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Sa Q, Liang H, Kostadinov R, Yu J, Waight J, Van Horn S, Xie Q, Griffin S, Hopson C, Sun N. Abstract A18: In vivo CRISPR screening in syngeneic tumor models to identify novel combinations for cancer immunotherapy. Cancer Immunol Res 2022. [DOI: 10.1158/2326-6074.tumimm22-a18] [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] [Indexed: 12/03/2022]
Abstract
Abstract
Inducible T cell Co-Stimulator (ICOS, CD278) is a receptor belonging to the CD28/CTLA-4 superfamily that is predominantly expressed on T cells following T cell receptor (TCR) activation and plays an important role in regulating adaptive immune response. ICOS represents possible node of therapeutic intervention for cancer, and as such, is under clinical evaluation. Although ICOS agonists have been shown to promote significant monotherapeutic efficacy in non-clinical studies, most patients do not respond to the single-agent approaches. Therefore, it is crucial to better understand the potential mechanisms of action as well as to develop novel combination strategies and biomarkers to best position therapeutic in the clinic. In an effort to identify novel combination partners and/or biomarkers for ICOS agonist, we utilized pooled in vivo genetic screening via CRISPR (clustered regularly interspaced short palindromic repeats)-Cas9 genome editing in the syngeneic CT26 colorectal mouse tumor model alongside agonist treatment for the target. We evaluated 509 druggable genes with four sgRNAs targeting each gene to identify genes where loss in CT26 tumor cells can increase sensitivity or resistance to this treatment. With a false discovery rate (FDR) <0.05, we were able to identify 38 sensitizing hits for ICOS agonist. To our knowledge, this is the first in vivo genetic screening in mouse models aiming to uncover potential combinational targets for anti-ICOS agonist. Importantly, this screening strategy can be adapted to orthogonal tumor types to confirm current hits or identify undescribed combination targets for a range of other immunotherapeutic approaches.
Citation Format: Qila Sa, Hongyu Liang, Rumen Kostadinov, Jong Yu, Jeremy Waight, Stephanie Van Horn, Qing Xie, Sue Griffin, Chris Hopson, Ning Sun. In vivo CRISPR screening in syngeneic tumor models to identify novel combinations for cancer immunotherapy [abstract]. In: Proceedings of the AACR Special Conference: Tumor Immunology and Immunotherapy; 2022 Oct 21-24; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(12 Suppl):Abstract nr A18.
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Affiliation(s)
- Qila Sa
- 1GlaxoSmithKline, Collegeville, PA,
| | | | | | - Jong Yu
- 1GlaxoSmithKline, Collegeville, PA,
| | | | | | - Qing Xie
- 1GlaxoSmithKline, Collegeville, PA,
| | | | | | - Ning Sun
- 1GlaxoSmithKline, Collegeville, PA,
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Nuzzo A, Van Horn S, Traini C, Perry CR, Dumont EF, Scangarella-Oman NE, Gardiner DF, Brown JR. Correction to: Microbiome recovery in adult females with uncomplicated urinary tract infections in a randomised phase 2A trial of the novel antibiotic gepotidacin (GSK2140944). BMC Microbiol 2021; 21:293. [PMID: 34702186 PMCID: PMC8549316 DOI: 10.1186/s12866-021-02356-2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Andrea Nuzzo
- Human Genetics, GlaxoSmithKline R&D, Medicines Research Centre, Gunnels Wood Road, Stevenage, SG1 2NY, UK.
| | | | | | | | | | | | | | - James R Brown
- Human Genetics, GlaxoSmithKline R&D, Collegeville, PA, USA.,Kaleido Biosciences, 65 Hayden Avenue, Lexington, MA, 02421, USA
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Nuzzo A, Van Horn S, Traini C, Perry CR, Dumont EF, Scangarella-Oman NE, Gardiner DF, Brown JR. Microbiome recovery in adult females with uncomplicated urinary tract infections in a randomised phase 2A trial of the novel antibiotic gepotidacin (GSK140944). BMC Microbiol 2021; 21:181. [PMID: 34130619 PMCID: PMC8207760 DOI: 10.1186/s12866-021-02245-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 06/02/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND With increasing concerns about the impact of frequent antibiotic usage on the human microbiome, it is important to characterize the potential for such effects in early antibiotic drug development clinical trials. In a randomised Phase 2a clinical trial study that evaluated the pharmacokinetics of repeated oral doses of gepotidacin, a first-in-chemical-class triazaacenaphthylene antibiotic with a distinct mechanism of action, in adult females with uncomplicated urinary tract infections for gepotidacin (GSK2140944) we evaluated the potential changes in microbiome composition across multiple time points and body-sites ( ClinicalTrials.gov : NCT03568942). RESULTS Samples of gastrointestinal tract (GIT), pharyngeal cavity and vaginal microbiota were collected with consent from 22 patients at three time points relative to the gepotidacin dosing regimen; Day 1 (pre-dose), Day 5 (end of dosing) and Follow-up (Day 28 ± 3 days). Microbiota composition was determined by DNA sequencing of 16S rRNA gene variable region 4 amplicons. By Day 5, significant changes were observed in the microbiome diversity relative to pre-dose across the tested body-sites. However, by the Follow-up visit, microbiome diversity changes were reverted to compositions comparable to Day 1. The greatest range of microbiome changes by body-site were GIT followed by the pharyngeal cavity then vagina. In Follow-up visit samples we found no statistically significant occurrences of pathogenic taxa. CONCLUSION Our findings suggest that gepotidacin alteration of the human microbiome after 5 days of dosing is temporary and rebound to pre-dosing states is evident within the first month post-treatment. We recommend that future antibiotic drug trials include similar exploratory investigations into the duration and context of microbiome modification and recovery. TRIAL REGISTRATION NCT03568942 . Registered 26 June 2018.
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Affiliation(s)
- Andrea Nuzzo
- Human Genetics, GlaxoSmithKline R&D, Medicines Research Centre, Gunnels Wood Road, Stevenage, SG1 2NY UK
| | | | | | | | | | | | | | - James R. Brown
- Human Genetics, GlaxoSmithKline R&D, Collegeville, PA USA
- Present Address: Kaleido Biosciences, 65 Hayden Avenue, Lexington, MA 02421 USA
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Nuzzo A, Van Horn S, Traini C, Perry CR, Dumont E, Scangarella-Oman N, Gardiner D, Brown JR. 1281. Longitudinal and Spatial Variation in the Human Microbiome in a Phase 2a Clinical Study of Gepotidacin in Adult Females with Uncomplicated Urinary Tract Infection. Open Forum Infect Dis 2020. [PMCID: PMC7776697 DOI: 10.1093/ofid/ofaa439.1464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Gepotidacin (GSK2140944) is a first in class novel oral triazaacenaphthylene bacterial topoisomerase inhibitor. In this study, we evaluated the potential impact of orally administered gepotidacin on the human microbiome, across three body-sites and at three specific time-points, as an exploratory endpoint in a Phase 2a clinical trial for the treatment of uncomplicated Urinary Tract Infection (uUTI) (ClinicalTrials.gov: NCT03568942). Methods Through DNA sequencing of the 16S rRNA variable region 4, we analyzed samples collected with consent from study subjects from the gastrointestinal tract or GIT (stool), pharyngeal cavity (saliva swabs) and vagina (vaginal swabs). Samples were taken at three time points which were pre-dosing (Day 1), end of dosing (Day 5) and follow-up visit (Day 28 ±3 days). A total of 156 samples were collected and 141 samples passed quality control criteria for DNA sequence analyses. Using a rigorous computational work-flow, changes in microbiome diversity and relative abundances of microbial species were quantified. Results Time series analyses showed that microbiota alpha diversity dropped, relative to pre-dose, by the end of gepotidacin dosing but trended a return trajectory to original pre-dose levels by the follow-up visit, for all body sites (Figure). However, the character and extent of the microbiota changes varied by location. The relative ordering from least to greatest changes in microbiota diversity of body sites is vaginal, pharyngeal and GIT. We found no statistically significant occurrences of pathogen related taxa, such as Clostridioides or Enterobacterales spp., at the final timepoints. Conclusion Since gepotidacin is both orally dosed and elimination includes the biliary route, it was predicted to affect the GIT microbiome, however changes in the distal pharyngeal and vaginal microbiota were also observed. Gepotidacin alteration of the endogenous microbial community appears to be temporary and reversible as microbiota diversity rebounded to near pre-dosing status within a period of several weeks. Our study illustrates how microbiome analyses in antibiotic clinical studies can quantify patterns of microbiota disruption and recovery. Disclosures Andrea Nuzzo, PHD, GlaxoSmithKline (Employee) Stephanie Van Horn, B.Sc., GlaxoSmithKline (Employee) Christopher Traini, PHD, GlaxoSmithKline (Employee) Caroline R. Perry, PhD, GlaxoSmithKline (Employee) Etienne Dumont, MD, GlaxoSmithKline (Employee) Nicole Scangarella-Oman, MS, GlaxoSmithKline plc. (Employee, Shareholder) David Gardiner, MD, GlaxoSmithKline (Employee) James R. Brown, PhD, GlaxoSmithKline (Employee)
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Michalovich D, Rodriguez-Perez N, Smolinska S, Pirozynski M, Mayhew D, Uddin S, Van Horn S, Sokolowska M, Altunbulakli C, Eljaszewicz A, Pugin B, Barcik W, Kurnik-Lucka M, Saunders KA, Simpson KD, Schmid-Grendelmeier P, Ferstl R, Frei R, Sievi N, Kohler M, Gajdanowicz P, Graversen KB, Lindholm Bøgh K, Jutel M, Brown JR, Akdis CA, Hessel EM, O'Mahony L. Obesity and disease severity magnify disturbed microbiome-immune interactions in asthma patients. Nat Commun 2019; 10:5711. [PMID: 31836714 PMCID: PMC6911092 DOI: 10.1038/s41467-019-13751-9] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 11/13/2019] [Indexed: 02/06/2023] Open
Abstract
In order to improve targeted therapeutic approaches for asthma patients, insights into the molecular mechanisms that differentially contribute to disease phenotypes, such as obese asthmatics or severe asthmatics, are required. Here we report immunological and microbiome alterations in obese asthmatics (n = 50, mean age = 45), non-obese asthmatics (n = 53, mean age = 40), obese non-asthmatics (n = 51, mean age = 44) and their healthy counterparts (n = 48, mean age = 39). Obesity is associated with elevated proinflammatory signatures, which are enhanced in the presence of asthma. Similarly, obesity or asthma induced changes in the composition of the microbiota, while an additive effect is observed in obese asthma patients. Asthma disease severity is negatively correlated with fecal Akkermansia muciniphila levels. Administration of A. muciniphila to murine models significantly reduces airway hyper-reactivity and airway inflammation. Changes in immunological processes and microbiota composition are accentuated in obese asthma patients due to the additive effects of both disease states, while A. muciniphila may play a non-redundant role in patients with a severe asthma phenotype.
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Affiliation(s)
| | - Noelia Rodriguez-Perez
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Sylwia Smolinska
- Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland.,ALL-MED' Medical Research Institute, Wroclaw, Poland
| | - Michal Pirozynski
- Department of Allergology and Pulmonology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - David Mayhew
- Computational Biology, Human Genetics, GSK R&D, Collegeville, PA, USA
| | - Sorif Uddin
- Adaptive Immunity Research Unit, GSK R&D, Stevenage, UK.,Boehringer Ingelheim, 88397, Biberach an der Riß, Germany
| | - Stephanie Van Horn
- Target and Pathway Validation, Target Sciences, GSK R&D, Collegeville, PA, USA
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Can Altunbulakli
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Andrzej Eljaszewicz
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, Bialystok, Poland
| | - Benoit Pugin
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Weronika Barcik
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | | | | | | | - Peter Schmid-Grendelmeier
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - Ruth Ferstl
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Remo Frei
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Noriane Sievi
- Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
| | - Malcolm Kohler
- Pulmonary Division, University Hospital of Zurich, Zurich, Switzerland
| | - Pawel Gajdanowicz
- Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland.,ALL-MED' Medical Research Institute, Wroclaw, Poland
| | - Katrine B Graversen
- National Food Institute, Technical University of Denmark, Copenhagen, Denmark
| | | | - Marek Jutel
- Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland.,ALL-MED' Medical Research Institute, Wroclaw, Poland
| | - James R Brown
- Computational Biology, Human Genetics, GSK R&D, Collegeville, PA, USA
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | | | - Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland. .,Depts of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland.
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Washburn ML, Wang Z, Walton AH, Goedegebuure SP, Figueroa DJ, Van Horn S, Grossman J, Remlinger K, Madsen H, Brown J, Srinivasan R, Wolf AI, Berger SB, Yi VN, Hawkins WG, Fields RC, Hotchkiss RS. T Cell- and Monocyte-Specific RNA-Sequencing Analysis in Septic and Nonseptic Critically Ill Patients and in Patients with Cancer. J Immunol 2019; 203:1897-1908. [PMID: 31484735 PMCID: PMC6761013 DOI: 10.4049/jimmunol.1900560] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/24/2019] [Indexed: 12/31/2022]
Abstract
Sepsis is characterized as life-threatening organ dysfunction caused by a dysregulated host immune response to infection. The purpose of this investigation was to determine the differential effect of sepsis on innate versus adaptive immunity, in humans, by examining RNA expression in specific immune cell subsets, including monocytes/macrophages and CD4 and CD8 T cells. A second aim was to determine immunosuppressive mechanisms operative in sepsis that might be amenable to immunotherapy. Finally, we examined RNA expression in peripheral cells from critically ill nonseptic patients and from cancer patients to compare the unique immune response in these disorders with that occurring in sepsis. Monocytes, CD4 T cells, and CD8 T cells from septic patients, critically ill nonseptic patients, patients with metastatic colon cancer, and healthy controls were analyzed by RNA sequencing. Sepsis induced a marked phenotypic shift toward downregulation of multiple immune response pathways in monocytes suggesting that impaired innate immunity may be fundamental to the immunosuppression that characterizes the disorder. In the sepsis cohort, there was a much more pronounced effect on gene transcription in CD4 T cells than in CD8 T cells. Potential mediators of sepsis-induced immunosuppression included Arg-1, SOCS-1, and SOCS-3, which were highly upregulated in multiple cell types. Multiple negative costimulatory molecules, including TIGIT, Lag-3, PD-1, and CTLA-4, were also highly upregulated in sepsis. Although cancer had much more profound effects on gene transcription in CD8 T cells, common immunosuppressive mechanisms were present in all disorders, suggesting that immunoadjuvant therapies that are effective in one disease may also be efficacious in the others.
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Affiliation(s)
- Michael L Washburn
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426;
| | - Zhang Wang
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
- Institute of Ecological Science, School of Life Science, South China Normal University, Guangzhou 510630, China
| | - Andrew H Walton
- Department of Anesthesiology, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110
| | - S Peter Goedegebuure
- Department of Surgery, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110
- Siteman Cancer Center, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110; and
| | - David J Figueroa
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
| | - Stephanie Van Horn
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
| | - Julie Grossman
- Department of Surgery, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110
| | - Katja Remlinger
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
| | - Heather Madsen
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
| | - James Brown
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
| | - Roopa Srinivasan
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
| | - Amaya I Wolf
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
| | - Scott B Berger
- Pharmaceuticals Research and Development, GlaxoSmithKline, Collegeville, PA 19426
| | - Victoria N Yi
- Department of Anesthesiology, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110
| | - William G Hawkins
- Department of Surgery, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110
- Siteman Cancer Center, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110; and
| | - Ryan C Fields
- Department of Surgery, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110
- Siteman Cancer Center, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110; and
| | - Richard S Hotchkiss
- Department of Anesthesiology, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110;
- Department of Surgery, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110
- Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO 63110
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Wang Z, Maschera B, Lea S, Kolsum U, Michalovich D, Van Horn S, Traini C, Brown JR, Hessel EM, Singh D. Airway host-microbiome interactions in chronic obstructive pulmonary disease. Respir Res 2019; 20:113. [PMID: 31170986 PMCID: PMC6555748 DOI: 10.1186/s12931-019-1085-z] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/28/2019] [Indexed: 12/31/2022] Open
Abstract
Background Little is known about the interactions between the lung microbiome and host response in chronic obstructive pulmonary disease (COPD). Methods We performed a longitudinal 16S ribosomal RNA gene-based microbiome survey on 101 sputum samples from 16 healthy subjects and 43 COPD patients, along with characterization of host sputum transcriptome and proteome in COPD patients. Results Dysbiosis of sputum microbiome was observed with significantly increased relative abundance of Moraxella in COPD versus healthy subjects and during COPD exacerbations, and Haemophilus in COPD ex-smokers versus current smokers. Multivariate modeling on sputum microbiome, host transcriptome and proteome profiles revealed that significant associations between Moraxella and Haemophilus, host interferon and pro-inflammatory signaling pathways and neutrophilic inflammation predominated among airway host-microbiome interactions in COPD. While neutrophilia was positively correlated with Haemophilus, interferon signaling was more strongly linked to Moraxella. Moreover, while Haemophilus was significantly associated with host factors both in stable state and during exacerbations, Moraxella-associated host responses were primarily related to exacerbations. Conclusions Our study highlights a significant airway host-microbiome interplay associated with COPD inflammation and exacerbations. These findings indicate that Haemophilus and Moraxella influence different components of host immune response in COPD, and that novel therapeutic strategies should consider targeting these bacteria and their associated host pathways in COPD. Electronic supplementary material The online version of this article (10.1186/s12931-019-1085-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zhang Wang
- Computational Biology, Human Genetics, Research and Development (R&D), GlaxoSmithKline (GSK), 1250 S. Collegeville Road, Collegeville, PA, 19426-0989, USA.,Present Address: School of Life Sciences, South China Normal University, Guangzhou, 510631, People's Republic of China
| | - Barbara Maschera
- Refractory Respiratory Inflammation Discovery Performance Unit, Respiratory Therapy Area, R&D, GSK, Stevenage, SG1 2NY, UK
| | - Simon Lea
- University of Manchester and University Hospital of South Manchester, Manchester, M23 9QZ, UK
| | - Umme Kolsum
- University of Manchester and University Hospital of South Manchester, Manchester, M23 9QZ, UK
| | - David Michalovich
- Refractory Respiratory Inflammation Discovery Performance Unit, Respiratory Therapy Area, R&D, GSK, Stevenage, SG1 2NY, UK
| | - Stephanie Van Horn
- Functional Genomics, Medicinal Science and Technology, R&D, GSK, Collegeville, PA, 19426, USA
| | - Christopher Traini
- Functional Genomics, Medicinal Science and Technology, R&D, GSK, Collegeville, PA, 19426, USA
| | - James R Brown
- Computational Biology, Human Genetics, Research and Development (R&D), GlaxoSmithKline (GSK), 1250 S. Collegeville Road, Collegeville, PA, 19426-0989, USA.
| | - Edith M Hessel
- Refractory Respiratory Inflammation Discovery Performance Unit, Respiratory Therapy Area, R&D, GSK, Stevenage, SG1 2NY, UK
| | - Dave Singh
- University of Manchester and University Hospital of South Manchester, Manchester, M23 9QZ, UK
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Mayhew D, Devos N, Lambert C, Brown JR, Clarke SC, Kim VL, Magid-Slav M, Miller BE, Ostridge KK, Patel R, Sathe G, Simola DF, Staples KJ, Sung R, Tal-Singer R, Tuck AC, Van Horn S, Weynants V, Williams NP, Devaster JM, Wilkinson TMA. Longitudinal profiling of the lung microbiome in the AERIS study demonstrates repeatability of bacterial and eosinophilic COPD exacerbations. Thorax 2018; 73:422-430. [PMID: 29386298 PMCID: PMC5909767 DOI: 10.1136/thoraxjnl-2017-210408] [Citation(s) in RCA: 176] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 11/29/2017] [Accepted: 12/05/2017] [Indexed: 12/28/2022]
Abstract
Background Alterations in the composition of the lung microbiome associated with adverse clinical outcomes, known as dysbiosis, have been implicated with disease severity and exacerbations in COPD. Objective To characterise longitudinal changes in the lung microbiome in the AERIS study (Acute Exacerbation and Respiratory InfectionS in COPD) and their relationship with associated COPD outcomes. Methods We surveyed 584 sputum samples from 101 patients with COPD to analyse the lung microbiome at both stable and exacerbation time points over 1 year using high-throughput sequencing of the 16S ribosomal RNA gene. We incorporated additional lung microbiology, blood markers and in-depth clinical assessments to classify COPD phenotypes. Results The stability of the lung microbiome over time was more likely to be decreased in exacerbations and within individuals with higher exacerbation frequencies. Analysis of exacerbation phenotypes using a Markov chain model revealed that bacterial and eosinophilic exacerbations were more likely to be repeated in subsequent exacerbations within a subject, whereas viral exacerbations were not more likely to be repeated. We also confirmed the association of bacterial genera, including Haemophilus and Moraxella, with disease severity, exacerbation events and bronchiectasis. Conclusions Subtypes of COPD have distinct bacterial compositions and stabilities over time. Some exacerbation subtypes have non-random probabilities of repeating those subtypes in the future. This study provides insights pertaining to the identification of bacterial targets in the lung and biomarkers to classify COPD subtypes and to determine appropriate treatments for the patient. Trial registration number Results, NCT01360398.
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Affiliation(s)
- David Mayhew
- Computational Biology, Target Sciences, GSK R&D, King of Prussia, Pennsylvania, USA
| | | | | | - James R Brown
- Computational Biology, Target Sciences, GSK R&D, King of Prussia, Pennsylvania, USA
| | - Stuart C Clarke
- Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK.,Southampton NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, UK
| | - Viktoriya L Kim
- Southampton NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, UK
| | - Michal Magid-Slav
- Computational Biology, Target Sciences, GSK R&D, King of Prussia, Pennsylvania, USA
| | - Bruce E Miller
- Respiratory Therapy Area Unit, GSK R&D, King of Prussia, Pennsylvania, USA
| | - Kristoffer K Ostridge
- Southampton NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, UK
| | - Ruchi Patel
- Target and Pathway Validation, Target Sciences, GSK R&D, King of Prussia, Pennsylvania, USA
| | - Ganesh Sathe
- Target and Pathway Validation, Target Sciences, GSK R&D, King of Prussia, Pennsylvania, USA
| | - Daniel F Simola
- Computational Biology, Target Sciences, GSK R&D, King of Prussia, Pennsylvania, USA
| | - Karl J Staples
- Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK.,Southampton NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, UK.,Wessex Investigational Sciences Hub, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK
| | - Ruby Sung
- Respiratory Therapy Area Unit, GSK R&D, King of Prussia, Pennsylvania, USA
| | - Ruth Tal-Singer
- Respiratory Therapy Area Unit, GSK R&D, King of Prussia, Pennsylvania, USA
| | - Andrew C Tuck
- Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK
| | - Stephanie Van Horn
- Target and Pathway Validation, Target Sciences, GSK R&D, King of Prussia, Pennsylvania, USA
| | | | - Nicholas P Williams
- Southampton NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, UK
| | | | - Tom M A Wilkinson
- Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK.,Southampton NIHR Respiratory Biomedical Research Unit, Southampton General Hospital, Southampton, UK.,Wessex Investigational Sciences Hub, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK
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Wang Z, Saha S, Van Horn S, Thomas E, Traini C, Sathe G, Rajpal DK, Brown JR. Gut microbiome differences between metformin- and liraglutide-treated T2DM subjects. Endocrinol Diabetes Metab 2018; 1:e00009. [PMID: 30815546 PMCID: PMC6360918 DOI: 10.1002/edm2.9] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [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: 10/31/2017] [Revised: 11/16/2017] [Accepted: 12/03/2017] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Metformin and glucagon-like peptide-1 (GLP-1) agonists are widely used for treating type two diabetes mellitus (T2DM). While recent studies suggest these drugs might modify the gastrointestinal tract (GIT) microbiome, further confirmation is required from human clinical trials. MATERIALS AND METHODS Here, we compare, in patients with T2DM, the effects of metformin (n = 18 subjects) and liraglutide (n = 19), a GLP-1 agonist, on their GIT microbiomes over a 42 day period (n = 74 samples) using 16S ribosomal RNA (rRNA) sequencing. RESULTS We found that these drugs had markedly different effects on the microbiome composition. At both baseline and Day 42, subjects taking metformin had a significant increase (Baseline adj. P = .038, Day 42 adj. P = .041) in the relative abundance of the bacterial genus Sutterella, whereas liraglutide dosing is associated with a significant increase (Baseline adj. P = .048, Day 42 adj. P = .003) in the genus Akkermansia, a GIT bacteria positively associated with gut barrier homoeostasis. Bacteroides and Akkermansia relative abundances were also significantly associated with duration of subject diabetes (adj P < .05). Specifically, there was a significantly higher abundance of Akkermansia in subjects with short and medium durations than those with long duration of diabetes. DISCUSSION To our knowledge, this is the first report of GLP-1 agonist-associated changes in the human microbiome and its differentiating effects to metformin. Our study suggests that modulation of the GIT microbiome is a potentially important component in the mechanism of action of these drugs.
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Affiliation(s)
- Zhang Wang
- Computational BiologyTarget SciencesGlaxoSmithKline Research and Development (R&D)CollegevillePAUSA
| | - Somdutta Saha
- Computational BiologyTarget SciencesGlaxoSmithKline Research and Development (R&D)CollegevillePAUSA
- Present address:
Solid BiosciencesCambridgeMAUSA
| | - Stephanie Van Horn
- Target and Pathway ValidationTarget SciencesGlaxoSmithKline R&DCollegevillePAUSA
| | - Elizabeth Thomas
- Target and Pathway ValidationTarget SciencesGlaxoSmithKline R&DCollegevillePAUSA
| | - Christopher Traini
- Target and Pathway ValidationTarget SciencesGlaxoSmithKline R&DCollegevillePAUSA
| | - Ganesh Sathe
- Target and Pathway ValidationTarget SciencesGlaxoSmithKline R&DCollegevillePAUSA
| | - Deepak K. Rajpal
- Computational BiologyTarget SciencesGlaxoSmithKline Research and Development (R&D)CollegevillePAUSA
| | - James R. Brown
- Computational BiologyTarget SciencesGlaxoSmithKline Research and Development (R&D)CollegevillePAUSA
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Wang Z, Singh R, Miller BE, Tal-Singer R, Van Horn S, Tomsho L, Mackay A, Allinson JP, Webb AJ, Brookes AJ, George LM, Barker B, Kolsum U, Donnelly LE, Belchamber K, Barnes PJ, Singh D, Brightling CE, Donaldson GC, Wedzicha JA, Brown JR. Sputum microbiome temporal variability and dysbiosis in chronic obstructive pulmonary disease exacerbations: an analysis of the COPDMAP study. Thorax 2017; 73:331-338. [DOI: 10.1136/thoraxjnl-2017-210741] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/02/2017] [Accepted: 11/27/2017] [Indexed: 12/31/2022]
Abstract
BackgroundRecent studies suggest that lung microbiome dysbiosis, the disease associated disruption of the lung microbial community, might play a key role in chronic obstructive pulmonary disease (COPD) exacerbations. However, characterising temporal variability of the microbiome from large longitudinal COPD cohorts is needed to better understand this phenomenon.MethodsWe performed a 16S ribosomal RNA survey of microbiome on 716 sputum samples collected longitudinally at baseline and exacerbations from 281 subjects with COPD at three UK clinical centres as part of the COPDMAP consortium.ResultsThe microbiome composition was similar among centres and between stable and exacerbations except for a small significant decrease of Veillonella at exacerbations. The abundance of Moraxella was negatively associated with bacterial alpha diversity. Microbiomes were distinct between exacerbations associated with bacteria versus eosinophilic airway inflammation. Dysbiosis at exacerbations, measured as significant within subject deviation of microbial composition relative to baseline, was present in 41% of exacerbations. Dysbiosis was associated with increased exacerbation severity indicated by a greater fall in forced expiratory volume in one second, forced vital capacity and a greater increase in CAT score, particularly in exacerbations with concurrent eosinophilic inflammation. There was a significant difference of temporal variability of microbial alpha and beta diversity among centres. The variation of beta diversity significantly decreased in those subjects with frequent historical exacerbations.ConclusionsMicrobial dysbiosis is a feature of some exacerbations and its presence, especially in concert with eosinophilic inflammation, is associated with more severe exacerbations indicated by a greater fall in lung function.Trial registration numberResults, NCT01620645.
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Rajpal DK, Klein JL, Mayhew D, Boucheron J, Spivak AT, Kumar V, Ingraham K, Paulik M, Chen L, Van Horn S, Thomas E, Sathe G, Livi GP, Holmes DJ, Brown JR. Selective Spectrum Antibiotic Modulation of the Gut Microbiome in Obesity and Diabetes Rodent Models. PLoS One 2015; 10:e0145499. [PMID: 26709835 PMCID: PMC4692534 DOI: 10.1371/journal.pone.0145499] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 12/04/2015] [Indexed: 01/21/2023] Open
Abstract
The gastrointestinal tract microbiome has been suggested as a potential therapeutic target for metabolic diseases such as obesity and Type 2 diabetes mellitus (T2DM). However, the relationship between changes in microbial communities and metabolic disease-phenotypes are still poorly understood. In this study, we used antibiotics with markedly different antibacterial spectra to modulate the gut microbiome in a diet-induced obesity mouse model and then measured relevant biochemical, hormonal and phenotypic biomarkers of obesity and T2DM. Mice fed a high-fat diet were treated with either ceftazidime (a primarily anti-Gram negative bacteria antibiotic) or vancomycin (mainly anti-Gram positive bacteria activity) in an escalating three-dose regimen. We also dosed animals with a well-known prebiotic weight-loss supplement, 10% oligofructose saccharide (10% OFS). Vancomycin treated mice showed little weight change and no improvement in glycemic control while ceftazidime and 10% OFS treatments induced significant weight loss. However, only ceftazidime showed significant, dose dependent improvement in key metabolic variables including glucose, insulin, protein tyrosine tyrosine (PYY) and glucagon-like peptide-1 (GLP-1). Subsequently, we confirmed the positive hyperglycemic control effects of ceftazidime in the Zucker diabetic fatty (ZDF) rat model. Metagenomic DNA sequencing of bacterial 16S rRNA gene regions V1-V3 showed that the microbiomes of ceftazidime dosed mice and rats were enriched for the phylum Firmicutes while 10% OFS treated mice had a greater abundance of Bacteroidetes. We show that specific changes in microbial community composition are associated with obesity and glycemic control phenotypes. More broadly, our study suggests that in vivo modulation of the microbiome warrants further investigation as a potential therapeutic strategy for metabolic diseases.
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Affiliation(s)
- Deepak K. Rajpal
- Computational Biology, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - Jean-Louis Klein
- Target and Pathway Validation, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - David Mayhew
- Computational Biology, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - Joyce Boucheron
- Enteroendocrine Discovery Performance Unit, Research and Development, GlaxoSmithKline, Research Triangle Park, North Carolina, United States of America
| | - Aaron T. Spivak
- Computational Biology, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - Vinod Kumar
- Computational Biology, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - Karen Ingraham
- Antibacterial Discovery Performance Unit, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - Mark Paulik
- Enteroendocrine Discovery Performance Unit, Research and Development, GlaxoSmithKline, Research Triangle Park, North Carolina, United States of America
| | - Lihong Chen
- Enteroendocrine Discovery Performance Unit, Research and Development, GlaxoSmithKline, Research Triangle Park, North Carolina, United States of America
| | - Stephanie Van Horn
- Target and Pathway Validation, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - Elizabeth Thomas
- Target and Pathway Validation, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - Ganesh Sathe
- Target and Pathway Validation, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - George P. Livi
- Target and Pathway Validation, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - David J. Holmes
- Antibacterial Discovery Performance Unit, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
| | - James R. Brown
- Computational Biology, Target Sciences, Research and Development, GlaxoSmithKline, Collegeville, Pennsylvania, United States of America
- * E-mail:
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Napolitano A, Miller S, Nicholls AW, Baker D, Van Horn S, Thomas E, Rajpal D, Spivak A, Brown JR, Nunez DJ. Novel gut-based pharmacology of metformin in patients with type 2 diabetes mellitus. PLoS One 2014; 9:e100778. [PMID: 24988476 PMCID: PMC4079657 DOI: 10.1371/journal.pone.0100778] [Citation(s) in RCA: 191] [Impact Index Per Article: 19.1] [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: 02/08/2014] [Accepted: 05/23/2014] [Indexed: 12/20/2022] Open
Abstract
UNLABELLED Metformin, a biguanide derivate, has pleiotropic effects beyond glucose reduction, including improvement of lipid profiles and lowering microvascular and macrovascular complications associated with type 2 diabetes mellitus (T2DM). These effects have been ascribed to adenosine monophosphate-activated protein kinase (AMPK) activation in the liver and skeletal muscle. However, metformin effects are not attenuated when AMPK is knocked out and intravenous metformin is less effective than oral medication, raising the possibility of important gut pharmacology. We hypothesized that the pharmacology of metformin includes alteration of bile acid recirculation and gut microbiota resulting in enhanced enteroendocrine hormone secretion. In this study we evaluated T2DM subjects on and off metformin monotherapy to characterize the gut-based mechanisms of metformin. Subjects were studied at 4 time points: (i) at baseline on metformin, (ii) 7 days after stopping metformin, (iii) when fasting blood glucose (FBG) had risen by 25% after stopping metformin, and (iv) when FBG returned to baseline levels after restarting the metformin. At these timepoints we profiled glucose, insulin, gut hormones (glucagon-like peptide-1 (GLP-1), peptide tyrosine-tyrosine (PYY) and glucose-dependent insulinotropic peptide (GIP) and bile acids in blood, as well as duodenal and faecal bile acids and gut microbiota. We found that metformin withdrawal was associated with a reduction of active and total GLP-1 and elevation of serum bile acids, especially cholic acid and its conjugates. These effects reversed when metformin was restarted. Effects on circulating PYY were more modest, while GIP changes were negligible. Microbiota abundance of the phylum Firmicutes was positively correlated with changes in cholic acid and conjugates, while Bacteroidetes abundance was negatively correlated. Firmicutes and Bacteroidetes representation were also correlated with levels of serum PYY. Our study suggests that metformin has complex effects due to gut-based pharmacology which might provide insights into novel therapeutic approaches to treat T2DM and associated metabolic diseases. TRIAL REGISTRATION www.ClinicalTrials.gov NCT01357876.
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Affiliation(s)
| | - Sam Miller
- Quantitative Sciences, GSK R&D, Stevenage, Herts, United Kingdom
| | | | - David Baker
- Safety Assessment, GSK R&D, Ware, Herts, United Kingdom
| | - Stephanie Van Horn
- Target and Pathways Validation, GSK R&D, Upper Providence, Pennsylvania, United States of America
| | - Elizabeth Thomas
- Target and Pathways Validation, GSK R&D, Upper Providence, Pennsylvania, United States of America
| | - Deepak Rajpal
- Computational Biology, GSK R&D, Upper Providence, Pennsylvania, United States of America
| | - Aaron Spivak
- Computational Biology, GSK R&D, Upper Providence, Pennsylvania, United States of America
| | - James R. Brown
- Computational Biology, GSK R&D, Upper Providence, Pennsylvania, United States of America
| | - Derek J. Nunez
- Enteroendocrine Discovery Unit, GlaxoSmithKline R&D, GSK R&D, Research Triangle Park, North Carolina, United States of America
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Woollard PM, Mehta NA, Vamathevan JJ, Van Horn S, Bonde BK, Dow DJ. The application of next-generation sequencing technologies to drug discovery and development. Drug Discov Today 2011; 16:512-9. [DOI: 10.1016/j.drudis.2011.03.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 02/24/2011] [Accepted: 03/17/2011] [Indexed: 12/17/2022]
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