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Enlund S, Sinha I, Neofytou C, Amor AR, Papadakis K, Nilsson A, Jiang Q, Hermanson O, Holm F. The CNS microenvironment promotes leukemia cell survival by disrupting tumor suppression and cell cycle regulation in pediatric T-cell acute lymphoblastic leukemia. Exp Cell Res 2024; 437:114015. [PMID: 38561062 DOI: 10.1016/j.yexcr.2024.114015] [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] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
A major obstacle in improving survival in pediatric T-cell acute lymphoblastic leukemia is understanding how to predict and treat leukemia relapse in the CNS. Leukemia cells are capable of infiltrating and residing within the CNS, primarily the leptomeninges, where they interact with the microenvironment and remain sheltered from systemic treatment. These cells can survive in the CNS, by hijacking the microenvironment and disrupting normal functions, thus promoting malignant transformation. While the protective effects of the bone marrow niche have been widely studied, the mechanisms behind leukemia infiltration into the CNS and the role of the CNS niche in leukemia cell survival remain unknown. We identified a dysregulated gene expression profile in CNS infiltrated T-ALL and CNS relapse, promoting cell survival, chemoresistance, and disease progression. Furthermore, we discovered that interactions between leukemia cells and human meningeal cells induced epigenetic alterations, such as changes in histone modifications, including H3K36me3 levels. These findings are a step towards understanding the molecular mechanisms promoting leukemia cell survival in the CNS microenvironment. Our results highlight genetic and epigenetic alterations induced by interactions between leukemia cells and the CNS niche, which could potentially be utilized as biomarkers to predict CNS infiltration and CNS relapse.
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Affiliation(s)
- Sabina Enlund
- Deparment of Women's and Children's Health, Division of Pediatric Oncology and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Indranil Sinha
- Deparment of Women's and Children's Health, Division of Pediatric Oncology and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Christina Neofytou
- Department of Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Amanda Ramilo Amor
- Deparment of Women's and Children's Health, Division of Pediatric Oncology and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Konstantinos Papadakis
- Deparment of Women's and Children's Health, Division of Pediatric Oncology and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Anna Nilsson
- Deparment of Women's and Children's Health, Division of Pediatric Oncology and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Qingfei Jiang
- Division of Regenerative Medicine, Department of Medicine, Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
| | - Ola Hermanson
- Department of Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Frida Holm
- Deparment of Women's and Children's Health, Division of Pediatric Oncology and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden.
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2
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Nilsson A. Unlocking the impact of the CRPD on Swedish mental health law. Int J Law Psychiatry 2024; 93:101966. [PMID: 38430626 DOI: 10.1016/j.ijlp.2024.101966] [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] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/13/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
The Convention on the Rights of Persons with Disabilities (CRPD) sets out a new vision for mental health care with equality and self-determination as its core standards. The CRPD fundamentally challenges long-standing practices in Sweden including the use of involuntary hospitalization, treatment without consent, and the use of restraints. This article discusses the impact of this new vision on Swedish mental health law and policy. An examination of mental health law inquiries from 2008 to 2023 reveals a notable lack of attention from policymakers towards the CRPD. Nevertheless, the Convention has emerged as a vital advocacy instrument for disability organizations and others opposing proposals that seek to broaden doctors' authority to employ coercion. In addition, the many efforts undertaken to reduce the use of coercion and to enhance the involvement of individuals with psychosocial disabilities in policy development align seamlessly with the principles of the Convention. This article concludes with a reflection on why the CRPD has not assumed a more prominent role in shaping mental health law in Sweden and calls on the government to seriously consider the CRPD's call for equality.
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Affiliation(s)
- Anna Nilsson
- Lund University, Faculty of Law, Lilla Gråbrödersgatan 4, Box 207, 221 00 Lund, Sweden.
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3
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Wallin S, Øra I, Prochazka G, Sandgren J, Björklund C, Ljungman G, Vogt H, Ek T, van Tilburg CM, Nilsson A. Implementing data on targeted therapy from the INFORM registry platform for children with relapsed cancer in Sweden. Front Oncol 2024; 14:1340099. [PMID: 38357207 PMCID: PMC10865092 DOI: 10.3389/fonc.2024.1340099] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/09/2024] [Indexed: 02/16/2024] Open
Abstract
Background Advances in treatment of childhood malignancies have improved overall cure rates to 80%. Nevertheless, cancer is still the most common cause of childhood mortality in Sweden. The prognosis is particularly poor for relapse of high-risk malignancies. In the international INFORM registry, tumor tissue from patients with relapsed, refractory, or progressive pediatric cancer as well as from very-high risk primary tumors is biologically characterized using next-generation sequencing to identify possible therapeutic targets. We analyzed data from Swedish children included in the INFORM registry concerning patient characteristics, survival, sequencing results and whether targeted treatment was administered to the children based on the molecular findings. Methods A registry-based descriptive analysis of 184 patients included in the INFORM registry in Sweden during 2016-2021. Results The most common diagnoses were soft tissue and bone sarcomas followed by high grade gliomas [including diffuse intrinsic pontine glioma (DIPG)]. Complete molecular analysis was successful for 203/212 samples originating from 184 patients. In 88% of the samples, at least one actionable target was identified. Highly prioritized targets, according to a preset scale, were identified in 48 (24%) samples from 40 patients and 24 of these patients received matched targeted treatment but only six children within a clinical trial. No statistically significant benefit in terms of overall survival or progression free survival was observed between children treated with matched targeted treatment compared to all others. Conclusion This international collaborative study demonstrate feasibility regarding sequencing of pediatric high-risk tumors providing molecular data regarding potential actionable targets to clinicians. For a few individuals the INFORM analysis was of utmost importance and should be regarded as a new standard of care with the potential to guide targeted therapy.
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Affiliation(s)
- Sofia Wallin
- Division of Pediatric Oncology, Department of Women and Children´s Health, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Øra
- Division of Pediatric Hematology-Oncology, Skåne University Hospital, & Clinical Sciences IKVL, Lund University, Lund, Sweden
| | - Gabriela Prochazka
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Johanna Sandgren
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Stockholm, Sweden
| | - Caroline Björklund
- Division of Pediatric Hematology-Oncology, Umeå University Hospital, Umeå, Sweden
| | - Gustaf Ljungman
- Department of Women and Children´s Health, Pediatric Hematology-Oncology Uppsala University, Uppsala, Sweden
| | - Hartmut Vogt
- Division of Pediatric Hematology-Oncology B153, Crown Princess Victoria Children’s Hospital, and Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Torben Ek
- University of Gothenburg and Children´s Cancer Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Cornelis M. van Tilburg
- Hopp Children’s Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), National Center for Tumor diseases (NCT), Heidelberg, Germany
| | - Anna Nilsson
- Division of Pediatric Oncology, Department of Women and Children´s Health, Karolinska Institutet, Stockholm, Sweden
- Division of Pediatric Hematology-Oncology, Tema Barn, Astrid Lindgren Children’s Hospital, Stockholm, Sweden
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4
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Pennesi E, Brivio E, Ammerlaan ACJ, Jiang Y, Van der Velden VHJ, Beverloo HB, Sleight B, Locatelli F, Brethon B, Rossig C, Engstler G, Nilsson A, Bruno B, Petit A, Bielorai B, Rizzari C, Rialland F, Rubio-San-Simón A, Sirvent FJB, Diaz-de-Heredia C, Rives S, Zwaan CM. Inotuzumab ozogamicin combined with chemotherapy in pediatric B-cell precursor CD22+ acute lymphoblastic leukemia: results of the phase IB ITCC-059 trial. Haematologica 2024. [PMID: 38186333 DOI: 10.3324/haematol.2023.284409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Indexed: 01/09/2024] Open
Abstract
Inotuzumab Ozogamicin (InO) is a CD22-directed antibody conjugated with calicheamicin. The Phase 1B of the ITCC-059 trial tested InO combined with chemotherapy in pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Relapsed /refractory CD22+ BCP-ALL pediatric patients were enrolled. The primary objective was to establish the Recommended Phase 2 Dose (RP2D). Secondary objectives included preliminary efficacy and tolerability. InO was combined with 1.5 mg/m2 of vincristine (days 3, 10, 17, 24), 20 mg/m2 of dexamethasone (two 5-day blocks, then amended), and intrathecal therapy. A rolling-6 design was used testing InO from 0.8 to 1.8 mg/m2/cycle. Between May-2020 and Apr-2022, 30 patients were treated, and 29 were evaluable for dose limiting toxicities (DLTs). At 1.1 mg/m2/cycle, two out of four patients had DLTs (liver toxicity). InO was de-escalated to 0.8 mg/m2/cycle (n=6) without DLTs while awaiting a protocol amendment to reduce dexamethasone dose to 10 mg/m2. Post amendment, InO was re-escalated to 1.1 mg/m2/cycle (n=6, 1 DLT), then to 1.4 mg/m2/cycle (n=3, no DLTs), and finally to 1.8 mg/m2/cycle (n=7, 1 DLT). Three additional patients were treated in an expansion cohort. The pooled response rate was 80% (24/30; 95%CI: 61.4% to 92.3%) and, among responders, 66.7% achieved minimal residual disease negativity. The RP2D of InO combined with vincristine, dexamethasone and IT therapy was declared at 1.8 mg/m2/cycle (1.5 mg/m2/cycle after remission) in a fractionated schedule. This combination showed an response rate similar to the single agent cohorts of this trial, with liver toxicity issues at the initial higher dexamethasone dose. #NTR5736.
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Affiliation(s)
- Edoardo Pennesi
- Department of Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht
| | - Erica Brivio
- Department of Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht
| | - Anneke C J Ammerlaan
- Department of Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht
| | - Yilin Jiang
- Princess Máxima Center for Pediatric Oncology, Utrecht
| | | | - H Berna Beverloo
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam
| | | | - Franco Locatelli
- Department of Hematology, Oncology and of Cell and Gene Therapy, IRCCS Ospedale Pediatrico Bambino Gesú, Catholic University of the Sacred Heart, Rome
| | - Benoit Brethon
- Pediatric Hematology-Immunology Unit, Hôpital Robert Debré, APHP, Paris
| | - Claudia Rossig
- Pediatric Hematology and Oncology, University Children's Hospital Muenster, Münster
| | - Gernot Engstler
- St Anna Children's Hospital, Medical University of Vienna, Vienna
| | - Anna Nilsson
- Pediatric Oncology and Hematology, Karolinska University Hospital, Stockholm
| | - Benedicte Bruno
- Pediatric Hematology, Hôpital Jeanne de Flandre, CHRU de Lille, Lille
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, Hopital Armand Trousseau, APHP, Sorbonne Université, Paris
| | - Bella Bielorai
- Division of Pediatric Hematology and Oncology, Sheba Medical Center, Ramat-Gan
| | - Carmelo Rizzari
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, MBBM Foundation, ASST Monza, University of Milano-Bicocca, Monza
| | - Fanny Rialland
- Service Onco-Hématologie Pédiatrique, Hôpital Mère-Enfant, Nantes University Hospital, Nantes
| | | | - Francisco J Bautista Sirvent
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Pediatric Oncology and Hematology, Hospital Niño Jesús, Madrid
| | - Cristina Diaz-de-Heredia
- Division of Pediatric Hematology and Oncology . Hospital Universitari Vall D'Hebron, Barcelona, Spain; Institut de Recerca Vall d'Hebron (VHIR), Barcelona
| | - Susana Rives
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Leukemia and Lymphoma Department. Pediatric Cancer Center Barcelona (PCCB), Hospital Sant Joan de Déu de Barcelona, Barcelona
| | - Christian M Zwaan
- Department of Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht.
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5
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Schöpf J, Uhrig S, Heilig CE, Lee KS, Walther T, Carazzato A, Dobberkau AM, Weichenhan D, Plass C, Hartmann M, Diwan GD, Carrero ZI, Ball CR, Hohl T, Kindler T, Rudolph-Hähnel P, Helm D, Schneider M, Nilsson A, Øra I, Imle R, Banito A, Russell RB, Jones BC, Lipka DB, Glimm H, Hübschmann D, Hartmann W, Fröhling S, Scholl C. Multi-omic and functional analysis for classification and treatment of sarcomas with FUS-TFCP2 or EWSR1-TFCP2 fusions. Nat Commun 2024; 15:51. [PMID: 38168093 PMCID: PMC10761971 DOI: 10.1038/s41467-023-44360-2] [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: 03/23/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
Linking clinical multi-omics with mechanistic studies may improve the understanding of rare cancers. We leverage two precision oncology programs to investigate rhabdomyosarcoma with FUS/EWSR1-TFCP2 fusions, an orphan malignancy without effective therapies. All tumors exhibit outlier ALK expression, partly accompanied by intragenic deletions and aberrant splicing resulting in ALK variants that are oncogenic and sensitive to ALK inhibitors. Additionally, recurrent CKDN2A/MTAP co-deletions provide a rationale for PRMT5-targeted therapies. Functional studies show that FUS-TFCP2 blocks myogenic differentiation, induces transcription of ALK and truncated TERT, and inhibits DNA repair. Unlike other fusion-driven sarcomas, TFCP2-rearranged tumors exhibit genomic instability and signs of defective homologous recombination. DNA methylation profiling demonstrates a close relationship with undifferentiated sarcomas. In two patients, sarcoma was preceded by benign lesions carrying FUS-TFCP2, indicating stepwise sarcomagenesis. This study illustrates the potential of linking precision oncology with preclinical research to gain insight into the classification, pathogenesis, and therapeutic vulnerabilities of rare cancers.
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Affiliation(s)
- Julia Schöpf
- Division of Applied Functional Genomics, German Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT), NCT Heidelberg, a Partnership Between DKFZ and Heidelberg University Hospital, Heidelberg, Germany
- Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Sebastian Uhrig
- Computational Oncology Group, Molecular Precision Oncology Program, NCT Heidelberg, and DKFZ, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Christoph E Heilig
- Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Kwang-Seok Lee
- Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany
| | - Tatjana Walther
- Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany
| | - Alexander Carazzato
- Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany
| | - Anna Maria Dobberkau
- Section of Translational Cancer Epigenomics, Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany
| | | | | | - Mark Hartmann
- Section of Translational Cancer Epigenomics, Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany
| | - Gaurav D Diwan
- Bioquant, Heidelberg University, Heidelberg, Germany
- Heidelberg University Biochemistry Center (BZH), Heidelberg, Germany
| | - Zunamys I Carrero
- Department for Translational Medical Oncology, NCT, NCT/UCC Dresden, a Partnership Between DKFZ, Heidelberg Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
- German Cancer Consortium (DKTK), Dresden, Germany
| | - Claudia R Ball
- Department for Translational Medical Oncology, NCT, NCT/UCC Dresden, a Partnership Between DKFZ, Heidelberg Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
- German Cancer Consortium (DKTK), Dresden, Germany
- Translational Medical Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD, Dresden, Germany
- Faculty of Biology, TUD Dresden University of Technology, Dresden, Germany
| | - Tobias Hohl
- Division of Applied Functional Genomics, German Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT), NCT Heidelberg, a Partnership Between DKFZ and Heidelberg University Hospital, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Thomas Kindler
- University Cancer Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Hematology, Medical Oncology and Pneumology, University Medical Center, Mainz, Germany
- German Cancer Consortium (DKTK), Mainz, Germany
| | - Patricia Rudolph-Hähnel
- University Cancer Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Hematology, Medical Oncology and Pneumology, University Medical Center, Mainz, Germany
- German Cancer Consortium (DKTK), Mainz, Germany
| | - Dominic Helm
- Proteomics Core Facility, DKFZ, Heidelberg, Germany
| | | | - Anna Nilsson
- Pediatric Oncology and Coagulation, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Øra
- Pediatric Oncology and Hematology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Roland Imle
- Soft-Tissue Sarcoma Junior Research Group, DKFZ, Heidelberg, Germany
- Hopp Children's Cancer Center (KiTZ) and NCT Heidelberg, Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ana Banito
- Soft-Tissue Sarcoma Junior Research Group, DKFZ, Heidelberg, Germany
- Hopp Children's Cancer Center (KiTZ) and NCT Heidelberg, Heidelberg, Germany
| | - Robert B Russell
- Bioquant, Heidelberg University, Heidelberg, Germany
- Heidelberg University Biochemistry Center (BZH), Heidelberg, Germany
| | - Barbara C Jones
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Hopp Children's Cancer Center (KiTZ) and NCT Heidelberg, Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Daniel B Lipka
- Section of Translational Cancer Epigenomics, Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany
| | - Hanno Glimm
- Department for Translational Medical Oncology, NCT, NCT/UCC Dresden, a Partnership Between DKFZ, Heidelberg Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
- German Cancer Consortium (DKTK), Dresden, Germany
- Translational Medical Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD, Dresden, Germany
- Translational Functional Cancer Genomics, DKFZ, Heidelberg, Germany
| | - Daniel Hübschmann
- Computational Oncology Group, Molecular Precision Oncology Program, NCT Heidelberg, and DKFZ, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Pattern Recognition and Digital Medicine Group, Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM), Heidelberg, Germany
| | - Wolfgang Hartmann
- Gerhard Domagk Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Stefan Fröhling
- Division of Translational Medical Oncology, DKFZ, and NCT Heidelberg, Heidelberg, Germany.
- German Cancer Consortium (DKTK), Heidelberg, Germany.
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany.
| | - Claudia Scholl
- Division of Applied Functional Genomics, German Cancer Research Center (DKFZ), and National Center for Tumor Diseases (NCT), NCT Heidelberg, a Partnership Between DKFZ and Heidelberg University Hospital, Heidelberg, Germany.
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6
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Fridjonsdottir E, Nilsson A, Fricker LD, Andrén PE. Two Different Strategies for Stabilization of Brain Tissue and Extraction of Neuropeptides. Methods Mol Biol 2024; 2758:49-60. [PMID: 38549007 DOI: 10.1007/978-1-0716-3646-6_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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Neuropeptides are bioactive peptides that are synthesized and secreted by neurons in signaling pathways in the brain. Peptides and proteins are extremely vulnerable to proteolytic cleavage when their biological surrounding changes. This makes neuropeptidomics challenging due to the rapid alterations that occur to the peptidome after harvesting of brain tissue samples. For a successful neuropeptidomic study, the biological tissue sample analyzed should resemble the living state as much as possible. Heat stabilization has been proven to inhibit postmortem degradation by denaturing proteolytic enzymes, hence increasing identification rates of neuropeptides. Here, we describe two different stabilization protocols for rodent brain samples that increase the number of intact mature neuropeptides and minimize interference from degradation products of abundant proteins. Additionally, we present an extraction protocol that aims to extract a wide range of hydrophilic and hydrophobic neuropeptides by sequentially using an aqueous and an organic extraction medium.
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Affiliation(s)
- Elva Fridjonsdottir
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Lloyd D Fricker
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Per E Andrén
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
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7
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Vallianatou T, Nilsson A, Bjärterot P, Shariatgorji R, Slijkhuis N, Aerts JT, Jansson ET, Svenningsson P, Andrén PE. Rapid Metabolic Profiling of 1 μL Crude Cerebrospinal Fluid by Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry Imaging Can Differentiate De Novo Parkinson's Disease. Anal Chem 2023; 95:18352-18360. [PMID: 38059473 PMCID: PMC10733901 DOI: 10.1021/acs.analchem.3c02900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023]
Abstract
Parkinson's disease (PD) is a highly prevalent neurodegenerative disorder affecting the motor system. However, the correct diagnosis of PD and atypical parkinsonism may be difficult with high clinical uncertainty. There is an urgent need to identify reliable biomarkers using high-throughput, molecular-specific methods to improve current diagnostics. Here, we present a matrix-assisted laser desorption/ionization mass spectrometry imaging method that requires minimal sample preparation and only 1 μL of crude cerebrospinal fluid (CSF). The method enables analysis of hundreds of samples in a single experiment while simultaneously detecting numerous metabolites with subppm mass accuracy. To test the method, we analyzed CSF samples from 12 de novo PD patients (that is, newly diagnosed and previously untreated) and 12 age-matched controls. Within the identified molecules, we found neurotransmitters and their metabolites such as γ-aminobutyric acid, 3-methoxytyramine, homovanillic acid, serotonin, histamine, amino acids, and metabolic intermediates. Limits of detection were estimated for multiple neurotransmitters with high linearity (R2 > 0.99) and sensitivity (as low as 16 pg/μL). Application of multivariate classification led to a highly significant (P < 0.001) model of PD prediction with a 100% classification rate, which was further thoroughly validated with a permutation test and univariate analysis. Molecules related to the neuromelanin pathway were found to be significantly increased in the PD group, indicated by their elevated relative intensities compared to the control group. Our method enables rapid detection of PD-related biomarkers in low sample volumes and could serve as a valuable tool in the development of robust PD diagnostics.
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Affiliation(s)
- Theodosia Vallianatou
- Department
of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science
for Life Laboratory, Uppsala University, Uppsala SE-75124, Sweden
| | - Anna Nilsson
- Department
of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science
for Life Laboratory, Uppsala University, Uppsala SE-75124, Sweden
| | - Patrik Bjärterot
- Department
of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science
for Life Laboratory, Uppsala University, Uppsala SE-75124, Sweden
| | - Reza Shariatgorji
- Department
of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science
for Life Laboratory, Uppsala University, Uppsala SE-75124, Sweden
| | - Nuria Slijkhuis
- Department
of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science
for Life Laboratory, Uppsala University, Uppsala SE-75124, Sweden
| | - Jordan T. Aerts
- Department
of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science
for Life Laboratory, Uppsala University, Uppsala SE-75124, Sweden
| | - Erik T. Jansson
- Department
of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science
for Life Laboratory, Uppsala University, Uppsala SE-75124, Sweden
| | - Per Svenningsson
- Department
of Clinical Neuroscience, Karolinska Institute, Stockholm SE-17177, Sweden
| | - Per E. Andrén
- Department
of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science
for Life Laboratory, Uppsala University, Uppsala SE-75124, Sweden
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8
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Hansen K, Yamba Yamba L, Wasserstrom L, Rünow E, Göransson T, Nilsson A, Ahl J, Riesbeck K. Exploring the microbial landscape: uncovering the pathogens associated with community-acquired pneumonia in hospitalized patients. Front Public Health 2023; 11:1258981. [PMID: 38152664 PMCID: PMC10752608 DOI: 10.3389/fpubh.2023.1258981] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/10/2023] [Indexed: 12/29/2023] Open
Abstract
Objectives This study aimed to investigate the etiology, clinical features, and outcomes of community-acquired pneumonia (CAP) in adults. Understanding the causative pathogens is essential for effective treatment and prevention. Design Between 2016-2018, 518 hospitalized adults with CAP and 241 controls without symptoms were prospectively enrolled. Urine samples were collected for pneumococcal urinary antigen tests and nasopharyngeal swabs for viral and bacterial analysis, combined with routine diagnostic care. Results Among the included CAP patients, Streptococcus pneumoniae was the most common pathogen, detected in 28% of patients, followed by Haemophilus influenzae in 16%. Viruses were identified in 28%, and concurrent viruses and bacteria were detected in 15%. There was no difference in mortality, length of stay, or symptoms at hospitalization when comparing patients with bacterial, viral, or mixed etiologies. Among the control subjects without respiratory symptoms, S. pneumoniae, H. influenzae, or Moraxella catarrhalis were detected in 5-7%, and viruses in 7%. Conclusion Streptococcus pneumoniae emerged as the predominant cause of CAP, followed closely by viruses and H. influenzae. Intriguingly, symptoms and outcome were similar regardless of etiology. These findings highlight the complexity of this respiratory infection and emphasize the importance of comprehensive diagnostic and treatment strategies.Clinical Trial Registration: ClinicalTrials.gov, identifier [NCT03606135].
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Affiliation(s)
- Karin Hansen
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
- Infectious Diseases, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
| | - Linda Yamba Yamba
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
| | - Lisa Wasserstrom
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
- Clinical Microbiology, Infection Control and Prevention, Laboratory Medicine, Lund, Sweden
| | - Elisabeth Rünow
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
- Infectious Diseases, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
| | - Tommy Göransson
- Clinical Microbiology, Infection Control and Prevention, Laboratory Medicine, Lund, Sweden
| | - Anna Nilsson
- Infectious Diseases, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
| | - Jonas Ahl
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
- Infectious Diseases, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
| | - Kristian Riesbeck
- Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine Lund University, Malmö, Sweden
- Clinical Microbiology, Infection Control and Prevention, Laboratory Medicine, Lund, Sweden
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9
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He Y, Kaya I, Shariatgorji R, Lundkvist J, Wahlberg LU, Nilsson A, Mamula D, Kehr J, Zareba-Paslawska J, Biverstål H, Chergui K, Zhang X, Andren PE, Svenningsson P. Prosaposin maintains lipid homeostasis in dopamine neurons and counteracts experimental parkinsonism in rodents. Nat Commun 2023; 14:5804. [PMID: 37726325 PMCID: PMC10509278 DOI: 10.1038/s41467-023-41539-5] [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: 05/08/2022] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
Prosaposin (PSAP) modulates glycosphingolipid metabolism and variants have been linked to Parkinson's disease (PD). Here, we find altered PSAP levels in the plasma, CSF and post-mortem brain of PD patients. Altered plasma and CSF PSAP levels correlate with PD-related motor impairments. Dopaminergic PSAP-deficient (cPSAPDAT) mice display hypolocomotion and depression/anxiety-like symptoms with mildly impaired dopaminergic neurotransmission, while serotonergic PSAP-deficient (cPSAPSERT) mice behave normally. Spatial lipidomics revealed an accumulation of highly unsaturated and shortened lipids and reduction of sphingolipids throughout the brains of cPSAPDAT mice. The overexpression of α-synuclein via AAV lead to more severe dopaminergic degeneration and higher p-Ser129 α-synuclein levels in cPSAPDAT mice compared to WT mice. Overexpression of PSAP via AAV and encapsulated cell biodelivery protected against 6-OHDA and α-synuclein toxicity in wild-type rodents. Thus, these findings suggest PSAP may maintain dopaminergic lipid homeostasis, which is dysregulated in PD, and counteract experimental parkinsonism.
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Affiliation(s)
- Yachao He
- Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Ibrahim Kaya
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
| | - Reza Shariatgorji
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden
| | - Johan Lundkvist
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
- Sinfonia Biotherapeutics AB, Huddinge, Sweden
| | - Lars U Wahlberg
- Division of Neurogeriatrics, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden
| | - Dejan Mamula
- Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jan Kehr
- Section of Pharmacological Neurochemistry, Department of Physiology and Pharmacology, Karolinska Institute, Solna, Sweden
| | - Justyna Zareba-Paslawska
- Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Biverstål
- Sinfonia Biotherapeutics AB, Huddinge, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Karima Chergui
- Laboratory of Molecular Neurophysiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Xiaoqun Zhang
- Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Per E Andren
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden
| | - Per Svenningsson
- Translational Neuropharmacology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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10
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Vicari M, Mirzazadeh R, Nilsson A, Shariatgorji R, Bjärterot P, Larsson L, Lee H, Nilsson M, Foyer J, Ekvall M, Czarnewski P, Zhang X, Svenningsson P, Käll L, Andrén PE, Lundeberg J. Spatial multimodal analysis of transcriptomes and metabolomes in tissues. Nat Biotechnol 2023:10.1038/s41587-023-01937-y. [PMID: 37667091 DOI: 10.1038/s41587-023-01937-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 08/08/2023] [Indexed: 09/06/2023]
Abstract
We present a spatial omics approach that combines histology, mass spectrometry imaging and spatial transcriptomics to facilitate precise measurements of mRNA transcripts and low-molecular-weight metabolites across tissue regions. The workflow is compatible with commercially available Visium glass slides. We demonstrate the potential of our method using mouse and human brain samples in the context of dopamine and Parkinson's disease.
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Affiliation(s)
- Marco Vicari
- Department of Gene Technology, KTH Royal Institute of Technology, Science for Life Laboratory, Stockholm, Sweden
| | - Reza Mirzazadeh
- Department of Gene Technology, KTH Royal Institute of Technology, Science for Life Laboratory, Stockholm, Sweden
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Reza Shariatgorji
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Patrik Bjärterot
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ludvig Larsson
- Department of Gene Technology, KTH Royal Institute of Technology, Science for Life Laboratory, Stockholm, Sweden
| | - Hower Lee
- Department of Biochemistry and Biophysics, Stockholm University, Science for Life Laboratory, Stockholm, Sweden
| | - Mats Nilsson
- Department of Biochemistry and Biophysics, Stockholm University, Science for Life Laboratory, Stockholm, Sweden
| | - Julia Foyer
- Department of Gene Technology, KTH Royal Institute of Technology, Science for Life Laboratory, Stockholm, Sweden
| | - Markus Ekvall
- Department of Gene Technology, KTH Royal Institute of Technology, Science for Life Laboratory, Stockholm, Sweden
| | - Paulo Czarnewski
- Department of Gene Technology, KTH Royal Institute of Technology, Science for Life Laboratory, Stockholm, Sweden
| | - Xiaoqun Zhang
- Department of Clinical Neuroscience, Section of Neurology, Karolinska Institutet, Stockholm, Sweden
| | - Per Svenningsson
- Department of Clinical Neuroscience, Section of Neurology, Karolinska Institutet, Stockholm, Sweden
- Basic and Clinical Neuroscience, King's College London, London, UK
| | - Lukas Käll
- Department of Gene Technology, KTH Royal Institute of Technology, Science for Life Laboratory, Stockholm, Sweden
| | - Per E Andrén
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
| | - Joakim Lundeberg
- Department of Gene Technology, KTH Royal Institute of Technology, Science for Life Laboratory, Stockholm, Sweden.
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11
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Kaya I, Nilsson A, Luptáková D, He Y, Vallianatou T, Bjärterot P, Svenningsson P, Bezard E, Andrén PE. Spatial lipidomics reveals brain region-specific changes of sulfatides in an experimental MPTP Parkinson's disease primate model. NPJ Parkinsons Dis 2023; 9:118. [PMID: 37495571 PMCID: PMC10372136 DOI: 10.1038/s41531-023-00558-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
Metabolism of MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) to the neurotoxin MPP+ in the brain causes permanent Parkinson's disease-like symptoms by destroying dopaminergic neurons in the pars compacta of the substantia nigra in humans and non-human primates. However, the complete molecular pathology underlying MPTP-induced parkinsonism remains poorly understood. We used dual polarity matrix-assisted laser desorption/ionization mass spectrometry imaging to thoroughly image numerous glycerophospholipids and sphingolipids in coronal brain tissue sections of MPTP-lesioned and control non-human primate brains (Macaca mulatta). The results revealed specific distributions of several sulfatide lipid molecules based on chain-length, number of double bonds, and importantly, hydroxylation stage. More specifically, certain long-chain hydroxylated sulfatides with polyunsaturated chains in the molecular structure were depleted within motor-related brain regions in the MPTP-lesioned animals, e.g., external and internal segments of globus pallidus and substantia nigra pars reticulata. In contrast, certain long-chain non-hydroxylated sulfatides were found to be elevated within the same brain regions. These findings demonstrate region-specific dysregulation of sulfatide metabolism within the MPTP-lesioned macaque brain. The depletion of long-chain hydroxylated sulfatides in the MPTP-induced pathology indicates oxidative stress and oligodendrocyte/myelin damage within the pathologically relevant brain regions. Hence, the presented findings improve our current understanding of the molecular pathology of MPTP-induced parkinsonism within primate brains, and provide a basis for further research regarding the role of dysregulated sulfatide metabolism in PD.
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Affiliation(s)
- Ibrahim Kaya
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Dominika Luptáková
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Yachao He
- Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Theodosia Vallianatou
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Patrik Bjärterot
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Per Svenningsson
- Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erwan Bezard
- University of Bordeaux, CNRS, IMN, UMR 5293, F-33000, Bordeaux, France
| | - Per E Andrén
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
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12
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Heipertz AE, Pajtler KW, Pfaff E, Schramm K, Blattner-Johnson M, Milde T, Jones BC, Zuliani C, Hutter C, Lohi O, Kattamis A, Dachowska-Kalwak I, Nilsson A, Gerber NU, Langenberg KPS, Goemans B, Zwaan CM, Molenaar JJ, Jäger N, Dirksen U, Witt R, Pfister SM, Jones DTW, Kopp-Schneider A, Witt O, van Tilburg CM. Outcome of Children and Adolescents With Relapsed/Refractory/Progressive Malignancies Treated With Molecularly Informed Targeted Drugs in the Pediatric Precision Oncology Registry INFORM. JCO Precis Oncol 2023; 7:e2300015. [PMID: 37364231 DOI: 10.1200/po.23.00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/15/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE INFORM is an international pediatric precision oncology registry, prospectively collecting molecular and clinical data of children with recurrent, progressive, or very high-risk malignancies. We have previously identified a subgroup of patients with improved outcomes on the basis of molecular profiling. The present analysis systematically investigates progression-free survival (PFS) and overall survival (OS) of patients receiving matching targeted treatment (MTT) with the most frequently applied drug classes and its correlation with underlying molecular alterations. METHODS A cohort of 519 patients with relapsed or refractory high-risk malignancies who had completed a follow-up of at least 2 years or shorter in the case of death or loss to follow-up was analyzed. Survival times were compared using the log-rank test. RESULTS MTT with anaplastic lymphoma kinase (ALK), neurotrophic tyrosine receptor kinase (NTRK), and B-RAF kinase (BRAF) inhibitors showed significantly improved PFS (P = .012) and OS (P = .036) in comparison with conventional treatment or no treatment. However, analysis of the four most commonly applied MTT groups, mitogen-activated protein kinase (MEK- n = 19), cyclin-dependent kinase (CDK- n = 23), other kinase (n = 62), and mammalian-target of rapamycin (mTOR- n = 20) inhibitors, did not reveal differences in PFS or OS compared with conventional treatment or no treatment in patients with similar molecular pathway alterations. We did not observe differences in the type of pathway alterations (eg, copy number alterations, single-nucleotide variants, InDels, gene fusions) addressed by MTT. CONCLUSION Patients with respective molecular alterations benefit from treatment with ALK, NTRK, and BRAF inhibitors as previously described. No survival benefit was observed with MTT for mutations in the MEK, CDK, other kinase, or mTOR signaling pathways. The noninterventional character of a registry has to be taken into account when interpreting these data and underlines the need for innovative interventional biomarker-driven clinical trials in pediatric oncology.
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Affiliation(s)
- Anna-Elisa Heipertz
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Heidelberg Medical Faculty, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Kristian W Pajtler
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elke Pfaff
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kathrin Schramm
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mirjam Blattner-Johnson
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Till Milde
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Barbara C Jones
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cecilia Zuliani
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Caroline Hutter
- Department of Pediatrics, St Anna Children's Hospital, Medical University of Vienna, and St Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - Olli Lohi
- Tampere Center for Child Health Research and Tays Cancer Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Antonis Kattamis
- Division of Pediatric Hematology-Oncology, First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
| | - Iwona Dachowska-Kalwak
- Department of Pediatric Hematology/Oncology and BMT, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Nilsson
- Astrid Lindgrens Childrens Hospital, Karolinska University Hospital, K6 Women's and Children's Health, K6 Paediatric Oncology and Paediatric Surgery, Stockholm, Sweden
| | - Nicolas U Gerber
- Department of Oncology, University Children's Hospital, Zurich, Switzerland
| | | | - Bianca Goemans
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - C Michel Zwaan
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Ped Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Jan J Molenaar
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Natalie Jäger
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Heidelberg Medical Faculty, University of Heidelberg, Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Uta Dirksen
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Heidelberg Medical Faculty, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- West German Cancer Center, Pediatrics III, University Hospital Essen, Essen, Germany
| | - Ruth Witt
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - David T W Jones
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annette Kopp-Schneider
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Department Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Olaf Witt
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Cornelis M van Tilburg
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
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13
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Aasa J, Tiselius E, Sinha I, Edman G, Wahlund M, Hedengren SS, Nilsson A, Berggren A. The Applicability of a 2-Transcript Signature to Identify Bacterial Infections in Children with Febrile Neutropenia. Children (Basel) 2023; 10:966. [PMID: 37371198 DOI: 10.3390/children10060966] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/30/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023]
Abstract
Febrile neutropenia is a common complication during chemotherapy in paediatric cancer care. In this setting, clinical features and current diagnostic tests do not reliably distinguish between bacterial and viral infections. Children with cancer (n = 63) presenting with fever and neutropenia were recruited for extensive microbiological and blood RNA sampling. RNA sequencing was successful in 43 cases of febrile neutropenia. These were classified as having probable bacterial infection (n = 17), probable viral infection (n = 13) and fever of unknown origin (n = 13) based on microbiological defined infections and CRP cut-off levels. RNA expression data with focus on the 2-transcript signature (FAM89A and IFI44L), earlier shown to identify bacterial infections with high specificity and sensitivity, was implemented as a disease risk score. The median disease risk score was higher in the probable bacterial infection group, -0.695 (max 2.795; min -5.478) compared to the probable viral infection group -3.327 (max 0.218; min -7.861), which in ROC analysis corresponded to a sensitivity of 0.88 and specificity of 0.54 with an AUC of 0.80. To further characterise the immune signature, analysis of significantly expressed genes and pathways was performed and upregulation of genes associated to antibacterial responses was present in the group classified as probable bacterial infection. Our results suggest that the 2-transcript signature may have a potential use as a diagnostic tool to identify bacterial infections in immunosuppressed children with febrile neutropenia.
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Affiliation(s)
- Johannes Aasa
- Division of Pediatric Oncology, Department of Women and Children's Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Eva Tiselius
- Division of Pediatric Oncology, Department of Women and Children's Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Indranil Sinha
- Division of Pediatric Oncology, Department of Women and Children's Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Gunnar Edman
- Department of Clinical Sciences, Karolinska Institutet, 17177 Stockholm, Sweden
- Research and Development, Norrtälje Hospital, 76145 Norrtälje, Sweden
| | | | - Shanie Saghafian Hedengren
- Division of Pediatric Oncology, Department of Women and Children's Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Anna Nilsson
- Division of Pediatric Oncology, Department of Women and Children's Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Division of Pediatric Hematology-Oncology, Tema Barn, Astrid Lindgren Children's Hospital, 17164 Solna, Sweden
| | - Anna Berggren
- Division of Pediatric Oncology, Department of Women and Children's Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Research and Development, Norrtälje Hospital, 76145 Norrtälje, Sweden
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14
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Kaya I, Schembri LS, Nilsson A, Shariatgorji R, Baijnath S, Zhang X, Bezard E, Svenningsson P, Odell LR, Andrén PE. On-Tissue Chemical Derivatization for Comprehensive Mapping of Brain Carboxyl and Aldehyde Metabolites by MALDI-MS Imaging. J Am Soc Mass Spectrom 2023; 34:836-846. [PMID: 37052344 PMCID: PMC10161219 DOI: 10.1021/jasms.2c00336] [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: 05/04/2023]
Abstract
The visualization of small metabolites by MALDI mass spectrometry imaging in brain tissue sections is challenging due to low detection sensitivity and high background interference. We present an on-tissue chemical derivatization MALDI mass spectrometry imaging approach for the comprehensive mapping of carboxyls and aldehydes in brain tissue sections. In this approach, the AMPP (1-(4-(aminomethyl)phenyl)pyridin-1-ium chloride) derivatization reagent is used for the covalent charge-tagging of molecules containing carboxylic acid (in the presence of peptide coupling reagents) and aldehydes. This includes free fatty acids and the associated metabolites, fatty aldehydes, dipeptides, neurotoxic reactive aldehydes, amino acids, neurotransmitters and associated metabolites, as well as tricarboxylic acid cycle metabolites. We performed sensitive ultrahigh mass resolution MALDI-MS detection and imaging of various carboxyl- and aldehyde-containing endogenous metabolites simultaneously in rodent brain tissue sections. We verified the AMPP-derivatized metabolites by tandem MS for structural elucidation. This approach allowed us to image numerous aldehydes and carboxyls, including certain metabolites which had been undetectable in brain tissue sections. We also demonstrated the application of on-tissue derivatization to carboxyls and aldehydes in coronal brain tissue sections of a nonhuman primate Parkinson's disease model. Our methodology provides a powerful tool for the sensitive, simultaneous spatial molecular imaging of numerous aldehydes and carboxylic acids during pathological states, including neurodegeneration, in brain tissue.
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Affiliation(s)
- Ibrahim Kaya
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, SE-75124 Uppsala, Sweden
| | | | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, SE-75124 Uppsala, Sweden
| | - Reza Shariatgorji
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, SE-75124 Uppsala, Sweden
| | - Sooraj Baijnath
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, SE-75124 Uppsala, Sweden
| | - Xiaoqun Zhang
- Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Erwan Bezard
- Université de Bordeaux, Institut des Maladies Neurodégénératives, F-33000 Bordeaux, France
| | - Per Svenningsson
- Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Luke R Odell
- Department of Medicinal Chemistry, Uppsala University, SE-75123 Uppsala, Sweden
| | - Per E Andrén
- Department of Pharmaceutical Biosciences, Spatial Mass Spectrometry, Science for Life Laboratory, Uppsala University, SE-75124 Uppsala, Sweden
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15
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Schoepf J, Uhrig S, Heilig CE, Lee KS, Walther T, Carazzato A, Dobberkau AM, Weichenhan D, Plass C, Hartmann M, Diwan G, Carrero Z, Ball CR, Hohl T, Kindler T, Rudolph-Hähnel P, Nilsson A, Øra I, Imle R, Banito A, Russell R, Jones BC, Lipka DB, Glimm H, Hübschmann D, Hartmann W, Fröhling S, Scholl C. Abstract 4544: Genomic, transcriptomic, functional, and mechanistic characterization of rhabdomyosarcoma with FUS-TFCP2 or EWSR1-TFCP2 fusions. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4544] [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: 04/07/2023]
Abstract
Abstract
Rhabdomyosarcoma (RMS) is a soft-tissue sarcoma subtype composed of malignant immature precursor cells with myogenic differentiation defined by aberrant expression of the transcription factors MYOD1 and MYOG. Four subtypes are distinguished, characterized by considerable clinical, histologic, and genetic heterogeneity. RMS with fusions of the transcription factor TFCP2 to either FUS or EWSR1 has only recently been observed, but its classification and pathogenesis are unclear. We studied the clinical course, histopathology, and molecular landscape of 12 cases of this new RMS type and determined the functional properties of tumor-specific genetic alterations. Unusually for gene fusion-driven sarcomas, most tumors had highly rearranged genomes, including chromothripsis, and signs of defective homologous recombination DNA repair. All tumors were characterized by extremely high expression of a truncated TERT variant and the receptor tyrosine kinase ALK. The latter was additionally affected by intragenic deletions (33%), which resulted, together with aberrant splicing events, in the expression of shortened ALK variants (58%). Three ALK variants were oncogenic in immortalized cells in vitro and after xenotransplantation in mice and responded variably to different ALK inhibitors. Additional recurrent alterations included CDKN2A/MTAP co-deletions (67%) and mutations in PAPPA2 (25%) encoding an IGFBP5-specific proteinase. DNA methylation analysis of FUS/EWSR1-TFCP2 RMS, along with 19 other soft-tissue sarcoma types, revealed a close relationship with undifferentiated sarcoma but not with other RMS subtypes, suggesting that FUS/EWSR1-TFCP2 RMS is a distinct sarcoma entity possibly arising from a different cell of origin than other RMS types. Transduction of TFCP2 fusions into immortalized human cells conferred anchorage-independent growth and blocked late myogenic differentiation. Genes significantly induced in these cells were also highly expressed in patient tumors, including ALK, TERT, and two known regulators of skeletal muscle cells, IGFBP5 and PTH1R. ACT-seq demonstrated direct binding of FUS-TFCP2 to the ALK and TERT gene loci outside their regular promoters, which correlated with the expression of alternative transcript variants. Finally, FUS-TFCP2 appeared to induce a defect in DNA double-strand repair in immortalized cells, rendering them sensitive to treatment with cisplatin. Together, our study gives insights into the pathogenesis of a new RMS subtype defined by FUS-TFCP2 or EWSR1-TFCP2 fusions and suggests entry points for therapeutic intervention with DNA-damaging agents, ALK inhibitors, and, in the case of additional CDKN2A/MTAP co-deletion, drugs targeting PRMT5.
Citation Format: Julia Schoepf, Sebastian Uhrig, Christoph E. Heilig, Kwang-Seok Lee, Tatjana Walther, Alexander Carazzato, Anna Maria Dobberkau, Dieter Weichenhan, Christoph Plass, Mark Hartmann, Gaurav Diwan, Zunamys Carrero, Claudia R. Ball, Tobias Hohl, Thomas Kindler, Patricia Rudolph-Hähnel, Anna Nilsson, Ingrid Øra, Roland Imle, Ana Banito, Robert Russell, Barbara C. Jones, Daniel B. Lipka, Hanno Glimm, Daniel Hübschmann, Wolfgang Hartmann, Stefan Fröhling, Claudia Scholl. Genomic, transcriptomic, functional, and mechanistic characterization of rhabdomyosarcoma with FUS-TFCP2 or EWSR1-TFCP2 fusions. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4544.
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Affiliation(s)
- Julia Schoepf
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | | | - Christoph E. Heilig
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Kwang-Seok Lee
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Tatjana Walther
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Alexander Carazzato
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Anna Maria Dobberkau
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | | | | | - Mark Hartmann
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Gaurav Diwan
- 3Heidelberg University Biochemistry Centre, Heidelberg University, Heidelberg, Germany
| | - Zunamys Carrero
- 4National Center for Tumor Diseases (NCT/UCC) Dresden, Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Claudia R. Ball
- 4National Center for Tumor Diseases (NCT/UCC) Dresden, Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Tobias Hohl
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Thomas Kindler
- 5University Cancer Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Anna Nilsson
- 6Pediatric Oncology and Coagulation, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Øra
- 7Pediatric Oncology and Hematology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Roland Imle
- 2German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ana Banito
- 2German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Robert Russell
- 3Heidelberg University Biochemistry Centre, Heidelberg University, Heidelberg, Germany
| | - Barbara C. Jones
- 8Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
| | - Daniel B. Lipka
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Hanno Glimm
- 4National Center for Tumor Diseases (NCT/UCC) Dresden, Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Daniel Hübschmann
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Wolfgang Hartmann
- 9Gerhard Domagk Institute of Pathology, University Hospital Münster, Münster, Germany
| | - Stefan Fröhling
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Claudia Scholl
- 1German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
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16
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Jacob J, Biering-Sørensen T, Holger Ehlers L, Edwards CH, Mohn KGI, Nilsson A, Hjelmgren J, Ma W, Sharma Y, Ciglia E, Mould-Quevedo J. Cost-Effectiveness of Vaccination of Older Adults with an MF59®-Adjuvanted Quadrivalent Influenza Vaccine Compared to Standard-Dose and High-Dose Vaccines in Denmark, Norway, and Sweden. Vaccines (Basel) 2023; 11:vaccines11040753. [PMID: 37112667 PMCID: PMC10145635 DOI: 10.3390/vaccines11040753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Individuals aged 65 years and above are at increased risk of complications and death from influenza compared with any other age group. Enhanced vaccines, as the MF59®-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose quadrivalent influenza vaccine (HD-QIV), provide increased protection for older adults in comparison to the traditional standard-dose quadrivalent influenza vaccines (SD-QIV). This study aimed to assess the cost-effectiveness of aQIV compared to SD-QIV and HD-QIV in Denmark, Norway, and Sweden for adults aged ≥65 years. A static decision tree model was used to evaluate costs and outcomes of different vaccination strategies from healthcare payer and societal perspectives. This model projects that compared to SD-QIV, vaccination with aQIV could prevent a combined total of 18,772 symptomatic influenza infections, 925 hospitalizations, and 161 deaths in one influenza season across the three countries. From a healthcare payer perspective, the incremental costs per quality adjusted life year (QALY) gained with aQIV versus SD-QIV were EUR 10,170/QALY in Denmark, EUR 12,515/QALY in Norway, and EUR 9894/QALY in Sweden. The aQIV was cost saving compared with HD-QIV. This study found that introducing aQIV to the entire population aged ≥65 years may contribute to reducing the disease and economic burden associated with influenza in these countries.
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17
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Shionoya K, Nilsson A, Engström Ruud L, Engblom D, Blomqvist A. Melanocortin-4 receptors on neurons in the parabrachial nucleus mediate inflammation-induced suppression of food-seeking behavior. Brain Behav Immun 2023; 110:80-84. [PMID: 36813210 DOI: 10.1016/j.bbi.2023.02.014] [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: 12/16/2022] [Revised: 02/02/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
Anorexia is a common symptom during infectious and inflammatory disease. Here we examined the role of melanocortin-4 receptors (MC4Rs) in inflammation-induced anorexia. Mice with transcriptional blockage of the MC4Rs displayed the same reduction of food intake following peripheral injection of lipopolysaccharide as wild type mice but were protected against the anorexic effect of the immune challenge in a test in which fasted animals were to use olfactory cues to find a hidden cookie. By using selective virus-mediated receptor re-expression we demonstrate that the suppression of the food-seeking behavior is subserved by MC4Rs in the brain stem parabrachial nucleus, a central hub for interoceptive information involved in the regulation of food intake. Furthermore, the selective expression of MC4R in the parabrachial nucleus also attenuated the body weight increase that characterizes MC4R KO mice. These data extend on the functions of the MC4Rs and show that MC4Rs in the parabrachial nucleus are critically involved in the anorexic response to peripheral inflammation but also contribute to body weight homeostasis during normal conditions.
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Affiliation(s)
- Kiseko Shionoya
- Division of Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Anna Nilsson
- Division of Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Linda Engström Ruud
- Institute of Neuroscience and Physiology, Department of Physiology, University of Gothenburg, Sweden
| | - David Engblom
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Anders Blomqvist
- Division of Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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18
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Hori K, Nilsson A, Tobias SM. Waves in planetary dynamos. Rev Mod Plasma Phys 2023; 7:5. [PMID: 36588584 PMCID: PMC9792417 DOI: 10.1007/s41614-022-00104-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/04/2022] [Indexed: 12/27/2022]
Abstract
This Special Topic focuses on magnetohydrodynamic (MHD) processes in the deep interiors of planets, in which their fluid dynamos are in operation. The dynamo-generated, global, magnetic fields provide a background for our solar-terrestrial environment. Probing the processes within the dynamos is a significant theoretical and computational challenge and any window into interior dynamics greatly increases our understanding. Such a window is provided by exploring rapid dynamics, particularly MHD waves about the dynamo-defined basic state. This field is the subject of current attention as geophysical observations and numerical modellings advance. We here pay particular attention to torsional Alfvén waves/oscillations and magnetic Rossby waves, which may be regarded as typical axisymmetric and nonaxisymmetric modes, respectively, amongst a wide variety of wave classes of rapidly rotating MHD fluids. The excitation of those waves has been evidenced for the Earth - whilst their presence has also been suggested for Jupiter. We shall overview their dynamics, summarise our current understanding, and give open questions for future perspectives.
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Affiliation(s)
- K. Hori
- Graduate School of System Informatics, Kobe University, Rokkodai 1-1, Nada, Kobe, 657-8501 Japan
| | - A. Nilsson
- Department of Geology, Lund University, Sölvegatan 12, Lund, 22362 Sweden
| | - S. M. Tobias
- Department of Applied Mathematics, University of Leeds, Woodhouse Lane, Leeds, LS2 9JT UK
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19
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Enlund S, Sinha I, Amor AR, Fard SS, Tamm EP, Jiang Q, Lundin V, Nilsson A, Holm F. Malignant DFFB isoform switching promotes leukemia survival in relapse pediatric T-cell acute lymphoblastic leukemia. EJHaem 2022; 4:115-124. [PMID: 36819185 PMCID: PMC9928657 DOI: 10.1002/jha2.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/02/2022] [Accepted: 12/08/2022] [Indexed: 12/31/2022]
Abstract
With modern treatment most children with acute lymphoblastic leukemia (ALL) survive without relapse. However, for children who relapse the prognosis is still poor, especially in children with T-cell phenotype (T-ALL) and remains the major cause of death. The exact mechanism of relapse is currently not known. While contribution of RNA processing alteration has been linked to other hematological malignancies, its contribution in pediatric T-ALL may provide new insights. Almost all human genes express more than one alternative splice isoform. Thus, gene modulation producing a diverse repertoire of the transcriptome and proteome have become a significant molecular marker of cancer and a potential therapeutic vulnerability. To study this, we performed RNA-sequencing analysis on patient-derived samples followed by splice isoform-specific PCR. We uncovered a distinct RNA splice isoform expression pattern characteristic for relapse samples compared to the leukemia samples from the time of diagnosis. We also identified deregulated splicing and apoptosis pathways specific for relapse T-ALL. Moreover, patients with T-ALL displayed pro-survival splice isoform switching favoring pro-survival isoforms compared to normal healthy stem cells. Cumulatively, pro-survival isoform switching and DFFB isoform regulation of SOX2 and MYCN may play a role in T-ALL proliferation and survival, thus serving as a potential therapeutic option.
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Affiliation(s)
- Sabina Enlund
- Deparment of Women's and Children's HealthDivision of Pediatric Oncology and SurgeryKarolinska InsitutetStockholmSweden
| | - Indranil Sinha
- Deparment of Women's and Children's HealthDivision of Pediatric Oncology and SurgeryKarolinska InsitutetStockholmSweden
| | - Amanda Ramilo Amor
- Deparment of Women's and Children's HealthDivision of Pediatric Oncology and SurgeryKarolinska InsitutetStockholmSweden
| | - Shahrzad Shirazi Fard
- Deparment of Women's and Children's HealthDivision of Pediatric Oncology and SurgeryKarolinska InsitutetStockholmSweden
| | | | - Qingfei Jiang
- Division of Regenerative MedicineDepartment of MedicineSanford Consortium for Regenerative MedicineUniversity of CaliforniaLa JollaCaliforniaUSA,Moores Cancer CenterLa JollaCaliforniaUSA
| | - Vanessa Lundin
- Center for Hematology and Regenerative MedicineDepartment of Medicine HuddingeKarolinska InstitutetStockholmSweden
| | - Anna Nilsson
- Deparment of Women's and Children's HealthDivision of Pediatric Oncology and SurgeryKarolinska InsitutetStockholmSweden
| | - Frida Holm
- Deparment of Women's and Children's HealthDivision of Pediatric Oncology and SurgeryKarolinska InsitutetStockholmSweden
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20
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Didriksson I, Leffler M, Spångfors M, Lindberg S, Reepalu A, Nilsson A, Cronqvist J, Andertun S, Nelderup M, Jungner M, Johnsson P, Lilja G, Frigyesi A, Friberg H. Intensive care unit burden is associated with increased mortality in critically ill COVID-19 patients. Acta Anaesthesiol Scand 2022; 67:329-338. [PMID: 36537243 PMCID: PMC9878196 DOI: 10.1111/aas.14184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/22/2022] [Accepted: 12/04/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Traditional models to predict intensive care outcomes do not perform well in COVID-19. We undertook a comprehensive study of factors affecting mortality and functional outcome after severe COVID-19. METHODS In this prospective multicentre cohort study, we enrolled laboratory-confirmed, critically ill COVID-19 patients at six ICUs in the Skåne Region, Sweden, between May 11, 2020, and May 10, 2021. Demographics and clinical data were collected. ICU burden was defined as the total number of ICU-treated COVID-19 patients in the region on admission. Surviving patients had a follow-up at 90 days for assessment of functional outcome using the Glasgow Outcome Scale-Extended (GOSE), an ordinal scale (1-8) with GOSE ≥5 representing a favourable outcome. The primary outcome was 90-day mortality; the secondary outcome was functional outcome at 90 days. RESULTS Among 498 included patients, 74% were male with a median age of 66 years and a median body mass index (BMI) of 30 kg/m2 . Invasive mechanical ventilation was employed in 72%. Mortality in the ICU, in-hospital and at 90 days was 30%, 38% and 39%, respectively. Mortality increased markedly at age 60 and older. Increasing ICU burden was independently associated with a two-fold increase in mortality. Higher BMI was not associated with increased mortality. Besides age and ICU burden, smoking status, cortisone use, Pa CO2 >7 kPa, and inflammatory markers on admission were independent factors of 90-day mortality. Lower GOSE at 90 days was associated with a longer stay in the ICU. CONCLUSION In critically ill COVID-19 patients, the 90-day mortality was 39% and increased considerably at age 60 or older. The ICU burden was associated with mortality, whereas a high BMI was not. A longer stay in the ICU was associated with unfavourable functional outcomes at 90 days.
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Affiliation(s)
- Ingrid Didriksson
- Department of Clinical Sciences, Anaesthesiology and Intensive CareLund UniversityLundSweden,Skåne University HospitalIntensive and Perioperative CareMalmöSweden
| | - Märta Leffler
- Department of Clinical Sciences, Anaesthesiology and Intensive CareLund UniversityLundSweden,Skåne University HospitalIntensive and Perioperative CareMalmöSweden
| | - Martin Spångfors
- Department of Clinical Sciences, Anaesthesiology and Intensive CareLund UniversityLundSweden,Kristianstad HospitalAnaesthesia and Intensive CareKristianstadSweden
| | - Sarah Lindberg
- Skåne University HospitalResearch and EducationLundSweden
| | - Anton Reepalu
- Department of Translational MedicineLund UniversityMalmöSweden,Department of Infectious DiseasesSkåne University HospitalMalmöSweden
| | - Anna Nilsson
- Department of Translational MedicineLund UniversityMalmöSweden,Department of Infectious DiseasesSkåne University HospitalMalmöSweden
| | - Jonas Cronqvist
- Department of Translational MedicineLund UniversityMalmöSweden,Department of Infectious DiseasesSkåne University HospitalMalmöSweden
| | - Sara Andertun
- Helsingborg HospitalAnaesthesia, and Intensive CareHelsingborgSweden
| | - Maria Nelderup
- Helsingborg HospitalAnaesthesia, and Intensive CareHelsingborgSweden
| | - Mårten Jungner
- Department of Clinical Sciences, Anaesthesiology and Intensive CareLund UniversityLundSweden,Skåne University HospitalIntensive and Perioperative CareMalmöSweden
| | - Patrik Johnsson
- Department of Clinical Sciences, Anaesthesiology and Intensive CareLund UniversityLundSweden,Skåne University HospitalIntensive and Perioperative CareMalmöSweden
| | - Gisela Lilja
- Skåne University HospitalDepartment of NeurologyLundSweden
| | - Attila Frigyesi
- Department of Clinical Sciences, Anaesthesiology and Intensive CareLund UniversityLundSweden,Skåne University HospitalIntensive and Perioperative CareLundSweden
| | - Hans Friberg
- Department of Clinical Sciences, Anaesthesiology and Intensive CareLund UniversityLundSweden,Skåne University HospitalIntensive and Perioperative CareMalmöSweden
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21
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr 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Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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22
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Sundberg E, Georgantzi K, Langenskiöld C, Król L, Nilsson F, Vogt H, Palle J, Ek T, Nilsson A. Low numbers of COVID-19 in Swedish pediatric oncology patients during the first pandemic year despite an open society. Pediatr Blood Cancer 2022; 69:e29750. [PMID: 35484955 PMCID: PMC9088657 DOI: 10.1002/pbc.29750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/07/2022] [Accepted: 04/01/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sweden adopted a different strategy than many other countries to combat the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and kept most schools open. Initial reports from China suggested that coronavirus disease 2019 (COVID-19) was milder in children compared to adults, but there was a lack of data from immunocompromised children. Therefore, we investigated the rate of verified SARS-CoV-2 infections in our Swedish pediatric oncology patients. PROCEDURE This was a multicenter retrospective study. A questionnaire including patient data as well as SARS-CoV-2 data was sent to the six Swedish childhood cancer centers in May 2021. RESULTS During the first pandemic year, 49 patients were identified as SARS-CoV-2 positive, and 22 (45%) children were hospitalized with COVID-19. Two children needed intensive care, but no COVID-19-related deaths were reported. Most patients (n = 36, 73%) were on active chemotherapy treatment and 23 children (49%) attended school or daycare at least part-time. Half of the SARS-CoV-2-positive patients experienced a delay in cancer treatment. CONCLUSIONS Despite the rapid spread of SARS-CoV-2 in Sweden, without a strict lockdown of the society, the number of nationally reported pediatric oncology patients with polymerase chain reaction (PCR)-verified infection was low, and the majority of children had mild disease. Our data show that treatment interruptions occurred frequently and this should clearly be avoided for the coming years.
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Affiliation(s)
- Emil Sundberg
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Kleopatra Georgantzi
- Division of Pediatric Hematology‐OncologyTema Barn, Astrid Lindgren Children's HospitalStockholmSweden
| | | | - Ladislav Król
- Division of Pediatric Hematology‐OncologySkåne University HospitalLundSweden
| | - Frans Nilsson
- Division of Pediatric Hematology‐OncologyUmeå University HospitalUmeåSweden
| | - Hartmut Vogt
- Crown Princess Victoria's Child and Youth Hospital, Division of Pediatric Hematology‐Oncology B153, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Josefine Palle
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden
| | - Torben Ek
- Children's Cancer CentreQueen Silvia Children's HospitalGothenburgSweden
| | - Anna Nilsson
- Division of Pediatric Hematology‐OncologyTema Barn, Astrid Lindgren Children's HospitalStockholmSweden,Department of Women's and Children's HealthKarolinska InstitutetSolnaSweden
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23
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Sundberg E, Hoffman T, Nilsson A, Pahnke S, Enblad G, Kolstad L, Rönnberg B, Lundkvist Å, Torkki M, Zhou O, Anderson J, Harila‐Saari A, Palle J. COVID-19 seroprevalence and clinical picture in Swedish pediatric oncology and hematology patients. Pediatr Blood Cancer 2022; 69:e29773. [PMID: 35615775 PMCID: PMC9348419 DOI: 10.1002/pbc.29773] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/24/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Children develop symptomatic coronavirus disease 2019 (COVID-19) more rarely than adults upon infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pediatric oncology and hematology patients may be at increased risk of severe COVID-19 due to their underlying disease or treatment. We investigated COVID-19 and seroprevalence of anti-SARS-CoV-2 antibodies, respectively, in a Swedish cohort of pediatric oncology and hematology patients. PROCEDURE Patients (n = 136) were recruited between June 2020 and September 2021 at Uppsala University Children's Hospital, Sweden. Up to six consecutive blood samples per patient were analyzed for wild-type anti-S1 IgM and IgG antibodies (including after vaccination, n = 4). Clinical data on COVID-19 (including polymerase chain reaction [PCR] test results) were collected from electronic medical records. A questionnaire was completed at recruitment. RESULTS A cumulative seroprevalence (IgM and IgG) of 33% (45/136 patients, 95% confidence interval: 25%-41%) was observed in this patient cohort, of whom 66% (90/136 patients) were under severe immunosuppressive treatment during the study period. Increasing patient age (p = .037) and PCR test results (p < .002) were associated with seropositivity in nonvaccinated cases. Most seropositive, nonvaccinated cases (32/43, 74%) were never PCR-verified for SARS-CoV-2 infection. Of the 13 patients with PCR-verified infection, nine (69%) reported mild disease. A majority (63%) reported continued school attendance during the pandemic. CONCLUSIONS Swedish pediatric oncology and hematology patients developed antibodies against SARS-CoV-2, despite their diagnosis and/or treatment, and the observed seroprevalence was similar to that in national pediatric outpatients. PCR-verified cases underestimate the true incidence of COVID-19 in this patient cohort.
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Affiliation(s)
- Emil Sundberg
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Tove Hoffman
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC)Uppsala UniversityUppsalaSweden
| | - Anna Nilsson
- Department of Women's and Children's Health, Pediatric OncologyKarolinska InstitutetStockholmSweden
| | - Simon Pahnke
- Unit of Oncology, Department of Medical SciencesUppsala UniversityUppsalaSweden
| | - Gunilla Enblad
- Department of Immunology, Genetics and PathologyUppsala UniversityUppsalaSweden
| | - Linda Kolstad
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC)Uppsala UniversityUppsalaSweden
| | - Bengt Rönnberg
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC)Uppsala UniversityUppsalaSweden,Laboratory of Clinical MicrobiologyUppsala University HospitalUppsalaSweden
| | - Åke Lundkvist
- Department of Medical Biochemistry and Microbiology, Zoonosis Science Center (ZSC)Uppsala UniversityUppsalaSweden
| | - Milla Torkki
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden
| | - Otto Zhou
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden
| | - Jenna Anderson
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Arja Harila‐Saari
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Josefine Palle
- Department of Children's Oncology and HematologyUppsala University HospitalUppsalaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
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24
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Porcu A, Nilsson A, Booreddy S, Barnes SA, Welsh DK, Dulcis D. Seasonal changes in day length induce multisynaptic neurotransmitter switching to regulate hypothalamic network activity and behavior. Sci Adv 2022; 8:eabn9867. [PMID: 36054362 PMCID: PMC10848959 DOI: 10.1126/sciadv.abn9867] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/19/2022] [Indexed: 05/18/2023]
Abstract
Seasonal changes in day length (photoperiod) affect numerous physiological functions. The suprachiasmatic nucleus (SCN)-paraventricular nucleus (PVN) axis plays a key role in processing photoperiod-related information. Seasonal variations in SCN and PVN neurotransmitter expression have been observed in humans and animal models. However, the molecular mechanisms by which the SCN-PVN network responds to altered photoperiod is unknown. Here, we show in mice that neuromedin S (NMS) and vasoactive intestinal polypeptide (VIP) neurons in the SCN display photoperiod-induced neurotransmitter plasticity. In vivo recording of calcium dynamics revealed that NMS neurons alter PVN network activity in response to winter-like photoperiod. Chronic manipulation of NMS neurons is sufficient to induce neurotransmitter switching in PVN neurons and affects locomotor activity. Our findings reveal previously unidentified molecular adaptations of the SCN-PVN network in response to seasonality and the role for NMS neurons in adjusting hypothalamic function to day length via a coordinated multisynaptic neurotransmitter switching affecting behavior.
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Affiliation(s)
- Alessandra Porcu
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Anna Nilsson
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sathwik Booreddy
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Samuel A. Barnes
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - David K. Welsh
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Davide Dulcis
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
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25
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Ribeiro HG, Nilsson A, Melo LDR, Oliveira A. Analysis of intact prophages in genomes of Paenibacillus larvae: An important pathogen for bees. Front Microbiol 2022; 13:903861. [PMID: 35923395 PMCID: PMC9341999 DOI: 10.3389/fmicb.2022.903861] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Paenibacillus larvae is the etiological agent of American Foulbrood (AFB), a highly contagious and worldwide spread bacterial disease that affects honeybee brood. In this study, all complete P. larvae genomes available on the NCBI database were analyzed in order to detect presence of prophages using the PHASTER software. A total of 55 intact prophages were identified in 11 P. larvae genomes (5.0 ± 2.3 per genome) and were further investigated for the presence of genes encoding relevant traits related to P. larvae. A closer look at the prophage genomes revealed the presence of several putative genes such as metabolic and antimicrobial resistance genes, toxins or bacteriocins, potentially influencing host performance. Some of the coding DNA sequences (CDS) were present in all ERIC-genotypes, while others were only found in a specific genotype. While CDS encoding toxins and antitoxins such as HicB and MazE were found in prophages of all bacterial genotypes, others, from the same category, were provided by prophages particularly to ERIC I (enhancin-like toxin), ERIC II (antitoxin SocA) and ERIC V strains (subunit of Panton-Valentine leukocidin system (PVL) LukF-PV). This is the first in-depth analysis of P. larvae prophages. It provides better knowledge on their impact in the evolution of virulence and fitness of P. larvae, by discovering new features assigned by the viruses.
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Affiliation(s)
- Henrique G. Ribeiro
- LIBRO – Laboratório de Investigação em Biofilmes Rosário Oliveira, Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS – Associate Laboratory on Biotechnology and Bioengineering, and Electromechanical Systems, Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Anna Nilsson
- Department of Ecology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Luís D. R. Melo
- LIBRO – Laboratório de Investigação em Biofilmes Rosário Oliveira, Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS – Associate Laboratory on Biotechnology and Bioengineering, and Electromechanical Systems, Centre of Biological Engineering, University of Minho, Braga, Portugal
- *Correspondence: Luís D. R. Melo,
| | - Ana Oliveira
- LIBRO – Laboratório de Investigação em Biofilmes Rosário Oliveira, Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS – Associate Laboratory on Biotechnology and Bioengineering, and Electromechanical Systems, Centre of Biological Engineering, University of Minho, Braga, Portugal
- Ana Oliveira,
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26
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Baijnath S, Kaya I, Nilsson A, Shariatgorji R, Andrén PE. Advances in spatial mass spectrometry enable in-depth neuropharmacodynamics. Trends Pharmacol Sci 2022; 43:740-753. [DOI: 10.1016/j.tips.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/06/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022]
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27
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Kiriamburi J, Muturi J, Mugweru J, Forsgren E, Nilsson A. Short Communication: Efficacy of Two Commercial Disinfectants on Paenibacillus larvae Spores. Front Vet Sci 2022; 9:884425. [PMID: 35647102 PMCID: PMC9133789 DOI: 10.3389/fvets.2022.884425] [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: 02/26/2022] [Accepted: 04/04/2022] [Indexed: 11/19/2022] Open
Abstract
Paenibacillus larvae is a spore-forming bacterium causing American foulbrood (AFB) in honey bee larvae. The remains of a diseased larva contains billions of extremely resilient P. larvae spores viable for decades. Burning clinically symptomatic colonies is widely considered the only workable strategy to prevent further spread of the disease, and the management practices used for decontamination requires high concentrations of chemicals or special equipment. The aim of this study was to test and compare the biocidal effect of two commercially available disinfectants, “Disinfection for beekeeping” and Virkon S on P. larvae. The two products were applied to P. larvae spores in suspension as well as inoculated on two common beehive materials, wood and Styrofoam. “Disinfection for beekeeping” had a 100 % biocidal effect on P. larvae spores in suspension compared to 87.0–88.6% for Virkon S which, however, had a significantly better effect on P. larvae on Styrofoam. The two disinfectants had similar effect on infected wood material.
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Affiliation(s)
| | - Jamleck Muturi
- Department of Biological Sciences, University of Embu, Embu, Kenya
| | - Julius Mugweru
- Department of Biological Sciences, University of Embu, Embu, Kenya
| | - Eva Forsgren
- Department of Ecology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Anna Nilsson
- Department of Ecology, Swedish University of Agricultural Sciences, Uppsala, Sweden
- *Correspondence: Anna Nilsson
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Hulme H, Fridjonsdottir E, Vallianatou T, Shariatgorji R, Nilsson A, Li Q, Bezard E, Andrén PE. Basal ganglia neuropeptides show abnormal processing associated with L-DOPA-induced dyskinesia. NPJ Parkinsons Dis 2022; 8:41. [PMID: 35418178 PMCID: PMC9007979 DOI: 10.1038/s41531-022-00299-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 03/04/2022] [Indexed: 12/23/2022] Open
Abstract
L-DOPA administration is the primary treatment for Parkinson’s disease (PD) but long-term administration is usually accompanied by hyperkinetic side-effects called L-DOPA-induced dyskinesia (LID). Signaling neuropeptides of the basal ganglia are affected in LID and changes in the expression of neuropeptide precursors have been described, but the final products formed from these precursors have not been well defined and regionally mapped. We therefore used mass spectrometry imaging to visualize and quantify neuropeptides in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine exposed parkinsonian and LID Macaca mulatta brain samples. We found that dyskinesia severity correlated with the levels of some abnormally processed peptides — notably, des-tyrosine dynorphins, substance P (1-7), and substance P (1-9) — in multiple brain regions. Levels of the active neuropeptides; dynorphin B, dynorphin A (1-8), α-neoendorphin, substance P (1-11), and neurokinin A, in the globus pallidus and substantia nigra correlated with putaminal levels of L-DOPA. Our results demonstrate that the abundance of selected active neuropeptides is associated with L-DOPA concentrations in the putamen, emphasizing their sensitivity to L-DOPA. Additionally, levels of truncated neuropeptides (which generally exhibit reduced or altered receptor affinity) correlate with dyskinesia severity, particularly for peptides associated with the direct pathway (i.e., dynorphins and tachykinins). The increases in tone of the tachykinin, enkephalin, and dynorphin neuropeptides in LID result in abnormal processing of neuropeptides with different biological activity and may constitute a functional compensatory mechanism for balancing the increased L-DOPA levels across the whole basal ganglia.
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Affiliation(s)
- Heather Hulme
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden.,Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden
| | - Elva Fridjonsdottir
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
| | - Theodosia Vallianatou
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
| | - Reza Shariatgorji
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden.,Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden.,Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden
| | - Qin Li
- Motac Neuroscience, Manchester, M15 6WE, UK
| | - Erwan Bezard
- Motac Neuroscience, Manchester, M15 6WE, UK.,Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France.,Centre National de la Recherche Scientifique, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Per E Andrén
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden. .,Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden.
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29
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Strittmatter N, Richards FM, Race AM, Ling S, Sutton D, Nilsson A, Wallez Y, Barnes J, Maglennon G, Gopinathan A, Brais R, Wong E, Serra MP, Atkinson J, Smith A, Wilson J, Hamm G, Johnson TI, Dunlop CR, Kaistha BP, Bunch J, Sansom OJ, Takats Z, Andrén PE, Lau A, Barry ST, Goodwin RJA, Jodrell DI. Method To Visualize the Intratumor Distribution and Impact of Gemcitabine in Pancreatic Ductal Adenocarcinoma by Multimodal Imaging. Anal Chem 2022; 94:1795-1803. [PMID: 35005896 DOI: 10.1021/acs.analchem.1c04579] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Gemcitabine (dFdC) is a common treatment for pancreatic cancer; however, it is thought that treatment may fail because tumor stroma prevents drug distribution to tumor cells. Gemcitabine is a pro-drug with active metabolites generated intracellularly; therefore, visualizing the distribution of parent drug as well as its metabolites is important. A multimodal imaging approach was developed using spatially coregistered mass spectrometry imaging (MSI), imaging mass cytometry (IMC), multiplex immunofluorescence microscopy (mIF), and hematoxylin and eosin (H&E) staining to assess the local distribution and metabolism of gemcitabine in tumors from a genetically engineered mouse model of pancreatic cancer (KPC) allowing for comparisons between effects in the tumor tissue and its microenvironment. Mass spectrometry imaging (MSI) enabled the visualization of the distribution of gemcitabine (100 mg/kg), its phosphorylated metabolites dFdCMP, dFdCDP and dFdCTP, and the inactive metabolite dFdU. Distribution was compared to small-molecule ATR inhibitor AZD6738 (25 mg/kg), which was codosed. Gemcitabine metabolites showed heterogeneous distribution within the tumor, which was different from the parent compound. The highest abundance of dFdCMP, dFdCDP, and dFdCTP correlated with distribution of endogenous AMP, ADP, and ATP in viable tumor cell regions, showing that gemcitabine active metabolites are reaching the tumor cell compartment, while AZD6738 was located to nonviable tumor regions. The method revealed that the generation of active, phosphorylated dFdC metabolites as well as treatment-induced DNA damage primarily correlated with sites of high proliferation in KPC PDAC tumor tissue, rather than sites of high parent drug abundance.
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Affiliation(s)
- Nicole Strittmatter
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
- Department of Chemistry, Technical University of Munich, 85748 Garching, Germany
| | - Frances M Richards
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, U.K
- Translational Medicine, Oncology R&D, Astra Zeneca, Cambridge CB4 0WG, United Kingdom
| | - Alan M Race
- Institute of Medical Bioinformatics and Biostatistics, Philipps University of Marburg, 35032 Marburg, Germany
| | - Stephanie Ling
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
| | - Daniel Sutton
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, 751 24 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, 751 24 Uppsala, Sweden
| | - Yann Wallez
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, U.K
- Bioscience, Oncology R&D, AstraZeneca, Cambridge CB2 0RE, United Kingdom
| | - Jennifer Barnes
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
| | - Gareth Maglennon
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
| | - Aarthi Gopinathan
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, U.K
| | - Rebecca Brais
- Cambridge University Hospitals NHS Trust, Cambridge CB2 0QQ, United Kingdom
| | - Edmond Wong
- Biologics Engineering, R&D, AstraZeneca, Cambridge CB12 6GH, United Kingdom
| | - Maria Paola Serra
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
| | - James Atkinson
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
| | - Aaron Smith
- DMPK, Oncology R&D, AstraZeneca, Cambridge CB2 0RE, United Kingdom
| | - Joanne Wilson
- DMPK, Oncology R&D, AstraZeneca, Cambridge CB2 0RE, United Kingdom
| | - Gregory Hamm
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
| | - Timothy I Johnson
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, U.K
| | - Charles R Dunlop
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, U.K
| | - Brajesh P Kaistha
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, U.K
- Clinical IO group, Early Oncology, AstraZeneca, Cambridge CB12 6GH, United Kingdom
| | - Josephine Bunch
- National Centre of Excellence in Mass Spectrometry Imaging, National Physical Laboratory, Teddington TW11 0LW, United Kingdom
- Rosalind Franklin Institute, Didcot OX11 0QS, United Kingdom
| | - Owen J Sansom
- Cancer Research UK Beatson Institute, Glasgow G61 1BD, United Kingdom
- Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, United Kingdom
| | - Zoltan Takats
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London SW7 2AZ, United Kingdom
- Rosalind Franklin Institute, Didcot OX11 0QS, United Kingdom
| | - Per E Andrén
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, 751 24 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, 751 24 Uppsala, Sweden
| | - Alan Lau
- Bioscience, Oncology R&D, AstraZeneca, Cambridge CB2 0RE, United Kingdom
| | - Simon T Barry
- Bioscience, Oncology R&D, AstraZeneca, Cambridge CB2 0RE, United Kingdom
| | - Richard J A Goodwin
- Imaging and Data Analytics, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, United Kingdom
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow G12 8TA, United Kingdom
| | - Duncan I Jodrell
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge CB2 0RE, U.K
- Department of Oncology, University of Cambridge, Cambridge CB2 0XZ, United Kingdom
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30
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Fridjonsdottir E, Vallianatou T, Mantas I, Shariatgorji R, Nilsson A, Schembri LS, Odell LR, Svenningsson P, Andrén PE. Region-Specific and Age-Dependent Multitarget Effects of Acetylcholinesterase Inhibitor Tacrine on Comprehensive Neurotransmitter Systems. ACS Chem Biol 2022; 17:147-158. [PMID: 34932310 PMCID: PMC8787750 DOI: 10.1021/acschembio.1c00803] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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]
Abstract
![]()
Regional brain distribution and
metabolism of neurotransmitters
and their response to drug treatment are fundamentally important for
understanding the central effects of neuroactive substances. We used
matrix-assisted laser desorption/ionization mass spectrometry imaging
in
combination with multivariate analysis to visualize in anatomical
detail metabolic effects of aging and tacrine-mediated acetylcholinesterase
inhibition on comprehensive neurotransmitter systems in multiple mouse
brain regions of 12-week-old and 14-month-old mice. We detected age-related
increases in 3,4-dihydroxyphenylacetaldehyde and histamine, indicating
oxidative stress and aging deficits in astrocytes. Tacrine had a significant
impact on the metabolism of neurotransmitters in both age groups;
predominantly, there was an increased norepinephrine turnover throughout
the brain and decreased 3-methoxy tyramine, a marker for dopamine
release,
in the striatum. The striatal levels of histamine were only elevated
after tacrine administration in the older animals. Our results demonstrated
that tacrine is a multitarget and region-specific neuroactive agent,
inducing age-specific responses. Although well-studied, the complete
mechanisms of the action of tacrine are not fully understood, and
the current findings reveal features that may help explain its treatment-related
effectiveness and central side effects.
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Affiliation(s)
- Elva Fridjonsdottir
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, SE-75124 Uppsala, Sweden
| | - Theodosia Vallianatou
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, SE-75124 Uppsala, Sweden
| | - Ioannis Mantas
- Department of Clinical Neuroscience, Section of Neurology, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Reza Shariatgorji
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, SE-75124 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, SE-75124 Uppsala, Sweden
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, SE-75124 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, SE-75124 Uppsala, Sweden
| | - Luke S. Schembri
- Department of Medicinal Chemistry, Uppsala University, SE-75123 Uppsala, Sweden
| | - Luke R. Odell
- Department of Medicinal Chemistry, Uppsala University, SE-75123 Uppsala, Sweden
| | - Per Svenningsson
- Department of Clinical Neuroscience, Section of Neurology, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Per E. Andrén
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, SE-75124 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, SE-75124 Uppsala, Sweden
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31
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Håkansson A, Cronhjort M, Lidin-Darlington P, Lilja G, Nilsson A, Schandl A, Friberg H. Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (CBT-ACT) vs. Standard Care After Critical Illness Due to COVID-19: Protocol for a Pilot Randomized Controlled Trial. Front Psychiatry 2022; 13:907215. [PMID: 35911237 PMCID: PMC9334556 DOI: 10.3389/fpsyt.2022.907215] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/20/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Post-covid syndrome is an emerging condition involving a wide range of symptoms, including high rates of poor mental health. The diagnostic relevance and clinical severity of these symptoms are largely unknown, and evidence for treatment of post-covid mental health symptoms is lacking. This protocol describes a pilot randomized clinical trial, primarily aiming to assess feasibility, participant adherence and satisfaction in a novel phycho-therapeutic intervention on post-covid anxiety and depression symptoms ≥1 year after critically ill COVID-19. Whether the intervention may generate improvements in post-covid depression, anxiety, post-traumatic stress and health-related quality of life (HRQoL) will be addressed in a following larger trial. METHODS A multicenter, investigator-initiated randomized controlled trial (Clinical Trial Identifier number NCT05119608) including Intensive Care Unit (ICU)-treated COVID-19 survivors, who display symptoms of anxiety and/or depression at follow-up 12 months after hospitalization (Hospital Anxiety and Depression Scale ≥8 for depression or anxiety). Eligible individuals are referred to a psychiatrist for structured diagnostic assessment and inclusion in the trial. Participants will be randomized to either a 10-week cognitive behavioral therapy intervention with added acceptance and commitment therapy (CBT-ACT) or standard care (primary care referral). Primary study outcome measure is feasibility and patient adherence, defined as the proportion of participants who consent to randomization and remain in the study including follow-up. Secondary outcome measures include reduced symptoms in the HADS depression/anxiety subscales, post-traumatic symptoms, HRQoL and user satisfaction at 3 months after the intervention. DISCUSSION This protocol describes a pilot trial to assess feasibility and preliminary effects of a structured psycho-therapeutic intervention to ameliorate mental health in a population severely affected by COVID-19, where evidence for structured psycho-therapy is lacking.
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Affiliation(s)
- Anders Håkansson
- Faculty of Medicine, Lund University, Lund, Sweden.,Clinical Research Unit, Department of Psychiatry, Malmø, Sweden
| | - Maria Cronhjort
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden.,Södersjukhuset AB Hospital, Stockholm, Sweden
| | - Pernilla Lidin-Darlington
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden.,Södersjukhuset AB Hospital, Stockholm, Sweden
| | - Gisela Lilja
- Faculty of Medicine, Lund University, Lund, Sweden.,Skåne University Hospital, Malmö, Sweden
| | - Anna Nilsson
- Faculty of Medicine, Lund University, Lund, Sweden.,Skåne University Hospital, Malmö, Sweden
| | - Anna Schandl
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden.,Södersjukhuset AB Hospital, Stockholm, Sweden
| | - Hans Friberg
- Faculty of Medicine, Lund University, Lund, Sweden.,Skåne University Hospital, Malmö, Sweden
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32
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Johansson C, Kampmann C, Nilsson A, Dicksved J, Engstrand L, Rautelin H. Genomic and Phenotypic Characteristics in Geographically Separated Clinical Campylobacter jejuni ST353CC Isolates. Microorganisms 2021; 9:2540. [PMID: 34946141 PMCID: PMC8709058 DOI: 10.3390/microorganisms9122540] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Campylobacter jejuni fecal isolates of eight international travelers, 5 of which had traveled to Ecuador and 3 to Bangladesh, were characterized, and the possible relationship between bacterial traits and clinical symptoms was further analyzed. All eight isolates belonged to the same Multi-Locus Sequence Type clonal complex (ST353CC). The three isolates from Bangladesh were all of the same sequence type (ST-9438), and when compared to isolates of various other sequence types, they had a larger quantity of unique genetic content, higher expression levels of some putative virulence genes involved in adhesion and invasion (flpA, ciaB and iamA), and showed higher adhesion levels to human HT-29 colon cancer cells in an in vitro infection model. However, in contrast to the seemingly higher pathogenic potential of these bacterial isolates, travelers infected with the ST-9438 isolates had no or only very mild symptoms, whereas the other individuals, whose bacterial isolates seemed to have less pathogenic potential, generally reported severe symptoms. When studying the 16S rRNA gene-based fecal microbiota in samples collected prior to travel, there was an individual variation in the relative abundance of the three major bacterial phyla Actinobacteria, Bacteroidetes and Firmicutes, but there were no associations between composition and diversity of microbiota and development of severe symptoms from the infection. It remains to be confirmed by larger studies whether an individual's characteristics such as gut microbiota, might be related to the severity of symptoms in Campylobacter infections.
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Affiliation(s)
- Cecilia Johansson
- Clinical Microbiology, Department of Medical Sciences, Uppsala University, SE-75185 Uppsala, Sweden; (C.J.); (C.K.); (A.N.)
| | - Christian Kampmann
- Clinical Microbiology, Department of Medical Sciences, Uppsala University, SE-75185 Uppsala, Sweden; (C.J.); (C.K.); (A.N.)
| | - Anna Nilsson
- Clinical Microbiology, Department of Medical Sciences, Uppsala University, SE-75185 Uppsala, Sweden; (C.J.); (C.K.); (A.N.)
| | - Johan Dicksved
- Department of Animal Nutrition and Management, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden;
| | - Lars Engstrand
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, SE-17177 Stockholm, Sweden;
| | - Hilpi Rautelin
- Clinical Microbiology, Department of Medical Sciences, Uppsala University, SE-75185 Uppsala, Sweden; (C.J.); (C.K.); (A.N.)
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33
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Strittmatter N, Kanvatirth P, Inglese P, Race AM, Nilsson A, Dannhorn A, Kudo H, Goldin RD, Ling S, Wong E, Seeliger F, Serra MP, Hoffmann S, Maglennon G, Hamm G, Atkinson J, Jones S, Bunch J, Andrén PE, Takats Z, Goodwin RJA, Mastroeni P. Holistic Characterization of a Salmonella Typhimurium Infection Model Using Integrated Molecular Imaging. J Am Soc Mass Spectrom 2021; 32:2791-2802. [PMID: 34767352 DOI: 10.1021/jasms.1c00240] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A more complete and holistic view on host-microbe interactions is needed to understand the physiological and cellular barriers that affect the efficacy of drug treatments and allow the discovery and development of new therapeutics. Here, we developed a multimodal imaging approach combining histopathology with mass spectrometry imaging (MSI) and same section imaging mass cytometry (IMC) to study the effects of Salmonella Typhimurium infection in the liver of a mouse model using the S. Typhimurium strains SL3261 and SL1344. This approach enables correlation of tissue morphology and specific cell phenotypes with molecular images of tissue metabolism. IMC revealed a marked increase in immune cell markers and localization in immune aggregates in infected tissues. A correlative computational method (network analysis) was deployed to find metabolic features associated with infection and revealed metabolic clusters of acetyl carnitines, as well as phosphatidylcholine and phosphatidylethanolamine plasmalogen species, which could be associated with pro-inflammatory immune cell types. By developing an IMC marker for the detection of Salmonella LPS, we were further able to identify and characterize those cell types which contained S. Typhimurium.
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Affiliation(s)
- Nicole Strittmatter
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Panchali Kanvatirth
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, U.K
| | - Paolo Inglese
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2AZ, U.K
| | - Alan M Race
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Anna Nilsson
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, 751 24 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, 751 24 Uppsala, Sweden
| | - Andreas Dannhorn
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Hiromi Kudo
- Division of Digestive Diseases, Section of Pathology, Imperial College London, St. Mary's Hospital, London W2 1NY, U.K
| | - Robert D Goldin
- Division of Digestive Diseases, Section of Pathology, Imperial College London, St. Mary's Hospital, London W2 1NY, U.K
- Department of Cellular Pathology, Charing Cross Hospital, London W6 8RF, U.K
| | - Stephanie Ling
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Edmond Wong
- Biologics Engineering, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Frank Seeliger
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Maria Paola Serra
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Scott Hoffmann
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
- BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, U.K
| | - Gareth Maglennon
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Gregory Hamm
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - James Atkinson
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Stewart Jones
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
| | - Josephine Bunch
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2AZ, U.K
- National Centre of Excellence in Mass Spectrometry Imaging (NiCE-MSI), National Physical Laboratory, Teddington TW11 0LW, U.K
| | - Per E Andrén
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, 751 24 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, 751 24 Uppsala, Sweden
| | - Zoltan Takats
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2AZ, U.K
| | - Richard J A Goodwin
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge CB4 0WG, U.K
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8TA, U.K
| | - Pietro Mastroeni
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, U.K
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34
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Ranta S, Broman LM, Abrahamsson J, Berner J, Fläring U, Hed Myrberg I, Kalzén H, Karlsson L, Mellgren K, Nilsson A, Norén-Nyström U, Palle J, von Schewelov K, Svahn JE, Törnudd L, Heyman M, Harila-Saari A. ICU Admission in Children With Acute Lymphoblastic Leukemia in Sweden: Prevalence, Outcome, and Risk Factors. Pediatr Crit Care Med 2021; 22:1050-1060. [PMID: 34074998 DOI: 10.1097/pcc.0000000000002787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Despite progress in the treatment of childhood acute lymphoblastic leukemia, severe complications are common, and the need of supportive care is high. We explored the cumulative prevalence, clinical risk factors, and outcomes of children with acute lymphoblastic leukemia, on first-line leukemia treatment in the ICUs in Sweden. DESIGN A nationwide prospective register and retrospective chart review study. SETTING Children with acute lymphoblastic leukemia were identified, and demographic and clinical data were obtained from the Swedish Childhood Cancer Registry. Data on intensive care were collected from the Swedish Intensive Care Registry. Data on patients with registered ICU admission in the Swedish Childhood Cancer Registry were supplemented through questionnaires to the pediatric oncology centers. PATIENTS All 637 children 0-17.9 years old with acute lymphoblastic leukemia diagnosed between June 2008 and December 2016 in Sweden were included. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Twenty-eight percent of the children (178/637) were admitted to an ICU at least once. The Swedish Intensive Care Registry data were available for 96% of admissions (241/252). An ICU admission was associated with poor overall survival (hazard ratio, 3.25; 95% CI, 1.97-5.36; p ≤ 0.0001). ICU admissions occurred often during early treatment; 48% (85/178) were admitted to the ICU before the end of the first month of acute lymphoblastic leukemia treatment (induction therapy). Children with T-cell acute lymphoblastic leukemia or CNS leukemia had a higher risk of being admitted to the ICU in multivariable analyses, both for early admissions before the end of induction therapy and for all admissions during the study period. CONCLUSIONS The need for intensive care in children with acute lymphoblastic leukemia, especially for children with T cell acute lymphoblastic leukemia and CNS leukemia, is high with most admissions occurring during early treatment.
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Affiliation(s)
- Susanna Ranta
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Oncology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Mikael Broman
- ECMO Centre Karolinska, Department of Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Abrahamsson
- Institution of Clinical Sciences, Department of Pediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jonas Berner
- ECMO Centre Karolinska, Department of Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Urban Fläring
- ECMO Centre Karolinska, Department of Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Ida Hed Myrberg
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Kalzén
- Department of Anesthesia, Södertälje Hospital, Södertälje, Sweden
- Department of Anaesthesia and Intensive Care, Karolinska Institutet at Danderyd Hospital (KIDS), Danderyd, Sweden
| | - Lene Karlsson
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Oncology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- ECMO Centre Karolinska, Department of Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Institution of Clinical Sciences, Department of Pediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Anesthesia, Södertälje Hospital, Södertälje, Sweden
- Department of Anaesthesia and Intensive Care, Karolinska Institutet at Danderyd Hospital (KIDS), Danderyd, Sweden
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
- Department of Women's and Children's Health, Uppsala University and Pediatric Oncology, Uppsala University Hospital, Uppsala, Sweden
- Department of Pediatric Oncology, Skåne University Hospital, Lund University, Lund, Sweden
- Department of Pediatrics, Linköping University Hospital, Linköping, Sweden
| | - Karin Mellgren
- Institution of Clinical Sciences, Department of Pediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Nilsson
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Pediatric Oncology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | | | - Josefine Palle
- Department of Women's and Children's Health, Uppsala University and Pediatric Oncology, Uppsala University Hospital, Uppsala, Sweden
| | - Katarina von Schewelov
- ECMO Centre Karolinska, Department of Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Johan E Svahn
- Department of Pediatric Oncology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Lisa Törnudd
- Department of Pediatrics, Linköping University Hospital, Linköping, Sweden
| | - Mats Heyman
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Arja Harila-Saari
- Department of Women's and Children's Health, Uppsala University and Pediatric Oncology, Uppsala University Hospital, Uppsala, Sweden
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Becker K, Cao S, Nilsson A, Erlandsson M, Hotop SK, Kuka J, Hansen J, Haldimann K, Grinberga S, Berruga-Fernández T, Huseby DL, Shariatgorji R, Lindmark E, Platzack B, Böttger EC, Crich D, Friberg LE, Vingsbo Lundberg C, Hughes D, Brönstrup M, Andrén PE, Liepinsh E, Hobbie SN. Antibacterial activity of apramycin at acidic pH warrants wide therapeutic window in the treatment of complicated urinary tract infections and acute pyelonephritis. EBioMedicine 2021; 73:103652. [PMID: 34740109 PMCID: PMC8577399 DOI: 10.1016/j.ebiom.2021.103652] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 12/26/2022] Open
Abstract
Background The clinical-stage drug candidate EBL-1003 (apramycin) represents a distinct new subclass of aminoglycoside antibiotics for the treatment of drug-resistant infections. It has demonstrated best-in-class coverage of resistant isolates, and preclinical efficacy in lung infection models. However, preclinical evidence for its utility in other disease indications has yet to be provided. Here we studied the therapeutic potential of EBL-1003 in the treatment of complicated urinary tract infection and acute pyelonephritis (cUTI/AP). Methods A combination of data-base mining, antimicrobial susceptibility testing, time-kill experiments, and four murine infection models was used in a comprehensive assessment of the microbiological coverage and efficacy of EBL-1003 against Gram-negative uropathogens. The pharmacokinetics and renal toxicology of EBL-1003 in rats was studied to assess the therapeutic window of EBL-1003 in the treatment of cUTI/AP. Findings EBL-1003 demonstrated broad-spectrum activity and rapid multi-log CFU reduction against a phenotypic variety of bacterial uropathogens including aminoglycoside-resistant clinical isolates. The basicity of amines in the apramycin molecule suggested a higher increase in positive charge at urinary pH when compared to gentamicin or amikacin, resulting in sustained drug uptake and bactericidal activity, and consequently in potent efficacy in mouse infection models. Renal pharmacokinetics, biomarkers for toxicity, and kidney histopathology in adult rats all indicated a significantly lower nephrotoxicity of EBL-1003 than of gentamicin. Interpretation This study provides preclinical proof-of-concept for the efficacy of EBL-1003 in cUTI/AP. Similar efficacy but lower nephrotoxicity of EBL-1003 in comparison to gentamicin may thus translate into a higher safety margin and a wider therapeutic window in the treatment of cUTI/API. Funding A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.
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Affiliation(s)
- Katja Becker
- Institute of Medical Microbiology, University of Zurich, Gloriastrasse 30, CH-8006 Zurich, Switzerland
| | - Sha Cao
- Department of Medical Biochemistry and Microbiology, Uppsala University, Box 582, 751 23 Uppsala, Sweden
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Uppsala University, Box 591, 751 24 Uppsala, Sweden; Science for Life Laboratory, Uppsala University, Box 591, 751 24 Uppsala, Sweden
| | - Maria Erlandsson
- RISE Research Institutes of Sweden, Forskargatan 20G, 151 36 Södertälje, Sweden
| | - Sven-Kevin Hotop
- Helmholtz Centre for Infection Research, Inhoffenstrasse 7, D-38124 Braunschweig, Germany
| | - Janis Kuka
- Latvian Institute of Organic Synthesis, Aizkraukles 21, LV-1006 Riga, Latvia
| | - Jon Hansen
- Statens Serum Institute, Artillerivej 5, DK-2300 Copenhagen, Denmark
| | - Klara Haldimann
- Institute of Medical Microbiology, University of Zurich, Gloriastrasse 30, CH-8006 Zurich, Switzerland
| | - Solveiga Grinberga
- Latvian Institute of Organic Synthesis, Aizkraukles 21, LV-1006 Riga, Latvia
| | - Talia Berruga-Fernández
- Department of Medical Biochemistry and Microbiology, Uppsala University, Box 582, 751 23 Uppsala, Sweden
| | - Douglas L Huseby
- Department of Medical Biochemistry and Microbiology, Uppsala University, Box 582, 751 23 Uppsala, Sweden
| | - Reza Shariatgorji
- Department of Pharmaceutical Biosciences, Uppsala University, Box 591, 751 24 Uppsala, Sweden; Science for Life Laboratory, Uppsala University, Box 591, 751 24 Uppsala, Sweden
| | - Evelina Lindmark
- RISE Research Institutes of Sweden, Forskargatan 20G, 151 36 Södertälje, Sweden
| | - Björn Platzack
- RISE Research Institutes of Sweden, Forskargatan 20G, 151 36 Södertälje, Sweden
| | - Erik C Böttger
- Institute of Medical Microbiology, University of Zurich, Gloriastrasse 30, CH-8006 Zurich, Switzerland
| | - David Crich
- Department of Pharmaceutical and Biomedical Sciences, University of Georgia, 250 W. Green Street, Athens, GA 30602, USA
| | - Lena E Friberg
- Department of Pharmacy, Uppsala University, Box 580, 751 23 Uppsala, Sweden
| | | | - Diarmaid Hughes
- Department of Medical Biochemistry and Microbiology, Uppsala University, Box 582, 751 23 Uppsala, Sweden
| | - Mark Brönstrup
- Helmholtz Centre for Infection Research, Inhoffenstrasse 7, D-38124 Braunschweig, Germany
| | - Per E Andrén
- Department of Pharmaceutical Biosciences, Uppsala University, Box 591, 751 24 Uppsala, Sweden; Science for Life Laboratory, Uppsala University, Box 591, 751 24 Uppsala, Sweden
| | - Edgars Liepinsh
- Latvian Institute of Organic Synthesis, Aizkraukles 21, LV-1006 Riga, Latvia
| | - Sven N Hobbie
- Institute of Medical Microbiology, University of Zurich, Gloriastrasse 30, CH-8006 Zurich, Switzerland.
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Hjelmgren H, Nilsson A, Myrberg IH, Andersson N, Ygge BM, Nordlund B. Capillary blood sampling increases the risk of preanalytical errors in pediatric hospital care: Observational clinical study. J SPEC PEDIATR NURS 2021; 26:e12337. [PMID: 33960595 DOI: 10.1111/jspn.12337] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 01/19/2021] [Accepted: 04/08/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The blood sampling procedure is complex and prone to failure, as reflected by preanalytical errors in pediatric hospital care. The primary aim was to evaluate if the risk of preanalytical errors was higher with capillary blood sampling than with venous blood sampling, and secondary, explore specific factors associated with preanalytical errors, both overall and stratified by capillary and venous blood sampling. DESIGN AND METHODS This observational pediatric hospital study collected outcomes from medical records and blood sampling surveys from year 2014 to 2016. The risk of preanalytical errors was analyzed with adjusted-odds ratio (adj-OR) by multivariable logistic regression with 95% confidence intervals (CIs). RESULTS Overall, 128 (13%) preanalytical errors were identified among 951 blood samples. The proportion and adj-OR of errors was significantly higher in capillary compared with venous blood samples, 72 (20%) of 354 versus 56 (9.4%) of 597, p = .001, adj-OR 2.88 (CI 1.79-4.64). Blood collection with multiple sample tubes was significantly associated with increased risk of preanalytical errors (n = 97 of 601, 16%), while log weight (kg) significantly decreased the risk of preanalytical errors adj-OR 0.66 (CI 0.50-0.86), indicating a protective effect of increasing weight. However, stratified analyses indicated a protective effect of increasing log weight for venous blood sampling adj-OR 0.52 (CI 0.38-0.72), but not capillary blood sampling, adj-OR 1.08 (CI 0.76-1.55). CONCLUSION This study indicates that capillary blood sampling collection increases the risk of preanalytical errors. Further, a child's increasing body weight reduced the risk of preanalytical errors, while multiple sample tube collections significantly increased the risk of preanalytical errors. PRACTICE IMPLICATIONS This new information may help nurses improve their knowledge concerning blood sampling collection in pediatrics. Altogether, this study also indicates that implementing more venous blood sampling and improve the cases of capillary sampling could reduce the number of preanalytical errors in pediatric hospitals.
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Affiliation(s)
- Henrik Hjelmgren
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Anna Nilsson
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Ida H Myrberg
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Nina Andersson
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Britt-Marie Ygge
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
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Shariatgorji R, Nilsson A, Fridjonsdottir E, Strittmatter N, Dannhorn A, Svenningsson P, Goodwin RJA, Odell LR, Andrén PE. Spatial visualization of comprehensive brain neurotransmitter systems and neuroactive substances by selective in situ chemical derivatization mass spectrometry imaging. Nat Protoc 2021; 16:3298-3321. [PMID: 34075230 DOI: 10.1038/s41596-021-00538-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/05/2021] [Indexed: 02/04/2023]
Abstract
Molecule-specific techniques such as MALDI and desorption electrospray ionization mass spectrometry imaging enable direct and simultaneous mapping of biomolecules in tissue sections in a single experiment. However, neurotransmitter imaging in the complex environment of biological samples remains challenging. Our covalent charge-tagging approach using on-tissue chemical derivatization of primary and secondary amines and phenolic hydroxyls enables comprehensive mapping of neurotransmitter networks. Here, we present robust and easy-to-use chemical derivatization protocols that facilitate quantitative and simultaneous molecular imaging of complete neurotransmitter systems and drugs in diverse biological tissue sections with high lateral resolution. This is currently not possible with any other imaging technique. The protocol, using fluoromethylpyridinium and pyrylium reagents, describes all steps from tissue preparation (~1 h), chemical derivatization (1-2 h), data collection (timing depends on the number of samples and lateral resolution) and data analysis and interpretation. The specificity of the chemical reaction can also help users identify unknown chemical identities. Our protocol can reveal the cellular locations in which signaling molecules act and thus shed light on the complex responses that occur after the administration of drugs or during the course of a disease.
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Affiliation(s)
- Reza Shariatgorji
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden
| | - Anna Nilsson
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden
| | - Elva Fridjonsdottir
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
| | - Nicole Strittmatter
- Imaging & Data Analytics, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Andreas Dannhorn
- Imaging & Data Analytics, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Per Svenningsson
- Department of Clinical Neuroscience, Section of Neurology, Karolinska Institutet, Stockholm, Sweden
| | - Richard J A Goodwin
- Imaging & Data Analytics, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK
| | - Luke R Odell
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Per E Andrén
- Department of Pharmaceutical Biosciences, Medical Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden.
- Science for Life Laboratory, Spatial Mass Spectrometry, Uppsala University, Uppsala, Sweden.
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Nilsson A. Is Compulsory Childhood Vaccination Compatible with the Right to Respect for Private Life? A Comment on Vavřička and Others v. the Czech Republic. Eur J Health Law 2021; 28:323-340. [PMID: 34157680 DOI: 10.1163/15718093-bja10048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Anna Nilsson
- Department of Law, Lund University Box 207, 221 00 Lund Sweden
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39
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Vallianatou T, Shariatgorji R, Nilsson A, Karlgren M, Hulme H, Fridjonsdottir E, Svenningsson P, Andrén PE. Integration of Mass Spectrometry Imaging and Machine Learning Visualizes Region-Specific Age-Induced and Drug-Target Metabolic Perturbations in the Brain. ACS Chem Neurosci 2021; 12:1811-1823. [PMID: 33939923 PMCID: PMC8291481 DOI: 10.1021/acschemneuro.1c00103] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 12/15/2022] Open
Abstract
![]()
Detailed metabolic
imaging of specific brain regions in early aging
may expose pathophysiological mechanisms and indicate effective neuropharmacological
targets in the onset of cognitive decline. Comprehensive imaging of
brain aging and drug-target effects is restricted using conventional
methodology. We simultaneously visualized multiple metabolic alterations
induced by normal aging in specific regions of mouse brains by integrating
Fourier-transform ion cyclotron resonance mass spectrometry imaging
and combined supervised and unsupervised machine learning models.
We examined the interplay between aging and the response to tacrine-induced
acetylcholinesterase inhibition, a well-characterized therapeutic
treatment against dementia. The dipeptide carnosine (β-alanyl-l-histidine) and the vitamin α-tocopherol were significantly
elevated by aging in different brain regions. l-Carnitine
and acetylcholine metabolism were found to be major pathways affected
by aging and tacrine administration in a brain region-specific manner,
indicating altered mitochondrial function and neurotransmission. The
highly interconnected hippocampus and retrosplenial cortex displayed
different age-induced alterations in lipids and acylcarnitines, reflecting
diverse region-specific metabolic effects. The subregional differences
observed in the hippocampal formation of several lipid metabolites
demonstrate the unique potential of the technique compared to standard
mass spectrometry approaches. An age-induced increase of endogenous
antioxidants, such as α-tocopherol, in the hippocampus was detected,
suggesting an augmentation of neuroprotective mechanisms in early
aging. Our comprehensive imaging approach visualized heterogeneous
age-induced metabolic perturbations in mitochondrial function, neurotransmission,
and lipid signaling, not always attenuated by acetylcholinesterase
inhibition.
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Affiliation(s)
- Theodosia Vallianatou
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
| | - Reza Shariatgorji
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
| | - Anna Nilsson
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
| | - Maria Karlgren
- Department of Pharmacy, Uppsala Drug Optimization and Pharmaceutical Profiling (UDOPP), Biomedical Centre 580, Uppsala University, SE-75123 Uppsala, Sweden
| | - Heather Hulme
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
| | - Elva Fridjonsdottir
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
| | - Per Svenningsson
- Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Per E. Andrén
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
- Science for Life Laboratory, Spatial Mass Spectrometry, Biomedical Centre 591, Uppsala University, SE-75124 Uppsala, Sweden
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40
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Weiss R, Beer K, Cox SE, Palm M, Kaufman-Janette J, Bassichis B, Biesman B, Joseph J, Almegård B, Nilsson A, Edwartz C. A Randomized, Controlled, Evaluator-Blinded, Multi-Center Study of Hyaluronic Acid Filler Effectiveness and Safety in Lip Fullness Augmentation. Dermatol Surg 2021; 47:527-532. [PMID: 33587369 PMCID: PMC8021234 DOI: 10.1097/dss.0000000000002856] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND HARK was recently approved in the US for lip augmentation and correction of upper perioral rhytids. OBJECTIVE To demonstrate noninferiority of HARK versus a control (HAJV) in lip fullness augmentation at Week 8 after last injection (blinded evaluation). Secondary objectives were to evaluate the effectiveness and safety of HARK in lip fullness augmentation and correction of upper perioral rhytids. METHODS AND MATERIALS Treatment with HARK or control (randomized 2:1) was administered on Day 1 in this 48-week, evaluator-blinded study with optional touch-up at Week 4. Primary endpoint was change from baseline to Week 8 in lip fullness. Secondary endpoints included lip fullness, wrinkle severity, aesthetic improvement, subject satisfaction, adverse events, and local tolerability (subject diary entries). RESULTS The primary objective was met; HARK was noninferior to control in lip fullness augmentation at Week 8. Lip fullness and wrinkle severity improvement persisted at Week 48, and was accompanied by high aesthetic improvement and subject satisfaction scores. The mean volume of HARK injected was approximately 20% lower than control. Treatment-related adverse events and local tolerability symptoms were predominantly mild and transient. CONCLUSION HARK was noninferior to control in lip fullness augmentation at Week 8, well-tolerated, and effective throughout this 48-week study.
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Affiliation(s)
- Robert Weiss
- Maryland Dermatology, Laser, Skin and Vein Institute, Hunt Valley, Maryland
| | - Kenneth Beer
- Research Institute of SouthEast, West Palm Beach, Florida
| | - Sue E. Cox
- Aesthetic Solutions, Chapel Hill, North Carolina
| | | | | | | | | | - John Joseph
- Clinical Testing of Beverly Hills, Encino, California
| | | | - Anna Nilsson
- Galderma Aesthetics, Clinical Development, Uppsala, Sweden;
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Saghafian-Hedengren S, Sverremark-Ekström E, Nilsson A. T Cell Subsets During Early Life and Their Implication in the Treatment of Childhood Acute Lymphoblastic Leukemia. Front Immunol 2021; 12:582539. [PMID: 33763058 PMCID: PMC7982872 DOI: 10.3389/fimmu.2021.582539] [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] [Received: 07/12/2020] [Accepted: 02/01/2021] [Indexed: 11/13/2022] Open
Abstract
The immune system plays a major role in recognizing and eliminating malignant cells, and this has been exploited in the development of immunotherapies aimed at either activating or reactivating the anti-tumor activity of a patient's immune system. A wide range of therapeutic approaches involving T lymphocytes, such as programmed cell death protein ligand-1 (PDL-1) inhibitors, cytotoxic T-lymphocyte-associated protein-4 (CTLA-4) blockers, and CD19-targeted T-cell therapy through chimeric antigen receptor (CAR)-T cells or CD19/CD3 bi-specific T-cell engagers, have been introduced to the field of oncology, leading to significant improvements in overall survival of adult cancer patients. During the past few years, the availability and approval of T-cell based immunotherapies have become a reality also for the treatment of childhood cancers. However, the distribution, ratio of regulatory to effector cells and the quality of T-cell responses early in life are distinct from those during adolescence and adulthood, raising the possibility that these differences impact the efficacy of immunotherapy. Herein we provide a brief overview of the properties of conventional T cell subsets during early life. Focusing on the most common cancer type during childhood, acute lymphoblastic leukemia (ALL), we describe how current conventional therapies used against ALL influence the T-cell compartment of small children. We describe early life T-cell responses in relation to immunotherapies engaging T-cell anticancer reactivity and present our opinion that it is not only immaturity of the adaptive immune system, but also the impact of an immunosuppressive environment that may prove disadvantageous in the setting of immunotherapies targeting pediatric cancer cells.
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Affiliation(s)
- Shanie Saghafian-Hedengren
- Division of Paediatric Oncology and Paediatric Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva Sverremark-Ekström
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Anna Nilsson
- Division of Paediatric Oncology and Paediatric Surgery, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Nilsson A, Chiodi F. Early Antiretroviral Therapy May Preserve Vaccine Responses in Human Immunodeficiency Virus-Infected Patients by Preventing Damage to Long-Lived Plasma Cells. J Infect Dis 2021; 222:176-179. [PMID: 31867631 DOI: 10.1093/infdis/jiz679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- Anna Nilsson
- Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden
| | - Francesca Chiodi
- Department of Microbiology, Tumor and Cell Biology at Biomedicum, Karolinska Institutet, Solna, Sweden
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Fridjonsdottir E, Shariatgorji R, Nilsson A, Vallianatou T, Odell LR, Schembri LS, Svenningsson P, Fernagut PO, Crossman AR, Bezard E, Andrén PE. Mass spectrometry imaging identifies abnormally elevated brain l-DOPA levels and extrastriatal monoaminergic dysregulation in l-DOPA-induced dyskinesia. Sci Adv 2021; 7:7/2/eabe5948. [PMID: 33523980 PMCID: PMC7787486 DOI: 10.1126/sciadv.abe5948] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/10/2020] [Indexed: 05/20/2023]
Abstract
l-DOPA treatment for Parkinson's disease frequently leads to dyskinesias, the pathophysiology of which is poorly understood. We used MALDI-MSI to map the distribution of l-DOPA and monoaminergic pathways in brains of dyskinetic and nondyskinetic primates. We report elevated levels of l-DOPA, and its metabolite 3-O-methyldopa, in all measured brain regions of dyskinetic animals and increases in dopamine and metabolites in all regions analyzed except the striatum. In dyskinesia, dopamine levels correlated well with l-DOPA levels in extrastriatal regions, such as hippocampus, amygdala, bed nucleus of the stria terminalis, and cortical areas, but not in the striatum. Our results demonstrate that l-DOPA-induced dyskinesia is linked to a dysregulation of l-DOPA metabolism throughout the brain. The inability of extrastriatal brain areas to regulate the formation of dopamine during l-DOPA treatment introduces the potential of dopamine or even l-DOPA itself to modulate neuronal signaling widely across the brain, resulting in unwanted side effects.
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Affiliation(s)
- Elva Fridjonsdottir
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Reza Shariatgorji
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
| | - Anna Nilsson
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
| | - Theodosia Vallianatou
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Luke R Odell
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Luke S Schembri
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
| | - Per Svenningsson
- Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Pierre-Olivier Fernagut
- Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France
- CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
- Université de Poitiers, INSERM, U0-1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Poitiers, France
| | | | - Erwan Bezard
- Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France.
- CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
- Motac Neuroscience, Manchester M15 6WE, UK
| | - Per E Andrén
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
- Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, Uppsala, Sweden
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Wahlund M, Lindqvist Appell M, Hed Myrberg I, Berggren A, Nilsson A. Genetic Sequence Variants in TLR4, MBL or IL-1 Receptor Antagonist is not Associated to Increased Risk for Febrile Neutropenia in Children with ALL. Children (Basel) 2020; 7:children7120296. [PMID: 33339376 PMCID: PMC7766164 DOI: 10.3390/children7120296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 12/02/2022]
Abstract
Sequence variants in genes involved in the immune system have previously been linked to neutropenia as well as infections in cancer patients. Sequence variants in genes coding for TLR4, MBL, and IL-1Ra were investigated in relation to clinical utility of identifying severe episodes of febrile neutropenia (FN) in a cohort of children undergoing treatment for acute lymphoblastic leukemia. The study included 122 children, where data on FN and microbiological findings were retrospectively collected from medical records. Sequence variants in genes coding for MBL, TLR4, and IL-1Ra were identified by pyrosequencing, TaqMan SNP genotyping assay, and gel electrophoresis. A total of 380 episodes of FN were identified and in 139 episodes, there was a microbiological defined infection. Age and treatment intensity were all associated with the risk of developing FN. No sequence variant was associated to increased numbers of FN episodes. Two sequence variants in the TLR4 gene increased the risk of viral infection, whilst sequence variants in the IL-1Ra gene were associated to a decreased risk of bacterial blood-stream infection (BSI). The investigated sequence variants did not associate with increased risk for FN or to severe infections, as to why the clinical utility as a risk-stratification tool is low. Most episodes of FN were classified as fever with unknown origin, emphasizing the need for improved microbial detection methods.
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Affiliation(s)
- Martina Wahlund
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, 171 64 Stockholm, Sweden; (M.W.); (A.B.)
- Department of Clinical Microbiology, Karolinska University Hospital, 171 64 Stockholm, Sweden
| | - Malin Lindqvist Appell
- Department of Medical and Health Sciences, Division of Drug Research, Linkoping University, 581 83 Linkoping, Sweden;
| | - Ida Hed Myrberg
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, 171 65 Stockholm, Sweden;
| | - Anna Berggren
- Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet, 171 64 Stockholm, Sweden; (M.W.); (A.B.)
| | - Anna Nilsson
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, 171 65 Stockholm, Sweden;
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, 171 64 Stockholm, Sweden
- Correspondence: ; Tel.: +46-707-500139
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Becker K, Aranzana-Climent V, Cao S, Nilsson A, Shariatgorji R, Haldimann K, Platzack B, Hughes D, Andrén PE, Böttger EC, Friberg LE, Hobbie SN. Efficacy of EBL-1003 (apramycin) against Acinetobacter baumannii lung infections in mice. Clin Microbiol Infect 2020; 27:1315-1321. [PMID: 33316399 DOI: 10.1016/j.cmi.2020.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 10/16/2020] [Revised: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Novel therapeutics are urgently required for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) causing critical infections with high mortality. Here we assessed the therapeutic potential of the clinical-stage drug candidate EBL-1003 (crystalline free base of apramycin) in the treatment of CRAB lung infections. METHODS The genotypic and phenotypic susceptibility of CRAB clinical isolates to aminoglycosides and colistin was assessed by database mining and broth microdilution. The therapeutic potential was assessed by target attainment simulations on the basis of time-kill kinetics, a murine lung infection model, comparative pharmacokinetic analysis in plasma, epithelial lining fluid (ELF) and lung tissue, and pharmacokinetic/pharmacodynamic (PKPD) modelling. RESULTS Resistance gene annotations of 5451 CRAB genomes deposited in the National Database of Antibiotic Resistant Organisms (NDARO) suggested >99.9% of genotypic susceptibility to apramycin. Low susceptibility to standard-of-care aminoglycosides and high susceptibility to EBL-1003 were confirmed by antimicrobial susceptibility testing of 100 A. baumannii isolates. Time-kill experiments and a mouse lung infection model with the extremely drug-resistant CRAB strain AR Bank #0282 resulted in rapid 4-log CFU reduction both in vitro and in vivo. A single dose of 125 mg/kg EBL-1003 in CRAB-infected mice resulted in an AUC of 339 h × μg/mL in plasma and 299 h × μg/mL in ELF, suggesting a lung penetration of 88%. PKPD simulations suggested a previously predicted dose of 30 mg/kg in patients (creatinine clearance (CLCr) = 80 mL/min) to result in >99% probability of -2 log target attainment for MICs up to 16 μg/mL. CONCLUSIONS This study provides proof of concept for the efficacy of EBL-1003 in the treatment of CRAB lung infections. Broad in vitro coverage, rapid killing, potent in vivo efficacy, and a high probability of target attainment render EBL-1003 a strong therapeutic candidate for a priority pathogen for which treatment options are very limited.
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Affiliation(s)
- Katja Becker
- University of Zurich, Institute of Medical Microbiology, Zurich, Switzerland
| | | | - Sha Cao
- Uppsala University, Department of Medical Biochemistry and Microbiology, Uppsala, Sweden
| | - Anna Nilsson
- Uppsala University, Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala, Sweden; Uppsala University, Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala, Sweden
| | - Reza Shariatgorji
- Uppsala University, Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala, Sweden; Uppsala University, Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala, Sweden
| | - Klara Haldimann
- University of Zurich, Institute of Medical Microbiology, Zurich, Switzerland
| | | | - Diarmaid Hughes
- Uppsala University, Department of Medical Biochemistry and Microbiology, Uppsala, Sweden
| | - Per E Andrén
- Uppsala University, Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala, Sweden; Uppsala University, Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala, Sweden
| | - Erik C Böttger
- University of Zurich, Institute of Medical Microbiology, Zurich, Switzerland
| | - Lena E Friberg
- Uppsala University, Pharmacometrics, Department of Pharmacy, Uppsala, Sweden
| | - Sven N Hobbie
- University of Zurich, Institute of Medical Microbiology, Zurich, Switzerland.
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Shariatgorji R, Nilsson A, Strittmatter N, Vallianatou T, Zhang X, Svenningsson P, Goodwin RJA, Andrén PE. Bromopyrylium Derivatization Facilitates Identification by Mass Spectrometry Imaging of Monoamine Neurotransmitters and Small Molecule Neuroactive Compounds. J Am Soc Mass Spectrom 2020; 31:2553-2557. [PMID: 32633532 DOI: 10.1021/jasms.0c00166] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Mass spectrometry imaging using matrix-assisted laser desorption/ionization and desorption electrospray ionization has recently been employed to investigate the distribution of neurotransmitters, including biogenic amines and amino acids, directly in brain tissue sections. Ionization is facilitated by charge-tagging through pyrylium derivatization of primary amine containing neurotransmitters directly in tissue sections, significantly improving the limit of detection. Since the derivatization adds carbon and hydrogen to the target compounds, the resulting isotopic patterns of the products are not distinctive from those of the nonderivatized species. Here, we describe an approach for chemically modifying the reactive pyrylium ion to introduce the distinct isotopic signature of bromine in mass spectra of chemically derivatized substances in tissue sections. The method enables monoamine compounds to be distinguished directly in tissue sections, facilitating their identification.
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Affiliation(s)
- Reza Shariatgorji
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala 75124, Sweden
- Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, Uppsala 75124, Sweden
| | - Anna Nilsson
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala 75124, Sweden
- Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, Uppsala 75124, Sweden
| | - Nicole Strittmatter
- Imaging & Data Analytics, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0SL, United Kingdom
| | - Theodosia Vallianatou
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala 75124, Sweden
- Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, Uppsala 75124, Sweden
| | - Xiaoqun Zhang
- Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Per Svenningsson
- Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Richard J A Goodwin
- Imaging & Data Analytics, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge CB2 0SL, United Kingdom
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - Per E Andrén
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala 75124, Sweden
- Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, Uppsala 75124, Sweden
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Källback P, Vallianatou T, Nilsson A, Shariatgorji R, Schintu N, Pereira M, Barré F, Wadensten H, Svenningsson P, Andrén PE. Cross-validated Matrix-Assisted Laser Desorption/Ionization Mass Spectrometry Imaging Quantitation Protocol for a Pharmaceutical Drug and Its Drug-Target Effects in the Brain Using Time-of-Flight and Fourier Transform Ion Cyclotron Resonance Analyzers. Anal Chem 2020; 92:14676-14684. [PMID: 33086792 PMCID: PMC7660593 DOI: 10.1021/acs.analchem.0c03203] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 12/17/2022]
Abstract
![]()
Matrix-assisted laser desorption/ionization
mass spectrometry imaging
(MALDI-MSI) is an established tool in drug development, which enables
visualization of drugs and drug metabolites at spatial localizations
in tissue sections from different organs. However, robust and accurate
quantitation by MALDI-MSI still remains a challenge. We present a
quantitative MALDI-MSI method using two instruments with different
types of mass analyzers, i.e., time-of-flight (TOF) and Fourier transform
ion cyclotron resonance (FTICR) MS, for mapping levels of the in vivo-administered drug citalopram, a selective serotonin
reuptake inhibitor, in mouse brain tissue sections. Six different
methods for applying calibration standards and an internal standard
were evaluated. The optimized method was validated according to authorities’
guidelines and requirements, including selectivity, accuracy, precision,
recovery, calibration curve, sensitivity, reproducibility, and stability
parameters. We showed that applying a dilution series of calibration
standards followed by a homogeneously applied, stable, isotopically
labeled standard for normalization and a matrix on top of the tissue
section yielded similar results to those from the reference method
using liquid chromatography–tandem mass spectrometry (LC–MS/MS).
The validation results were within specified limits and the brain
concentrations for TOF MS (51.1 ± 4.4 pmol/mg) and FTICR MS (56.9
± 6.0 pmol/mg) did not significantly differ from those of the
cross-validated LC–MS/MS method (55.0 ± 4.9 pmol/mg).
The effect of in vivo citalopram administration on
the serotonin neurotransmitter system was studied in the hippocampus,
a brain region that is the principal target of the serotonergic afferents
along with the limbic system, and it was shown that serotonin was
significantly increased (2-fold), but its metabolite 5-hydroxyindoleacetic
acid was not. This study makes a substantial step toward establishing
MALDI-MSI as a fully quantitative validated method.
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Affiliation(s)
- Patrik Källback
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, BMC 591, 75124 Uppsala, Sweden
| | - Theodosia Vallianatou
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, BMC 591, 75124 Uppsala, Sweden
| | - Anna Nilsson
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, BMC 591, 75124 Uppsala, Sweden.,Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, BMC 591, 75124 Uppsala, Sweden
| | - Reza Shariatgorji
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, BMC 591, 75124 Uppsala, Sweden.,Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, BMC 591, 75124 Uppsala, Sweden
| | - Nicoletta Schintu
- Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Marcela Pereira
- Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Florian Barré
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, BMC 591, 75124 Uppsala, Sweden
| | - Henrik Wadensten
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, BMC 591, 75124 Uppsala, Sweden
| | - Per Svenningsson
- Department of Neurology and Clinical Neuroscience, Karolinska Institutet and Karolinska University Hospital, 17176, Stockholm, Sweden
| | - Per E Andrén
- Medical Mass Spectrometry Imaging, Department of Pharmaceutical Biosciences, Uppsala University, BMC 591, 75124 Uppsala, Sweden.,Science for Life Laboratory, National Resource for Mass Spectrometry Imaging, Uppsala University, BMC 591, 75124 Uppsala, Sweden
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Ali Z, Nilsson A, Vildevall M, Rizzo L, Huge Y, Sherif A, Fahlgren A, Jensen LDE. Abstract 6124: Translation of zebrafish tumor-derived xenograft-models for improved diagnosis and treatment planning in urinary bladder cancer patients. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-6124] [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: 11/16/2022]
Abstract
Abstract
Precision medicine in oncology aims to identify the most effective treatment for any given patient based on individualized analyses of patient material. Currently, precision medicine relies on sequencing of DNA or RNA to identify patient tumor-specific mutational profiles that may be coupled to drug response. These techniques, however, fail to reveal actionable mutations in approximately 85% of the cancer patients, and have not been established at all for many commonly used drugs including cisplatin-based treatments used in urinary bladder cancer. While mouse-PDX models can determine drug response rates with high accuracy in most patients and for most drugs, such techniques are too slow and expensive to be relevant for first line treatment planning. Urinary bladder cancer patients are often treated with cisplatin-containing combination therapy, with the hope of down-staging tumors before surgery. 60%, however, do not respond or even progress on this treatment, and these patients would benefit from immediate surgery upon diagnosis. To help identify non-responding patients, we show here that patient-derived tumor xenograft models can be established in zebrafish larvae (ZTX models) and that the resulting tumors exhibit differential responses to the two main cisplatin-containing treatments GC and MVAC.
Preliminary results from the first 19 patients are presented. Two tumor biopsies were destroyed during transport and two did not allow isolation of sufficient viable cells for implantation. From the remaining 15 samples an average of 2,6 million cells with average viability of 53% were isolated and used to implant at least 60 2-days old larvae. All 15 samples implanted in the larvae and survived and/or grew exhibiting varying degrees of metastatic dissemination (average between 2 and 13 metastasized cells per embryo and model) within only three days from implantation. Four ZTX models exhibited different responses to GC and MVAC demonstrating that these treatments are not equally effective in all patients. Non-response in ZTX models was associated with tumors having re-appeared in the bladder upon radical cystectomy in all patients undergoing surgery prior to Dec. 5th 2019 (n=3). GC inhibited metastasis in all models (average 69% inhibition), whereas MVAC inhibited metastasis in 40% of the models (average 36% inhibition).
In conclusion: The ZTX urinary bladder cancer platform presented here overcome limitations associated with long assay time and high cost of other functional models within precision medicine as well as the low hit-rate of actionable mutations associated with genomic techniques. ZTX models will therefore likely become a powerful method for functional precision medicine within oncology, in the near future.
Citation Format: Zaheer Ali, Anna Nilsson, Malin Vildevall, Larissa Rizzo, Ylva Huge, Amir Sherif, Anna Fahlgren, Lasse DE Jensen. Translation of zebrafish tumor-derived xenograft-models for improved diagnosis and treatment planning in urinary bladder cancer patients [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6124.
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Affiliation(s)
| | | | | | | | - Ylva Huge
- 2Region Östergötland, Norrköping, Sweden
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Ali Z, Nilsson A, Vildevall M, Schueler J, Liberg D, Fahlgren A, Jensen LDE. Abstract 6126: Zebrafish patient tumor-derived xenograft models used for pre-clinical evaluation of CAN04 for lung and pancreatic cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-6126] [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: 11/16/2022]
Abstract
Abstract
Lung cancer is one of the most deadly diseases accounting for 24% of all cancer deaths worldwide. One reason for this high mortality is the high interindividual heterogeneity but generally poor efficacy of current treatments, leading to an urgent need for new and more effective drugs. Understanding the individual variability in the efficacy of new treatment candidates, delineating whether they should be combined with existing chemotherapeutics and to what extent they affect metastatic dissemination of the tumor cells are key preclinical indicators needed to increase the chance of success in clinical trials. Developing such data, however, requires animal models that recapitulate individual differences of different lung cancer patients, include insights into metastatic activity and allow analysis of a large amounts of treatment combinations for each patient model. As such, an in vivo screening system which has higher throughput than mouse models and at the same time allows analysis of metastatic activity would be very valuable in mimicking human disease.
Here we conducted zebrafish patient tumor derived xenograft (PDX)-studies based on cisplatin sensitive and -resistant lung cancer PDX material, to test the efficacy of a a novel antibody, CAN04, under development for this indication. CAN04 targets Interleukin-1 Accessory Protein (IL1RAP) and has shown synergistic effects with cisplatin in murine models of cancer. CAN04 is currently in phase II development in combination with chemotherapy in lung cancer and pancreatic cancer. CAN04 was given either alone or with cisplatin at three different concentrations, and the effects on primary tumor growth and metastasis three days after tumor implantation was evaluated. We show that CAN04 was able to synergize with cisplatin in causing almost complete (85%-98%) tumor regression even of cisplatin-resistant tumors, compared to non-treated controls. The effects were concentration- and model-dependent. Interestingly, in the cisplatin-resistant model, the antibody and cisplatin co-treatment led to robust inhibition of metastatic dissemination, which was not seen in either group alone. This substantiates the beneficial therapeutic efficacy of combining CAN04 to cisplatin treatment in lung cancer.
In conclusion, zebrafish-PDX (ZTX) models are powerful tools for evaluating individual differences in drug sensitivity on both primary tumor growth and metastasis and are suitable for screening various drug concentrations and/or combinations in multiple models with results being generated within one or a few weeks. We further conclude that CAN04 is inducing cisplatin sensitivity and synergize with cisplatin to inhibit metastasis, at least in some cisplatin resistant lung cancers.
Citation Format: Zaheer Ali, Anna Nilsson, Malin Vildevall, Julia Schueler, David Liberg, Anna Fahlgren, Lasse DE Jensen. Zebrafish patient tumor-derived xenograft models used for pre-clinical evaluation of CAN04 for lung and pancreatic cancer [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6126.
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Wahlund M, Sinha I, Broliden K, Saghafian-Hedengren S, Nilsson A, Berggren A. The Feasibility of Host Transcriptome Profiling as a Diagnostic Tool for Microbial Etiology in Childhood Cancer Patients with Febrile Neutropenia. Int J Mol Sci 2020; 21:ijms21155305. [PMID: 32722616 PMCID: PMC7432212 DOI: 10.3390/ijms21155305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/22/2020] [Revised: 07/13/2020] [Accepted: 07/21/2020] [Indexed: 12/23/2022] Open
Abstract
Infection is a common and serious complication of cancer treatment in children that often presents as febrile neutropenia (FN). Gene-expression profiling techniques can reveal transcriptional signatures that discriminate between viral, bacterial and asymptomatic infections in otherwise healthy children. Here, we examined whether gene-expression profiling was feasible in children with FN who were undergoing cancer treatment. The blood transcriptome of the children (n = 63) was investigated at time of FN diagnosed as viral, bacterial, co-infection or unknown etiology, respectively, and compared to control samples derived from 12 of the patients following the FN episode. RNA sequencing was successful in 43 (68%) of the FN episodes. Only two genes were significantly differentially expressed in the bacterial versus the control group. Significantly up-regulated genes in patients with the other three etiologies versus the control group were enriched with cellular processes related to proliferation and cellular stress response, with no clear enrichment with innate responses to pathogens. Among the significantly down-regulated genes, a few clustered into pathways connected to responses to infection. In the present study of children during cancer treatment, the blood transcriptome was not suitable for determining the etiology of FN because of too few circulating immune cells for reliable gene expression analysis.
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Affiliation(s)
- Martina Wahlund
- Department of Medicine Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden; (M.W.); (K.B.)
- Clinical Microbiology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Indranil Sinha
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, 171 76 Stockholm, Sweden; (I.S.); (S.S.-H.); (A.N.)
| | - Kristina Broliden
- Department of Medicine Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden; (M.W.); (K.B.)
| | - Shanie Saghafian-Hedengren
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, 171 76 Stockholm, Sweden; (I.S.); (S.S.-H.); (A.N.)
| | - Anna Nilsson
- Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, 171 76 Stockholm, Sweden; (I.S.); (S.S.-H.); (A.N.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Anna Berggren
- Department of Medicine Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden; (M.W.); (K.B.)
- Correspondence:
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