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Sachs N, Zohar-Dayan E, Ben Zeev B, Gilboa T, Kurd M, Latzer IT, Meirson H, Krause I, Dizitzer Y, Cohen EG. Autoimmune encephalitis in Israeli children - A retrospective nationwide study. Eur J Paediatr Neurol 2024; 50:1-5. [PMID: 38518418 DOI: 10.1016/j.ejpn.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/08/2024] [Accepted: 03/02/2024] [Indexed: 03/24/2024]
Abstract
Immune-mediated or autoimmune encephalitis (AE) is a relatively new, rare and elusive form of encephalitis in children. We retrospectively collected seropositive children (0-18 years old) with well characterized antibodies through 3 reference laboratories in Israel. Clinical symptoms, MRI and EEG findings and treatment courses were described. A total of 16 patients were included in the study, with 10 females. Anti NMDA encephalitis was most common followed by anti HU and anti mGLuR1. Psychiatric symptoms, abnormal movements, seizures and behavioral changes were the most common presentation. Pathological MRI and EEG findings were described in 37% and 56% of children, respectively. Treatment with corticosteroids, Intravenous immunoglobulins (IVIG) was first line in most children. Following inadequate response children were treated with plasmapheresis and/or rituximab. Two patients relapsed following both first and second line protocols. In terms of long term prognosis, 9 children (56%) had one or more residual behavioral, psychiatric or neurologic findings. Three children required hospitalization for rehabilitation. AE remains a rare diagnosis with variable presenting symptoms, requiring a high index of suspicion. Consensus recommended treatment is generally effective in the pediatric population. Female gender was associated with a higher chance of severe disease. Larger cohorts would be needed to identify prognostic factors in the pediatric population.
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Affiliation(s)
- Nimrod Sachs
- Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Efrat Zohar-Dayan
- Pediatric Neurology Unit, Safra Pediatric Hospital, Sheba Medical Center, Ramat-Gan, Israel
| | - Bruria Ben Zeev
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Unit, Safra Pediatric Hospital, Sheba Medical Center, Ramat-Gan, Israel
| | - Tal Gilboa
- Pediatric Neurology Unit, Hadassah Medical Center, Jerusalem, Israel; School of Medicine, The Hebrew University of Jerusalem, Israel
| | - Mohammad Kurd
- Pediatric Neurology Unit, Hadassah Medical Center, Jerusalem, Israel
| | - Itay Tokatly Latzer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel-Aviv Medical Center, Israel
| | - Hadas Meirson
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel-Aviv Medical Center, Israel
| | - Irit Krause
- Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yotam Dizitzer
- Department of Pediatrics C, Schneider Children's Medical Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Esther Ganelin Cohen
- The Neuro-immunological Clinic, The Neurological Institute, Schneider Children's Center of Israel, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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2
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Kurd M, Pratt LT, Gilboa T, Fattal-Valevski A, Vaknin-Dembinsky A, Gadoth A, Hacohen Y, Meirson H. Validation of the 2023 international diagnostic criteria for MOGAD in a pediatric cohort. Eur J Paediatr Neurol 2024; 49:13-16. [PMID: 38290170 DOI: 10.1016/j.ejpn.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/10/2023] [Accepted: 01/22/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVE To validate the recently published diagnostic criteria for Myelin Oligodendrocyte Glycoprotein-antibody associated disease (MOGAD) in real-world cohort of children with acquired demyelinating syndromes. METHODS Patients <18yrs presenting with demyelinating disease to Pediatric neuroimmunology clinics at two Israeli tertiary centers who had MOG antibodies (MOG-Abs) tested between 01/07/2017 and 15/08/2023 were included. Diagnostic criteria for MOGAD were applied and sensitivity and specificities were calculated. RESULTS MOG-Abs were detected in 28/63 (44 %). Median age at onset for all patients was 11.4 yrs (range 1.1-17.6 yrs) and 41 (65 %) were female. Of the patients testing negative, ADEM was the most common diagnosis (n = 11) followed by MS (n = 8). No patients without MOG-Abs were diagnosed with MOGAD. All patients with a clinical diagnosis of MOGAD had positive MOG-Abs and fulfilled the 2023 international diagnostic criteria for MOGAD. Sensitivity, specificity, positive predictive value, and negative predictive value were 100 %. We found no difference between younger (<10yrs old) and older (>10 yrs old) children in the number of supportive criteria fulfilled at onset (median 2 vs. 2.5, p = 0.4) The number of supporting features was higher in patients with relapsing (n = 5) vs. monophasic (n = 23) disease course at onset (median 3 vs. 2, p = 0.03) and at final follow-up (median 5 vs. 2, p = 0.004). CONCLUSION Recent MOGAD diagnostic criteria had excellent performance in this pediatric cohort but did not add to the diagnostic accuracy of the antibody test alone.
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Affiliation(s)
- Mohammad Kurd
- Department of Pediatric Neurology, Hadassah University Medical Centre, Jerusalem, Israel
| | - Li-Tal Pratt
- Department of Neuroradiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tal Gilboa
- Department of Pediatric Neurology, Hadassah University Medical Centre, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Aviva Fattal-Valevski
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adi Vaknin-Dembinsky
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; The Department of Neurology and Laboratory of Neuroimmunology, The Agnes-Ginges Centre for Human Neurogenetics, Hadassah-Hebrew University Medical Centre, Jerusalem, Israel
| | - Avi Gadoth
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Hacohen
- Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Hadas Meirson
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
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Gilboa T, Swank Z, Thakur R, Gould RA, Ooi KH, Norman M, Flynn EA, Deveney BT, Chen A, Borberg E, Kuzkina A, Ndayisaba A, Khurana V, Weitz DA, Walt DR. Toward the quantification of α-synuclein aggregates with digital seed amplification assays. Proc Natl Acad Sci U S A 2024; 121:e2312031121. [PMID: 38194461 PMCID: PMC10801878 DOI: 10.1073/pnas.2312031121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/22/2023] [Indexed: 01/11/2024] Open
Abstract
The quantification and characterization of aggregated α-synuclein in clinical samples offer immense potential toward diagnosing, treating, and better understanding neurodegenerative synucleinopathies. Here, we developed digital seed amplification assays to detect single α-synuclein aggregates by partitioning the reaction into microcompartments. Using pre-formed α-synuclein fibrils as reaction seeds, we measured aggregate concentrations as low as 4 pg/mL. To improve our sensitivity, we captured aggregates on antibody-coated magnetic beads before running the amplification reaction. By first characterizing the pre-formed fibrils with transmission electron microscopy and size exclusion chromatography, we determined the specific aggregates targeted by each assay platform. Using brain tissue and cerebrospinal fluid samples collected from patients with Parkinson's Disease and multiple system atrophy, we demonstrated that the assay can detect endogenous pathological α-synuclein aggregates. Furthermore, as another application for these assays, we studied the inhibition of α-synuclein aggregation in the presence of small-molecule inhibitors and used a custom image analysis pipeline to quantify changes in aggregate growth and filament morphology.
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Affiliation(s)
- Tal Gilboa
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA02115
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115
- Harvard Medical School, Boston, MA02115
| | - Zoe Swank
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA02115
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115
- Harvard Medical School, Boston, MA02115
| | - Rohan Thakur
- John A. Paulson School of Engineering & Applied Sciences, Harvard University, Cambridge, MA02138
- Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA02139
| | - Russell A. Gould
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115
| | - Kean Hean Ooi
- Department of Medical Sciences, Harvard Medical School, Boston, MA02115
| | - Maia Norman
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA02115
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115
- Harvard Medical School, Boston, MA02115
- Physician Scientist Training Program, Massachusetts General Hospital/McLean Residency in Adult Psychiatry, Boston, MA02114
| | - Elizabeth A. Flynn
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA02115
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115
| | - Brendan T. Deveney
- John A. Paulson School of Engineering & Applied Sciences, Harvard University, Cambridge, MA02138
| | - Anqi Chen
- John A. Paulson School of Engineering & Applied Sciences, Harvard University, Cambridge, MA02138
| | - Ella Borberg
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA02115
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115
- Harvard Medical School, Boston, MA02115
| | - Anastasia Kuzkina
- Harvard Medical School, Boston, MA02115
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA02115
| | - Alain Ndayisaba
- Harvard Medical School, Boston, MA02115
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA02115
| | - Vikram Khurana
- Harvard Medical School, Boston, MA02115
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA02115
- Harvard Stem Cell Institute, Cambridge, MA02138
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA02142
| | - David A. Weitz
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115
- John A. Paulson School of Engineering & Applied Sciences, Harvard University, Cambridge, MA02138
- Department of Physics, Harvard University, Cambridge, MA02138
| | - David R. Walt
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA02115
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115
- Harvard Medical School, Boston, MA02115
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4
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Bulkowstein Y, Nitzan-Luques A, Schnapp A, Barnoy N, Reif S, Gilboa T, Volovesky O. The manifestations of metabolic acidosis during acetazolamide treatment in a cohort of pediatric idiopathic intracranial hypertension. Pediatr Nephrol 2024; 39:185-191. [PMID: 37480382 DOI: 10.1007/s00467-023-06084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Idiopathic intracranial hypertension is characterized by increased intracranial pressure with unidentified pathology. Despite its use as the first-line treatment, data on acetazolamide's effectiveness and safety in pediatric idiopathic intracranial hypertension is sparse. This study's objective was to assess those issues and the need for routine blood gas monitoring during treatment. METHODS Retrospective observational cohort study, based on multicenter computerized medical charts of pediatric patients with idiopathic intracranial hypertension diagnosed between 2007-2018 in three medical centers serving one metropolitan area (an estimated population of 400,000 children). Clinical and laboratory data of children up to 18 years old, fulfilling the Friedman criteria and taking acetazolamide, were collected and analyzed. RESULTS Sixty-eight patients were included with a mean acetazolamide treatment duration of 8.5 months and a median maximal dose 18 mg/kg/d. Sixty-two children had mild (76%), moderate (13%), or severe (1.5%) metabolic acidosis. At least one adverse effect (neurologic, gastrointestinal, renal) was recorded among 27% of patients. No significant difference was found between the mean pH of children with or without clinical adverse effects (p = 0.35). No correlation was found between laboratory acidosis and adverse effect severity (p = 0.3), or between median acetazolamide dose and acidosis level (p = 0.57). CONCLUSIONS Although laboratory finding of metabolic acidosis is common among patients with idiopathic intracranial hypertension treated with acetazolamide, it is not correlated with clinics. Therefore, we recommend sending blood tests during acetazolamide treatment based on clinical judgment. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
| | - Adi Nitzan-Luques
- Pediatric Department, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
- Pediatric Hematology Oncology Department, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Aviad Schnapp
- Pediatric Department, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Noa Barnoy
- Pediatric Neurology Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Shimon Reif
- Pediatric Department, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Tal Gilboa
- Pediatric Neurology Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Oded Volovesky
- Pediatric Nephrology Unit and Research Lab, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel.
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5
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Tzadok M, Gur-Pollack R, Florh H, Michaeli Y, Gilboa T, Lezinger M, Heyman E, Chernuha V, Gudis I, Nissenkorn A, Lerman-Sagie T, Ben Zeev B, Uliel-Sibony S. Real-Life Experience With Purified Cannabidiol Treatment for Refractory Epilepsy: A Multicenter Retrospective Study. Pediatr Neurol 2024; 150:91-96. [PMID: 37995414 DOI: 10.1016/j.pediatrneurol.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 10/18/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Drug-resistant epilepsy (DRE) affects the development and quality of life of children and young adults. We analyzed the effectiveness and safety of purified CBD in this population. METHODS A retrospective analysis of medical records of 139 children and young adults (54.7% female, median age 12.0 years) with DRE treated with purified CBD from 2018 to 2022 at five medical centers in Israel. RESULTS The most common diagnosis was Lennox-Gastaut syndrome (37.4%) followed by Dravet syndrome (16.5%) and tuberous sclerosis complex (16.5%). Median purified CBD dose was 12.5 mg/kg (range 2.5 to 20.0), and median treatment duration was 9.0 months (range 0.5 to 48.0). Most patients (92.2%) had a reduced seizure frequency following treatment initiation; 41.1% had >50% reduction. Fifty-three patients (38.1%) had positive effects: improved alertness (31.7%), improved speech (10.1%), and achievement of new developmental milestones (2.2%). A multivariate linear model assessing predictive factors for seizure reduction demonstrated that patients previously treated with CBD oils, especially those with >50% seizure reduction on prior treatment, were also more likely to have a reduced seizure frequency while they were treated with purified CBD (P = 0.01, P < 0.0001). Development, diagnosis, age, purified CBD dose (0 to 10 mg/kg/day vs 10 to 20 mg/kg/day), and concomitant treatment with clobazam, valproic acid, or everolimus did not affect seizure reduction by purified CBD. The most common adverse events were irritability (20.9%) and drowsiness (12.9%). CONCLUSION Purified CBD is well-tolerated and effective in reducing seizure frequency in children and young adults with DRE.
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Affiliation(s)
- Michal Tzadok
- Pediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | - Hadar Florh
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology and Development Center, Shamir Medical Center (Assaf Harofeh), Be'er Ya'akov, Israel
| | - Yael Michaeli
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
| | - Tal Gilboa
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Pediatric Neurology Unit, Hadassah University Hospital, Jerusalem, Israel
| | - Mirit Lezinger
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology and Development Center, Shamir Medical Center (Assaf Harofeh), Be'er Ya'akov, Israel
| | - Eli Heyman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology and Development Center, Shamir Medical Center (Assaf Harofeh), Be'er Ya'akov, Israel
| | - Veronika Chernuha
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Irina Gudis
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
| | - Andreea Nissenkorn
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
| | - Tally Lerman-Sagie
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
| | - Bruria Ben Zeev
- Pediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shimrit Uliel-Sibony
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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6
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Smith TB, Rea A, Thomas HB, Thompson K, Oláhová M, Maroofian R, Zamani M, He L, Sadeghian S, Galehdari H, Lotan NS, Gilboa T, Herman KC, McCorvie TJ, Yue WW, Houlden H, Taylor RW, Newman WG, O'Keefe RT. Novel homozygous variants in PRORP expand the genotypic spectrum of combined oxidative phosphorylation deficiency 54. Eur J Hum Genet 2023; 31:1190-1194. [PMID: 37558808 PMCID: PMC10545766 DOI: 10.1038/s41431-023-01437-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/07/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
Biallelic hypomorphic variants in PRORP have been recently described as causing the autosomal recessive disorder combined oxidative phosphorylation deficiency type 54 (COXPD54). COXPD54 encompasses a phenotypic spectrum of sensorineural hearing loss and ovarian insufficiency (Perrault syndrome) to leukodystrophy. Here, we report three additional families with homozygous missense PRORP variants with pleiotropic phenotypes. Each missense variant altered a highly conserved residue within the metallonuclease domain. In vitro mitochondrial tRNA processing assays with recombinant TRMT10C, SDR5C1 and PRORP indicated two COXPD54-associated PRORP variants, c.1159A>G (p.Thr387Ala) and c.1241C>T (p.Ala414Val), decreased pre-tRNAIle cleavage, consistent with both variants impacting tRNA processing. No significant decrease in tRNA processing was observed with PRORP c.1093T>C (p.Tyr365His), which was identified in an individual with leukodystrophy. These data provide independent evidence that PRORP variants are associated with COXPD54 and that the assessment of 5' leader mitochondrial tRNA processing is a valuable assay for the functional analysis and clinical interpretation of novel PRORP variants.
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Affiliation(s)
- Thomas B Smith
- Division of Evolution, Infection and Genomics, School of Biological Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Alessandro Rea
- Division of Evolution, Infection and Genomics, School of Biological Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Huw B Thomas
- Division of Evolution, Infection and Genomics, School of Biological Sciences, University of Manchester, Manchester, M13 9PL, UK
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Kyle Thompson
- Wellcome Centre for Mitochondrial Research, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Monika Oláhová
- Wellcome Centre for Mitochondrial Research, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- Department of Applied Sciences, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Reza Maroofian
- Department of Molecular Neuroscience, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Mina Zamani
- Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
- Narges Medical Genetics and Prenatal Diagnosis Laboratory, Kianpars, Ahvaz, Iran
| | - Langping He
- NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK
| | - Saeid Sadeghian
- Department of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hamid Galehdari
- Narges Medical Genetics and Prenatal Diagnosis Laboratory, Kianpars, Ahvaz, Iran
| | - Nava Shaul Lotan
- Genetic Department, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Tal Gilboa
- Pediatric Neurology, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Kristin C Herman
- UC Davis Medical Center MIND Institute, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Thomas J McCorvie
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Wyatt W Yue
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
| | - Henry Houlden
- Department of Molecular Neuroscience, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
- NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK
| | - William G Newman
- Division of Evolution, Infection and Genomics, School of Biological Sciences, University of Manchester, Manchester, M13 9PL, UK.
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, M13 9WL, UK.
| | - Raymond T O'Keefe
- Division of Evolution, Infection and Genomics, School of Biological Sciences, University of Manchester, Manchester, M13 9PL, UK.
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7
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Mo A, Paz‐Ebstein E, Yanovsky‐Dagan S, Lai A, Mor‐Shaked H, Gilboa T, Yang E, Shao DD, Walsh CA, Harel T. A recurrent de novo variant in NUSAP1 escapes nonsense-mediated decay and leads to microcephaly, epilepsy, and developmental delay. Clin Genet 2023; 104:73-80. [PMID: 37005340 PMCID: PMC10236379 DOI: 10.1111/cge.14335] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/04/2023]
Abstract
NUSAP1 encodes a cell cycle-dependent protein with key roles in mitotic progression, spindle formation, and microtubule stability. Both over- and under-expression of NUSAP1 lead to dysregulation of mitosis and impaired cell proliferation. Through exome sequencing and Matchmaker Exchange, we identified two unrelated individuals with the same recurrent, de novo heterozygous variant (NM_016359.5 c.1209C > A; p.(Tyr403Ter)) in NUSAP1. Both individuals had microcephaly, severe developmental delay, brain abnormalities, and seizures. The gene is predicted to be tolerant of heterozygous loss-of-function mutations, and we show that the mutant transcript escapes nonsense mediated decay, suggesting that the mechanism is likely dominant-negative or toxic gain of function. Single-cell RNA-sequencing of an affected individual's post-mortem brain tissue indicated that the NUSAP1 mutant brain contains all main cell lineages, and that the microcephaly could not be attributed to loss of a specific cell type. We hypothesize that pathogenic variants in NUSAP1 lead to microcephaly possibly by an underlying defect in neural progenitor cells.
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Affiliation(s)
- Alisa Mo
- Department of Neurology, Boston Children's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Emuna Paz‐Ebstein
- Department of GeneticsHadassah Medical CenterJerusalemIsrael
- Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
| | | | - Abbe Lai
- Division of Genetics and Genomics, Department of PediatricsBoston Children's HospitalBostonMassachusettsUSA
| | - Hagar Mor‐Shaked
- Department of GeneticsHadassah Medical CenterJerusalemIsrael
- Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
| | - Tal Gilboa
- Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
- Pediatric Neurology UnitHadassah Medical CenterJerusalemIsrael
| | - Edward Yang
- Department of RadiologyBoston Children's HospitalBostonMassachusettsUSA
| | - Diane D. Shao
- Department of Neurology, Boston Children's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Christopher A. Walsh
- Division of Genetics and Genomics, Department of PediatricsBoston Children's HospitalBostonMassachusettsUSA
- Howard Hughes Medical InstituteBoston Children's HospitalBostonMassachusettsUSA
| | - Tamar Harel
- Department of GeneticsHadassah Medical CenterJerusalemIsrael
- Faculty of MedicineHebrew University of JerusalemJerusalemIsrael
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8
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Ter-Ovanesyan D, Gilboa T, Budnik B, Nikitina A, Whiteman S, Lazarovits R, Trieu W, Kalish D, Church GM, Walt DR. Improved isolation of extracellular vesicles by removal of both free proteins and lipoproteins. eLife 2023; 12:86394. [PMID: 37252755 DOI: 10.7554/elife.86394] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/08/2023] [Indexed: 05/31/2023] Open
Abstract
Extracellular vesicles (EVs) are released by all cells into biofluids such as plasma. The separation of EVs from highly abundant free proteins and similarly sized lipoproteins remains technically challenging. We developed a digital ELISA assay based on Single Molecule Array (Simoa) technology for ApoB-100, the protein component of several lipoproteins. Combining this ApoB-100 assay with previously developed Simoa assays for albumin and three tetraspanin proteins found on EVs (Ter-Ovanesyan, Norman et al., 2021), we were able to measure the separation of EVs from both lipoproteins and free proteins. We used these five assays to compare EV separation from lipoproteins using size exclusion chromatography with resins containing different pore sizes. We also developed improved methods for EV isolation based on combining several types of chromatography resins in the same column. We present a simple approach to quantitatively measure the main impurities of EV isolation in plasma and apply this approach to develop novel methods for enriching EVs from human plasma. These methods will enable applications where high-purity EVs are required to both understand EV biology and profile EVs for biomarker discovery.
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Affiliation(s)
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
- Department of Pathology, Brigham and Women's Hospital, Boston, United States
| | - Bogdan Budnik
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
| | - Adele Nikitina
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
| | - Sara Whiteman
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
| | - Roey Lazarovits
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
| | - Wendy Trieu
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
| | - David Kalish
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
| | - George M Church
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
- Harvard Medical School, Boston, United States
| | - David R Walt
- Wyss Institute for Biologically Inspired Engineering, Boston, United States
- Department of Pathology, Brigham and Women's Hospital, Boston, United States
- Harvard Medical School, Boston, United States
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9
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Melkonian AV, Gilboa T, Walt DR. Disulfide Bonds Are Not Necessary for Intrinsic TNSALP Activity. J Phys Chem B 2023; 127:1744-1748. [PMID: 36795426 DOI: 10.1021/acs.jpcb.2c08392] [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: 02/17/2023]
Abstract
Recent developments in single-molecule enzymology (SME) have allowed for the observation of subpopulations present in enzyme ensembles. Tissue-nonspecific alkaline phosphatase (TNSALP), a homodimeric monophosphate esterase central to bone metabolism, has become a model enzyme for SME studies. TNSALP contains two internal disulfide bonds that are critical for its effective dimerization; mutations in its disulfide bonding framework have been reported in patients with hypophosphatasia, a rare disease characterized by impaired bone and tooth mineralization. In this paper, we present the kinetics of these mutants and show that these disulfide bonds are not crucial for TNSALP enzymatic function. This surprising result reveals that the enzyme's active conformation does not rely on its disulfide bonds. We posit that the signs and symptoms seen in hypophosphatasia are likely not primarily due to impaired enzyme function, but rather decreased enzyme expression and trafficking.
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Affiliation(s)
- Arek V Melkonian
- Harvard Medical School, Boston, Massachusetts 02115, United States.,Brigham and Women's Hospital, Department of Pathology, Boston, Massachusetts 02115, United States.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States
| | - Tal Gilboa
- Harvard Medical School, Boston, Massachusetts 02115, United States.,Brigham and Women's Hospital, Department of Pathology, Boston, Massachusetts 02115, United States.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States
| | - David R Walt
- Harvard Medical School, Boston, Massachusetts 02115, United States.,Brigham and Women's Hospital, Department of Pathology, Boston, Massachusetts 02115, United States.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States
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10
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Kawar RA, Gross I, Biro Y, Guzner N, Peyser-Rosenberg M, Azulai S, Mechulam H, Gilboa T, Cohen H, Hashavya S. The yield of ophthalmoscopy as a screening tool for intracranial pathology in pediatric headache. Eur J Pediatr 2023; 182:609-614. [PMID: 36401633 DOI: 10.1007/s00431-022-04708-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 11/20/2022]
Abstract
Headache is a common complaint in children who present at the pediatric emergency department (PED). Serious conditions such as intracranial tumors and idiopathic intracranial hypertension (IIH) should be rapidly ruled out. Ophthalmoscopy for the presence of papilledema has long been considered critical to the assessment of headaches in children; however, the yield of this procedure is poorly validated. This retrospective study implemented a computerized search of the medical records of a single tertiary center to identify all children aged 2-18 years who presented at the PED complaining of headache between 2007 and 2017. The clinical, demographic, radiographic, and laboratory data were analyzed. Of the 948 children aged 2-18 years who presented at the PED complaining of headache, 536 had an ophthalmoscopy examination carried out by an ophthalmologist. Forty-one had papilledema, of whom 7 had an intracranial tumor, 15 had IIH, and 9 had optic nerve head drusen. Of the 495 children without papilledema, 3 had intracranial tumor, and 11 had IIH. The sensitivity and specificity of papilledema for the diagnosis of intracranial tumor were 70% and 93.5%, respectively, with an NPV and PPV of 99.4% and 17.1%, respectively. The sensitivity and specificity of papilledema for the diagnosis of intracranial pathology in general were 61.1% and 96.2%, respectively, with an NPV and PPV of 97.2% and 53.7%, respectively. Conclusion: Assessment by ophthalmoscopy for papilledema in children presenting to the PED with headache had high sensitivity and high specificity, thus reinforcing the importance of ophthalmoscopy as a screening tool in these children. What is Known: • Headache is a common complaint in children. Serious intracranial pathologies need to be rapidly excluded. • Ophthalmoscopy for the presence of papilledema is commonly used as a screening tool for intracranial pathology, but this procedure is poorly validated. What is New: • Ophthalmoscopy for the assessment of papilledema in children who present with headache to the pediatric emergency department is shown to exhibit sensitivity and specificity for the diagnosis of intracranial pathology.
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Affiliation(s)
- Rawan Azzam Kawar
- Department of Pediatrics, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel
| | - Itai Gross
- Department of Pediatric Emergency Medicine, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel.
| | - Yael Biro
- Department of Pediatric Emergency Medicine, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel
| | - Noa Guzner
- Faculty of Medicine, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel
| | | | - Shira Azulai
- Faculty of Medicine, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel
| | - Hadas Mechulam
- Pediatric Ophthalmology Unit, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel
| | - Tal Gilboa
- Child Neurology Unit, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel
| | - Hodaya Cohen
- The Dyna and Fala Weinstock Department of Pediatric Hemato-Oncology, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel
| | - Saar Hashavya
- Department of Pediatric Emergency Medicine, Hadassah and The Hebrew University Medical Center, Jerusalem, Israel
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11
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Gilboa T, Elefant N, Meiner V, Hacohen N. Delineating the phenotype and genetic basis of AMPD2-related pontocerebellar hypoplasia. Neurogenetics 2023; 24:61-66. [PMID: 36445597 DOI: 10.1007/s10048-022-00706-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022]
Abstract
Pontocerebellar hypoplasia is a group of disorders with a wide range of presentations. We describe here the genetic and phenotypic features of PCH type 9 due to mutations in AMPD2. All patients have severe intellectual disability, and the vast majority manifest abnormal tone, cortical blindness, and microcephaly. Almost all have agenesis of the corpus callosum and severe cerebellar hypoplasia. The course is not progressive, however, few die in the first decade of life. Mutations are spread throughout the gene, and no hot spot can be identified. One of the mutations we report here is the most distal truncating variant known in this gene and is predicted to result in a truncated protein. The phenotype is severe in all cases; thus, no clear genotype-phenotype correlation can be established.
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Affiliation(s)
- Tal Gilboa
- Pediatric Neurology Unit, Hadassah University Medical Center, 9112001, Jerusalem, Israel.
| | - Naama Elefant
- Department of Genetics, Hadassah University Medical Center, 9112001, Jerusalem, Israel
| | - Vardiella Meiner
- Department of Genetics, Hadassah University Medical Center, 9112001, Jerusalem, Israel
| | - Nuphar Hacohen
- Department of Genetics, Hadassah University Medical Center, 9112001, Jerusalem, Israel
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12
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Vander T, Stroganova T, Doufish D, Eliashiv D, Gilboa T, Medvedovsky M, Ekstein D. What is the optimal duration of home-video-EEG monitoring for patients with <1 seizure per day? A simulation study. Front Neurol 2022; 13:938294. [PMID: 36071898 PMCID: PMC9441894 DOI: 10.3389/fneur.2022.938294] [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: 05/07/2022] [Accepted: 07/28/2022] [Indexed: 11/22/2022] Open
Abstract
Ambulatory “at home” video-EEG monitoring (HVEM) may offer a more cost-effective and accessible option as compared to traditional inpatient admissions to epilepsy monitoring units. However, home monitoring may not allow for safe tapering of anti-seizure medications (ASM). As a result, longer periods of monitoring may be necessary to capture a sufficient number of the patients' stereotypic seizures. We aimed to quantitatively estimate the necessary length of HVEM corresponding to various diagnostic scenarios in clinical practice. Using available seizure frequency statistics, we estimated the HVEM duration required to capture one, three, or five seizures on different days, by simulating 100,000 annual time-courses of seizure occurrence in adults and children with more than one and <30 seizures per month (89% of adults and 85% of children). We found that the durations of HVEM needed to record 1, 3, or 5 seizures in 80% of children were 2, 5, and 8 weeks (median 2, 12, and 21 days), respectively, and significantly longer in adults −2, 6, and 10 weeks (median 3, 14, and 26 days; p < 10−10 for all comparisons). Thus, longer HVEM than currently used is needed for expanding its clinical value from diagnosis of nonepileptic or very frequent epileptic events to a presurgical tool for patients with drug-resistant epilepsy. Technical developments and further studies are warranted.
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Affiliation(s)
- Tatiana Vander
- Herzfeld Geriatric Rehabilitation Medical Center, Gedera, Israel
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tatiana Stroganova
- MEG-Center, Moscow State University of Psychology and Education, Moscow, Russia
| | - Diya Doufish
- Department of Neurology and Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel
| | - Dawn Eliashiv
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Tal Gilboa
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- The Neuropediatric Unit, Division of Pediatrics, Hadassah Medical Organization, Jerusalem, Israel
| | - Mordekhay Medvedovsky
- Department of Neurology and Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel
| | - Dana Ekstein
- Department of Neurology and Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- *Correspondence: Dana Ekstein
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13
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Gilboa T, Ogata AF, Reilly C, Walt DR. Single-molecule studies reveal method for tuning the heterogeneous activity of Alkaline Phosphatase. Biophys J 2022; 121:2027-2034. [DOI: 10.1016/j.bpj.2022.05.005] [Citation(s) in RCA: 2] [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: 12/12/2021] [Revised: 03/09/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022] Open
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14
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Zhai Y, Goyal G, Prabhala P, Patil A, Kim MS, Junaid A, Ku MW, Mahajan G, Bausk B, Gilboa T, Lazarovits R, Sharma S, Cohen L, Ferrante T, Walt DR, Ingber DE. A human ectopic-lymphoid-follicle-on-a-chip for testing vaccines and adjuvants. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.116.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
New vaccine candidates evaluated in animals can lead to unpredicted toxicities or poor efficacy in human clinical trials due to species-specific differences in immune responses. To address this problem, we developed the human ectopic lymphoid follicle (LF) chip containing primary human immune cells, including autologous blood B and T lymphocytes and antigen presenting cells, cultured in a three-dimensional extracellular matrix (ECM) gel within an organ-on-a-chip microfluidic device. Superfusion via a parallel channel separated by a microporous membrane is required for LF formation and prevents lymphocyte autoactivation. These germinal center-like LFs contain B cells expressing activation-induced cytidine deaminase and exhibit plasma cell differentiation upon activation. Increased basal lymphocyte proliferation is observed in the human LF chip as compared to conventional 2D cultures lacking ECM or perfusion. The human LF chips demonstrated improved antibody responses to split virion influenza vaccination compared to conventional planar 2D cultures, which were enhanced by the addition of a squalene-in-water emulsion (SWE) adjuvant, and this was accompanied by increases in LF size and number. To extend this work, we modelled intramuscular vaccination by co-culturing monocytes with muscle cells in the presence of different vaccines and adjuvants. We found that presence of muscle cells can promote cytokine production, antigen uptake and monocyte activation. Seeding these monocytes into the LF chips with autologous T and B cells could promote cytokine production and LF formation, which extends the LF chips usage for testing intramuscular vaccination.
Supported by grants from the Defense Advanced Research Projects Agency under Cooperative Agreement Number W911NF-12-2-0036, the National Institutes of Health grant UG3HL141797, Bill and Melinda Gates Foundation and the Wyss Institute for Biologically Inspired Engineering.
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Affiliation(s)
- Yunhao Zhai
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Girija Goyal
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Pranav Prabhala
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Aditya Patil
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Min Sun Kim
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Abidemi Junaid
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Min Wen Ku
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Gautam Mahajan
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Bruce Bausk
- 2Brigham and Women’s Hosp. and Harvard Medi. Sch
| | - Tal Gilboa
- 2Brigham and Women’s Hosp. and Harvard Medi. Sch
| | | | - Sanjay Sharma
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Limor Cohen
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - Thomas Ferrante
- 1Wyss Inst. for Biologically Inspired Engin. at Harvard Univ
| | - David R Walt
- 2Brigham and Women’s Hosp. and Harvard Medi. Sch
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15
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Goyal G, Prabhala P, Mahajan G, Bausk B, Gilboa T, Xie L, Zhai Y, Lazarovits R, Mansour A, Kim MS, Patil A, Curran D, Long JM, Sharma S, Junaid A, Cohen L, Ferrante TC, Levy O, Prantil‐Baun R, Walt DR, Ingber DE. Ectopic Lymphoid Follicle Formation and Human Seasonal Influenza Vaccination Responses Recapitulated in an Organ-on-a-Chip. Adv Sci (Weinh) 2022; 9:e2103241. [PMID: 35289122 PMCID: PMC9109055 DOI: 10.1002/advs.202103241] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/08/2021] [Indexed: 05/13/2023]
Abstract
Lymphoid follicles (LFs) are responsible for generation of adaptive immune responses in secondary lymphoid organs and form ectopically during chronic inflammation. A human model of ectopic LF formation will provide a tool to understand LF development and an alternative to non-human primates for preclinical evaluation of vaccines. Here, it is shown that primary human blood B- and T-lymphocytes autonomously assemble into ectopic LFs when cultured in a 3D extracellular matrix gel within one channel of a two-channel organ-on-a-chip microfluidic device. Superfusion via a parallel channel separated by a microporous membrane is required for LF formation and prevents lymphocyte autoactivation. These germinal center-like LFs contain B cells expressing Activation-Induced Cytidine Deaminase and exhibit plasma cell differentiation upon activation. To explore their utility for seasonal vaccine testing, autologous monocyte-derived dendritic cells are integrated into LF Chips. The human LF chips demonstrate improved antibody responses to split virion influenza vaccination compared to 2D cultures, which are enhanced by a squalene-in-water emulsion adjuvant, and this is accompanied by increases in LF size and number. When inoculated with commercial influenza vaccine, plasma cell formation and production of anti-hemagglutinin IgG are observed, as well as secretion of cytokines similar to vaccinated humans over clinically relevant timescales.
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Affiliation(s)
- Girija Goyal
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Pranav Prabhala
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Gautam Mahajan
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Bruce Bausk
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
- Department of PathologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMA02115USA
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
- Department of PathologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMA02115USA
| | - Liangxia Xie
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
- Department of PathologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMA02115USA
| | - Yunhao Zhai
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Roey Lazarovits
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Adam Mansour
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Min Sun Kim
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Aditya Patil
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Danielle Curran
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Jaclyn M. Long
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Sanjay Sharma
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Abidemi Junaid
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Limor Cohen
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
- Department of PathologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMA02115USA
| | - Thomas C. Ferrante
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Oren Levy
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - Rachelle Prantil‐Baun
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
| | - David R. Walt
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
- Department of PathologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMA02115USA
| | - Donald E. Ingber
- Wyss Institute for Biologically Inspired Engineering at Harvard UniversityBostonMA02115USA
- Vascular Biology Program and Department of SurgeryBoston Children's Hospital and Harvard Medical SchoolBostonMA02115USA
- Harvard John A. Paulson School of Engineering and Applied SciencesHarvard UniversityCambridgeMA02139USA
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16
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Ogata AF, Lazarovits R, Uwamanzu-Nna A, Gilboa T, Cheng CA, Walt DR. Severe Acute Respiratory Syndrome Coronavirus 2 Antigens as Targets of Antibody Responses. Clin Lab Med 2022; 42:97-109. [PMID: 35153051 PMCID: PMC8563368 DOI: 10.1016/j.cll.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Humoral immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during acute infection and convalescence has been widely studied since March 2020. In this review, the authors summarize literature on humoral responses to SARS-CoV-2 antigens with a focus on spike, nucleocapsid, and the receptor-binding domain as targets of antibody responses. They highlight serologic studies during acute SARS-CoV-2 infection and discuss the clinical relevance of antibody levels in COVID-19 progression. Antibody responses in pediatric COVID-19 patients are also reviewed. Finally, the authors discuss antibody responses during convalescence and their role in protection from SARS-CoV-2 reinfection.
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Affiliation(s)
- Alana F. Ogata
- Department of Pathology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02215, USA,Wyss Institute for Biologically Inspired Engineering, 3 Blackfan Cir, Harvard University, Boston, MA 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Roey Lazarovits
- Department of Pathology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02215, USA,Wyss Institute for Biologically Inspired Engineering, 3 Blackfan Cir, Harvard University, Boston, MA 02115, USA
| | - Augusta Uwamanzu-Nna
- Department of Pathology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02215, USA
| | - Tal Gilboa
- Department of Pathology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02215, USA,Wyss Institute for Biologically Inspired Engineering, 3 Blackfan Cir, Harvard University, Boston, MA 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Chi-An Cheng
- Department of Pathology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02215, USA,Wyss Institute for Biologically Inspired Engineering, 3 Blackfan Cir, Harvard University, Boston, MA 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - David R. Walt
- Department of Pathology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02215, USA,Wyss Institute for Biologically Inspired Engineering, 3 Blackfan Cir, Harvard University, Boston, MA 02115, USA,Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA,Corresponding author. 60 Fenwood Road, Boston, MA 02116
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17
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Norman M, Gilboa T, Walt DR. High-Sensitivity Single Molecule Array Assays for Pathological Isoforms in Parkinson’s Disease. Clin Chem 2022; 68:431-440. [DOI: 10.1093/clinchem/hvab251] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/12/2021] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Clinical trials for neurodegenerative diseases are increasingly utilizing measurements of post-translational modifications (PTMs) and pathological isoforms as surrogate markers of target engagement and therapeutic efficacy. These isoforms, however, tend to exist at femtomolar concentrations, well below the detection limit of conventional immunoassays. Therefore, highly sensitive and well-validated assays for these isoforms are needed.
Methods
We developed a novel panel of single molecule array assays for pathological isoforms and PTMs implicated in the development and pathophysiology of Parkinson’s disease. We validated this panel by measuring these analytes in the cerebrospinal fluid of a cross-sectional cohort of 100 patients with Parkinson’s disease and 100 healthy controls.
Results
When comparing patients with Parkinson’s disease to healthy controls, alpha synuclein, pSer129 alpha synuclein, DJ-1, and C-reactive protein were shown to be reduced in patients with Parkinson’s disease while p396 tau and neurofilament light chain were shown to be increased. A random forest analysis produced an area under the curve of 0.70 for the panel.
Conclusions
Measurement of post-translational modifications and pathological isoforms in patients with Parkinson’s disease improved diagnostic accuracy above that of total protein measurements, demonstrating the potential utility of these assays for monitoring patients in clinical trials.
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Affiliation(s)
- Maia Norman
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, USA
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, USA
| | - Tal Gilboa
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - David R Walt
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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18
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Bausk BP, Sherman AC, Desjardins M, Izaguirre NE, Cheng CA, Powell M, Senussi Y, Gilboa T, Krauss JH, Dirr B, Power E, Joyce A, Stewart L, Ometoruwa O, Novack LA, Evans B, Woods T, Tong A, Walt D, Soiffer R, Ho VT, Issa NC, Baden LR. 25. Immunogenicity and Reactogenicity of COVID-19 mRNA Vaccines in Allogeneic Stem Cell Transplant Recipients. Open Forum Infect Dis 2021. [PMCID: PMC8644500 DOI: 10.1093/ofid/ofab466.025] [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] [Indexed: 11/20/2022] Open
Abstract
Background Allogeneic stem cell transplant (SCT) recipients are at an increased risk of poor outcomes from COVID-19. While the mRNA-1273 (Moderna) and BNT162b2 (Pfizer) COVID-19 mRNA vaccines are highly immunogenic in the general population, the immune response in SCT recipients is poorly understood. We characterized the immunogenicity and reactogenicity of COVID-19 mRNA vaccines in a cohort of SCT patients. Methods We performed a prospective cohort study of 16 allogeneic SCT patients and 23 healthy controls. Blood samples for both cohorts were collected prior to first vaccination (baseline), at the time of second vaccination, and approximately 28 days post-second vaccination. Anti-Spike (S), anti-S1, anti-receptor binding domain (RBD), and anti-Nucleocapsid (N) IgG levels were measured quantitatively from plasma using a multiplexed single molecule array (Simoa) immunoassay. Reactogenicity was captured for the SCT cohort via a self-reported post-vaccination diary for 7 days after each dose. Results Demographics and SCT recipients’ characteristics are shown in Table 1. In the SCT cohort, we observed a significantly lower anti-S (p< 0.0001), S1 (p< 0.0001), and RBD (p< 0.0001) IgG responses as compared to healthy controls, both at the time of dose 2 and 28 days post-vaccine series (Fig 1). Overall, 62.5% of SCT recipients were responders after vaccine series completion, as compared to 100% of healthy controls (Fig 2). While no patients had a reported history of COVID-19 diagnosis, 2 patients in the SCT cohort had elevated anti-S IgG levels and 1 showed elevated anti-N at baseline. 10/16 participants in the SCT cohort completed at least one post-vaccination diary. Local and systemic reactions were reported by 67% and 22% of participants, respectively, after dose 1, and 63% and 50% after dose 2 (Figure 3). All reported events were mild. Table 1: Demographics ![]()
Figure 1: Plasma IgG Titers ![]()
Anti-Spike (A), anti-S1 (B), anti-RBD (C), and anti-nucleocapsid (D) IgG titers were measured at baseline, time of second dose, and approximately 28 days after second vaccination. IgG levels were measured quantitatively using multiplexed single molecule array (Simoa) immunoassays, and are reported as Normalized Average Enzymes per Bead (AEB). Allogeneic stem cell transplant recipients (mauve) showed significantly lower anti-S, S1, and RBD IgG responses as compared to healthy controls (mint). Low titers of anti-N IgG demonstrates no history of COVID-19 natural infection during the course of the study. Figure 3. Solicited Local and Systemic Adverse Events ![]()
10 allogeneic stem cell transplant recipients completed at least one diary for 7 days after vaccination. Reactions after dose 1 are shown in light blue, and reactions after dose 2 are shown in dark blue. Local reactions (A) were reported by 67% (6/9) of participants after dose 1, and 63% (5/8) after dose 2. Systemic reactions (B) were reported by 22% (2/9) of participants after dose 1, and 50% (4/8) after dose 2. All reported events were mild (Grade 1). Conclusion Among SCT recipients, mRNA COVID-19 vaccines were well-tolerated but less immunogenic than in healthy controls. Further study is warranted to better understand heterogeneous characteristics that may affect the immune response in order to optimize COVID-19 vaccination strategies for SCT recipients. Figure 2: Response Rate to COVID-19 Vaccination ![]()
An internally validated threshold for responders was established using pre-pandemic sera from healthy adults. A positive antibody response was was defined as individuals with anti-Spike IgG levels above the 1.07 Normalized AEB threshold. Disclosures Amy Joyce, NP, Kadmon (Advisor or Review Panel member) Lewis A. Novack, MS, Lumicell Inc. (Scientific Research Study Investigator, Research Grant or Support)Precision Healing, Inc. (Scientific Research Study Investigator, Research Grant or Support) David Walt, PhD, Quanterix Corporation (Board Member, Shareholder) Robert Soiffer, MD, alexion (Consultant)gilead (Advisor or Review Panel member)jazz (Advisor or Review Panel member)juno/bms (Advisor or Review Panel member)kiadis (Board Member)precision bioscience (Consultant)Rheos (Consultant)takeda (Consultant) Nicolas C. Issa, MD, AiCuris (Scientific Research Study Investigator)Astellas (Scientific Research Study Investigator)GSK (Scientific Research Study Investigator)Merck (Scientific Research Study Investigator)
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Affiliation(s)
| | - Amy C Sherman
- Harvard Medical School/Brigham and Women’s Hospital, Boston, Massachusetts
| | | | | | - Chi-An Cheng
- Brigham and Women’s Hospital, Boston, Massachusetts
| | - Megan Powell
- BWH Division of Infectious Diseases, Boston, Massachusetts
| | | | - Tal Gilboa
- Brigham and Womens' hospital, Brookline, Massachusetts
| | | | - Bonnie Dirr
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Elyssa Power
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Amy Joyce
- Dana Farber Cancer Institute, Boston, Massachusetts
| | - Lisa Stewart
- Dana Farber Cancer Institute, Boston, Massachusetts
| | | | | | | | | | | | - David Walt
- Harvard Medical School/Brigham and Women’s Hospital/Wyss Institute, Boston, Massachusetts
| | | | - Vincent T Ho
- Dana-Farber Cancer Institute, Boston, Massachusetts
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19
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Izaguirre NE, Sherman AC, Crombie J, Desjardins M, Cheng CA, Gilboa T, Powell M, Bausk BP, Abasciano N, Baker P, McDonough M, Armand P, Walt D, Issa NC, Baden LR. 586. Immunogenicity of COVID-19 mRNA Vaccines in Patients with Lymphoid Malignancies. Open Forum Infect Dis 2021. [PMCID: PMC8644561 DOI: 10.1093/ofid/ofab466.784] [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] [Indexed: 11/29/2022] Open
Abstract
Background Patients with lymphoid malignancies are at high risk of severe COVID-19 disease and were not included in the phase 3 mRNA vaccine trials. Many patients with lymphoid malignancies receive immunosuppressive therapies, including B-cell depleting agents, that may negatively impact humoral response to vaccination. Methods We recruited patients with lymphoid malignancies and healthy participants who planned to receive two doses of SARS-CoV-2 mRNA vaccine (BNT162b2 or mRNA-1273). Blood was drawn at baseline, prior to second dose of vaccine, and 28 days after last vaccination. Disease characteristics and therapies were extracted from patients’ electronic medical record. An ultrasensitive, single molecule array (Simoa) assay detected anti-Spike (S), anti-S1, anti-receptor binding domain (RBD), and anti-Nucleocapsid (N) IgG from plasma at each timepoint. Results 23 healthy participants and 37 patients with lymphoid malignancies were enrolled (Table 1). Low titers of anti-N (Fig 1A) demonstrate no prior exposure or acquisition of COVID-19 before vaccination or during the study. 37.8% of the lymphoid malignancy cohort responded to the vaccine, using an internally validated AEB cutoff of 1.07. A significantly higher magnitude of anti-S (p< 0.0001), anti-S1 (p< 0.0001) and anti-RBD (p< 0.0001) are present in the healthy as compared to lymphoid malignancy cohort at the second dose and day 28 post-series (Fig 1B, Fig 1C and Fig 1D). Anti-S IgG titers were compared between the healthy cohort, treatment naïve, and treatment experienced groups (Fig 2). The treatment naïve cohort had high titers by series completion which were not significantly different from the healthy cohort (p=0.2259), although the treatment experienced group had significantly decreased titers (p< 0.0001). Of the 20 patients who had received CD20 therapy, there was no clear correlation of anti-S IgG response with time from CD20 therapy, although most patients who received CD20 therapies within 12 months from the vaccine had no response (Figure 3). Table 1. Demographics ![]()
Figure 1. Anti-N, Anti-S, Anti-S1, Anti-RBD and Anti-N Ig G for healthy v. lymphoid malignancy cohort ![]()
The dotted line at 1.07 marks in an internally validated threshold to mark anti-S IgG response. The black bars denote median with 95% CI. Figure 2: Anti-S IgG for healthy v. treatment naïve v. treatment experienced ![]()
The dotted line at 1.07 marks in an internally validated threshold to mark antibody response. The black bars denote median with 95% CI. Conclusion The vaccine-induced immune response was poor among treatment-experienced patients with lymphoid malignancies, especially among those who received CD20 therapies within 12 months. Figure 3. Months from CD20 therapy v. anti-S IgG titers ![]()
The dotted line at 1.07 marks in an internally validated threshold to mark antibody response. Disclosures Jennifer Crombie, MD, AbbVie (Grant/Research Support)Bauer (Grant/Research Support)Karyopharm (Consultant)MorphoSys (Consultant) Philippe Armand, MD PhD, ADCT, Celgene, Morphosys, Daiichi, Miltenyi, Tessa, C4, Genmab, Enterome, Regeneron, Genentech, Epizyme, Astra Zeneca (Consultant, Sorry to put them all in, hope you can deconvolute for me)Affimed, Adaptive, BMS, Merck, Kite, IGM, Genentech (Research Grant or Support, Institutional research funding) David Walt, PhD, Quanterix Corporation (Board Member, Shareholder) Nicolas C. Issa, MD, AiCuris (Scientific Research Study Investigator)Astellas (Scientific Research Study Investigator)GSK (Scientific Research Study Investigator)Merck (Scientific Research Study Investigator)
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Affiliation(s)
| | - Amy C Sherman
- Harvard Medical School/Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Chi-An Cheng
- Brigham and Women’s Hospital, Boston, Massachusetts
| | - Tal Gilboa
- Brigham and Womens' Hospital, Brookline, Massachusetts
| | - Megan Powell
- BWH Division of Infectious Diseases, Boston, Massachusetts
| | | | | | - Peter Baker
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | | | - David Walt
- Harvard Medical School/Brigham and Women's Hospital/Wyss Institute, Boston, Massachusetts
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20
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Gilboa T, Cohen L, Cheng C, Lazarovits R, Uwamanzu‐Nna A, Han I, Griswold K, Barry N, Thompson DB, Kohman RE, Woolley AE, Karlson EW, Walt DR. A SARS‐CoV‐2 Neutralization Assay Using Single Molecule Arrays. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202110702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Tal Gilboa
- Harvard Medical School Boston MA 02115 USA
- Brigham and Women's Hospital Department of Pathology Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - Limor Cohen
- Harvard Medical School Boston MA 02115 USA
- Brigham and Women's Hospital Department of Pathology Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - Chi‐An Cheng
- Harvard Medical School Boston MA 02115 USA
- Brigham and Women's Hospital Department of Pathology Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - Roey Lazarovits
- Harvard Medical School Boston MA 02115 USA
- Brigham and Women's Hospital Department of Pathology Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - Augusta Uwamanzu‐Nna
- Harvard Medical School Boston MA 02115 USA
- Brigham and Women's Hospital Department of Pathology Boston MA 02115 USA
| | - Isaac Han
- Harvard Medical School Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - Kettner Griswold
- Harvard Medical School Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - Nick Barry
- Harvard Medical School Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - David B. Thompson
- Harvard Medical School Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - Richie E. Kohman
- Harvard Medical School Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
| | - Ann E. Woolley
- Harvard Medical School Boston MA 02115 USA
- Brigham and Women's Hospital Department of Medicine Boston MA 02115 USA
| | - Elizabeth W. Karlson
- Harvard Medical School Boston MA 02115 USA
- Brigham and Women's Hospital Department of Medicine Boston MA 02115 USA
| | - David R. Walt
- Harvard Medical School Boston MA 02115 USA
- Brigham and Women's Hospital Department of Pathology Boston MA 02115 USA
- Wyss Institute for Biologically Inspired Engineering Harvard University Boston MA 02115 USA
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21
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Gilboa T, Cohen L, Cheng C, Lazarovits R, Uwamanzu‐Nna A, Han I, Griswold K, Barry N, Thompson DB, Kohman RE, Woolley AE, Karlson EW, Walt DR. A SARS-CoV-2 Neutralization Assay Using Single Molecule Arrays. Angew Chem Int Ed Engl 2021; 60:25966-25972. [PMID: 34534408 PMCID: PMC8653099 DOI: 10.1002/anie.202110702] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 08/09/2021] [Indexed: 11/09/2022]
Abstract
Coronavirus disease 2019 (COVID-19) manifests with high clinical variability and warrants sensitive and specific assays to analyze immune responses in infected and vaccinated individuals. Using Single Molecule Arrays (Simoa), we developed an assay to assess antibody neutralization with high sensitivity and multiplexing capabilities based on antibody-mediated blockage of the ACE2-spike interaction. The assay does not require live viruses or cells and can be performed in a biosafety level 2 laboratory within two hours. We used this assay to assess neutralization and antibody levels in patients who died of COVID-19 and patients hospitalized for a short period of time and show that neutralization and antibody levels increase over time. We also adapted the assay for SARS-CoV-2 variants and measured neutralization capacity in pre-pandemic healthy, COVID-19 infected, and vaccinated individuals. This assay is highly adaptable for clinical applications, such as vaccine development and epidemiological studies.
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Affiliation(s)
- Tal Gilboa
- Harvard Medical SchoolBostonMA02115USA
- Brigham and Women's HospitalDepartment of PathologyBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Limor Cohen
- Harvard Medical SchoolBostonMA02115USA
- Brigham and Women's HospitalDepartment of PathologyBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Chi‐An Cheng
- Harvard Medical SchoolBostonMA02115USA
- Brigham and Women's HospitalDepartment of PathologyBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Roey Lazarovits
- Harvard Medical SchoolBostonMA02115USA
- Brigham and Women's HospitalDepartment of PathologyBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Augusta Uwamanzu‐Nna
- Harvard Medical SchoolBostonMA02115USA
- Brigham and Women's HospitalDepartment of PathologyBostonMA02115USA
| | - Isaac Han
- Harvard Medical SchoolBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Kettner Griswold
- Harvard Medical SchoolBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Nick Barry
- Harvard Medical SchoolBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - David B. Thompson
- Harvard Medical SchoolBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Richie E. Kohman
- Harvard Medical SchoolBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Ann E. Woolley
- Harvard Medical SchoolBostonMA02115USA
- Brigham and Women's HospitalDepartment of MedicineBostonMA02115USA
| | - Elizabeth W. Karlson
- Harvard Medical SchoolBostonMA02115USA
- Brigham and Women's HospitalDepartment of MedicineBostonMA02115USA
| | - David R. Walt
- Harvard Medical SchoolBostonMA02115USA
- Brigham and Women's HospitalDepartment of PathologyBostonMA02115USA
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
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22
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Langellotto F, Dellacherie MO, Yeager C, Ijaz H, Yu J, Cheng C, Dimitrakakis N, Seiler BT, Gebre MS, Gilboa T, Johnson R, Storm N, Bardales S, Graveline A, White D, Tringides CM, Cartwright MJ, Doherty EJ, Honko A, Griffiths A, Barouch DH, Walt DR, Mooney DJ. A Modular Biomaterial Scaffold-Based Vaccine Elicits Durable Adaptive Immunity to Subunit SARS-CoV-2 Antigens. Adv Healthc Mater 2021; 10:e2101370. [PMID: 34605223 PMCID: PMC8652677 DOI: 10.1002/adhm.202101370] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/07/2021] [Indexed: 12/14/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic demonstrates the importance of generating safe and efficacious vaccines that can be rapidly deployed against emerging pathogens. Subunit vaccines are considered among the safest, but proteins used in these typically lack strong immunogenicity, leading to poor immune responses. Here, a biomaterial COVID-19 vaccine based on a mesoporous silica rods (MSRs) platform is described. MSRs loaded with granulocyte-macrophage colony-stimulating factor (GM-CSF), the toll-like receptor 4 (TLR-4) agonist monophosphoryl lipid A (MPLA), and SARS-CoV-2 viral protein antigens slowly release their cargo and form subcutaneous scaffolds that locally recruit and activate antigen-presenting cells (APCs) for the generation of adaptive immunity. MSR-based vaccines generate robust and durable cellular and humoral responses against SARS-CoV-2 antigens, including the poorly immunogenic receptor binding domain (RBD) of the spike (S) protein. Persistent antibodies over the course of 8 months are found in all vaccine configurations tested and robust in vitro viral neutralization is observed both in a prime-boost and a single-dose regimen. These vaccines can be fully formulated ahead of time or stored lyophilized and reconstituted with an antigen mixture moments before injection, which can facilitate its rapid deployment against emerging SARS-CoV-2 variants or new pathogens. Together, the data show a promising COVID-19 vaccine candidate and a generally adaptable vaccine platform against infectious pathogens.
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Affiliation(s)
- Fernanda Langellotto
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Maxence O. Dellacherie
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
- Harvard John A. Paulson School of Engineering and Applied SciencesHarvard UniversityCambridgeMA02138USA
| | - Chyenne Yeager
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Hamza Ijaz
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Jingyou Yu
- Center for Virology and Vaccine ResearchBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA02115USA
| | - Chi‐An Cheng
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
- Department of PathologyBrigham and Women's HospitalBostonMA02115USA
- Harvard Medical SchoolBostonMA02115USA
| | - Nikolaos Dimitrakakis
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Benjamin T. Seiler
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Makda S. Gebre
- Center for Virology and Vaccine ResearchBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA02115USA
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
- Department of PathologyBrigham and Women's HospitalBostonMA02115USA
- Harvard Medical SchoolBostonMA02115USA
| | - Rebecca Johnson
- Department of MicrobiologyBoston University School of Medicine and National Emerging Infectious Diseases LaboratoriesBostonMA02118USA
| | - Nadia Storm
- Department of MicrobiologyBoston University School of Medicine and National Emerging Infectious Diseases LaboratoriesBostonMA02118USA
| | - Sarai Bardales
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Amanda Graveline
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Des White
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Christina M. Tringides
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
- Harvard Program in BiophysicsHarvard UniversityCambridgeMA02138USA
- Harvard–MIT Division in Health Sciences and TechnologyMassachusetts Institute of TechnologyCambridgeMA02139USA
| | - Mark J. Cartwright
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Edward J. Doherty
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
| | - Anna Honko
- Department of MicrobiologyBoston University School of Medicine and National Emerging Infectious Diseases LaboratoriesBostonMA02118USA
| | - Anthony Griffiths
- Department of MicrobiologyBoston University School of Medicine and National Emerging Infectious Diseases LaboratoriesBostonMA02118USA
| | - Dan H. Barouch
- Center for Virology and Vaccine ResearchBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA02115USA
- Ragon Institute of MGHMIT, and HarvardCambridgeMA02139USA
- Massachusetts Consortium on Pathogen ReadinessBostonMA02215USA
| | - David R. Walt
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
- Department of PathologyBrigham and Women's HospitalBostonMA02115USA
- Harvard Medical SchoolBostonMA02115USA
| | - David J. Mooney
- Wyss Institute for Biologically Inspired EngineeringHarvard UniversityBostonMA02115USA
- Harvard John A. Paulson School of Engineering and Applied SciencesHarvard UniversityCambridgeMA02138USA
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23
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Benoliel T, Gilboa T, Har-Shai Yahav P, Zelker R, Kreigsberg B, Tsizin E, Arviv O, Ekstein D, Medvedovsky M. Digital Semiology: A Prototype for Standardized, Computer-Based Semiologic Encoding of Seizures. Front Neurol 2021; 12:711378. [PMID: 34675865 PMCID: PMC8525609 DOI: 10.3389/fneur.2021.711378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022] Open
Abstract
Video-EEG monitoring (VEM) is imperative in seizure classification and presurgical assessment of epilepsy patients. Analysis of VEM is currently performed in most institutions using a freeform report, a time-consuming process resulting in a non-standardized report, limiting the use of this essential diagnostic tool. Herein we present a pilot feasibility study of our experience with “Digital Semiology” (DS), a novel seizure encoding software. It allows semiautomated annotation of the videos of suspected events from a predetermined, hierarchal set of options, with highly detailed semiologic descriptions, somatic localization, and timing. In addition, the software's semiologic extrapolation functions identify characteristics of focal seizures and PNES, sequences compatible with a Jacksonian march, and risk factors for SUDEP. Sixty episodes from a mixed adult and pediatric cohort from one level 4 epilepsy center VEM archives were analyzed using DS and the reports were compared with the standard freeform ones, written by the same epileptologists. The behavioral characteristics appearing in the DS and freeform reports overlapped by 78–80%. Encoding of one episode using DS required an average of 18 min 13 s (standard deviation: 14 min and 16 s). The focality function identified 19 out of 43 focal episodes, with a sensitivity of 45.45% (CI 30.39–61.15%) and specificity of 87.50% (CI 61.65–98.45%). The PNES function identified 6 of 12 PNES episodes, with a sensitivity of 50% (95% CI 21.09–78.91%) and specificity of 97.2 (95% CI 88.93–99.95%). Eleven events of GTCS triggered the SUDEP risk alert. Overall, these results show that video recordings of suspected seizures can be encoded using the DS software in a precise manner, offering the added benefit of semiologic alerts. The present study represents an important step toward the formation of an annotated video archive, to be used for machine learning purposes. This will further the goal of automated VEM analysis, ultimately contributing to wider utilization of VEM and therefore to the reduction of the treatment gap in epilepsy.
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Affiliation(s)
- Tal Benoliel
- Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tal Gilboa
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.,Pediatric Neurology Unit, Hadassah Medical Organization, Jerusalem, Israel
| | - Paz Har-Shai Yahav
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Revital Zelker
- School of Nursing, The Hebrew University of Jerusalem, Israel and Hadassah Medical Organization, Jerusalem, Israel
| | - Bilha Kreigsberg
- Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.,School of Nursing, The Hebrew University of Jerusalem, Israel and Hadassah Medical Organization, Jerusalem, Israel
| | - Evgeny Tsizin
- Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel
| | - Oshrit Arviv
- Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dana Ekstein
- Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mordekhay Medvedovsky
- Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem, Israel
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24
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Mysore V, Cullere X, Settles ML, Ji X, Kattan MW, Desjardins M, Durbin-Johnson B, Gilboa T, Baden LR, Walt DR, Lichtman AH, Jehi L, Mayadas TN. Protective heterologous T cell immunity in COVID-19 induced by the trivalent MMR and Tdap vaccine antigens. Med 2021; 2:1050-1071.e7. [PMID: 34414383 PMCID: PMC8363466 DOI: 10.1016/j.medj.2021.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 05/18/2021] [Revised: 06/25/2021] [Accepted: 08/06/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND T cells control viral infection, promote vaccine durability, and in coronavirus disease 2019 (COVID-19) associate with mild disease. We investigated whether prior measles-mumps-rubella (MMR) or tetanus-diphtheria-pertussis (Tdap) vaccination elicits cross-reactive T cells that mitigate COVID-19. METHODS Antigen-presenting cells (APC) loaded ex vivo with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MMR, or Tdap antigens and autologous T cells from COVID-19-convalescent participants, uninfected individuals, and COVID-19 mRNA-vaccinated donors were co-cultured. T cell activation and phenotype were detected by interferon-γ (IFN-γ) enzyme-linked immunospot (ELISpot) assays and flow cytometry. ELISAs (enzyme-linked immunosorbant assays) and validation studies identified the APC-derived cytokine(s) driving T cell activation. TCR clonotyping and single-cell RNA sequencing (scRNA-seq) identified cross-reactive T cells and their transcriptional profile. A propensity-weighted analysis of COVID-19 patients estimated the effects of MMR and Tdap vaccination on COVID-19 outcomes. FINDINGS High correlation was observed between T cell responses to SARS-CoV-2 (spike-S1 and nucleocapsid) and MMR and Tdap proteins in COVID-19-convalescent and -vaccinated individuals. The overlapping T cell population contained an effector memory T cell subset (effector memory re-expressing CD45RA on T cells [TEMRA]) implicated in protective, anti-viral immunity, and their detection required APC-derived IL-15, known to sensitize T cells to activation. Cross-reactive TCR repertoires detected in antigen-experienced T cells recognizing SARS-CoV-2, MMR, and Tdap epitopes had TEMRA features. Indices of disease severity were reduced in MMR- or Tdap-vaccinated individuals by 32%-38% and 20%-23%, respectively, among COVID-19 patients. CONCLUSIONS Tdap and MMR memory T cells reactivated by SARS-CoV-2 may provide protection against severe COVID-19. FUNDING This study was supported by a National Institutes of Health (R01HL065095, R01AI152522, R01NS097719) donation from Barbara and Amos Hostetter and the Chleck Foundation.
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Affiliation(s)
- Vijayashree Mysore
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Xavier Cullere
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Matthew L Settles
- Bioinformatics Core Facility in the Genome Center, University of California, Davis, Davis, CA 95616, USA
| | - Xinge Ji
- Quantitative Health Science Department, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Michael W Kattan
- Quantitative Health Science Department, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Michaël Desjardins
- Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | | | - Tal Gilboa
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Lindsey R Baden
- Department of Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Andrew H Lichtman
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
| | - Lara Jehi
- Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Tanya N Mayadas
- Department of Pathology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA 02115, USA
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25
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Kurd M, Hashavya S, Benenson S, Gilboa T. Seizures as the main presenting manifestation of acute SARS-CoV-2 infection in children. Seizure 2021; 92:89-93. [PMID: 34481322 PMCID: PMC8397499 DOI: 10.1016/j.seizure.2021.08.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/26/2021] [Accepted: 08/25/2021] [Indexed: 12/20/2022] Open
Abstract
Objectives To explore the rate, characteristics, risk factors, and prognosis of children presenting with seizures as the main symptom of acute COVID-19 (coronavirus disease 2019). Methods We conducted a systematic retrospective study to identify all children who presented to the emergency departments of a tertiary academic medical center between March 1st and December 31st 2020 and had a SARS-CoV-2 infection based on RT-PCR (reverse transcription-polymerase chain reaction) from nasopharyngeal swab. Clinical and demographic data were extracted from the electronic medical records and reviewed. Results Total of 175 children were diagnosed with acute SARS-CoV-2 infection in the emergency departments during the study period. Of those, 11 presented with seizures. Age ranged from six months to 17 years and 4 were girls. Five presented with status epilepticus and responded to loading doses of anti-seizure medications. Six had fever. Seven had prior history of neurological disorder. Full recovery was the rule. Significance Unlike in adults, seizures occur early and may be the main manifestation of acute COVID-19 in children. Seizures, including status epilepticus, may occur without fever even in children with no history of epilepsy and are not associated with severe disease. A high index of suspicion is required for early diagnosis thus infection control measures can be taken.
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Affiliation(s)
- Mohammad Kurd
- Pediatric neurology unit, Hadassah medical center, Jerusalem, Israel
| | - Saar Hashavya
- School of medicine, the Hebrew university of Jerusalem, Israel; Pediatric emergency department, Hadassah medical center, Jerusalem, Israel
| | - Shmuel Benenson
- School of medicine, the Hebrew university of Jerusalem, Israel; Unit for Infection Prevention and Control, Hadassah medical center, Jerusalem, Israel
| | - Tal Gilboa
- Pediatric neurology unit, Hadassah medical center, Jerusalem, Israel; School of medicine, the Hebrew university of Jerusalem, Israel.
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26
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Gilboa T, Ogata AF, Walt D. Single-molecule enzymology for diagnostics: profiling alkaline phosphatase activity in clinical samples. Chembiochem 2021; 23:e202100358. [PMID: 34375495 DOI: 10.1002/cbic.202100358] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/06/2021] [Indexed: 11/05/2022]
Abstract
Enzymes can be used as biomarkers for a variety of diseases. However, profiling enzyme activity in clinical samples is challenging due to the heterogeneity in enzyme activity, and the low abundance of the target enzyme in biofluids. Single-molecule methods can overcome these challenges by providing information on the distribution of enzyme activities in a sample. Here, we describe the concept of using the single-molecule enzymology (SME) method to analyze enzymatic activity in clinical samples. We present recent work focused on measuring alkaline phosphatase isotypes in serum samples using SME. Future work will involve improving and simplifying this technology, and applying it to other enzymes for diagnostics.
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Affiliation(s)
- Tal Gilboa
- Brigham and Women's Hospital, pathology, 60 Fenwood Rd, Bbf-8006, 02115-6195, Boston, UNITED STATES
| | - Alana F Ogata
- Brigham and Women's Hospital, pathology, UNITED STATES
| | - David Walt
- Harvard Medical School, -, -, -, -, UNITED STATES
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27
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Zvuloni E, Zrehen A, Gilboa T, Meller A. Fast and Deterministic Fabrication of Sub-5 Nanometer Solid-State Pores by Feedback-Controlled Laser Processing. ACS Nano 2021; 15:12189-12200. [PMID: 34219449 PMCID: PMC8320231 DOI: 10.1021/acsnano.1c03773] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/28/2021] [Indexed: 05/26/2023]
Abstract
Nanopores are single-molecule sensors capable of detecting and quantifying a broad range of unlabeled biomolecules including DNA and proteins. Nanopores' generic sensing principle has permitted the development of a vast range of biomolecular applications in genomics and proteomics, including single-molecule DNA sequencing and protein fingerprinting. Owing to their superior mechanical and electrical stability, many of the recent studies involved synthetic nanopores fabricated in thin solid-state membranes such as freestanding silicon nitride. However, to date, one of the bottlenecks in this field is the availability of a fast, reliable, and deterministic fabrication method capable of repeatedly forming small nanopores (i.e., sub 5 nm) in situ. Recently, it was demonstrated that a tightly focused laser beam can induce controlled etching of silicon nitride membranes suspended in buffered aqueous solutions. Herein, we demonstrate that nanopore laser drilling (LD) can produce nanopores deterministically to a prespecified size without user intervention. By optimizing the optical apparatus, and by designing a multistep control algorithm for the LD process, we demonstrate a fully automatic fabrication method for any user-defined nanopore size within minutes. The LD process results in a double bowl-shaped structure having a typical size of the laser point-spread function (PSF) at its openings. Numerical simulations of the characteristic LD nanopore shape provide conductance curves that fit the experimental result and support the idea that the pore is produced at the thinnest area formed by the back-to-back facings bowls. The presented LD fabrication method significantly enhances nanopore fabrication throughput and accuracy and hence can be adopted for a large range of biomolecular sensing applications.
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Affiliation(s)
- Eran Zvuloni
- Department
of Biomedical Engineering, Technion-IIT, Haifa 32000, Israel
| | - Adam Zrehen
- Department
of Biomedical Engineering, Technion-IIT, Haifa 32000, Israel
| | - Tal Gilboa
- Department
of Pathology, Brigham and Women’s
Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Wyss
Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States
| | - Amit Meller
- Department
of Biomedical Engineering, Technion-IIT, Haifa 32000, Israel
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28
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Yonker LM, Gilboa T, Ogata AF, Senussi Y, Lazarovits R, Boribong BP, Bartsch YC, Loiselle M, Rivas MN, Porritt RA, Lima R, Davis JP, Farkas EJ, Burns MD, Young N, Mahajan VS, Hajizadeh S, Lopez XIH, Kreuzer J, Morris R, Martinez EE, Han I, Griswold K, Barry NC, Thompson DB, Church G, Edlow AG, Haas W, Pillai S, Arditi M, Alter G, Walt DR, Fasano A. Multisystem inflammatory syndrome in children is driven by zonulin-dependent loss of gut mucosal barrier. J Clin Invest 2021; 131:149633. [PMID: 34032635 DOI: 10.1172/jci149633] [Citation(s) in RCA: 146] [Impact Index Per Article: 48.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/19/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUNDWeeks after SARS-CoV-2 infection or exposure, some children develop a severe, life-threatening illness called multisystem inflammatory syndrome in children (MIS-C). Gastrointestinal (GI) symptoms are common in patients with MIS-C, and a severe hyperinflammatory response ensues with potential for cardiac complications. The cause of MIS-C has not been identified to date.METHODSHere, we analyzed biospecimens from 100 children: 19 with MIS-C, 26 with acute COVID-19, and 55 controls. Stools were assessed for SARS-CoV-2 by reverse transcription PCR (RT-PCR), and plasma was examined for markers of breakdown of mucosal barrier integrity, including zonulin. Ultrasensitive antigen detection was used to probe for SARS-CoV-2 antigenemia in plasma, and immune responses were characterized. As a proof of concept, we treated a patient with MIS-C with larazotide, a zonulin antagonist, and monitored the effect on antigenemia and the patient's clinical response.RESULTSWe showed that in children with MIS-C, a prolonged presence of SARS-CoV-2 in the GI tract led to the release of zonulin, a biomarker of intestinal permeability, with subsequent trafficking of SARS-CoV-2 antigens into the bloodstream, leading to hyperinflammation. The patient with MIS-C treated with larazotide had a coinciding decrease in plasma SARS-CoV-2 spike antigen levels and inflammatory markers and a resultant clinical improvement above that achieved with currently available treatments.CONCLUSIONThese mechanistic data on MIS-C pathogenesis provide insight into targets for diagnosing, treating, and preventing MIS-C, which are urgently needed for this increasingly common severe COVID-19-related disease in children.
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Affiliation(s)
- Lael M Yonker
- Mucosal Immunology and Biology Research Center and.,Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Tal Gilboa
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Alana F Ogata
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Yasmeen Senussi
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Roey Lazarovits
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Brittany P Boribong
- Mucosal Immunology and Biology Research Center and.,Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Yannic C Bartsch
- Harvard Medical School, Boston, Massachusetts, USA.,Ragon Institute of MIT, MGH and Harvard, Cambridge, Massachusetts, USA
| | | | - Magali Noval Rivas
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rebecca A Porritt
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Rosiane Lima
- Mucosal Immunology and Biology Research Center and
| | | | - Eva J Farkas
- Mucosal Immunology and Biology Research Center and
| | | | - Nicola Young
- Mucosal Immunology and Biology Research Center and
| | - Vinay S Mahajan
- Harvard Medical School, Boston, Massachusetts, USA.,Ragon Institute of MIT, MGH and Harvard, Cambridge, Massachusetts, USA
| | - Soroush Hajizadeh
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Xcanda I Herrera Lopez
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Johannes Kreuzer
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Robert Morris
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Enid E Martinez
- Mucosal Immunology and Biology Research Center and.,Harvard Medical School, Boston, Massachusetts, USA.,Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Isaac Han
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Kettner Griswold
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Nicholas C Barry
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - David B Thompson
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - George Church
- Harvard Medical School, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.,Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea G Edlow
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and.,Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Wilhelm Haas
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Shiv Pillai
- Harvard Medical School, Boston, Massachusetts, USA.,Ragon Institute of MIT, MGH and Harvard, Cambridge, Massachusetts, USA
| | - Moshe Arditi
- Department of Pediatrics, Division of Infectious Diseases and Immunology, Infectious and Immunologic Diseases Research Center (IIDRC) and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Galit Alter
- Harvard Medical School, Boston, Massachusetts, USA.,Ragon Institute of MIT, MGH and Harvard, Cambridge, Massachusetts, USA
| | - David R Walt
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Alessio Fasano
- Mucosal Immunology and Biology Research Center and.,Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,European Biomedical Research Institute of Salerno (EBRIS), Salerno, Italy
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29
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Ogata AF, Maley AM, Wu C, Gilboa T, Norman M, Lazarovits R, Mao CP, Newton G, Chang M, Nguyen K, Kamkaew M, Zhu Q, Gibson TE, Ryan ET, Charles RC, Marasco WA, Walt DR. Ultra-Sensitive Serial Profiling of SARS-CoV-2 Antigens and Antibodies in Plasma to Understand Disease Progression in COVID-19 Patients with Severe Disease. Clin Chem 2021; 66:1562-1572. [PMID: 32897389 DOI: 10.1093/clinchem/hvaa213] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [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: 08/16/2020] [Accepted: 09/01/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 21 million people worldwide since August 16, 2020. Compared to PCR and serology tests, SARS-CoV-2 antigen assays are underdeveloped, despite their potential to identify active infection and monitor disease progression. METHODS We used Single Molecule Array (Simoa) assays to quantitatively detect SARS-CoV-2 spike, S1 subunit, and nucleocapsid antigens in the plasma of patients with coronavirus disease (COVID-19). We studied plasma from 64 patients who were COVID-19 positive, 17 who were COVID-19 negative, and 34 prepandemic patients. Combined with Simoa anti-SARS-CoV-2 serological assays, we quantified changes in 31 SARS-CoV-2 biomarkers in 272 longitudinal plasma samples obtained for 39 patients with COVID-19. Data were analyzed by hierarchical clustering and were compared to longitudinal RT-PCR test results and clinical outcomes. RESULTS SARS-CoV-2 S1 and N antigens were detectable in 41 out of 64 COVID-19 positive patients. In these patients, full antigen clearance in plasma was observed a mean ± 95% CI of 5 ± 1 days after seroconversion and nasopharyngeal RT-PCR tests reported positive results for 15 ± 5 days after viral-antigen clearance. Correlation between patients with high concentrations of S1 antigen and ICU admission (77%) and time to intubation (within 1 day) was statistically significant. CONCLUSIONS The reported SARS-CoV-2 Simoa antigen assay is the first to detect viral antigens in the plasma of patients who were COVID-19 positive to date. These data show that SARS-CoV-2 viral antigens in the blood are associated with disease progression, such as respiratory failure, in COVID-19 cases with severe disease.
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Affiliation(s)
- Alana F Ogata
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
| | - Adam M Maley
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
| | - Connie Wu
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
| | - Tal Gilboa
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
| | - Maia Norman
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Tufts University School of Medicine, Boston, MA
| | - Roey Lazarovits
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Chih-Ping Mao
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Gail Newton
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Matthew Chang
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA
| | - Katrina Nguyen
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA
| | - Maliwan Kamkaew
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA
| | - Quan Zhu
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - Travis E Gibson
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Edward T Ryan
- Department of Medicine, Harvard Medical School, Boston, MA.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA.,Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Richelle C Charles
- Department of Medicine, Harvard Medical School, Boston, MA.,Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA
| | - Wayne A Marasco
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA.,Harvard Medical School, Boston, MA
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30
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Trombetta BA, Kandigian SE, Kitchen RR, Grauwet K, Webb PK, Miller GA, Jennings CG, Jain S, Miller S, Kuo Y, Sweeney T, Gilboa T, Norman M, Simmons DP, Ramirez CE, Bedard M, Fink C, Ko J, De León Peralta EJ, Watts G, Gomez-Rivas E, Davis V, Barilla RM, Wang J, Cunin P, Bates S, Morrison-Smith C, Nicholson B, Wong E, El-Mufti L, Kann M, Bolling A, Fortin B, Ventresca H, Zhou W, Pardo S, Kwock M, Hazra A, Cheng L, Ahmad QR, Toombs JA, Larson R, Pleskow H, Luo NM, Samaha C, Pandya UM, De Silva P, Zhou S, Ganhadeiro Z, Yohannes S, Gay R, Slavik J, Mukerji SS, Jarolim P, Walt DR, Carlyle BC, Ritterhouse LL, Suliman S. Correction to: Evaluation of serological lateral flow assays for severe acute respiratory syndrome coronavirus-2. BMC Infect Dis 2021; 21:628. [PMID: 34210278 PMCID: PMC8246132 DOI: 10.1186/s12879-021-06333-y] [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: 11/10/2022] Open
Affiliation(s)
- Bianca A Trombetta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Savannah E Kandigian
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Robert R Kitchen
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Mass General Brigham Innovation, Boston, MA, USA
| | - Korneel Grauwet
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Pia Kivisäkk Webb
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Charles G Jennings
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA.,Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sejal Jain
- Department of Medical Oncology and Center for Cancer-Genome Discovery, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Samara Miller
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA.,Harvard Stem Cell Institute, Cambridge, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Yikai Kuo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA.,Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Thadryan Sweeney
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Maia Norman
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Sackler School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Daimon P Simmons
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher E Ramirez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Melissa Bedard
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine Fink
- Medical Diagnostic Technology Evaluation, LLC, Carlisle, MA, USA
| | - Jina Ko
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Esmarline J De León Peralta
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.,Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA.,Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Gerald Watts
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Emma Gomez-Rivas
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Vannessa Davis
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rocky M Barilla
- Evergrande Center for Immunologic Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Jianing Wang
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Pierre Cunin
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Samuel Bates
- Functional Genomics Laboratory, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Chevaun Morrison-Smith
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin Nicholson
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Edmond Wong
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Leena El-Mufti
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Michael Kann
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Anna Bolling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Brooke Fortin
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Hayden Ventresca
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Wen Zhou
- Division of Nephrology and Endocrine Unit Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Santiago Pardo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Megan Kwock
- Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA, USA
| | - Aditi Hazra
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Division of Preventative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Leo Cheng
- Radiology and pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Rushdy Ahmad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - James A Toombs
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca Larson
- Immunology Program, Harvard Medical School, Boston, MA, USA.,Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Haley Pleskow
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.,Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Unnati M Pandya
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Vincent Center for Reproductive Biology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Pushpamali De Silva
- Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA
| | - Sally Zhou
- Department of Biology, Northeastern University, Boston, MA, USA.,College of Science, Northeastern University, Boston, MA, USA
| | - Zakary Ganhadeiro
- Department of Biology, Northeastern University, Boston, MA, USA.,College of Science, Northeastern University, Boston, MA, USA
| | - Sara Yohannes
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rakiesha Gay
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA.,College of Science, Northeastern University, Boston, MA, USA
| | - Jacqueline Slavik
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Shibani S Mukerji
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Petr Jarolim
- Department of Pathology, Harvard Medical School, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David R Walt
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Becky C Carlyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lauren L Ritterhouse
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA.,Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Sara Suliman
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA. .,Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA.
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31
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Nilles EJ, Karlson EW, Norman M, Gilboa T, Fischinger S, Atyeo C, Zhou G, Bennett CL, Tolan NV, Oganezova K, Walt DR, Alter G, Simmons DP, Schur P, Jarolim P, Woolley AE, Baden LR. Evaluation of Three Commercial and Two Non-Commercial Immunoassays for the Detection of Prior Infection to SARS-CoV-2. J Appl Lab Med 2021; 6:1561-1570. [PMID: 34196711 PMCID: PMC8420636 DOI: 10.1093/jalm/jfab072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/03/2021] [Accepted: 06/15/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Serological testing provides a record of prior infection with SARS-CoV-2, but assay performance requires independent assessment. METHODS We evaluated 3 commercial (Roche Diagnostics pan-IG, and Epitope Diagnostics IgM and IgG) and 2 non-commercial (Simoa and Ragon/MGH IgG) immunoassays against 1083 unique samples that included 251 PCR-positive and 832 prepandemic samples. RESULTS The Roche assay registered the highest specificity 99.6% (3/832 false positives), the Ragon/MGH assay 99.5% (4/832), the primary Simoa assay model 99.0% (8/832), and the Epitope IgG and IgM 99.0% (8/830) and 99.5% (4/830), respectively. Overall sensitivities for the Simoa, Roche pan-IG, Epitope IgG, Ragon/MGH IgG, and Epitope IgM were 92.0%, 82.9%, 82.5%, 64.5% and 47.0%, respectively. The Simoa immunoassay demonstrated the highest sensitivity among samples stratified by days postsymptom onset (PSO), <8 days PSO (57.69%) 8-14 days PSO (93.51%), 15-21 days PSO (100%), and > 21 days PSO (95.18%). CONCLUSIONS All assays demonstrated high to very high specificities while sensitivities were variable across assays.
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Affiliation(s)
- Eric J Nilles
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Elizabeth W Karlson
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA,Address correspondence to this author at: Brigham and Women’s Hospital, 75 Francis St., Boston, MA 02115, USA. Fax 508-785-0351; e-mail
| | - Maia Norman
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA,Tufts University School of Medicine, Boston, MA,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Tal Gilboa
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | | | | | - Guohai Zhou
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Christopher L Bennett
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA,Massachusetts General Hospital, Boston, MA
| | - Nicole V Tolan
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | | | - David R Walt
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA
| | - Galit Alter
- Harvard Medical School, Boston, MA,Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA,Harvard T.H. Chan School of Public Health, Boston, MA
| | - Daimon P Simmons
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Peter Schur
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Petr Jarolim
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Ann E Woolley
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Lindsey R Baden
- Brigham and Women’s Hospital, Boston, MA,Harvard Medical School, Boston, MA
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32
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Trombetta BA, Kandigian SE, Kitchen RR, Grauwet K, Webb PK, Miller GA, Jennings CG, Jain S, Miller S, Kuo Y, Sweeney T, Gilboa T, Norman M, Simmons DP, Ramirez CE, Bedard M, Fink C, Ko J, De León Peralta EJ, Watts G, Gomez-Rivas E, Davis V, Barilla RM, Wang J, Cunin P, Bates S, Morrison-Smith C, Nicholson B, Wong E, El-Mufti L, Kann M, Bolling A, Fortin B, Ventresca H, Zhou W, Pardo S, Kwock M, Hazra A, Cheng L, Ahmad QR, Toombs JA, Larson R, Pleskow H, Luo NM, Samaha C, Pandya UM, De Silva P, Zhou S, Ganhadeiro Z, Yohannes S, Gay R, Slavik J, Mukerji SS, Jarolim P, Walt DR, Carlyle BC, Ritterhouse LL, Suliman S. Evaluation of serological lateral flow assays for severe acute respiratory syndrome coronavirus-2. BMC Infect Dis 2021; 21:580. [PMID: 34134647 PMCID: PMC8206878 DOI: 10.1186/s12879-021-06257-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/25/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND COVID-19 has resulted in significant morbidity and mortality worldwide. Lateral flow assays can detect anti-Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) antibodies to monitor transmission. However, standardized evaluation of their accuracy and tools to aid in interpreting results are needed. METHODS We evaluated 20 IgG and IgM assays selected from available tests in April 2020. We evaluated the assays' performance using 56 pre-pandemic negative and 56 SARS-CoV-2-positive plasma samples, collected 10-40 days after symptom onset, confirmed by a molecular test and analyzed by an ultra-sensitive immunoassay. Finally, we developed a user-friendly web app to extrapolate the positive predictive values based on their accuracy and local prevalence. RESULTS Combined IgG + IgM sensitivities ranged from 33.9 to 94.6%, while combined specificities ranged from 92.6 to 100%. The highest sensitivities were detected in Lumiquick for IgG (98.2%), BioHit for both IgM (96.4%), and combined IgG + IgM sensitivity (94.6%). Furthermore, 11 LFAs and 8 LFAs showed perfect specificity for IgG and IgM, respectively, with 15 LFAs showing perfect combined IgG + IgM specificity. Lumiquick had the lowest estimated limit-of-detection (LOD) (0.1 μg/mL), followed by a similar LOD of 1.5 μg/mL for CareHealth, Cellex, KHB, and Vivachek. CONCLUSION We provide a public resource of the accuracy of select lateral flow assays with potential for home testing. The cost-effectiveness, scalable manufacturing process, and suitability for self-testing makes LFAs an attractive option for monitoring disease prevalence and assessing vaccine responsiveness. Our web tool provides an easy-to-use interface to demonstrate the impact of prevalence and test accuracy on the positive predictive values.
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Affiliation(s)
- Bianca A Trombetta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Savannah E Kandigian
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Robert R Kitchen
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Mass General Brigham Innovation, Boston, MA, USA
| | - Korneel Grauwet
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Pia Kivisäkk Webb
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Charles G Jennings
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sejal Jain
- Department of Medical Oncology and Center for Cancer-Genome Discovery, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Samara Miller
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Center for Regenerative Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Stem Cell Institute, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Yikai Kuo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Thadryan Sweeney
- Cardiology Division, Massachusetts General Hospital, Charlestown, MA, USA
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Maia Norman
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Sackler School of Biomedical Sciences, Tufts University School of Medicine, Boston, MA, USA
| | - Daimon P Simmons
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Christopher E Ramirez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Melissa Bedard
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Catherine Fink
- Medical Diagnostic Technology Evaluation, LLC, Carlisle, MA, USA
| | - Jina Ko
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA, USA
| | - Esmarline J De León Peralta
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Gerald Watts
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Emma Gomez-Rivas
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Vannessa Davis
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rocky M Barilla
- Evergrande Center for Immunologic Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Jianing Wang
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Pierre Cunin
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA
| | - Samuel Bates
- Functional Genomics Laboratory, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Chevaun Morrison-Smith
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin Nicholson
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Edmond Wong
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Leena El-Mufti
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Michael Kann
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Anna Bolling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Brooke Fortin
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Hayden Ventresca
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Wen Zhou
- Division of Nephrology and Endocrine Unit Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Santiago Pardo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Megan Kwock
- Cancer Center Protocol Office, Massachusetts General Hospital, Boston, MA, USA
| | - Aditi Hazra
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Preventative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Leo Cheng
- Radiology and pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Rushdy Ahmad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - James A Toombs
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca Larson
- Immunology Program, Harvard Medical School, Boston, MA, USA
- Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Haley Pleskow
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Unnati M Pandya
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Vincent Center for Reproductive Biology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Pushpamali De Silva
- Wellman Center for Photomedicine, Massachusetts General Research Institute, Boston, MA, USA
| | - Sally Zhou
- Department of Biology, Northeastern University, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Zakary Ganhadeiro
- Department of Biology, Northeastern University, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Sara Yohannes
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Rakiesha Gay
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
- College of Science, Northeastern University, Boston, MA, USA
| | - Jacqueline Slavik
- Brigham Research Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Shibani S Mukerji
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
| | - Petr Jarolim
- Department of Pathology, Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David R Walt
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Becky C Carlyle
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lauren L Ritterhouse
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA
| | - Sara Suliman
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, MA, USA.
- Mass General Brigham COVID Center for Innovation, Diagnostics Accelerator, Boston, MA, USA.
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33
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Brukner AM, Billington S, Benifla M, Nguyen TB, Han H, Bennett O, Gilboa T, Blatch D, Fellig Y, Volkov O, Unadkat JD, Ekstein D, Eyal S. Abundance of P-glycoprotein and Breast Cancer Resistance Protein Measured by Targeted Proteomics in Human Epileptogenic Brain Tissue. Mol Pharm 2021; 18:2263-2273. [PMID: 34008992 PMCID: PMC8488956 DOI: 10.1021/acs.molpharmaceut.1c00083] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
![]()
Our goal was to measure the absolute
differential abundance of
key drug transporters in human epileptogenic brain tissue and to compare
them between patients and at various distances from the epileptogenic
zone within the same patient. Transporter protein abundance was quantified
in brain tissue homogenates from patients who underwent epilepsy surgery,
using targeted proteomics, and correlations with clinical and tissue
characteristics were assessed. Fourteen brain samples (including four
epileptogenic hippocampal samples) were collected from nine patients.
Among the quantifiable drug transporters, the abundance (median, range)
ranked: breast cancer resistance protein (ABCG2/BCRP; 0.55, 0.01–3.26
pmol/g tissue) > P-glycoprotein (ABCB1/MDR1; 0.30,
0.02–1.15 pmol/g tissue) > equilibrative nucleoside transporter
1 (SLC29A1/ENT1; 0.06, 0.001–0.35 pmol/g tissue). The ABCB1/ABCG2
ratio (mean 0.27, range 0.08–0.47) was comparable with literature
values from nonepileptogenic brain tissue (mean 0.5–0.8). Transporter
abundance was lower in the hippocampi than in the less epileptogenic
neocortex of the same patients. ABCG2/BCRP and ABCB1/MDR1 expression
strongly correlated with that of glucose transporter 1 (SLC2A1/GLUT1)
(r = 0.97, p < 0.001; r = 0.90, p < 0.01, respectively). Low
transporter abundance was found in patients with overt vascular pathology,
whereas the highest abundance was seen in a sample with normally appearing
blood vessels. In conclusion, drug transporter abundance highly varies
across patients and between epileptogenic and less epileptogenic brain
tissue of the same patient. The strong correlation in abundance of
ABCB1/MDR1, ABCG2/BCRP, and SLC2A1/GLUT1 suggests variation in the
content of the functional vasculature within the tissue samples. The
epileptogenic tissue can be depleted of key drug transport mechanisms,
warranting consideration when selecting treatments for patients with
drug-resistant epilepsy.
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Affiliation(s)
- Aniv Mann Brukner
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Room 613, Ein Kerem, Jerusalem 91120, Israel
| | - Sarah Billington
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington 98195, United States
| | - Mony Benifla
- Children's Neurosurgery Department, Rambam Academic Hospital, Haifa 31999, Israel
| | - Tot Bui Nguyen
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington 98195, United States
| | - Hadas Han
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Room 613, Ein Kerem, Jerusalem 91120, Israel
| | - Odeya Bennett
- Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem 91031, Israel
| | - Tal Gilboa
- Neuropediatric Unit, Pediatrics Division, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel.,The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel
| | - Dana Blatch
- Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem 91120, Israel
| | - Yakov Fellig
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel.,Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Olga Volkov
- Nuclear Medicine Institute, Sheba Medical Center, Tel Hashomer 52621, Israel
| | - Jashvant D Unadkat
- Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington 98195, United States
| | - Dana Ekstein
- The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91120, Israel.,Department of Neurology, Agnes Ginges Center for Human Neurogenetics, Hadassah Medical Organization, Jerusalem 91120, Israel
| | - Sara Eyal
- Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, Room 613, Ein Kerem, Jerusalem 91120, Israel
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34
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Mysore V, Cullere X, Settles ML, Ji X, Kattan MW, Desjardins M, Durbin-Johnson B, Gilboa T, Baden LR, Walt DR, Lichtman A, Jehi L, Mayadas TN. Protective heterologous T cell immunity in COVID-19 induced by MMR and Tdap vaccine antigens. bioRxiv 2021:2021.05.03.441323. [PMID: 33972940 PMCID: PMC8109200 DOI: 10.1101/2021.05.03.441323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
T cells are critical for control of viral infection and effective vaccination. We investigated whether prior Measles-Mumps-Rubella (MMR) or Tetanus-Diphtheria-pertussis (Tdap) vaccination elicit cross-reactive T cells that mitigate COVID-19. Using co-cultures of antigen presenting cells (APC) loaded with antigens and autologous T cells, we found a high correlation between responses to SARS-CoV-2 (Spike-S1 and Nucleocapsid) and MMR and Tdap vaccine proteins in both SARS-CoV-2 infected individuals and individuals immunized with mRNA-based SARS-CoV-2 vaccines. The overlapping T cell population contained effector memory T cells (TEMRA) previously implicated in anti-viral immunity and their activation required APC-derived IL-15. TCR- and scRNA-sequencing detected cross-reactive clones with TEMRA features among the cells recognizing SARS-CoV-2, MMR and Tdap epitopes. A propensity-weighted analysis of 73,582 COVID-19 patients revealed that severe disease outcomes (hospitalization and transfer to intensive care unit or death) were reduced in MMR or Tdap vaccinated individuals by 38-32% and 23-20% respectively. In summary, SARS-CoV-2 re-activates memory T cells generated by Tdap and MMR vaccines, which may reduce disease severity.
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35
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Ter-Ovanesyan D, Gilboa T, Lazarovits R, Rosenthal A, Yu X, Li JZ, Church GM, Walt DR. Ultrasensitive Measurement of Both SARS-CoV-2 RNA and Antibodies from Saliva. Anal Chem 2021; 93:5365-5370. [PMID: 33755419 DOI: 10.1021/acs.analchem.1c00515] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Tests for COVID-19 generally measure SARS-CoV-2 viral RNA from nasal swabs or antibodies against the virus from blood. It has been shown, however, that both viral particles and antibodies against those particles are present in saliva, which is more accessible than both swabs and blood. We present methods for highly sensitive measurements of both viral RNA and antibodies from the same saliva sample. We developed an efficient saliva RNA extraction method and combined it with an ultrasensitive antibody test based on single molecule array (Simoa) technology. We apply our test to the saliva of patients who presented to the hospital with COVID-19 symptoms, some of whom tested positive with a conventional RT-qPCR nasopharyngeal swab test. We demonstrate that combining viral RNA detection by RT-qPCR with antibody detection by Simoa identifies more patients as infected than either method alone. Our results demonstrate the utility of combining viral RNA and antibody testing from saliva, a single easily accessible biofluid.
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Affiliation(s)
- Dmitry Ter-Ovanesyan
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States
| | - Tal Gilboa
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States.,Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, United States
| | - Roey Lazarovits
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States
| | - Alexandra Rosenthal
- Infectious Disease Division, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, United States
| | - Xu Yu
- Infectious Disease Division, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, United States.,Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts 02139, United States
| | - Jonathan Z Li
- Infectious Disease Division, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, United States
| | - George M Church
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States.,Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - David R Walt
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts 02115, United States.,Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, United States
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36
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Gilboa T, Maley AM, Ogata AF, Wu C, Walt DR. Sequential Protein Capture in Multiplex Single Molecule Arrays: A Strategy for Eliminating Assay Cross-Reactivity. Adv Healthc Mater 2021; 10:e2001111. [PMID: 32893488 PMCID: PMC8238389 DOI: 10.1002/adhm.202001111] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/12/2020] [Indexed: 12/31/2022]
Abstract
Measurements of multiple biomolecules within the same biological sample are important for many clinical applications to enable accurate disease diagnosis or classification. These disease-related biomarkers often exist at very low levels in biological fluids, necessitating ultrasensitive measurement methods. Single-molecule arrays (Simoa), a bead-based digital enzyme-linked immunosorbent assay, is the current state of the art for ultrasensitive protein detection and can detect sub-femtomolar protein concentrations, but its ability to achieve high-order multiplexing without cross-reactivity remains a challenge. Here, a sequential protein capture approach for multiplex Simoa assays is implemented to eliminate cross-reactivity between binding reagents by sequentially capturing each protein analyte and then incubating each capture bead with only its corresponding detection antibody. This strategy not only reduces cross-reactivity to background levels and significantly improves measurement accuracies, but also enables higher-order multiplexing. As a proof of concept, the sequential multiplex Simoa assay is used to measure five different cytokines in plasma samples from Coronavirus Disease 2019 (COVID-19) patients. The ultrasensitive sequential multiplex Simoa assays will enable the simultaneous measurements of multiple low-abundance analytes in a time- and cost-effective manner and will prove especially critical in many cases where sample volumes are limited.
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Affiliation(s)
- Tal Gilboa
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - Adam M Maley
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - Alana F Ogata
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - Connie Wu
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
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37
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Burck N, Gilboa T, Gadi A, Patkin Nehrer M, Schneider RJ, Meller A. Nanopore Identification of Single Nucleotide Mutations in Circulating Tumor DNA by Multiplexed Ligation. Clin Chem 2021; 67:753-762. [PMID: 33496315 DOI: 10.1093/clinchem/hvaa328] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Circulating tumor DNAs (ctDNAs) are highly promising cancer biomarkers, potentially applicable for noninvasive liquid biopsy and disease monitoring. However, to date, sequencing of ctDNAs has proven to be challenging primarily due to small sample size and high background of fragmented cell-free DNAs (cfDNAs) derived from normal cells in the circulation, specifically in early stage cancer. METHODS Solid-state nanopores (ssNPs) have recently emerged as a highly efficient tool for single-DNA sensing and analysis. Herein, we present a rapid nanopore genotyping strategy to enable an amplification-free identification and classification of ctDNA mutations. A biochemical ligation detection assay was used for the creation of specific fluorescently-labelled short DNA reporter molecules. Color conjugation with multiple fluorophores enabled a unique multi-color signature for different mutations, offering multiplexing potency. Single-molecule readout of the fluorescent labels was carried out by electro-optical sensing via solid-state nanopores drilled in titanium oxide membranes. RESULTS As proof of concept, we utilized our method to detect the presence of low-quantity ERBB2 F310S and PIK3Ca H1047R breast cancer mutations from both plasmids and xenograft mice blood samples. We demonstrated an ability to distinguish between a wild type and a mutated sample, and between the different mutations in the same sample. CONCLUSIONS Our method can potentially enable rapid and low cost ctDNA analysis that completely circumvents PCR amplification and library preparation. This approach will thus meet a currently unmet demand in terms of sensitivity, multiplexing and cost, opening new avenues for early diagnosis of cancer.
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Affiliation(s)
- Nitza Burck
- Department of Biomedical Engineering, Technion- IIT, Haifa, Israel
| | - Tal Gilboa
- Department of Biomedical Engineering, Technion- IIT, Haifa, Israel.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA
| | - Abhilash Gadi
- Department of Microbiology, NYU School of Medicine, New York, NY, USA
| | | | | | - Amit Meller
- Department of Biomedical Engineering, Technion- IIT, Haifa, Israel.,Russell Berrie Nanotechnology Institute, Technion- IIT, Haifa, Israel
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38
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Rozevsky Y, Gilboa T, van Kooten XF, Kobelt D, Huttner D, Stein U, Meller A. Quantification of mRNA Expression Using Single-Molecule Nanopore Sensing. ACS Nano 2020; 14:13964-13974. [PMID: 32930583 PMCID: PMC7510349 DOI: 10.1021/acsnano.0c06375] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
RNA quantification methods are broadly used in life science research and in clinical diagnostics. Currently, real-time reverse transcription polymerase chain reaction (RT-qPCR) is the most common analytical tool for RNA quantification. However, in cases of rare transcripts or inhibiting contaminants in the sample, an extensive amplification could bias the copy number estimation, leading to quantification errors and false diagnosis. Single-molecule techniques may bypass amplification but commonly rely on fluorescence detection and probe hybridization, which introduces noise and limits multiplexing. Here, we introduce reverse transcription quantitative nanopore sensing (RT-qNP), an RNA quantification method that involves synthesis and single-molecule detection of gene-specific cDNAs without the need for purification or amplification. RT-qNP allows us to accurately quantify the relative expression of metastasis-associated genes MACC1 and S100A4 in nonmetastasizing and metastasizing human cell lines, even at levels for which RT-qPCR quantification produces uncertain results. We further demonstrate the versatility of the method by adapting it to quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA against a human reference gene. This internal reference circumvents the need for producing a calibration curve for each measurement, an imminent requirement in RT-qPCR experiments. In summary, we describe a general method to process complicated biological samples with minimal losses, adequate for direct nanopore sensing. Thus, harnessing the sensitivity of label-free single-molecule counting, RT-qNP can potentially detect minute expression levels of RNA biomarkers or viral infection in the early stages of disease and provide accurate amplification-free quantification.
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Affiliation(s)
- Yana Rozevsky
- Department
of Biomedical Engineering, The Technion—IIT, Haifa 32000, Israel
| | - Tal Gilboa
- Department
of Biomedical Engineering, The Technion—IIT, Haifa 32000, Israel
- Department
of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States
- Wyss
Institute, Harvard University, Boston, Massachusetts 02115, United States
| | | | - Dennis Kobelt
- Experimental
and Clinical Research Center, Charité
Universitätsmedizin, Berlin 10117, Germany
- Max-Delbrück-Center
for Molecular Medicine in the Helmholtz Association, Berlin 13125, Germany
- German
Cancer Consortium, Heidelberg 69120, Germany
| | - Diana Huttner
- Department
of Biomedical Engineering, The Technion—IIT, Haifa 32000, Israel
| | - Ulrike Stein
- Experimental
and Clinical Research Center, Charité
Universitätsmedizin, Berlin 10117, Germany
- Max-Delbrück-Center
for Molecular Medicine in the Helmholtz Association, Berlin 13125, Germany
- German
Cancer Consortium, Heidelberg 69120, Germany
| | - Amit Meller
- Department
of Biomedical Engineering, The Technion—IIT, Haifa 32000, Israel
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39
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Norman M, Gilboa T, Ogata AF, Maley AM, Cohen L, Busch EL, Lazarovits R, Mao CP, Cai Y, Zhang J, Feldman JE, Hauser BM, Caradonna TM, Chen B, Schmidt AG, Alter G, Charles RC, Ryan ET, Walt DR. Ultrasensitive high-resolution profiling of early seroconversion in patients with COVID-19. Nat Biomed Eng 2020; 4:1180-1187. [PMID: 32948854 PMCID: PMC7498988 DOI: 10.1038/s41551-020-00611-x] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [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: 06/12/2020] [Accepted: 08/17/2020] [Indexed: 01/19/2023]
Abstract
Sensitive assays are essential for the accurate identification of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we report a multiplexed assay for the fluorescence-based detection of seroconversion in infected individuals from less than 1 µl of blood, and as early as the day of the first positive nucleic acid test after symptom onset. The assay uses dye-encoded antigen-coated beads to quantify the levels of immunoglobulin G (IgG), IgM and IgA antibodies against four SARS-CoV-2 antigens. A logistic regression model trained using samples collected during the pandemic and samples collected from healthy individuals and patients with respiratory infections before the first outbreak of coronavirus disease 2019 (COVID-19) was 99% accurate in the detection of seroconversion in a blinded validation cohort of samples collected before the pandemic and from patients with COVID-19 five or more days after a positive nasopharyngeal test by PCR with reverse transcription. The high-throughput serological profiling of patients with COVID-19 allows for the interrogation of interactions between antibody isotypes and viral proteins, and should help us to understand the heterogeneity of clinical presentations.
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Affiliation(s)
- Maia Norman
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Tufts University School of Medicine, Boston, MA, USA
| | - Tal Gilboa
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Alana F Ogata
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Adam M Maley
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Limor Cohen
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Department of Chemical Biology, Harvard University, Cambridge, MA, USA
| | - Evan L Busch
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Roey Lazarovits
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Chih-Ping Mao
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Yongfei Cai
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA
| | - Jun Zhang
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | - Blake M Hauser
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | | | - Bing Chen
- Division of Molecular Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Aaron G Schmidt
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.,Department of Microbiology, Harvard Medical School, Boston, MA, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA
| | - Richelle C Charles
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Edward T Ryan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA.,Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA. .,Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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40
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Nilles EJ, Karlson EW, Norman M, Gilboa T, Fischinger S, Atyeo C, Zhou G, Bennett CL, Tolan NV, Oganezova K, Walt DR, Alter G, Simmons DP, Schur P, Jarolim P, Baden LR. Evaluation of two commercial and two non-commercial immunoassays for the detection of prior infection to SARS-CoV-2. medRxiv 2020:2020.06.24.20139006. [PMID: 32607518 PMCID: PMC7325183 DOI: 10.1101/2020.06.24.20139006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Seroepidemiology is an important tool to characterize the epidemiology and immunobiology of SARS-CoV-2 but many immunoassays have not been externally validated raising questions about reliability of study findings. To ensure meaningful data, particularly in a low seroprevalence population, assays need to be rigorously characterized with high specificity. Methods We evaluated two commercial (Roche Diagnostics and Epitope Diagnostics IgM/IgG) and two non-commercial (Simoa and Ragon/MGH IgG) immunoassays against 68 confirmed positive and 232 pre-pandemic negative controls. Sensitivity was stratified by time from symptom onset. The Simoa multiplex assay applied three pre-defined algorithm models to determine sample result. Results The Roche and Ragon/MGH IgG assays each registered 1/232 false positive, the primary Simoa model registered 2/232 false positives, and the Epitope registered 2/230 and 3/230 false positives for the IgG and IgM assays respectively. Sensitivity >21 days post symptom-onset was 100% for all assays except Epitope IgM, but lower and/or with greater variability between assays for samples collected 9-14 days (67-100%) and 15-21 days (69-100%) post-symptom onset. The Simoa and Epitope IgG assays demonstrated excellent sensitivity earlier in the disease course. The Roche and Ragon/MGH IgG assays were less sensitive during early disease, particularly among immunosuppressed individuals. Conclusions The Epitope IgG demonstrated good sensitivity and specificity. The Roche and Ragon/MGH IgG assays registered rare false positives with lower early sensitivity. The Simoa assay primary model had excellent sensitivity and few false positives.
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Affiliation(s)
- Eric J Nilles
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | | | - Maia Norman
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Tufts University School of Medicine, Boston, MA
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA
| | - Tal Gilboa
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA
| | | | | | - Guohai Zhou
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Christopher L Bennett
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Boston, MA
| | - Nicole V Tolan
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | | | - David R Walt
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA
| | - Galit Alter
- Harvard Medical School, Boston, MA
- Ragon Institute of MGH, MIT and Harvard, Cambridge, MA
- Harvard T.H. Chan School of Public Health
| | - Daimon P Simmons
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Peter Schur
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Petr Jarolim
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Lindsey R Baden
- Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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41
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Norman M, Gilboa T, Ogata AF, Maley AM, Cohen L, Cai Y, Zhang J, Feldman JE, Hauser BM, Caradonna TM, Chen B, Schmidt AG, Alter G, Charles RC, Ryan ET, Walt DR. Ultra-Sensitive High-Resolution Profiling of Anti-SARS-CoV-2 Antibodies for Detecting Early Seroconversion in COVID-19 Patients. medRxiv 2020:2020.04.28.20083691. [PMID: 32511657 PMCID: PMC7277013 DOI: 10.1101/2020.04.28.20083691] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The COVID-19 pandemic continues to infect millions of people worldwide. In order to curb its spread and reduce morbidity and mortality, it is essential to develop sensitive and quantitative methods that identify infected individuals and enable accurate population-wide screening of both past and present infection. Here we show that Single Molecule Array assays detect seroconversion in COVID-19 patients as soon as one day after symptom onset using less than a microliter of blood. This multiplexed assay format allows us to quantitate IgG, IgM and IgA immunoglobulins against four SARS-CoV-2 targets, thereby interrogating 12 antibody isotype-viral protein interactions to give a high resolution profile of the immune response. Using a cohort of samples collected prior to the outbreak as well as samples collected during the pandemic, we demonstrate a sensitivity of 86% and a specificity of 100% during the first week of infection, and 100% sensitivity and specificity thereafter. This assay should become the gold standard for COVID19 serological profiling and will be a valuable tool for answering important questions about the heterogeneity of clinical presentation seen in the ongoing pandemic.
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42
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Hengel H, Bosso-Lefèvre C, Grady G, Szenker-Ravi E, Li H, Pierce S, Lebigot É, Tan TT, Eio MY, Narayanan G, Utami KH, Yau M, Handal N, Deigendesch W, Keimer R, Marzouqa HM, Gunay-Aygun M, Muriello MJ, Verhelst H, Weckhuysen S, Mahida S, Naidu S, Thomas TG, Lim JY, Tan ES, Haye D, Willemsen MAAP, Oegema R, Mitchell WG, Pierson TM, Andrews MV, Willing MC, Rodan LH, Barakat TS, van Slegtenhorst M, Gavrilova RH, Martinelli D, Gilboa T, Tamim AM, Hashem MO, AlSayed MD, Abdulrahim MM, Al-Owain M, Awaji A, Mahmoud AAH, Faqeih EA, Asmari AA, Algain SM, Jad LA, Aldhalaan HM, Helbig I, Koolen DA, Riess A, Kraegeloh-Mann I, Bauer P, Gulsuner S, Stamberger H, Ng AYJ, Tang S, Tohari S, Keren B, Schultz-Rogers LE, Klee EW, Barresi S, Tartaglia M, Mor-Shaked H, Maddirevula S, Begtrup A, Telegrafi A, Pfundt R, Schüle R, Ciruna B, Bonnard C, Pouladi MA, Stewart JC, Claridge-Chang A, Lefeber DJ, Alkuraya FS, Mathuru AS, Venkatesh B, Barycki JJ, Simpson MA, Jamuar SS, Schöls L, Reversade B. Loss-of-function mutations in UDP-Glucose 6-Dehydrogenase cause recessive developmental epileptic encephalopathy. Nat Commun 2020; 11:595. [PMID: 32001716 PMCID: PMC6992768 DOI: 10.1038/s41467-020-14360-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/19/2019] [Indexed: 12/16/2022] Open
Abstract
Developmental epileptic encephalopathies are devastating disorders characterized by intractable epileptic seizures and developmental delay. Here, we report an allelic series of germline recessive mutations in UGDH in 36 cases from 25 families presenting with epileptic encephalopathy with developmental delay and hypotonia. UGDH encodes an oxidoreductase that converts UDP-glucose to UDP-glucuronic acid, a key component of specific proteoglycans and glycolipids. Consistent with being loss-of-function alleles, we show using patients' primary fibroblasts and biochemical assays, that these mutations either impair UGDH stability, oligomerization, or enzymatic activity. In vitro, patient-derived cerebral organoids are smaller with a reduced number of proliferating neuronal progenitors while mutant ugdh zebrafish do not phenocopy the human disease. Our study defines UGDH as a key player for the production of extracellular matrix components that are essential for human brain development. Based on the incidence of variants observed, UGDH mutations are likely to be a frequent cause of recessive epileptic encephalopathy.
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Affiliation(s)
- Holger Hengel
- Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Célia Bosso-Lefèvre
- Institute of Medical Biology, A*STAR, Biopolis, Singapore, 138648, Singapore
- National University of Singapore, Department of Paediatrics, Yong Loo Lin School of Medicine, Biopolis, Singapore, Singapore
| | - George Grady
- Department of Molecular and Structural Biochemistry North Carolina State University, Raleigh, NC, 27607, USA
| | | | - Hankun Li
- Yale-NUS College, 12 College Avenue West, Biopolis, Singapore, Singapore
| | - Sarah Pierce
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Élise Lebigot
- Service De Biochimie, Hopital Bicêtre, Assistance publique-Hôpitaux de Paris, 78 avenue du general leclerc, Le Kremlin Bicêtre, France
| | - Thong-Teck Tan
- Institute of Medical Biology, Singapore Stem Cell Bank, A∗STAR, Biopolis, Singapore, 138648, Singapore
| | - Michelle Y Eio
- Institute of Medical Biology, Singapore Stem Cell Bank, A∗STAR, Biopolis, Singapore, 138648, Singapore
| | - Gunaseelan Narayanan
- Institute of Medical Biology, Singapore Stem Cell Bank, A∗STAR, Biopolis, Singapore, 138648, Singapore
| | - Kagistia Hana Utami
- Translational Laboratory in Genetic Medicine, Agency for Science, Technology, and Research, Singapore (A*STAR), 8A Biomedical Grove, Immunos, Level 5, Singapore, 138648, Singapore
| | - Monica Yau
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Department of Molecular Genetics, The University of Toronto, Toronto, ON, Canada
| | - Nader Handal
- Caritas Baby Hospital Bethlehem, Bethlehem, State of Palestine
| | | | - Reinhard Keimer
- Ped Neurology, Staufer Hospital, Wetzgauer Straße 85, Schwäbisch-Gmünd, Germany
| | | | - Meral Gunay-Aygun
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Michael J Muriello
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Helene Verhelst
- Department of Paediatric Neurology, Ghent University Hospital, Ghent, Belgium
| | - Sarah Weckhuysen
- Center for Molecular Neurology, VIB, Antwerp, Belgium
- Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology, University Hospital Antwerp, Antwerp, Belgium
| | - Sonal Mahida
- Division of Neurology and Neurogenetics, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Sakkubai Naidu
- Division of Neurology and Neurogenetics, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Terrence G Thomas
- Neurology Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jiin Ying Lim
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Genomic Medicine Centre, Singapore, Singapore
| | - Ee Shien Tan
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Genomic Medicine Centre, Singapore, Singapore
| | - Damien Haye
- Service de Génétique Médicale, CHU De Nice Hôpital de l'Archet 2, 151 route Saint Antoine de la Ginestière, CS 23079 062002, Nice, Cedex 3, France
| | - Michèl A A P Willemsen
- Department of Pediatric Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Renske Oegema
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wendy G Mitchell
- Neurology Division, Childrens Hospital Los Angeles & Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles, CA, 90033, USA
| | - Tyler Mark Pierson
- Department of Pediatrics, Department of Neurology, & the Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Marisa V Andrews
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Marcia C Willing
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Lance H Rodan
- Division of Genetics and Genomics and Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Tahsin Stefan Barakat
- Department of Clinical Genetics, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Marjon van Slegtenhorst
- Department of Clinical Genetics, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Ralitza H Gavrilova
- Department of Clinical Genomics, Mayo Clinic, 200 First Street SW, Rochester, MN, USA
| | - Diego Martinelli
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, viale San Paolo 15, 00146, Rome, Italy
| | - Tal Gilboa
- Child Neurology Unit, Hadassah-Hebrew University Medical Center, 9112001, Jerusalem, Israel
| | - Abdullah M Tamim
- Pediatric Neurology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mais O Hashem
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Moeenaldeen D AlSayed
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Maha M Abdulrahim
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohammed Al-Owain
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ali Awaji
- Department of Pediatrics, King Fahad Central Hospital in Jizan, Abu Arish, Saudi Arabia
| | - Adel A H Mahmoud
- Pediatric Neurology Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Eissa A Faqeih
- Section of Medical Genetics, Children's Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ali Al Asmari
- Section of Medical Genetics, Children's Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Sulwan M Algain
- General Pediatrics and Adolescents, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Lamyaa A Jad
- Pediatric Neurology Department, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Hesham M Aldhalaan
- Neuroscience Department King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ingo Helbig
- Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - David A Koolen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Angelika Riess
- Institute of Medical Genetics and Applied Genomics (Tübingen) and Centogene AG (Rostock), Rostock, Germany
| | | | - Peter Bauer
- Institute of Medical Genetics and Applied Genomics (Tübingen) and Centogene AG (Rostock), Rostock, Germany
| | - Suleyman Gulsuner
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Hannah Stamberger
- Center for Molecular Neurology, VIB, Antwerp, Belgium
- Laboratory of Neurogenetics, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology, University Hospital Antwerp, Antwerp, Belgium
| | - Alvin Yu Jin Ng
- Institute of Molecular and Cell Biology, A*STAR, Biopolis, Singapore, 138673, Singapore
| | - Sha Tang
- Division of Clinical Genomics, Ambry Genetics, Aliso Viejo, CA, USA
| | - Sumanty Tohari
- Institute of Molecular and Cell Biology, A*STAR, Biopolis, Singapore, 138673, Singapore
| | - Boris Keren
- APHP, GH Pitié Salpêtrière, Department of Genetics, Unit of Development Genomics, Paris, France
| | | | - Eric W Klee
- Department of Clinical Genomics, Mayo Clinic, 200 First Street SW, Rochester, MN, USA
| | - Sabina Barresi
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, viale San Paolo 15, 00146, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, viale San Paolo 15, 00146, Rome, Italy
| | - Hagar Mor-Shaked
- Department of Genetic and Metabolic Diseases, Hadassah-Hebrew University Medical Center, 9112001, Jerusalem, Israel
| | - Sateesh Maddirevula
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Amber Begtrup
- GeneDx, 207 Perry Parkway, Gaithersburg, MD, 20877, USA
| | | | - Rolph Pfundt
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rebecca Schüle
- Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Brian Ciruna
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, Department of Molecular Genetics, The University of Toronto, Toronto, ON, Canada
| | - Carine Bonnard
- Institute of Medical Biology, A*STAR, Biopolis, Singapore, 138648, Singapore
| | - Mahmoud A Pouladi
- Translational Laboratory in Genetic Medicine, Agency for Science, Technology, and Research, Singapore (A*STAR), 8A Biomedical Grove, Immunos, Level 5, Singapore, 138648, Singapore
- Department of Physiology, National University of Singapore, Singapore, 117597, Singapore
- Department of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - James C Stewart
- Institute of Molecular and Cell Biology, A*STAR, Biopolis, Singapore, 138673, Singapore
| | - Adam Claridge-Chang
- Institute of Molecular and Cell Biology, A*STAR, Biopolis, Singapore, 138673, Singapore
- Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore, Singapore
| | - Dirk J Lefeber
- Department of Neurology, Donders Center for Brain, Cognition, and Behavior, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Translational Metabolic Laboratory, Nijmegen, The Netherlands
| | - Fowzan S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ajay S Mathuru
- Yale-NUS College, 12 College Avenue West, Biopolis, Singapore, Singapore
- Institute of Molecular and Cell Biology, A*STAR, Biopolis, Singapore, 138673, Singapore
| | - Byrappa Venkatesh
- National University of Singapore, Department of Paediatrics, Yong Loo Lin School of Medicine, Biopolis, Singapore, Singapore
- Institute of Molecular and Cell Biology, A*STAR, Biopolis, Singapore, 138673, Singapore
| | - Joseph J Barycki
- Department of Molecular and Structural Biochemistry North Carolina State University, Raleigh, NC, 27607, USA
| | - Melanie A Simpson
- Department of Molecular and Structural Biochemistry North Carolina State University, Raleigh, NC, 27607, USA
| | - Saumya S Jamuar
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
- Paediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
- SingHealth Duke-NUS Genomic Medicine Centre, Singapore, Singapore
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore, Singapore
| | - Ludger Schöls
- Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
- German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany.
| | - Bruno Reversade
- Institute of Medical Biology, A*STAR, Biopolis, Singapore, 138648, Singapore.
- National University of Singapore, Department of Paediatrics, Yong Loo Lin School of Medicine, Biopolis, Singapore, Singapore.
- Institute of Molecular and Cell Biology, A*STAR, Biopolis, Singapore, 138673, Singapore.
- Medical Genetics Department, Koç University School of Medicine, 34010, Istanbul, Turkey.
- Reproductive Biology Laboratory, Obstetrics and Gynaecology, Academic Medical Center (AMC), Meibergdreef 9, 1105 AZ, Amsterdam-Zuidoost, The Netherlands.
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Fichtman B, Harel T, Biran N, Zagairy F, Applegate CD, Salzberg Y, Gilboa T, Salah S, Shaag A, Simanovsky N, Ayoubieh H, Sobreira N, Punzi G, Pierri CL, Hamosh A, Elpeleg O, Harel A, Edvardson S. Pathogenic Variants in NUP214 Cause "Plugged" Nuclear Pore Channels and Acute Febrile Encephalopathy. Am J Hum Genet 2019; 105:48-64. [PMID: 31178128 DOI: 10.1016/j.ajhg.2019.05.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 05/06/2019] [Indexed: 12/15/2022] Open
Abstract
We report biallelic missense and frameshift pathogenic variants in the gene encoding human nucleoporin NUP214 causing acute febrile encephalopathy. Clinical symptoms include neurodevelopmental regression, seizures, myoclonic jerks, progressive microcephaly, and cerebellar atrophy. NUP214 and NUP88 protein levels were reduced in primary skin fibroblasts derived from affected individuals, while the total number and density of nuclear pore complexes remained normal. Nuclear transport assays exhibited defects in the classical protein import and mRNA export pathways in affected cells. Direct surface imaging of fibroblast nuclei by scanning electron microscopy revealed a large increase in the presence of central particles (known as "plugs") in the nuclear pore channels of affected cells. This observation suggests that large transport cargoes may be delayed in passage through the nuclear pore channel, affecting its selective barrier function. Exposure of fibroblasts from affected individuals to heat shock resulted in a marked delay in their stress response, followed by a surge in apoptotic cell death. This suggests a mechanistic link between decreased cell survival in cell culture and severe fever-induced brain damage in affected individuals. Our study provides evidence by direct imaging at the single nuclear pore level of functional changes linked to a human disease.
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Affiliation(s)
- Boris Fichtman
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Tamar Harel
- Department of Genetic and Metabolic Diseases, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Nitzan Biran
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Fadia Zagairy
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Carolyn D Applegate
- McKusick-Nathans Institute of Genetic Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Yuval Salzberg
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Tal Gilboa
- Pediatric Neurology Unit, Hadassah-Hebrew University Medical Center, Jerusalem 91240, Israel
| | - Somaya Salah
- Department of Genetic and Metabolic Diseases, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Avraham Shaag
- Department of Genetic and Metabolic Diseases, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; Monique and Jacques Roboh Department of Genetic Research, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Natalia Simanovsky
- Department of Medical Imaging, Hadassah Medical Center, Jerusalem 91240, Israel
| | - Houriya Ayoubieh
- McKusick-Nathans Institute of Genetic Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Baylor-Hopkins Center for Mendelian Genomics, Jerusalem 91240, Israel, Jerusalem 91240, Israel
| | - Nara Sobreira
- McKusick-Nathans Institute of Genetic Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Baylor-Hopkins Center for Mendelian Genomics, Jerusalem 91240, Israel, Jerusalem 91240, Israel
| | - Giuseppe Punzi
- Laboratory of Biochemistry, Molecular and Computational Biology; Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, 70125 Bari, Italy
| | - Ciro Leonardo Pierri
- Laboratory of Biochemistry, Molecular and Computational Biology; Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, 70125 Bari, Italy
| | - Ada Hamosh
- McKusick-Nathans Institute of Genetic Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; Baylor-Hopkins Center for Mendelian Genomics, Jerusalem 91240, Israel, Jerusalem 91240, Israel
| | - Orly Elpeleg
- Department of Genetic and Metabolic Diseases, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; Monique and Jacques Roboh Department of Genetic Research, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Amnon Harel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel.
| | - Simon Edvardson
- Pediatric Neurology Unit, Hadassah-Hebrew University Medical Center, Jerusalem 91240, Israel; Monique and Jacques Roboh Department of Genetic Research, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
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Wang R, Gilboa T, Song J, Huttner D, Grinstaff MW, Meller A. Single-Molecule Discrimination of Labeled DNAs and Polypeptides Using Photoluminescent-Free TiO 2 Nanopores. ACS Nano 2018; 12:11648-11656. [PMID: 30372037 DOI: 10.1021/acsnano.8b07055] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Multicolor fluorescence substantially expands the sensing capabilities of nanopores by complementing or substituting the resistive pulsing signals. However, to date single-fluorophore detection in multiple color channels has proven to be challenging primarily due to high photoluminescence (PL) emanating from the silicon nitride (SiN x) membrane. We hypothesize that the high bandgap of titanium oxide (TiO2) would eliminate the PL background when used as a substrate for a nanopore, and hence enable individual fluorophore sensing during the fast passage of biomolecules through the pore. Herein, we introduce a method for fabricating locally supported, free-standing, TiO2 membranes, in which solid-state nanopores can be readily drilled. These devices produce essentially no PL in the blue-to-red visible spectral range, even when excited by multiple lasers simultaneously. At the same time, the TiO2 nanopores exhibit low electrical noise comparable with standard SiN x devices. Importantly, the optical signal-to-background ratio (SBR) in single-molecule sensing is improved by an order of magnitude, enabling the differentiation among labeled DNA molecules of similar length based solely on their labeling scheme. Finally, the increased SBR of the TiO2 devices allows detection of single fluorophores conjugated to the lysine or cysteine residues of short polypeptides, thus introducing the possibility for optical based peptide/protein discrimination in nanopores.
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Affiliation(s)
- Rui Wang
- Department of Biomedical Engineering, Technion-IIT , Haifa , 32000 , Israel
| | - Tal Gilboa
- Department of Biomedical Engineering, Technion-IIT , Haifa , 32000 , Israel
| | - Jiaxi Song
- Department of Biomedical Engineering , Boston University , Boston , Massachusetts 02215 , United States
| | - Diana Huttner
- Department of Biomedical Engineering, Technion-IIT , Haifa , 32000 , Israel
| | - Mark W Grinstaff
- Department of Biomedical Engineering , Boston University , Boston , Massachusetts 02215 , United States
| | - Amit Meller
- Department of Biomedical Engineering, Technion-IIT , Haifa , 32000 , Israel
- Department of Biomedical Engineering , Boston University , Boston , Massachusetts 02215 , United States
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Abstract
BACKGROUND Tuberous sclerosis complex (TSC) is a multisystem disorder diagnosed by clinical criteria and/or genetic testing. Genetic testing reveals atypical phenotypes that have not met clinical criteria, with practical implications. METHODS We describe 4 family members with pathogenic partial deletion in TSC1 who individually did not meet tuberous sclerosis complex clinical criteria. RESULTS Family members had different and atypical findings of tuberous sclerosis complex. Although none of the family members fulfilled the clinical criteria for tuberous sclerosis complex, they all carried the same genomic deletion (9q34.13q34.2) that included part of the TSC1 gene. One member had ganglioglioma and intractable seizures, one sibling presented with seizures, developmental delay, and displayed white matter abnormalities; another sibling had no clinical manifestations but has cortical tuber. Their mother has facial angiofibroma, cortical tuber, and seizures during infancy. CONCLUSIONS Ganglioglioma may be a phenotypic expression of TSC1. Genetic testing is recommended for infants with brain tumors, especially those with an abnormal familial history.
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Affiliation(s)
- Tal Gilboa
- 1 Neuropediatric Unit, Hadassah Medical Center, Jerusalem, Israel
| | - Reeval Segel
- 2 Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Sharon Zeligson
- 2 Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Gheona Alterescu
- 2 Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Hilla Ben-Pazi
- 3 Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
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Zrehen A, Gilboa T, Meller A. Real-time visualization and sub-diffraction limit localization of nanometer-scale pore formation by dielectric breakdown. Nanoscale 2017; 9:16437-16445. [PMID: 29058736 DOI: 10.1039/c7nr02629c] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Herein, we introduce synchronous, real-time, electro-optical monitoring of nanopore formation by DB. Using the same principle as sub-diffraction microscopy, our nanopore localization platform based on wide-field microscopy and calcium indicators provides nanoscale sensitivity. This enables us to establish critical limitations of the fabrication process and improve its reliability. In particular, we find that under certain conditions, multiple nanopores may form and that nanopores may preferentially localize at the membrane junction, either of which potentially render nanopore sensing ineffective. As the breakdown parameters of silicon materials are highly manufacturer-specific, we anticipate that our visualization platform will enable users to easily optimize DB fabrication according to specific needs. Furthermore, our technique furthers the applicability of DB to more complicated architectures, such as membranes with selectively thinned regions and plasmonic nanowells.
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Affiliation(s)
- Adam Zrehen
- Department of Biomedical Engineering, The Technion - Israel Institute of Technology, Haifa, 32000, Israel.
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Weisman H, Fried I, Gilboa T, Bennett-Back O, Ekstein D, Shweiki M, Shoshan Y, Benifla M. Prevalence, Characteristics, and Long-Term Prognosis of Epilepsy Associated with Pediatric Brain Tumors. World Neurosurg 2017; 109:e594-e600. [PMID: 29054779 DOI: 10.1016/j.wneu.2017.10.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We investigated the prevalence, onset, characteristics, and long-term course of epilepsy disease in children who underwent surgical intervention for diagnosed brain tumors. METHODS We reviewed the medical records of children with diagnosed brain tumors who underwent surgery during 2004-2014 at the Hadassah Medical Center. All patients with epilepsy were invited to a clinical visit that included a neurologic examination. The primary outcome measures were neurologic status according to the Glasgow outcome score (GOS) and postoperative seizure outcome according to the Engel system. We compared clinical characteristics according to the timing of epilepsy onset. RESULTS The mean follow-up was 49 months. Of 128 patients included in the study, 44 (34%) had seizures; 23 (18%) developed epilepsy after surgery. Of the 30 patients with epilepsy who survived, 21 (70%) are in Engel class I and 13% Engel are in class II. Forty-five percent of the children are classified as GOS 5. Children who developed epilepsy after surgery were more likely to be in GOS 1-2 than were those who had seizures before surgery (P = 0.0173). Children with seizures were more likely to have cortical tumors and less likely to have tumors of the posterior fossa (P < 0.001). Children who underwent gross total resection were less likely to have epilepsy (P < 0.001). CONCLUSIONS We show a high incidence of epilepsy in the late course of pediatric brain tumor disease. In the long term, seizure outcome was excellent. However, postsurgical onset of epilepsy was associated with a less favorable neurologic outcome.
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Affiliation(s)
- Hadar Weisman
- Hematology-Oncology Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | - Iris Fried
- Hematology-Oncology Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | - Tal Gilboa
- Pediatric Neurology Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | - Odeya Bennett-Back
- Pediatric Neurology Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | - Dana Ekstein
- Neurology Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | - Moatasem Shweiki
- Neurosurgery Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | - Yigal Shoshan
- Neurosurgery Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | - Mony Benifla
- The Pediatric Neurosurgery Unit, Rambam Health Care Campus, Haifa, Israel.
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48
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Keret A, Bennett-Back O, Rosenthal G, Gilboa T, Shweiki M, Shoshan Y, Benifla M. Posttraumatic epilepsy: long-term follow-up of children with mild traumatic brain injury. J Neurosurg Pediatr 2017; 20:64-70. [PMID: 28474982 DOI: 10.3171/2017.2.peds16585] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 12/20/2022]
Abstract
OBJECTIVE Posttraumatic epilepsy (PTE) is a known complication of traumatic brain injury (TBI). The true incidence of PTE in children is still uncertain, because most research has been based primarily on adults. This study aimed to determine the true incidence of PTE in a pediatric population with mild TBI (MTBI) and to identify risk factors for the development of epileptic events. METHODS Data were collected from electronic medical records of children 0-17 years of age, who were admitted to a single medical center between 2007 and 2009 with a diagnosis of MTBI. This prospective research consisted of a telephone survey between 2015 and 2016 of children or their caregivers, querying for information about epileptic episodes and current seizure and neurological status. The primary outcome measure was the incidence of epilepsy following TBI, which was defined as ≥ 2 unprovoked seizure episodes. Posttraumatic seizure (PTS) was defined as a single, nonrecurrent convulsive episode that occurred > 24 hours following injury. Seizures within 24 hours of the injury were defined as immediate PTS. RESULTS Of 290 children eligible for this study, 191 of them or their caregivers were reached by telephone survey and were included in the analysis. Most injuries (80.6%) were due to falls. Six children had immediate PTS. All children underwent CT imaging; of them, 72.8% demonstrated fractures and 10.5% did not demonstrate acute findings. The mean follow-up was 7.4 years. Seven children (3.7%) experienced PTS; of them, 6 (85.7%) developed epilepsy and 3 (42.9%) developed intractable epilepsy. The overall incidence of epilepsy and intractable epilepsy in this cohort was 3.1% and 1.6%, respectively. None of the children who had immediate PTS developed epilepsy. Children who developed epilepsy spent an average of 2 extra days in the hospital at the time of the injury. The mean time between trauma and onset of seizures was 3.1 years. Immediate PTS was not correlated with PTE. CONCLUSIONS In this analysis of data from medical records and long-term follow-up, MTBI was found to confer increased risk for the development of PTE and intractable PTE, of 4.5 and 8 times higher, respectively. As has been established in adults, these findings confirm that MTBI increases the risk for PTE in the pediatric population.
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Affiliation(s)
| | - Odeya Bennett-Back
- Pediatric Neurology Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | | | - Tal Gilboa
- Pediatric Neurology Department, Hadassah Ein Kerem Medical Center, Jerusalem, Israel
| | | | | | - Mony Benifla
- Pediatric Neurosurgery Unit.,Neurosurgery Department, and
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Assad ON, Gilboa T, Spitzberg J, Juhasz M, Weinhold E, Meller A. Light-Enhancing Plasmonic-Nanopore Biosensor for Superior Single-Molecule Detection. Adv Mater 2017; 29:1605442. [PMID: 28026129 DOI: 10.1002/adma.201605442] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 11/12/2016] [Indexed: 05/26/2023]
Abstract
A stacked plasmonic nanowell-nanopore biosensor strongly suppresses the background fluorescence from the bulk and yields net more than tenfold enhancement of the fluorescence intensity. The device offers extremely high signal-to-background (S/B) ratio for single-molecule detection at ultralow excitation laser intensities, while maintaining extremely high temporal bandwidth for single-DNA sensing.
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Affiliation(s)
- Ossama N Assad
- Department of Biomedical Engineering, The Technion -Israel Institute of Technology, Haifa, 32000, Israel
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
| | - Tal Gilboa
- Department of Biomedical Engineering, The Technion -Israel Institute of Technology, Haifa, 32000, Israel
| | - Joshua Spitzberg
- Department of Biomedical Engineering, The Technion -Israel Institute of Technology, Haifa, 32000, Israel
| | - Matyas Juhasz
- Institute of Organic Chemistry, RWTH Aachen University, Landoltweg 1, Aachen, 52056, Germany
| | - Elmar Weinhold
- Institute of Organic Chemistry, RWTH Aachen University, Landoltweg 1, Aachen, 52056, Germany
| | - Amit Meller
- Department of Biomedical Engineering, The Technion -Israel Institute of Technology, Haifa, 32000, Israel
- Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA
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50
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Squires AH, Gilboa T, Torfstein C, Varongchayakul N, Meller A. Single-Molecule Characterization of DNA-Protein Interactions Using Nanopore Biosensors. Methods Enzymol 2016; 582:353-385. [PMID: 28062042 DOI: 10.1016/bs.mie.2016.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 01/19/2023]
Abstract
Detection and characterization of nucleic acid-protein interactions, particularly those involving DNA and proteins such as transcription factors, enzymes, and DNA packaging proteins, remain significant barriers to our understanding of genetic regulation. Nanopores are an extremely sensitive and versatile sensing platform for label-free detection of single biomolecules. Analyte molecules are drawn to and through a nanoscale aperture by an electrophoretic force, which acts upon their native charge while in the sensing region of the pore. When the nanopore's diameter is only slightly larger than the biopolymer's cross section (typically a few nm); the latter must translocate through the pore in a linear fashion due to the constricted geometry in this region. These features allow nanopores to interrogate protein-nucleic acids in multiple sensing modes: first, by scanning and mapping the locations of binding sites along an analyte molecule, and second, by probing the strength of the bond between a protein and nucleic acid, using the native charge of the nucleic acid to apply an electrophoretic force to the complex while the protein is geometrically prevented from passing through the nanopore. In this chapter, we describe progress toward nanopore sensing of protein-nucleic acid complexes in the context of both mapping binding sites and performing force spectroscopy to determine the strength of interactions. We conclude by reviewing the strengths and challenges of the nanopore technique in the context of studying DNA-protein interactions.
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Affiliation(s)
- A H Squires
- Stanford University, Stanford, CA, United States
| | | | | | | | - A Meller
- The Technion, Haifa, Israel; Boston University, Boston, MA, United States.
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