, Platnich JM, Muruve DA, Buret AG, Jijon H. Interleukin-8 in gastrointestinal inflammation and malignancy: induction and clinical consequences. ACTA ACUST UNITED AC 2016. [DOI: 10.2147/ijicmr.s63682] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Affiliation(s)
- Ryan T. Lewinson
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, Alberta T2N 4N1, Canada
| | - Michael B. Keough
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, Alberta T2N 4N1, Canada
| | - Paul L. Beck
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, Alberta T2N 4N1, Canada
| | - Morley D. Hollenberg
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, Alberta T2N 4N1, Canada
| | - Bryan G. Yipp
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, Alberta T2N 4N1, Canada
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Chung H, Vilaysane A, Lau A, Stahl M, Morampudi V, Bondzi-Simpson A, Platnich JM, Bracey NA, French MC, Beck PL, Chun J, Vallance BA, Muruve DA. NLRP3 regulates a non-canonical platform for caspase-8 activation during epithelial cell apoptosis. Cell Death Differ 2016; 23:1331-46. [PMID: 26891693 DOI: 10.1038/cdd.2016.14] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 12/30/2015] [Accepted: 01/20/2016] [Indexed: 12/31/2022] Open
Abstract
Nod-like receptor, pyrin containing 3 (NLRP3) is characterized primarily as a canonical caspase-1 activating inflammasome in macrophages. NLRP3 is also expressed in the epithelium of the kidney and gut; however, its function remains largely undefined. Primary mouse tubular epithelial cells (TEC) lacking Nlrp3 displayed reduced apoptosis downstream of the tumor necrosis factor (TNF) receptor and CD95. TECs were identified as type II apoptotic cells that activated caspase-8, tBid and mitochondrial apoptosis via caspase-9, responses that were reduced in Nlrp3-/- cells. The activation of caspase-8 during extrinsic apoptosis induced by TNFα/cycloheximide (TNFα/CHX) was dependent on adaptor protein apoptosis-associated speck-like protein containing a CARD (ASC) and completely independent of caspase-1 or caspase-11. TECs and primary human proximal tubular epithelial cells (HPTC) did not activate a canonical inflammasome, caspase-1, or IL-1β secretion in response to TNFα/CHX or NLRP3-dependent triggers, such as ATP or nigericin. In cell fractionation studies and by confocal microscopy, NLRP3 colocalized with ASC and caspase-8 in speck-like complexes at the mitochondria during apoptosis. The formation of NLRP3/ASC/caspase-8 specks in response to TNFα/CHX was downstream of TNFR signaling and dependent on potassium efflux. Epithelial ASC specks were present in enteroids undergoing apoptosis and in the injured tubules of wild-type but not Nlrp3-/- or ASC-/- mice following ureteric unilateral obstruction in vivo. These data show that NLRP3 and ASC form a conserved non-canonical platform for caspase-8 activation, independent of the inflammasome that regulates apoptosis within epithelial cells.
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Affiliation(s)
- H Chung
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - A Vilaysane
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - A Lau
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - M Stahl
- Department of Pediatrics, Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - V Morampudi
- Department of Pediatrics, Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - A Bondzi-Simpson
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - J M Platnich
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - N A Bracey
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - M-C French
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - P L Beck
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - J Chun
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - B A Vallance
- Department of Pediatrics, Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - D A Muruve
- Department of Medicine, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
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Tulk SE, Liao KC, Muruve DA, Li Y, Beck PL, MacDonald JA. Vitamin D₃ metabolites enhance the NLRP3-dependent secretion of IL-1β from human THP-1 monocytic cells. J Cell Biochem 2015; 116:711-20. [PMID: 25639477 DOI: 10.1002/jcb.24985] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/22/2014] [Indexed: 01/18/2023]
Abstract
Vitamin D3 has emerged as an important regulator of the immune system. With metabolic enzymes for vitamin D3 activation and vitamin D receptors (VDR) now identified in a variety of immune cells, the active vitamin D3 metabolite 1,25(OH)2D3, is thought to possess immunomodulatory properties. We examined whether 1,25(OH)2D3 might also enhance the NLRP3-dependent release of mature IL-1β from macrophages. PMA-differentiated THP-1 cells were stimulated with vitamin D3 metabolites and assessed for CYP27, CYP24, NLRP3, ASC, pro-caspase-1 expression by western blot and real-time qPCR as well as inflammasome activation with pro-inflammatory cytokine IL-1β release measured by ELISA. Exposure to 1,25(OH)2D3 had no effect on the basal expression levels of VDR; however, CYP27A1 transcript was suppressed and CYP24A1 transcript was substantively elevated. Both 1,25(OH)2D3 - and 25(OH)D3 induced IL-1β release from THP-1 cells, and these effects were blocked with application of the caspase-1 inhibitor YVAD and the NLRP3 inhibitors glyburide and Bay 11-7082. Interestingly, 1,25 (OH)2D3 exposure reduced NLRP3 protein expression but had no effect on ASC or pro-caspase-1 protein levels. The increase in mature IL-1β elicited by 1,25(OH)2D3 was modest compared to that found for ATP or C. difficile toxins. However, co-treatment of THP-1 cells with ATP and 1,25(OH)2D3 resulted in more IL-1β secretion than ATP or 1,25(OH)2D3 alone.
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Affiliation(s)
- Sarah E Tulk
- Department of Biochemistry & Molecular Biology, University of Calgary, 3280, Hospital Drive, NW, Calgary, AB, T2N 4Z6, Canada
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Roberts JI, Beatty JK, Peplowski MA, Keough MB, Yipp BG, Hollenberg MD, Beck PL. Proceedings from the 6th Annual University of Calgary Leaders in Medicine Research Symposium. ACTA ACUST UNITED AC 2015; 38:E318-50. [PMID: 26654516 DOI: 10.25011/cim.v38i6.26196] [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] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Indexed: 11/03/2022]
Abstract
On November 14, 2014, the Leaders in Medicine (LIM) program at the Cumming School of Medicine, University of Calgary hosted its 6th Annual Research Symposium. Dr. Danuta Skowronski, Epidemiology Lead for Influenza and Emerging Respiratory Pathogens at the British Columbia Centre for Disease Control (BCCDC), was the keynote speaker and presented a lecture entitled "Rapid response research during emerging public health crises: influenza and reflections from the five year anniversary of the 2009 pandemic". The LIM symposium provides a forum for both LIM and non-LIM medical students to present their research work, either as an oral or poster presentation. There were a total of six oral presentations and 77 posters presented.
The oral presentations included: Swathi Damaraju, "The role of cell communication and 3D Cell-Matrix environment in a stem cell-based tissue engineering strategy for bone repair"; Menglin Yang, "The proteolytic activity of Nepenthes pitcher fluid as a therapeutic for the treatment of celiac disease"; Amelia Kellar, "Monitoring pediatric inflammatory bowel disease - a retrospective analysis of transabdominal ultrasound"; Monica M. Faria-Crowder, "The design and application of a molecular profiling strategy to identify polymicrobial acute sepsis infections"; Waleed Rahmani, "Hair follicle dermal stem cells regenerate the dermal sheath, repopulate the dermal papilla and modulate hair type"; and, Laura Palmer, "A novel role for amyloid beta protein during hypoxia/ischemia".
The article on the University of Calgary Leaders in Medicine Program, "A Prescription that Addresses the Decline of Basic Science Education in Medical School," in a previous issue of CIM (2014 37(5):E292) provides more details on the program. Briefly, the LIM Research Symposium has the following objectives: (1) to showcase the impressive variety of projects undertaken by students in the LIM Program as well as University of Calgary medical students; (2) to encourage medical student participation in research and special projects; and, (3) to inform students and faculty about the diversity of opportunities available for research and special projects during medical school and beyond.
The following abstracts were submitted for publication.
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Roberts JI, Beatty JK, Peplowski MA, Keough MB, Yipp BG, Hollenberg MD, Beck PL. Highlights from the 6th Annual University of Calgary Leaders in Medicine Research Symposium and the Keynote Address by Dr. Danuta Skowronski. ACTA ACUST UNITED AC 2015; 38:E314-7. [PMID: 26654515 DOI: 10.25011/cim.v38i6.26195] [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] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Indexed: 11/03/2022]
Abstract
The Leaders in Medicine (LIM) Program at the University of Calgary hosted its 6th Annual Research Symposium on November 14, 2014, showcasing the quality and breadth of work performed by students at the Cumming School of Medicine. Participation at this year's event was our most successful to date, with a total of six oral and 77 poster presentations during the afternoon symposium. For a detailed description of the work presented at the symposium, please see the Proceedings from the 6th Annual University of Calgary Leaders in Medicine Research Symposium published in this issue of Clinical and Investigative Medicine.
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Schenck LP, Beck PL, MacDonald JA. Gastrointestinal dysbiosis and the use of fecal microbial transplantation in Clostridium difficile infection. World J Gastrointest Pathophysiol 2015; 6:169-180. [PMID: 26600975 PMCID: PMC4644881 DOI: 10.4291/wjgp.v6.i4.169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/28/2015] [Accepted: 10/13/2015] [Indexed: 02/06/2023] Open
Abstract
The impact of antibiotics on the human gut microbiota is a significant concern. Antibiotic-associated diarrhea has been on the rise for the past few decades with the increasing usage of antibiotics. Clostridium difficile infections (CDI) have become one of the most prominent types of infectious diarrheal disease, with dramatically increased incidence in both the hospital and community setting worldwide. Studies show that variability in the innate host response may in part impact upon CDI severity in patients. That being said, CDI is a disease that shows the most prominent links to alterations to the gut microbiota, in both cause and treatment. With recurrence rates still relatively high, it is important to explore alternative therapies to CDI. Fecal microbiota transplantation (FMT) and other types of bacteriotherapy have become exciting avenues of treatment for CDI. Recent clinical trials have generated excitement for the use of FMT as a therapeutic option for CDI; however, the exact components of the human gut microbiota needed for protection against CDI have remained elusive. Additional investigations on the effects of antibiotics on the human gut microbiota and subsequent CDI will help reduce the socioeconomic burden of CDI and potentially lead to new therapeutic modalities.
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Frydman GH, Davis N, Beck PL, Fox JG. Helicobacter pylori Eradication in Patients with Immune Thrombocytopenic Purpura: A Review and the Role of Biogeography. Helicobacter 2015; 20:239-51. [PMID: 25728540 PMCID: PMC4506733 DOI: 10.1111/hel.12200] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Idiopathic thrombocytopenic purpura (ITP) is typically a diagnosis of exclusion, assigned by clinicians after ruling out other identifiable etiologies. Since a report by Gasbarrini et al. in 1998, an accumulating body of evidence has proposed a pathophysiological link between ITP and chronic Helicobacter pylori (H. pylori) infection. Clinical reports have described a spontaneous resolution of ITP symptoms in about 50% of chronic ITP patients following empirical treatment of H. pylori infection, but response appears to be geography dependent. Studies have also documented that ITP patients in East Asian countries are more likely to express positive antibody titers against H. pylori-specific cytotoxic-associated gene A (CagA), a virulence factor that is associated with an increased risk for gastric diseases including carcinoma. While a definitive mechanism by which H. pylori may induce thrombocytopenia remains elusive, proposed pathways include molecular mimicry of CagA by host autoantibodies against platelet surface glycoproteins, as well as perturbations in the phagocytic activity of monocytes. Traditional treatments of ITP have been largely empirical, involving the use of immunosuppressive agents and immunoglobulin therapy. However, based on the findings of clinical reports emerging over the past 20 years, health organizations around the world increasingly suggest the detection and eradication of H. pylori as a treatment for ITP. Elucidating the exact molecular mechanisms of platelet activation in H. pylori-positive ITP patients, while considering biogeographical differences in response rates, could offer insight into how best to use clinical H. pylori eradication to treat ITP, but will require well-designed studies to confirm the suggested causative relationship between bacterial infection and an autoimmune disease state.
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Affiliation(s)
- Galit H. Frydman
- Department of Biological Engineering, Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Nick Davis
- Department of Biological Engineering, Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Paul L. Beck
- The Gastrointestinal Research Group, Division of Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - James G. Fox
- Department of Biological Engineering, Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA
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MacEachern SJ, Patel BA, Keenan CM, Dicay M, Chapman K, McCafferty DM, Savidge TC, Beck PL, MacNaughton WK, Sharkey KA. Inhibiting Inducible Nitric Oxide Synthase in Enteric Glia Restores Electrogenic Ion Transport in Mice With Colitis. Gastroenterology 2015; 149:445-55.e3. [PMID: 25865048 PMCID: PMC4516675 DOI: 10.1053/j.gastro.2015.04.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 03/06/2015] [Accepted: 04/06/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Disturbances in the control of ion transport lead to epithelial barrier dysfunction in patients with colitis. Enteric glia regulate intestinal barrier function and colonic ion transport. However, it is not clear whether enteric glia are involved in epithelial hyporesponsiveness. We investigated enteric glial regulation of ion transport in mice with trinitrobenzene sulfonic acid- or dextran sodium sulfate-induced colitis and in Il10(-/-) mice. METHODS Electrically evoked ion transport was measured in full-thickness segments of colon from CD1 and Il10(-/-) mice with or without colitis in Ussing chambers. Nitric oxide (NO) production was assessed using amperometry. Bacterial translocation was investigated in the liver, spleen, and blood of mice. RESULTS Electrical stimulation of the colon evoked a tetrodotoxin-sensitive chloride secretion. In mice with colitis, ion transport almost completely disappeared. Inhibiting inducible NO synthase (NOS2), but not neuronal NOS (NOS1), partially restored the evoked secretory response. Blocking glial function with fluoroacetate, which is not a NOS2 inhibitor, also partially restored ion transport. Combined NOS2 inhibition and fluoroacetate administration fully restored secretion. Epithelial responsiveness to vasoactive intestinal peptide was increased after enteric glial function was blocked in mice with colitis. In colons of mice without colitis, NO was produced in the myenteric plexus almost completely via NOS1. NO production was increased in mice with colitis, compared with mice without colitis; a substantial proportion of NOS2 was blocked by fluoroacetate administration. Inhibition of enteric glial function in vivo reduced the severity of trinitrobenzene sulfonic acid-induced colitis and associated bacterial translocation. CONCLUSIONS Increased production of NOS2 in enteric glia contributes to the dysregulation of intestinal ion transport in mice with colitis. Blocking enteric glial function in these mice restores epithelial barrier function and reduces bacterial translocation.
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Affiliation(s)
- Sarah J. MacEachern
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Bhavik A. Patel
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Huxley Building, Brighton, UK
| | - Catherine M. Keenan
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael Dicay
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kevin Chapman
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Donna-Marie McCafferty
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tor C. Savidge
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Paul L. Beck
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Wallace K. MacNaughton
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Keith A. Sharkey
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Cotton JA, Motta JP, Schenck LP, Hirota SA, Beck PL, Buret AG. Giardia duodenalis infection reduces granulocyte infiltration in an in vivo model of bacterial toxin-induced colitis and attenuates inflammation in human intestinal tissue. PLoS One 2014; 9:e109087. [PMID: 25289678 PMCID: PMC4188619 DOI: 10.1371/journal.pone.0109087] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 09/08/2014] [Indexed: 12/22/2022] Open
Abstract
Giardia duodenalis (syn. G. intestinalis, G. lamblia) is a predominant cause of waterborne diarrheal disease that may lead to post-infectious functional gastrointestinal disorders. Although Giardia-infected individuals could carry as much as 106 trophozoites per centimetre of gut, their intestinal mucosa is devoid of overt signs of inflammation. Recent studies have shown that in endemic countries where bacterial infectious diseases are common, Giardia infections can protect against the development of diarrheal disease and fever. Conversely, separate observations have indicated Giardia infections may enhance the severity of diarrheal disease from a co-infecting pathogen. Polymorphonuclear leukocytes or neutrophils (PMNs) are granulocytic, innate immune cells characteristic of acute intestinal inflammatory responses against bacterial pathogens that contribute to the development of diarrheal disease following recruitment into intestinal tissues. Giardia cathepsin B cysteine proteases have been shown to attenuate PMN chemotaxis towards IL-8/CXCL8, suggesting Giardia targets PMN accumulation. However, the ability of Giardia infections to attenuate PMN accumulation in vivo and how in turn this effect may alter the host inflammatory response in the intestine has yet to be demonstrated. Herein, we report that Giardia infection attenuates granulocyte tissue infiltration induced by intra-rectal instillation of Clostridium difficile toxin A and B in an isolate-dependent manner. This attenuation of granulocyte infiltration into colonic tissues paralled decreased expression of several cytokines associated with the recruitment of PMNs. Giardia trophozoite isolates that attenuated granulocyte infiltration in vivo also decreased protein expression of cytokines released from inflamed mucosal biopsy tissues collected from patients with active Crohn’s disease, including several cytokines associated with PMN recruitment. These results demonstrate for the first time that certain Giardia infections may attenuate PMN accumulation by decreasing the expression of the mediators responsible for their recruitment.
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Affiliation(s)
- James A. Cotton
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
- Inflammation Research Network, University of Calgary, Calgary, Alberta, Canada
- Host-Parasite Interactions, University of Calgary, Calgary, Alberta, Canada
| | - Jean-Paul Motta
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
- Inflammation Research Network, University of Calgary, Calgary, Alberta, Canada
- Host-Parasite Interactions, University of Calgary, Calgary, Alberta, Canada
| | - L. Patrick Schenck
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Simon A. Hirota
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
- Department of Immunology, Microbiology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Paul L. Beck
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andre G. Buret
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
- Inflammation Research Network, University of Calgary, Calgary, Alberta, Canada
- Host-Parasite Interactions, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
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Miller D, Thornton CS, Keough MB, Roberts JI, Yipp B, Hollenberg M, Bau JT, Peplowski MA, Beck PL. A Prescription that Addresses the Decline of Basic Science Education
in Medical School. ACTA ACUST UNITED AC 2014; 37:E284-91. [DOI: 10.25011/cim.v37i5.22009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Indexed: 11/03/2022]
Abstract
Over 30 years ago a cry rang out through the proverbial halls of academia; “The clinician scientist is an endangered species.” These prophetic words have been reverberated in the ears of every specialty and every general medical organization in deafening tones. Why is the role of the clinician scientist or clinician investigator so important that this phrase has been repeated subsequently in medical and educational journals? Simply put, the clinician scientist bridges the ravine between the ever-growing mountain of scientific knowledge and the demanding patient centered clinical care. Here, we describe the current educational model established by the University of Calgary, Leaders in Medicine Program. Our program seeks to train future physicians and clinician scientists by incorporating training in basic science, translational and clinical research with clinical and medical education in a longitudinal program to students of traditional MD/PhD, MD/MSc or MD/MBA stream as well as interested Doctor of Medicine students.
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Thornton CS, Keough MB, Roberts JI, Yipp B, Hollenberg M, Bau JT, Peplowski MA, Beck PL. Proceedings from the 5th Annual University of Calgary Leaders in Medicine Research Symposium. CLIN INVEST MED 2014. [DOI: 10.25011/cim.v37i5.22010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
On November 8, 2013, the Leaders in Medicine (LIM) program hosted the 5th Annual Research Symposium. Dr. Jerrold Ellner, Chief of the Infectious Diseases section at Boston Medical Centre and Professor of Medicine at Boston University School of Medicine, was the keynote speaker and presented his lecture entitled “Tuberculosis – Past, Present and Future”. The LIM symposium gives a forum for LIM as well as non-LIM medical students to present their research work as either an oral or poster presentation. There were a total of 53 abstracts presented and five oral presentations. The symposium was attended by over 100 students and more than 30 staff members.
The oral presentations included
• Amrita Roy, Aboriginal identity, ethnic minority status, and prenatal depressive symptoms in a longitudinal pregnancy cohort study in Alberta.
• David Nicholl, Obstructive sleep apnea treatment with continuous positive airway pressure decreases intraglomerular pressure and alters renal sensitivity to angiotensin.
• James Cotton, An assemblage A Giardia cathepsin B protease degrades interleukin-8 and attenuates neutrophil chemotaxis.
• Krystyna Ediger, Alexander Arnold and Emily Shelton, Rebuilding the Calgary Student Run Clinic: A Model for Sustainability.
• Sarah MacEachern, Inhibiting inducible nitric oxide synthase restores electrogenic ion transport in experimental IBD: a novel role for enteric glia.
See the article on the University of Calgary Leaders in Medicine Program, “A Prescription that Addresses the Decline of Basic Science Education in Medical School” in this same issue of CIM for more details on the program. In short, the LIM Research Symposium has the following objectives: (1) to showcase the impressive variety of projects undertaken by students in the LIM Program as well as U of C medical students; (2) to encourage medical student participation in research and special projects; and, (3) to inform students and faculty about the diversity of opportunities available for research and special projects during medical school and beyond.
The following abstracts are those that were put forward for publication.
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Wang A, Keita ÅV, Phan V, McKay CM, Schoultz I, Lee J, Murphy MP, Fernando M, Ronaghan N, Balce D, Yates R, Dicay M, Beck PL, MacNaughton WK, Söderholm JD, McKay DM. Targeting mitochondria-derived reactive oxygen species to reduce epithelial barrier dysfunction and colitis. Am J Pathol 2014; 184:2516-27. [PMID: 25034594 DOI: 10.1016/j.ajpath.2014.05.019] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/05/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023]
Abstract
Epithelial permeability is often increased in inflammatory bowel diseases. We hypothesized that perturbed mitochondrial function would cause barrier dysfunction and hence epithelial mitochondria could be targeted to treat intestinal inflammation. Mitochondrial dysfunction was induced in human colon-derived epithelial cell lines or colonic biopsy specimens using dinitrophenol, and barrier function was assessed by transepithelial flux of Escherichia coli with or without mitochondria-targeted antioxidant (MTA) cotreatment. The impact of mitochondria-targeted antioxidants on gut permeability and dextran sodium sulfate (DSS)-induced colitis in mice was tested. Mitochondrial superoxide evoked by dinitrophenol elicited significant internalization and translocation of E. coli across epithelia and control colonic biopsy specimens, which was more striking in Crohn's disease biopsy specimens; the mitochondria-targeted antioxidant, MitoTEMPO, inhibited these barrier defects. Increased gut permeability and reduced epithelial mitochondrial voltage-dependent anion channel expression were observed 3 days after DSS. These changes and the severity of DSS-colitis were reduced by MitoTEMPO treatment. In vitro DSS-stimulated IL-8 production by epithelia was reduced by MitoTEMPO. Metabolic stress evokes significant penetration of commensal bacteria across the epithelium, which is mediated by mitochondria-derived superoxide acting as a signaling, not a cytotoxic, molecule. MitoTEMPO inhibited this barrier dysfunction and suppressed colitis in DSS-colitis, likely via enhancing barrier function and inhibiting proinflammatory cytokine production. These novel findings support consideration of MTAs in the maintenance of epithelial barrier function and the management of inflammatory bowel diseases.
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Affiliation(s)
- Arthur Wang
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Åsa V Keita
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Surgery, County Council of Östergötland, Linköping, Sweden
| | - Van Phan
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Catherine M McKay
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Ida Schoultz
- Nutrition-Gut-Brain Interactions Research Centre, the Faculty of Medicine, Örebro University, Örebro, Sweden
| | - Joshua Lee
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | | | - Maria Fernando
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Natalie Ronaghan
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Dale Balce
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Robin Yates
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael Dicay
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Paul L Beck
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Wallace K MacNaughton
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Johan D Söderholm
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Surgery, County Council of Östergötland, Linköping, Sweden
| | - Derek M McKay
- Gastrointestinal Research Group, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada; Inflammation Research Network, Department of Physiology and Pharmacology, Calvin, Phoebe, and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.
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Negrón ME, Barkema HW, Rioux K, De Buck J, Checkley S, Proulx MC, Frolkis A, Beck PL, Dieleman LA, Panaccione R, Ghosh S, Kaplan GG. Clostridium difficile infection worsens the prognosis of ulcerative colitis. Can J Gastroenterol Hepatol 2014; 28:373-80. [PMID: 25157528 PMCID: PMC4144455 DOI: 10.1155/2014/914303] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The impact of Clostridium difficile infections among ulcerative colitis (UC) patients is well characterized. However, there is little knowledge regarding the association between C difficile infections and postoperative complications among UC patients. OBJECTIVE To determine whether C difficile infection is associated with undergoing an emergent colectomy and experiencing postoperative complications. METHODS The present population-based case-control study identified UC patients admitted to Calgary Health Zone hospitals for a flare between 2000 and 2009. C difficile toxin tests ordered in hospital or 90 days before hospital admission were provided by Calgary Laboratory Services (Calgary, Alberta). Hospital records were reviewed to confirm diagnoses and to extract clinical data. Multivariate logistic regression analyses were performed among individuals tested for C difficile to examine the association between C difficile infection and emergent colectomy and diagnosis of any postoperative complications and, secondarily, an infectious postoperative complication. Estimates were presented as adjusted ORs with 95% CIs. RESULTS C difficile was tested in 278 (58%) UC patients and 6.1% were positive. C difficile infection was associated with an increased risk for emergent colectomy (adjusted OR 3.39 [95% CI 1.02 to 11.23]). Additionally, a preoperative diagnosis of C difficile was significantly associated with the development of postoperative infectious complications (OR 4.76 [95% CI 1.10 to 20.63]). CONCLUSION C difficile diagnosis worsened the prognosis of UC by increasing the risk of colectomy and postoperative infectious complications following colectomy. Future studies are needed to explore whether early detection and aggressive management of C difficile infection will improve UC outcomes.
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Affiliation(s)
- María E Negrón
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary
| | - Herman W Barkema
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Community Health Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary
| | - Kevin Rioux
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary
| | - Jeroen De Buck
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary
| | - Sylvia Checkley
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary
| | | | - Alexandra Frolkis
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Community Health Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary
| | - Paul L Beck
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary
| | - Levinus A Dieleman
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Medicine, Faculty of Medicine, University of Alberta, Edmonton, Alberta
| | - Remo Panaccione
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary
| | - Subrata Ghosh
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary
| | - Gilaad G Kaplan
- Alberta Inflammatory Bowel Disease Consortium, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Community Health Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary
- Department of Medicine, Faculty of Medicine, University of Calgary, Calgary
- Correspondence: Dr Gilaad Kaplan, Teaching Research and Wellness Centre, 6D56, 3280 Hospital Drive Northwest, Calgary, Alberta T2N 4N1. Telephone 403-592-5015, fax 403-592-5090, e-mail
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Bracey NA, Gershkovich B, Chun J, Vilaysane A, Meijndert HC, Wright JR, Fedak PW, Beck PL, Muruve DA, Duff HJ. Mitochondrial NLRP3 protein induces reactive oxygen species to promote Smad protein signaling and fibrosis independent from the inflammasome. J Biol Chem 2014; 289:19571-84. [PMID: 24841199 DOI: 10.1074/jbc.m114.550624] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Nucleotide-binding domain and leucine-rich repeat containing PYD-3 (NLRP3) is a pattern recognition receptor that is implicated in the pathogenesis of inflammation and chronic diseases. Although much is known regarding the NLRP3 inflammasome that regulates proinflammatory cytokine production in innate immune cells, the role of NLRP3 in non-professional immune cells is unclear. Here we report that NLRP3 is expressed in cardiac fibroblasts and increased during TGFβ stimulation. NLRP3-deficient cardiac fibroblasts displayed impaired differentiation and R-Smad activation in response to TGFβ. Only the central nucleotide binding domain of NLRP3 was required to augment R-Smad signaling because the N-terminal Pyrin or C-terminal leucine-rich repeat domains were dispensable. Interestingly, NLRP3 regulation of myofibroblast differentiation proceeded independently from the inflammasome, IL-1β/IL-18, or caspase 1. Instead, mitochondrially localized NLRP3 potentiated reactive oxygen species to augment R-Smad activation. In vivo, NLRP3-deficient mice were protected against angiotensin II-induced cardiac fibrosis with preserved cardiac architecture and reduced collagen 1. Together, these results support a distinct role for NLRP3 in non-professional immune cells independent from the inflammasome to regulate differential aspects of wound healing and chronic disease.
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Affiliation(s)
| | | | | | | | | | - James R Wright
- Department of Pathology and Laboratory Medicine, The University of Calgary, Calgary, Alberta T2N 4N1, Canada
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Lee JY, Hirota SA, Glover LE, Armstrong GD, Beck PL, MacDonald JA. Effects of nitric oxide and reactive oxygen species on HIF-1α stabilization following clostridium difficile toxin exposure of the Caco-2 epithelial cell line. Cell Physiol Biochem 2013; 32:417-30. [PMID: 23988581 DOI: 10.1159/000354448] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Stabilization of the hypoxia-inducible factor (HIF-1α) is proposed to provide a protective host-response to C. difficile intoxication. Here, we aimed to elucidate whether nitric oxide and/or reactive oxygen species produced during C. difficile toxin exposure could influence HIF-1α stability and initiate protection against epithelial cell damage. METHODS/RESULTS HIF-1α and inducible nitric oxide synthase (iNOS) proteins were up-regulated whereas factor-inhibiting HIF-1 (FIH-1) protein was down-regulated in Caco-2 epithelial cell monolayers with in vitro toxin exposure. We demonstrate using the biotin-switch assay that the stabilization of HIF-1α protein occurred via iNOS-dependent nitrosylation. Inhibition of iNOS activity by selective inhibitor (1400W) attenuated HIF-1α stabilization and exacerbated toxin-dependent disruptions in Caco-2 monolayer morphology and tight junctional integrity in vitro. Treatment of Caco-2 cell monolayers with N-actylcysteine (NAC), a scavenger of reactive oxygen species (ROS), attenuated toxin-dependent increases in iNOS and HIF-1α protein levels but had no effect on FIH-1 responses. In addition, mice that were exposed to C. difficile toxin in vivo also demonstrated a significant increase in HIF-1α protein and nitrosylation levels. CONCLUSION Taken together, these data suggest that important synergistic actions exist between nitric oxide and ROS to stabilize HIF-1α and its innate, protective actions in the context of C. difficile toxin-mediated epithelial injury.
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Affiliation(s)
- Joshua Y Lee
- Gastrointestinal Research Group at the Snyder Institute for Chronic Disease, Departments of Biochemistry & Molecular Biology, University of Calgary, Calgary, AB, Canada
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Stewart MJ, Shaffer E, Urbanski SJ, Beck PL, Storr MA. The association between celiac disease and eosinophilic esophagitis in children and adults. BMC Gastroenterol 2013; 13:96. [PMID: 23721294 PMCID: PMC3682941 DOI: 10.1186/1471-230x-13-96] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [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] [Received: 12/02/2012] [Accepted: 05/24/2013] [Indexed: 02/08/2023] Open
Abstract
Background An association between eosinophilic esophagitis (EoE) and celiac disease (CD) has been suggested in the literature. Our aim was to confirm and quantify the association between these two diseases. Methods All patients in a large Canadian city diagnosed with EoE or CD over a five-year period were identified. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were calculated. Results Over the five-year study EoE was diagnosed in 421 patients and CD was diagnosed in 763 patients. The incidence of EoE ranged from 2.1 to 10.7 cases per 100,000 population. The incidence of CD ranged from 10.4 to 15.7 cases per 100,000 population. Among the EoE cohort, 83 (20%) cases of EoE and 245 (32%) cases of CD were diagnosed in pediatric patients. The incidence of EoE in the pediatric subpopulation ranged from 3.7 to 6.9 cases per 100,000 population. The incidence of CD in the pediatric subpopulation ranged from 9.5 to 22.7 cases per 100,000 population. The concomitant diagnosis of both EoE and CD was made in three patients, all of whom were pediatric males. The SIR for EoE in the CD cohort was 48.4 (95% CI = 9.73, 141.41) with a SIR for CD within the paediatric EoE cohort of 75.05 (95% CI = 15.08, 219.28). Conclusions This study confirms the association between EoE and CD. However, this association may be limited to pediatrics where the risk of each condition is increased 50 to 75-fold in patients diagnosed with the alternative condition. The concomitant diagnosis of these conditions should be considered in pediatric patients with upper gastrointestinal symptoms.
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Affiliation(s)
- Michael J Stewart
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada.
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Dey I, Beck PL, Chadee K. Lymphocytic colitis is associated with increased pro-inflammatory cytokine profile and up regulation of prostaglandin receptor EP4. PLoS One 2013; 8:e61891. [PMID: 23613969 PMCID: PMC3629156 DOI: 10.1371/journal.pone.0061891] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 03/18/2013] [Indexed: 12/25/2022] Open
Abstract
Microscopic colitis (MC) is comprised of two entities, lymphocytic (LC) and collagenous colitis. Up to 20% of patients with chronic diarrhea that have a normal appearing colonoscopy will be diagnosed with MC. Since MC was first described less than 40 years ago, little is known about the mechanisms involved in disease pathogenesis. Nonsteroidal anti-inflammatory drugs are associated with an increased risk of MC and some reports suggest a dysregulation in prostaglandin production. Recent genome wide screens have found an association between prostaglandin receptor EP4 expression and inflammatory bowel disease; however, EP4 expression has never been studied in MC. The aim of this study was to assess colonic mucosal inflammatory cytokine profiles in patients with LC and to assess expression of the prostaglandin receptor EP4. Colonic mucosal biopsies were obtained from patients undergoing colonoscopy for investigation of diarrhea and in those undergoing colon cancer screening. Following histological assessment, expression of cytokines and the prostaglandin receptor EP4 was analyzed using real-time reverse transcriptase-PCR and immunohistochemistry. Patients with LC had markedly increased mRNA expression for TNF-α, IFN-γ and IL-8 compared to normal controls (p<0.001). No significant differences were noted for IL-1β, IL-4, IL-10 or IL-12/23. Interestingly, those with LC had increased EP4 receptor expression, which positively correlated with increased TNF-α expression. This is the first report to demonstrate that LC is associated with increased TNF-α, INF-γ and IL-8 concurrent with a marked up-regulation of EP4. These findings add to our knowledge on the pathogenesis of LC and may give rise to possible new therapeutic and/or diagnostic tools in the management of MC.
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Affiliation(s)
- Indranil Dey
- Departments of Microbiology, Immunology and Infectious Disease, Health Sciences Centre, Snyder Institute for Chronic Inflammation, University of Calgary, Calgary, Alberta, Canada
| | - Paul L. Beck
- Division of Gastroenterology, Health Sciences Centre, Snyder Institute for Chronic Inflammation, University of Calgary, Calgary, Alberta, Canada
| | - Kris Chadee
- Departments of Microbiology, Immunology and Infectious Disease, Health Sciences Centre, Snyder Institute for Chronic Inflammation, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
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Abstract
The pathogenesis of inflammatory bowel disease (IBD) is multifactorial and results from an interaction between genetic, immunologic, microbial, and environmental factors. Certain drugs could act as a trigger for the disease and have been implicated in the development of new onset IBD in a number a studies. These relationships are based on case reports and cohort studies, as proving this in the context of randomized controlled trials would be difficult. Drugs that have been linked to causing or worsening IBD include isotretinoin, antibiotics, nonsteroidal antiinflammatory drugs, oral contraceptives, mycophenolate mofetil, etanercept, ipilimumab, and rituximab. Bowel preparation for colonoscopy has also been associated with aphthoid lesions that may be confused with IBD. However, given the source of these reports we have to be cautious in the interpretation of the data before concluding that these drugs trigger IBD and what is being observed is not related to other confounding factors. Different pathogenic mechanisms have been suggested for the different drugs listed above. In order to clarify the confusion a comprehensive literature review was performed with the goal of advancing the knowledge on this subject.
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Affiliation(s)
- Marie-France Dubeau
- Inflammatory Bowel Disease Clinic and the Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
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