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Gutor SS, Richmond BW, Agrawal V, Brittain EL, Shaver CM, Wu P, Boyle TK, Mallugari RR, Douglas K, Piana RN, Johnson JE, Miller RF, Newman JH, Blackwell TS, Polosukhin VV. Pulmonary vascular disease in Veterans with post-deployment respiratory syndrome. Cardiovasc Pathol 2024; 71:107640. [PMID: 38604505 DOI: 10.1016/j.carpath.2024.107640] [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: 12/12/2023] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 04/13/2024] Open
Abstract
Exertional dyspnea has been documented in US military personnel after deployment to Iraq and Afghanistan. We studied whether continued exertional dyspnea in this patient population is associated with pulmonary vascular disease (PVD). We performed detailed histomorphometry of pulmonary vasculature in 52 Veterans with biopsy-proven post-deployment respiratory syndrome (PDRS) and then recruited five of these same Veterans with continued exertional dyspnea to undergo a follow-up clinical evaluation, including symptom questionnaire, pulmonary function testing, surface echocardiography, and right heart catheterization (RHC). Morphometric evaluation of pulmonary arteries showed significantly increased intima and media thicknesses, along with collagen deposition (fibrosis), in Veterans with PDRS compared to non-diseased (ND) controls. In addition, pulmonary veins in PDRS showed increased intima and adventitia thicknesses with prominent collagen deposition compared to controls. Of the five Veterans involved in our clinical follow-up study, three had borderline or overt right ventricle (RV) enlargement by echocardiography and evidence of pulmonary hypertension (PH) on RHC. Together, our studies suggest that PVD with predominant venular fibrosis is common in PDRS and development of PH may explain exertional dyspnea and exercise limitation in some Veterans with PDRS.
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Affiliation(s)
- Sergey S Gutor
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Bradley W Richmond
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Department of Veterans Affairs, Nashville VA, Nashville, TN; Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN
| | - Vineet Agrawal
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Evan L Brittain
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ciara M Shaver
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Pingsheng Wu
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN
| | - Taryn K Boyle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ravinder R Mallugari
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Katrina Douglas
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Robert N Piana
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Joyce E Johnson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Robert F Miller
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - John H Newman
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Timothy S Blackwell
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN; Department of Veterans Affairs, Nashville VA, Nashville, TN; Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN
| | - Vasiliy V Polosukhin
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.
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2
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Chioma OS, Mallott E, Shah-Gandhi B, Wiggins Z, Langford M, Lancaster AW, Gelbard A, Wu H, Johnson JE, Lancaster L, Wilfong EM, Crofford LJ, Montgomery CG, Van Kaer L, Bordenstein S, Newcomb DC, Drake WP. Low Gut Microbial Diversity Augments Estrogen-Driven Pulmonary Fibrosis in Female-Predominant Interstitial Lung Disease. Cells 2023; 12:766. [PMID: 36899902 PMCID: PMC10000459 DOI: 10.3390/cells12050766] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
Although profibrotic cytokines, such as IL-17A and TGF-β1, have been implicated in the pathogenesis of interstitial lung disease (ILD), the interactions between gut dysbiosis, gonadotrophic hormones and molecular mediators of profibrotic cytokine expression, such as the phosphorylation of STAT3, have not been defined. Here, through chromatin immunoprecipitation sequencing (ChIP-seq) analysis of primary human CD4+ T cells, we show that regions within the STAT3 locus are significantly enriched for binding by the transcription factor estrogen receptor alpha (ERa). Using the murine model of bleomycin-induced pulmonary fibrosis, we found significantly increased regulatory T cells compared to Th17 cells in the female lung. The genetic absence of ESR1 or ovariectomy in mice significantly increased pSTAT3 and IL-17A expression in pulmonary CD4+ T cells, which was reduced after the repletion of female hormones. Remarkably, there was no significant reduction in lung fibrosis under either condition, suggesting that factors outside of ovarian hormones also contribute. An assessment of lung fibrosis among menstruating females in different rearing environments revealed that environments favoring gut dysbiosis augment fibrosis. Furthermore, hormone repletion following ovariectomy further augmented lung fibrosis, suggesting pathologic interactions between gonadal hormones and gut microbiota in relation to lung fibrosis severity. An analysis of female sarcoidosis patients revealed a significant reduction in pSTAT3 and IL-17A levels and a concomitant increase in TGF-β1 levels in CD4+ T cells compared to male sarcoidosis patients. These studies reveal that estrogen is profibrotic in females and that gut dysbiosis in menstruating females augments lung fibrosis severity, supporting a critical interaction between gonadal hormones and gut flora in lung fibrosis pathogenesis.
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Affiliation(s)
- Ozioma S. Chioma
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Elizabeth Mallott
- Department of Biology, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Binal Shah-Gandhi
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - ZaDarreyal Wiggins
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Madison Langford
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | | | - Alexander Gelbard
- Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Hongmei Wu
- Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Joyce E. Johnson
- Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Lisa Lancaster
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Erin M. Wilfong
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Leslie J. Crofford
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Department of Biology, Washington University in St. Louis, St. Louis, MO 63130, USA
| | - Courtney G. Montgomery
- Genes and Human Disease Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Luc Van Kaer
- Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Seth Bordenstein
- Department of Biology and Entomology, Pennsylvania State University, College Station, PA 16801, USA
| | - Dawn C. Newcomb
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Wonder Puryear Drake
- Departments of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
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3
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Chioma OS, Mallott E, Shah-Gandhi B, Wiggins Z, Langford M, Lancaster AW, Gelbard A, Wu H, Johnson JE, Lancaster L, Wilfong EM, Crofford LJ, Montgomery CG, Van Kaer L, Bordenstein S, Newcomb DC, Drake WP. Low Gut Microbial Diversity Augments Estrogen-driven Pulmonary Fibrosis in Female-Predominant Interstitial Lung Disease. bioRxiv 2023:2023.02.15.528630. [PMID: 36824732 PMCID: PMC9948999 DOI: 10.1101/2023.02.15.528630] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Although profibrotic cytokines such as IL-17A and TGF-β1 have been implicated in interstitial lung disease (ILD) pathogenesis, interactions between gut dysbiosis, gonadotrophic hormones and molecular mediators of profibrotic cytokine expression, such as phosphorylation of STAT3, have not been defined. Here we show by chromatin immunoprecipitation sequencing (ChIP-seq) analysis of primary human CD4+ T cells that regions within the STAT3 locus are significantly enriched for binding by the transcription factor estrogen receptor alpha (ERa). Using the murine model of bleomycin-induced pulmonary fibrosis, we found significantly increased regulatory T cells compared to Th17 cells in the female lung. Genetic absence of ESR1 or ovariectomy in mice significantly increased pSTAT3 and IL-17A expression in pulmonary CD4+ T cells, which was reduced after repletion of female hormones. Remarkably, there was no significant reduction in lung fibrosis under either condition, suggesting that factors outside of ovarian hormones also contribute. Assessment of lung fibrosis among menstruating females in different rearing environments revealed that environments favoring gut dysbiosis augment fibrosis. Furthermore, hormone repletion following ovariectomy further augmented lung fibrosis, suggesting pathologic interactions between gonadal hormones and gut microbiota on lung fibrosis severity. Analysis in female sarcoidosis patients revealed a significant reduction in pSTAT3 and IL-17A levels and a concomitant increase in TGF-β1 levels in CD4+ T cells, compared to male sarcoidosis patients. These studies reveal that estrogen is profibrotic in females and that gut dysbiosis in menstruating females augments lung fibrosis severity, supporting a critical interaction between gonadal hormones and gut flora in lung fibrosis pathogenesis.
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Jacobs JW, Adkins BD, Ahmad Y, Bahar B, Bulow US, Herrmann AC, McDonald MM, Jackson NR, Mills AM, Owczarczyk AB, Shafi S, Shanes ED, Wang H, Woo JS, Compton ML, Johnson JE, Wheeler AP, Booth GS. Pathology and Abortion Rights Advocacy: Considerations in a Post-Roe World. Am J Clin Pathol 2022; 158:776-777. [PMID: 36197882 DOI: 10.1093/ajcp/aqac120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | - Burak Bahar
- Children's National Hospital, Washington, DC, USA
| | | | | | | | | | - Anne M Mills
- University of Virginia Health System, Charlotteville, VA, USA
| | | | - Saba Shafi
- The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Elisheva D Shanes
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hannah Wang
- Pathologist and Clinical Microbiologist in Northeast Ohio, USA
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Johnson JE, Stellwag LG. Nurses as bridge builders: Advancing nursing through the diffusion of knowledge. J Adv Nurs 2022; 78:e137-e146. [DOI: 10.1111/jan.15405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/06/2022] [Accepted: 07/21/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Joyce E. Johnson
- The Catholic University of America Conway School of Nursing Washington District of Columbia USA
| | - Lorelei G. Stellwag
- AVP MedStar Capacity and Transfer Center MedStar Georgetown University Hospital Washington District of Columbia USA
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6
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Gutor SS, Richmond BW, Du RH, Wu P, Lee JW, Ware LB, Shaver CM, Novitskiy SV, Johnson JE, Newman JH, Rennard SI, Miller RF, Blackwell TS, Polosukhin VV. Characterization of Immunopathology and Small Airway Remodeling in Constrictive Bronchiolitis. Am J Respir Crit Care Med 2022; 206:260-270. [PMID: 35550018 PMCID: PMC9890264 DOI: 10.1164/rccm.202109-2133oc] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 05/13/2022] [Indexed: 02/04/2023] Open
Abstract
Rationale: Constrictive bronchiolitis (ConB) is a relatively rare and understudied form of lung disease whose underlying immunopathology remains incompletely defined. Objectives: Our objectives were to quantify specific pathological features that differentiate ConB from other diseases that affect the small airways and to investigate the underlying immune and inflammatory phenotype present in ConB. Methods: We performed a comparative histomorphometric analysis of small airways in lung biopsy samples collected from 50 soldiers with postdeployment ConB, 8 patients with sporadic ConB, 55 patients with chronic obstructive pulmonary disease, and 25 nondiseased control subjects. We measured immune and inflammatory gene expression in lung tissue using the NanoString nCounter Immunology Panel from six control subjects, six soldiers with ConB, and six patients with sporadic ConB. Measurements and Main Results: Compared with control subjects, we found shared pathological changes in small airways from soldiers with postdeployment ConB and patients with sporadic ConB, including increased thickness of the smooth muscle layer, increased collagen deposition in the subepithelium, and lymphocyte infiltration. Using principal-component analysis, we showed that ConB pathology was clearly separable both from control lungs and from small airway disease associated with chronic obstructive pulmonary disease. NanoString gene expression analysis from lung tissue revealed T-cell activation in both groups of patients with ConB with upregulation of proinflammatory pathways, including cytokine-cytokine receptor interactions, NF-κB (nuclear factor-κB) signaling, TLR (Toll-like receptor) signaling, T-cell receptor signaling, and antigen processing and presentation. Conclusions: These findings indicate shared immunopathology among different forms of ConB and suggest that an ongoing T-helper cell type 1-type adaptive immune response underlies airway wall remodeling in ConB.
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Affiliation(s)
- Sergey S. Gutor
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Bradley W. Richmond
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
- Veterans Affairs Medical Center, Nashville, Tennessee
| | - Rui-Hong Du
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Pingsheng Wu
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
- Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Jae Woo Lee
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California; and
| | - Lorraine B. Ware
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ciara M. Shaver
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Sergey V. Novitskiy
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Joyce E. Johnson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - John H. Newman
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Stephen I. Rennard
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Robert F. Miller
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
| | - Timothy S. Blackwell
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
- Veterans Affairs Medical Center, Nashville, Tennessee
| | - Vasiliy V. Polosukhin
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, and
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7
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Gutor SS, Richmond BW, Du RH, Wu P, Sandler KL, MacKinnon G, Brittain EL, Lee JW, Ware LB, Loyd JE, Johnson JE, Miller RF, Newman JH, Rennard SI, Blackwell TS, Polosukhin VV. Postdeployment Respiratory Syndrome in Soldiers With Chronic Exertional Dyspnea. Am J Surg Pathol 2021; 45:1587-1596. [PMID: 34081035 PMCID: PMC8585675 DOI: 10.1097/pas.0000000000001757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
After deployment to Southwest Asia, some soldiers develop persistent respiratory symptoms, including exercise intolerance and exertional dyspnea. We identified 50 soldiers with a history of deployment to Southwest Asia who presented with unexplained dyspnea and underwent an unrevealing clinical evaluation followed by surgical lung biopsy. Lung tissue specimens from 17 age-matched, nonsmoking subjects were used as controls. Quantitative histomorphometry was performed for evaluation of inflammation and pathologic remodeling of small airways, pulmonary vasculature, alveolar tissue and visceral pleura. Compared with control subjects, lung biopsies from affected soldiers revealed a variety of pathologic changes involving their distal lungs, particularly related to bronchovascular bundles. Bronchioles from soldiers had increased thickness of the lamina propria, smooth muscle hypertrophy, and increased collagen content. In adjacent arteries, smooth muscle hypertrophy and adventitial thickening resulted in increased wall-to-lumen ratio in affected soldiers. Infiltration of CD4 and CD8 T lymphocytes was noted within airway walls, along with increased formation of lymphoid follicles. In alveolar parenchyma, collagen and elastin content were increased and capillary density was reduced in interalveolar septa from soldiers compared to control subjects. In addition, pleural involvement with inflammation and/or fibrosis was present in the majority (92%) of soldiers. Clinical follow-up of 29 soldiers (ranging from 1 to 15 y) showed persistence of exertional dyspnea in all individuals and a decline in total lung capacity. Susceptible soldiers develop a postdeployment respiratory syndrome that includes exertional dyspnea and complex pathologic changes affecting small airways, pulmonary vasculature, alveolar tissue, and visceral pleura.
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Affiliation(s)
- Sergey S. Gutor
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
| | - Bradley W. Richmond
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
- Veterans Affairs Medical Center
| | - Rui-Hong Du
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
| | - Pingsheng Wu
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
- Department of Biostatistics, Vanderbilt University School of Medicine
| | | | - Grant MacKinnon
- Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Evan L. Brittain
- Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Jae Woo Lee
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA
| | - Lorraine B. Ware
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
- Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
| | - James E. Loyd
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
| | - Joyce E. Johnson
- Pathology, Microbiology and Immunology, Vanderbilt University Medical Center
| | - Robert F. Miller
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
| | - John H. Newman
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
| | - Stephen I. Rennard
- Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy, University of Nebraska Medical Center, Omaha, NE
| | - Timothy S. Blackwell
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine
- Veterans Affairs Medical Center
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8
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Wilfong EM, Vowell KN, Bunn KE, Rizzi E, Annapureddy N, Dudenhofer RB, Barnado A, Bonami RH, Johnson JE, Crofford LJ, Kendall PL. CD19 + CD21 lo/neg cells are increased in systemic sclerosis-associated interstitial lung disease. Clin Exp Med 2021; 22:209-220. [PMID: 34374937 PMCID: PMC8828801 DOI: 10.1007/s10238-021-00745-5] [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] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/12/2021] [Indexed: 12/17/2022]
Abstract
Interstitial lung disease (ILD) represents a significant cause of morbidity and mortality in systemic sclerosis (SSc). The purpose of this study was to examine recirculating lymphocytes from SSc patients for potential biomarkers of interstitial lung disease (ILD). Peripheral blood mononuclear cells (PBMCs) were isolated from patients with SSc and healthy controls enrolled in the Vanderbilt University Myositis and Scleroderma Treatment Initiative Center cohort between 9/2017–6/2019. Clinical phenotyping was performed by chart abstraction. Immunophenotyping was performed using both mass cytometry and fluorescence cytometry combined with t-distributed stochastic neighbor embedding analysis and traditional biaxial gating. This study included 34 patients with SSc-ILD, 14 patients without SSc-ILD, and 25 healthy controls. CD21lo/neg cells are significantly increased in SSc-ILD but not in SSc without ILD (15.4 ± 13.3% vs. 5.8 ± 0.9%, p = 0.002) or healthy controls (5.0 ± 0.5%, p < 0.0001). While CD21lo/neg B cells can be identified from a single biaxial gate, tSNE analysis reveals that the biaxial gate is comprised of multiple distinct subsets, all of which are increased in SSc-ILD. CD21lo/neg cells in both healthy controls and SSc-ILD are predominantly tBET positive and do not have intracellular CD21. Immunohistochemistry staining demonstrated that CD21lo/neg B cells diffusely infiltrate the lung parenchyma of an SSc-ILD patient. Additional work is needed to validate this biomarker in larger cohorts and longitudinal studies and to understand the role of these cells in SSc-ILD.
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Affiliation(s)
- Erin M Wilfong
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.,Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine N Vowell
- Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kaitlyn E Bunn
- Deparment of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Elise Rizzi
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Narender Annapureddy
- Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rosemarie B Dudenhofer
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - April Barnado
- Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachel H Bonami
- Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,Deparment of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, TN, USA
| | - Joyce E Johnson
- Deparment of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,Deparment of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, TN, USA
| | - Peggy L Kendall
- Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA. .,Deparment of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA. .,Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, TN, USA. .,Division of Allergy and Immunology, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8122, St. Louis, MO, 63110, USA.
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9
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Johnson JE, Berry JA. The role of Cytochrome b 6f in the control of steady-state photosynthesis: a conceptual and quantitative model. Photosynth Res 2021; 148:101-136. [PMID: 33999328 PMCID: PMC8292351 DOI: 10.1007/s11120-021-00840-4] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 04/26/2021] [Indexed: 05/06/2023]
Abstract
Here, we present a conceptual and quantitative model to describe the role of the Cytochrome [Formula: see text] complex in controlling steady-state electron transport in [Formula: see text] leaves. The model is based on new experimental methods to diagnose the maximum activity of Cyt [Formula: see text] in vivo, and to identify conditions under which photosynthetic control of Cyt [Formula: see text] is active or relaxed. With these approaches, we demonstrate that Cyt [Formula: see text] controls the trade-off between the speed and efficiency of electron transport under limiting light, and functions as a metabolic switch that transfers control to carbon metabolism under saturating light. We also present evidence that the onset of photosynthetic control of Cyt [Formula: see text] occurs within milliseconds of exposure to saturating light, much more quickly than the induction of non-photochemical quenching. We propose that photosynthetic control is the primary means of photoprotection and functions to manage excitation pressure, whereas non-photochemical quenching functions to manage excitation balance. We use these findings to extend the Farquhar et al. (Planta 149:78-90, 1980) model of [Formula: see text] photosynthesis to include a mechanistic description of the electron transport system. This framework relates the light captured by PS I and PS II to the energy and mass fluxes linking the photoacts with Cyt [Formula: see text], the ATP synthase, and Rubisco. It enables quantitative interpretation of pulse-amplitude modulated fluorometry and gas-exchange measurements, providing a new basis for analyzing how the electron transport system coordinates the supply of Fd, NADPH, and ATP with the dynamic demands of carbon metabolism, how efficient use of light is achieved under limiting light, and how photoprotection is achieved under saturating light. The model is designed to support forward as well as inverse applications. It can either be used in a stand-alone mode at the leaf-level or coupled to other models that resolve finer-scale or coarser-scale phenomena.
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Affiliation(s)
- J E Johnson
- Dept. Global Ecology, Carnegie Institution, Stanford, CA, 94305, USA.
| | - J A Berry
- Dept. Global Ecology, Carnegie Institution, Stanford, CA, 94305, USA
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10
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Obradovic A, Chowdhury N, Haake SM, Ager C, Wang V, Vlahos L, Guo XV, Aggen DH, Rathmell WK, Jonasch E, Johnson JE, Roth M, Beckermann KE, Rini BI, McKiernan J, Califano A, Drake CG. Single-cell protein activity analysis identifies recurrence-associated renal tumor macrophages. Cell 2021; 184:2988-3005.e16. [PMID: 34019793 PMCID: PMC8479759 DOI: 10.1016/j.cell.2021.04.038] [Citation(s) in RCA: 135] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 02/10/2021] [Accepted: 04/23/2021] [Indexed: 12/11/2022]
Abstract
Clear cell renal carcinoma (ccRCC) is a heterogeneous disease with a variable post-surgical course. To assemble a comprehensive ccRCC tumor microenvironment (TME) atlas, we performed single-cell RNA sequencing (scRNA-seq) of hematopoietic and non-hematopoietic subpopulations from tumor and tumor-adjacent tissue of treatment-naive ccRCC resections. We leveraged the VIPER algorithm to quantitate single-cell protein activity and validated this approach by comparison to flow cytometry. The analysis identified key TME subpopulations, as well as their master regulators and candidate cell-cell interactions, revealing clinically relevant populations, undetectable by gene-expression analysis. Specifically, we uncovered a tumor-specific macrophage subpopulation characterized by upregulation of TREM2/APOE/C1Q, validated by spatially resolved, quantitative multispectral immunofluorescence. In a large clinical validation cohort, these markers were significantly enriched in tumors from patients who recurred following surgery. The study thus identifies TREM2/APOE/C1Q-positive macrophage infiltration as a potential prognostic biomarker for ccRCC recurrence, as well as a candidate therapeutic target.
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MESH Headings
- Adult
- Apolipoproteins E/genetics
- Apolipoproteins E/metabolism
- Biomarkers, Tumor/genetics
- Carcinoma, Renal Cell/genetics
- Carcinoma, Renal Cell/metabolism
- Carcinoma, Renal Cell/pathology
- Cohort Studies
- Female
- Gene Expression/genetics
- Gene Expression Regulation, Neoplastic/genetics
- Humans
- Kidney/metabolism
- Kidney Neoplasms/pathology
- Lymphocytes, Tumor-Infiltrating/pathology
- Macrophages/metabolism
- Male
- Membrane Glycoproteins/genetics
- Membrane Glycoproteins/metabolism
- Middle Aged
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/metabolism
- Prognosis
- Receptors, Complement/genetics
- Receptors, Complement/metabolism
- Receptors, Immunologic/genetics
- Receptors, Immunologic/metabolism
- Sequence Analysis, RNA/methods
- Single-Cell Analysis/methods
- Tumor Microenvironment
- Tumor-Associated Macrophages/metabolism
- Tumor-Associated Macrophages/physiology
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Affiliation(s)
- Aleksandar Obradovic
- Columbia Center for Translational Immunology (CCTI), Columbia University Irving Medical Center (CUMC), New York, NY 10032, USA; Department of Systems Biology, HICC, New York, NY 10032, USA
| | - Nivedita Chowdhury
- Columbia Center for Translational Immunology (CCTI), Columbia University Irving Medical Center (CUMC), New York, NY 10032, USA; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | | | - Casey Ager
- Columbia Center for Translational Immunology (CCTI), Columbia University Irving Medical Center (CUMC), New York, NY 10032, USA
| | - Vinson Wang
- Department of Urology, Herbert Irving Comprehensive Cancer Center (HICC), New York, NY 10032, USA
| | - Lukas Vlahos
- Department of Systems Biology, HICC, New York, NY 10032, USA
| | - Xinzheng V Guo
- Columbia Center for Translational Immunology (CCTI), Columbia University Irving Medical Center (CUMC), New York, NY 10032, USA
| | - David H Aggen
- Columbia Center for Translational Immunology (CCTI), Columbia University Irving Medical Center (CUMC), New York, NY 10032, USA
| | | | - Eric Jonasch
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Marc Roth
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Brian I Rini
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - James McKiernan
- Department of Urology, Herbert Irving Comprehensive Cancer Center (HICC), New York, NY 10032, USA; HICC, Columbia University, New York, NY, USA
| | - Andrea Califano
- Department of Systems Biology, HICC, New York, NY 10032, USA; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; HICC, Columbia University, New York, NY, USA; Department of Biochemistry and Molecular Biophysics, Columbia University, New York, NY; Department of Biomedical Informatics, Columbia University, New York, NY, USA; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; J.P. Sulzberger Columbia Genome Center, New York, NY, USA.
| | - Charles G Drake
- Columbia Center for Translational Immunology (CCTI), Columbia University Irving Medical Center (CUMC), New York, NY 10032, USA; Department of Urology, Herbert Irving Comprehensive Cancer Center (HICC), New York, NY 10032, USA; HICC, Columbia University, New York, NY, USA.
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11
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Waghorn KA, Vadakkepuliyambatta S, Plaza-Faverola A, Johnson JE, Bünz S, Waage M. Crustal processes sustain Arctic abiotic gas hydrate and fluid flow systems. Sci Rep 2020; 10:10679. [PMID: 32606428 PMCID: PMC7326923 DOI: 10.1038/s41598-020-67426-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/05/2020] [Indexed: 11/09/2022] Open
Abstract
The Svyatogor Ridge and surroundings, located on the sediment-covered western flank of the Northern Knipovich Ridge, host extensive gas hydrate and related fluid flow systems. The fluid flow system here manifests in the upper sedimentary sequence as gas hydrates and free gas, indicated by bottom simulating reflections (BSRs) and amplitude anomalies. Using 2D seismic lines and bathymetric data, we map tectonic features such as faults, crustal highs, and indicators of fluid flow processes. Results indicate a strong correlation between crustal faults, crustal highs and fluid accumulations in the overlying sediments, as well as an increase in geothermal gradient over crustal faults. We conclude here that gas generated during the serpentinization of exhumed mantle rocks drive the extensive occurrence of gas hydrate and fluid flow systems in the region and transform faults act as an additional major pathway for fluid circulation.
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Affiliation(s)
- K A Waghorn
- CAGE - Centre for Arctic Gas Hydrate, Environment and Climate, Department of Geosciences, UiT - The Arctic University of Norway, Dramsveien 201, 9037, Tromsø, Norway.
| | - S Vadakkepuliyambatta
- CAGE - Centre for Arctic Gas Hydrate, Environment and Climate, Department of Geosciences, UiT - The Arctic University of Norway, Dramsveien 201, 9037, Tromsø, Norway
| | - A Plaza-Faverola
- CAGE - Centre for Arctic Gas Hydrate, Environment and Climate, Department of Geosciences, UiT - The Arctic University of Norway, Dramsveien 201, 9037, Tromsø, Norway
| | - J E Johnson
- Department of Earth Sciences, University of New Hampshire, 56 College Road, Durham, NH, 03824, USA
| | - S Bünz
- CAGE - Centre for Arctic Gas Hydrate, Environment and Climate, Department of Geosciences, UiT - The Arctic University of Norway, Dramsveien 201, 9037, Tromsø, Norway
| | - M Waage
- CAGE - Centre for Arctic Gas Hydrate, Environment and Climate, Department of Geosciences, UiT - The Arctic University of Norway, Dramsveien 201, 9037, Tromsø, Norway
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12
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Abstract
Recent reports from the Institute of Medicine document the increase in the number of nurses enrolled in doctoral education preparing for nurse scientist and leadership roles in the transformation of health care. This means that many doctoral students will acquire a knowledge of the research process, learn how to review and critique relevant literature, select appropriate research designs, and with the guidance of their dissertation chair and committee, design and conduct high quality, scholarly research studies that culminate in successfully defended doctoral dissertations. The health care profession expects that these dissertations, which include quantitative, qualitative, or mixed methods, will contribute to the knowledge base of the nursing profession and advance improvement in clinical and public health outcomes in the populations served by the nursing profession. This article reviews the concept of rigor in research, the rationale for rigor, various approaches that increase rigor, and the associated concepts that strengthen a research study.
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Affiliation(s)
- Petra Goodman
- Doctoral Program, Conway School of Nursing, The Catholic University of America, Washington, DC
| | - Rebecca C Robert
- Doctoral Program, Conway School of Nursing, The Catholic University of America, Washington, DC
| | - Joyce E Johnson
- Doctoral Program, Conway School of Nursing, The Catholic University of America, Washington, DC
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13
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Celada LJ, Kropski JA, Herazo-Maya JD, Luo W, Creecy A, Abad AT, Chioma OS, Lee G, Hassell NE, Shaginurova GI, Wang Y, Johnson JE, Kerrigan A, Mason WR, Baughman RP, Ayers GD, Bernard GR, Culver DA, Montgomery CG, Maher TM, Molyneaux PL, Noth I, Mutsaers SE, Prele CM, Peebles RS, Newcomb DC, Kaminski N, Blackwell TS, Van Kaer L, Drake WP. PD-1 up-regulation on CD4 + T cells promotes pulmonary fibrosis through STAT3-mediated IL-17A and TGF-β1 production. Sci Transl Med 2019; 10:10/460/eaar8356. [PMID: 30257954 DOI: 10.1126/scitranslmed.aar8356] [Citation(s) in RCA: 198] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/02/2018] [Accepted: 09/05/2018] [Indexed: 12/11/2022]
Abstract
Pulmonary fibrosis is a progressive inflammatory disease with high mortality and limited therapeutic options. Previous genetic and immunologic investigations suggest common intersections between idiopathic pulmonary fibrosis (IPF), sarcoidosis, and murine models of pulmonary fibrosis. To identify immune responses that precede collagen deposition, we conducted molecular, immunohistochemical, and flow cytometric analysis of human and murine specimens. Immunohistochemistry revealed programmed cell death-1 (PD-1) up-regulation on IPF lymphocytes. PD-1+CD4+ T cells with reduced proliferative capacity and increased transforming growth factor-β (TGF-β)/interleukin-17A (IL-17A) expression were detected in IPF, sarcoidosis, and bleomycin CD4+ T cells. PD-1+ T helper 17 cells are the predominant CD4+ T cell subset expressing TGF-β. Coculture of PD-1+CD4+ T cells with human lung fibroblasts induced collagen-1 production. Strikingly, ex vivo PD-1 pathway blockade resulted in reductions in TGF-β and IL-17A expression from CD4+ T cells, with concomitant declines in collagen-1 production from fibroblasts. Molecular analysis demonstrated PD-1 regulation of the transcription factor STAT3 (signal transducer and activator of transcription 3). Chemical blockade of STAT3, using the inhibitor STATTIC, inhibited collagen-1 production. Both bleomycin administration to PD-1 null mice or use of antibody against programmed cell death ligand 1 (PD-L1) demonstrated significantly reduced fibrosis compared to controls. This work identifies a critical, previously unrecognized role for PD-1+CD4+ T cells in pulmonary fibrosis, supporting the use of readily available therapeutics that directly address interstitial lung disease pathophysiology.
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Affiliation(s)
- Lindsay J Celada
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
| | - Jonathan A Kropski
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Jose D Herazo-Maya
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT 06510, USA
| | - Weifeng Luo
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Amy Creecy
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
| | - Andrew T Abad
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Ozioma S Chioma
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Grace Lee
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Natalie E Hassell
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Guzel I Shaginurova
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Yufen Wang
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Joyce E Johnson
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Amy Kerrigan
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Wendi R Mason
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Robert P Baughman
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati Medical Center, Cincinnati, OH 45219, USA
| | - Gregory D Ayers
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Gordon R Bernard
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Daniel A Culver
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Courtney G Montgomery
- Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.,Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73126, USA
| | - Toby M Maher
- National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton Hospital, London SW7 2AZ, UK.,Fibrosis Research Group, National Heart and Lung Institute, Imperial College, London SW7 2AZ, UK
| | - Philip L Molyneaux
- National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton Hospital, London SW7 2AZ, UK.,Fibrosis Research Group, National Heart and Lung Institute, Imperial College, London SW7 2AZ, UK
| | - Imre Noth
- Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL 60637, USA
| | - Steven E Mutsaers
- Centre for Cell Therapy and Regenerative Medicine, School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia 6009, Australia.,Institute for Respiratory Health, Centre for Respiratory Health, School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia 6009, Australia
| | - Cecilia M Prele
- Centre for Cell Therapy and Regenerative Medicine, School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia 6009, Australia.,Institute for Respiratory Health, Centre for Respiratory Health, School of Biomedical Sciences, University of Western Australia, Nedlands, Western Australia 6009, Australia
| | - R S Peebles
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.,Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Dawn C Newcomb
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.,Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Naftali Kaminski
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT 06510, USA
| | - Timothy S Blackwell
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Luc Van Kaer
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Wonder P Drake
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA. .,Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
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14
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Wilfong EM, Lentz RJ, Guttentag A, Tolle JJ, Johnson JE, Kropski JA, Kendall PL, Blackwell TS, Crofford LJ. Interstitial Pneumonia With Autoimmune Features: An Emerging Challenge at the Intersection of Rheumatology and Pulmonology. Arthritis Rheumatol 2018; 70:1901-1913. [PMID: 30058242 DOI: 10.1002/art.40679] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 07/24/2018] [Indexed: 01/03/2023]
Abstract
Interstitial lung disease (ILD) remains a cause of significant morbidity and mortality in patients with connective tissue disease (CTD)-associated ILD. While some patients meet clear classification criteria for a systemic rheumatic disease, a subset of patients do not meet classification criteria but still benefit from immunosuppressive therapy. In 2015, the American Thoracic Society and European Respiratory Society described classification criteria for interstitial pneumonia with autoimmune features (IPAF) to identify patients with lung-predominant CTD who lack sufficient features of a systemic rheumatic disease to meet classification criteria. Although these criteria are imperfect, they are an important attempt to classify the patient with undifferentiated disease for future study. Rheumatologists play a key role in the evaluation of potential IPAF in patients, especially as many patients with a myositis-spectrum disease (e.g., non-Jo-1 antisynthetase syndrome, anti-melanoma differentiation-associated protein 5 antibody inflammatory myositis, or anti-PM/Scl antibody-associated inflammatory myositis) would be classified under IPAF using the currently available criteria for inflammatory myositis, and would therefore benefit from rheumatologic comanagement. The aim of this review was to describe the historical context that led to the development of these criteria and to discuss the limitations of the current criteria, diagnostic challenges, treatment options, and strategies for disease monitoring.
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Affiliation(s)
- Erin M Wilfong
- Vanderbilt University, Nashville, Tennessee, and University of California San Francisco
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15
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Johnson JE, Rulo K. Problem in the profession: How and why writing skills in nursing must be improved. J Prof Nurs 2018; 35:57-64. [PMID: 30709467 DOI: 10.1016/j.profnurs.2018.05.005] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/28/2018] [Accepted: 05/15/2018] [Indexed: 11/19/2022]
Abstract
As a profession, nursing is obligated to disseminate knowledge by publishing research in the professional literature. Beyond producing scholarly work for publication, nurses need writing skills to complete doctoral dissertations and scholarly projects, and to succeed in obtaining funds for new nurse-directed business ventures. Ultimately, good writing skills are essential for the future of the nursing profession. In this article, we describe the critical role of writing in nursing, and offer a practical 10-point strategy for improving the writing ability of individual advanced practice nurses who need to improve their writing skills. This article also offers suggestions for increasing nursing's surveillance of nurses' writing skills such as increasing the emphasis on writing instruction as a priority in today's nursing graduate school curriculum, greater writing support for nurses who are writing dissertations and scholarly projects, evaluating writing programs, and monitoring the completion rate of nursing dissertations.
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Affiliation(s)
- Joyce E Johnson
- The Catholic University of America, School of Nursing, 201 Gowan Hall, Michigan Avenue, NE Washington, DC 20064, United States.; The Catholic University of America, 219 Mullen Library, Michigan Avenue, NE Washington, DC 20064, United States..
| | - Kevin Rulo
- The Catholic University of America, School of Nursing, 201 Gowan Hall, Michigan Avenue, NE Washington, DC 20064, United States.; The Catholic University of America, 219 Mullen Library, Michigan Avenue, NE Washington, DC 20064, United States..
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16
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Wallmann K, Riedel M, Hong WL, Patton H, Hubbard A, Pape T, Hsu CW, Schmidt C, Johnson JE, Torres ME, Andreassen K, Berndt C, Bohrmann G. Gas hydrate dissociation off Svalbard induced by isostatic rebound rather than global warming. Nat Commun 2018; 9:83. [PMID: 29311564 PMCID: PMC5758787 DOI: 10.1038/s41467-017-02550-9] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [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: 07/28/2017] [Accepted: 12/07/2017] [Indexed: 11/25/2022] Open
Abstract
Methane seepage from the upper continental slopes of Western Svalbard has previously been attributed to gas hydrate dissociation induced by anthropogenic warming of ambient bottom waters. Here we show that sediment cores drilled off Prins Karls Foreland contain freshwater from dissociating hydrates. However, our modeling indicates that the observed pore water freshening began around 8 ka BP when the rate of isostatic uplift outpaced eustatic sea-level rise. The resultant local shallowing and lowering of hydrostatic pressure forced gas hydrate dissociation and dissolved chloride depletions consistent with our geochemical analysis. Hence, we propose that hydrate dissociation was triggered by postglacial isostatic rebound rather than anthropogenic warming. Furthermore, we show that methane fluxes from dissociating hydrates were considerably smaller than present methane seepage rates implying that gas hydrates were not a major source of methane to the oceans, but rather acted as a dynamic seal, regulating methane release from deep geological reservoirs. Methane seepage from continental slopes has been attributed to gas hydrate dissociation induced by anthropogenic bottom water warming. Here, the authors show that hydrates dissociated before the Anthropocene when the isostatic rebound induced by deglaciation of the Arctic ice sheet outpaced eustatic sea-level rise.
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Affiliation(s)
- Klaus Wallmann
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Wischhofstr. 1-3, Kiel, 24148, Germany.
| | - M Riedel
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Wischhofstr. 1-3, Kiel, 24148, Germany
| | - W L Hong
- Geological Survey of Norway, N-7022, Trondheim, Norway.,CAGE Centre for Arctic Gas Hydrate Research, Environment and Climate, Department of Geosciences, UiT-The Arctic University of Norway, Tromsø, N-9037, Norway
| | - H Patton
- CAGE Centre for Arctic Gas Hydrate Research, Environment and Climate, Department of Geosciences, UiT-The Arctic University of Norway, Tromsø, N-9037, Norway
| | - A Hubbard
- CAGE Centre for Arctic Gas Hydrate Research, Environment and Climate, Department of Geosciences, UiT-The Arctic University of Norway, Tromsø, N-9037, Norway.,Department of Geography & Earth Science, Aberystwyth University, Wales, SY23 3DB, UK
| | - T Pape
- MARUM-Center for Marine Environmental Sciences and Department of Geosciences, University of Bremen, Klagenfurter Str., Bremen, 28359, Germany
| | - C W Hsu
- MARUM-Center for Marine Environmental Sciences and Department of Geosciences, University of Bremen, Klagenfurter Str., Bremen, 28359, Germany
| | - C Schmidt
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Wischhofstr. 1-3, Kiel, 24148, Germany
| | - J E Johnson
- Department of Earth Sciences, University of New Hampshire, 56 College Rd., Durham, NH, 03824-3589, USA
| | - M E Torres
- College of Oceanic and Atmospheric Sciences, Oregon State University, 104 Ocean Admin Building, Corvallis, OR, 97331-5503, USA
| | - K Andreassen
- CAGE Centre for Arctic Gas Hydrate Research, Environment and Climate, Department of Geosciences, UiT-The Arctic University of Norway, Tromsø, N-9037, Norway
| | - C Berndt
- GEOMAR Helmholtz Centre for Ocean Research Kiel, Wischhofstr. 1-3, Kiel, 24148, Germany
| | - G Bohrmann
- MARUM-Center for Marine Environmental Sciences and Department of Geosciences, University of Bremen, Klagenfurter Str., Bremen, 28359, Germany
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17
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Johnson JE, Hamann L, Dettman DL, Kim-Hak D, Leavitt SW, Monson RK, Papuga SA. Performance of induction module cavity ring-down spectroscopy (IM-CRDS) for measuring δ 18 O and δ 2 H values of soil, stem, and leaf waters. Rapid Commun Mass Spectrom 2017; 31:547-560. [PMID: 28010033 DOI: 10.1002/rcm.7813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 12/19/2016] [Accepted: 12/20/2016] [Indexed: 06/06/2023]
Abstract
RATIONALE Induction module cavity ring-down spectroscopy (IM-CRDS) has been proposed as a rapid and cost-effective alternative to cryogenic vacuum distillation (CVD) and isotope ratio mass spectrometry (IRMS) for the measurement of δ18 O and δ2 H values in matrix-bound waters. In the current study, we characterized the performance of IM-CRDS relative to CVD and IRMS and investigated the mechanisms responsible for differences between the methods. METHODS We collected a set of 75 soil, stem, and leaf water samples, and measured the δ18 O and δ2 H values of each sample with four techniques: CVD and IRMS, CVD and CRDS, CVD and IM-CRDS, and IM-CRDS alone. We then calculated the isotopic errors for each of the three CRDS methods relative to CVD and IRMS, and analyzed the relationships among these errors and suites of diagnostic spectral parameters that are indicative of organic contamination. RESULTS The IM-CRDS technique accurately assessed the δ18 O and δ2 H values of pure waters, but exhibited progressively increasing errors for soil waters, stem waters, and leaf waters. For soils, the errors were attributable to subsampling of isotopically heterogeneous source material, whereas for stems and leaves, they were attributable to spectral interference. Unexpectedly, the magnitude of spectral interference was higher for the solid samples analyzed directly via IM-CRDS than for those originally extracted via CVD and then analyzed by IM-CRDS. CONCLUSIONS There are many types of matrix-bound water samples for which IM-CRDS measurements include significant errors from spectral interference. As a result, spectral analysis and validation should be incorporated into IM-CRDS post-processing procedures. In the future, IM-CRDS performance could be improved through: (i) identification of the compounds that cause spectral interference, and either (ii) modification of the combustion step to completely oxidize these compounds to CO2 , and/or (iii) incorporation of corrections for these compounds into the spectral fitting models used by the CRDS analyzers. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- J E Johnson
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, 85721, USA
- Department of Global Ecology, Carnegie Institution, 260 Panama Street, Stanford, CA, 94305, USA
| | - L Hamann
- School of Natural Resources and the Environment, University of Arizona, Tucson, AZ, 85721, USA
| | - D L Dettman
- Department of Geosciences, University of Arizona, Tucson, AZ, 85721, USA
| | - D Kim-Hak
- Picarro, Inc., 3105 Patrick Henry Drive, Santa Clara, CA, 95054, USA
| | - S W Leavitt
- Laboratory of Tree-Ring Research, University of Arizona, Tucson, AZ, 85721, USA
| | - R K Monson
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, 85721, USA
- Laboratory of Tree-Ring Research, University of Arizona, Tucson, AZ, 85721, USA
| | - S A Papuga
- School of Natural Resources and the Environment, University of Arizona, Tucson, AZ, 85721, USA
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18
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Lentz RJ, Fessel JP, Johnson JE, Maldonado F, Miller RF, Rickman OB. Transbronchial Cryobiopsy Can Diagnose Constrictive Bronchiolitis in Veterans of Recent Conflicts in the Middle East. Am J Respir Crit Care Med 2016; 193:806-8. [PMID: 27035783 PMCID: PMC4824934 DOI: 10.1164/rccm.201509-1724le] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Robert J Lentz
- 1 Vanderbilt University School of Medicine Nashville, Tennessee and
| | - Joshua P Fessel
- 1 Vanderbilt University School of Medicine Nashville, Tennessee and
- 2 Department of Veterans Affairs Medical Center Nashville, Tennessee
| | - Joyce E Johnson
- 1 Vanderbilt University School of Medicine Nashville, Tennessee and
- 2 Department of Veterans Affairs Medical Center Nashville, Tennessee
| | - Fabien Maldonado
- 1 Vanderbilt University School of Medicine Nashville, Tennessee and
| | - Robert F Miller
- 1 Vanderbilt University School of Medicine Nashville, Tennessee and
| | - Otis B Rickman
- 1 Vanderbilt University School of Medicine Nashville, Tennessee and
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19
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Douleh DG, Morone PJ, Johnson JE, Paueksakon P, Wellons JC. Actinomycosis Mimicking Tolosa-Hunt Syndrome in a 6-Year-Old Boy: Case Report. Pediatr Neurosurg 2016; 51:214-7. [PMID: 27070954 DOI: 10.1159/000444940] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 02/20/2016] [Indexed: 11/19/2022]
Abstract
Tolosa-Hunt syndrome is an idiopathic inflammatory process of the cavernous sinus or orbit manifesting as painful ophthalmoplegia. In this report, we detail the case of a 6-year-old boy who presented with several weeks of unilateral headache and diplopia. He was found to have an infiltrative process involving the bilateral cavernous sinuses and pituitary gland on MRI. Given a progressing infiltrative central nervous system process on repeat MRI and the development of cerebral salt wasting, a biopsy was performed revealing actinomycosis. To our knowledge, this is the first reported case of actinomycosis masquerading as Tolosa-Hunt syndrome in a child.
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Affiliation(s)
- Diana G Douleh
- Vanderbilt University School of Medicine, Nashville, Tenn., USA
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20
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Abstract
PROBLEM Nursing has been identified as one of the top 20 occupations that will be affected by baby boomer retirements. Boomer nurses, born between 1946 and 1964, have begun leaving the profession at an alarming rate. This nursing exodus is occurring at a time when demand for nurses is very high, the nursing shortage continues throughout the country, and financial forecasts predict very difficult financial times ahead for boomer nurses. METHODS A literature review was conducted on research on retirement planning, habits and beliefs of boomer nurses, and the market forces that affect retirement savings. FINDINGS Boomer nurses will face an unprecedented retirement crisis because they simply have not saved enough for a secure financial future after their retirement from the profession. CONCLUSIONS The case studies and recommendations in this article suggest that there are actions nurses at all ages can take to improve their retirement savings. Johnson Morrissey.
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Affiliation(s)
- Joyce E Johnson
- The Catholic University of America, School of Nursing, Washington, DC
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Kropski JA, Pritchett JM, Zoz DF, Crossno PF, Markin C, Garnett ET, Degryse AL, Mitchell DB, Polosukhin VV, Rickman OB, Choi L, Cheng DS, McConaha ME, Jones BR, Gleaves LA, McMahon FB, Worrell JA, Solus JF, Ware LB, Lee JW, Massion PP, Zaynagetdinov R, White ES, Kurtis JD, Johnson JE, Groshong SD, Lancaster LH, Young LR, Steele MP, Phillips Iii JA, Cogan JD, Loyd JE, Lawson WE, Blackwell TS. Extensive phenotyping of individuals at risk for familial interstitial pneumonia reveals clues to the pathogenesis of interstitial lung disease. Am J Respir Crit Care Med 2015; 191:417-26. [PMID: 25389906 DOI: 10.1164/rccm.201406-1162oc] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Asymptomatic relatives of patients with familial interstitial pneumonia (FIP), the inherited form of idiopathic interstitial pneumonia, carry increased risk for developing interstitial lung disease. OBJECTIVES Studying these at-risk individuals provides a unique opportunity to investigate early stages of FIP pathogenesis and develop predictive models of disease onset. METHODS Seventy-five asymptomatic first-degree relatives of FIP patients (mean age, 50.8 yr) underwent blood sampling and high-resolution chest computed tomography (HRCT) scanning in an ongoing cohort study; 72 consented to bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial biopsies. Twenty-seven healthy individuals were used as control subjects. MEASUREMENTS AND MAIN RESULTS Eleven of 75 at-risk subjects (14%) had evidence of interstitial changes by HRCT, whereas 35.2% had abnormalities on transbronchial biopsies. No differences were noted in inflammatory cells in BAL between at-risk individuals and control subjects. At-risk subjects had increased herpesvirus DNA in cell-free BAL and evidence of herpesvirus antigen expression in alveolar epithelial cells (AECs), which correlated with expression of endoplasmic reticulum stress markers in AECs. Peripheral blood mononuclear cell and AEC telomere length were shorter in at-risk individuals than healthy control subjects. The minor allele frequency of the Muc5B rs35705950 promoter polymorphism was increased in at-risk subjects. Levels of several plasma biomarkers differed between at-risk subjects and control subjects, and correlated with abnormal HRCT scans. CONCLUSIONS Evidence of lung parenchymal remodeling and epithelial dysfunction was identified in asymptomatic individuals at risk for FIP. Together, these findings offer new insights into the early pathogenesis of idiopathic interstitial pneumonia and provide an ongoing opportunity to characterize presymptomatic abnormalities that predict progression to clinical disease.
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Braun NA, Celada LJ, Herazo-Maya JD, Abraham S, Shaginurova G, Sevin CM, Grutters J, Culver DA, Dworski R, Sheller J, Massion PP, Polosukhin VV, Johnson JE, Kaminski N, Wilkes DS, Oswald-Richter KA, Drake WP. Blockade of the programmed death-1 pathway restores sarcoidosis CD4(+) T-cell proliferative capacity. Am J Respir Crit Care Med 2014; 190:560-71. [PMID: 25073001 DOI: 10.1164/rccm.201401-0188oc] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
RATIONALE Effective therapeutic interventions for chronic, idiopathic lung diseases remain elusive. Normalized T-cell function is an important contributor to spontaneous resolution of pulmonary sarcoidosis. Up-regulation of inhibitor receptors, such as programmed death-1 (PD-1) and its ligand, PD-L1, are important inhibitors of T-cell function. OBJECTIVES To determine the effects of PD-1 pathway blockade on sarcoidosis CD4(+) T-cell proliferative capacity. METHODS Gene expression profiles of sarcoidosis and healthy control peripheral blood mononuclear cells were analyzed at baseline and follow-up. Flow cytometry was used to measure ex vivo expression of PD-1 and PD-L1 on systemic and bronchoalveolar lavage-derived cells of subjects with sarcoidosis and control subjects, as well as the effects of PD-1 pathway blockade on cellular proliferation after T-cell receptor stimulation. Immunohistochemistry analysis for PD-1/PD-L1 expression was conducted on sarcoidosis, malignant, and healthy control lung specimens. MEASUREMENTS AND MAIN RESULTS Microarray analysis demonstrates longitudinal increase in PDCD1 gene expression in sarcoidosis peripheral blood mononuclear cells. Immunohistochemistry analysis revealed increased PD-L1 expression within sarcoidosis granulomas and lung malignancy, but this was absent in healthy lungs. Increased numbers of sarcoidosis PD-1(+) CD4(+) T cells are present systemically, compared with healthy control subjects (P < 0.0001). Lymphocytes with reduced proliferative capacity exhibited increased proliferation with PD-1 pathway blockade. Longitudinal analysis of subjects with sarcoidosis revealed reduced PD-1(+) CD4(+) T cells with spontaneous clinical resolution but not with disease progression. CONCLUSIONS Analogous to the effects in other chronic lung diseases, these findings demonstrate that the PD-1 pathway is an important contributor to sarcoidosis CD4(+) T-cell proliferative capacity and clinical outcome. Blockade of the PD-1 pathway may be a viable therapeutic target to optimize clinical outcomes.
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Kropski JA, Mitchell DB, Markin C, Polosukhin VV, Choi L, Johnson JE, Lawson WE, Phillips JA, Cogan JD, Blackwell TS, Loyd JE. A novel dyskerin (DKC1) mutation is associated with familial interstitial pneumonia. Chest 2014; 146:e1-e7. [PMID: 24504062 DOI: 10.1378/chest.13-2224] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Short telomeres are frequently identified in patients with idiopathic pulmonary fibrosis (IPF) and its inherited form, familial interstitial pneumonia (FIP). We identified a kindred with FIP with short telomeres who did not carry a mutation in known FIP genes TERT or hTR . We performed targeted sequencing of other telomere-related genes to identify the genetic basis of FIP in this kindred. The proband was a 69 year-old man with dyspnea, restrictive pulmonary function test results, and reticular changes on high-resolution CT scan. An older male sibling had died from IPF. The proband had markedly shortened telomeres in peripheral blood and undetectably short telomeres in alveolar epithelial cells. Polymerase chain reaction-based sequencing of NOP10 , TINF2 , NHP2 , and DKC1 revealed that both affected siblings shared a novel A to G 1213 transition in DKC1 near the hTR binding domain that is predicted to encode a Thr405Ala amino acid substitution. hTR levels were decreased out of proportion to DKC1 expression in the T405A DKC1 proband, suggesting this mutation destabilizes hTR and impairs telomerase function. This DKC1 variant represents the third telomere-related gene identified as a genetic cause of FIP. Further investigation into the mechanism by which dyskerin contributes to the development of lung fibrosis is warranted.
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Affiliation(s)
- Jonathan A Kropski
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
| | - Daphne B Mitchell
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Cheryl Markin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Vasiliy V Polosukhin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Leena Choi
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN
| | - Joyce E Johnson
- Department of Pediatrics, Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN
| | - William E Lawson
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Vanderbilt University School of Medicine, Nashville, TN; Department of Veterans Affairs Medical Center, Vanderbilt University School of Medicine, Nashville, TN
| | - John A Phillips
- Division of Medical Genetics and Genomic Medicine, Vanderbilt University School of Medicine, Nashville, TN; Department of Pediatrics, Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN
| | - Joy D Cogan
- Division of Medical Genetics and Genomic Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Timothy S Blackwell
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Vanderbilt University School of Medicine, Nashville, TN; Department of Veterans Affairs Medical Center, Vanderbilt University School of Medicine, Nashville, TN; Department of Cancer Biology, Vanderbilt University School of Medicine, Nashville, TN; Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, Nashville, TN
| | - James E Loyd
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Vanderbilt University School of Medicine, Nashville, TN
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Johnson JE, Beltran C, Herman MG, Kruse JJ. SU-D-BRE-06: Modeling the Dosimetric Effects of Volumetric and Layer-Based Repainting Strategies in Spot Scanning Proton Treatment Plans. Med Phys 2014. [DOI: 10.1118/1.4887877] [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] [Indexed: 11/07/2022] Open
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Abstract
PROBLEM Historically, unions and professional associations such as the American Nurses Association have been adversaries in the fight to represent the best interests of the nursing profession. METHODS We reviewed the literature on the evolution of nursing unions, nursing's historical unease about unions, the Magnet designation in nursing, the tensions between the unions and Magnet, the core values and commonalities they share, and the obligations of nursing as a profession. FINDINGS Refocusing on the advancement of our profession provides a positive pathway in which the collective efforts of nursing unions and professional initiatives such as the Magnet designation converge during these turbulent times for our profession. CONCLUSION The single, central organizing idea of nursing-where nursing unions and Magnet converge-is the pivotal role of nurses in delivering high-quality patient care. The often-maligned dialectic between unions and Magnet has advanced and not hindered the nursing profession.
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Affiliation(s)
- Joyce E Johnson
- Robert Wood Johnson University Hospital, New Brunswick, NJ; Rutgers University School of Nursing, New Brunswick, NJ
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Kropski JA, Pritchett JM, Mason WR, Sivarajan L, Gleaves LA, Johnson JE, Lancaster LH, Lawson WE, Blackwell TS, Steele MP, Loyd JE, Rickman OB. Bronchoscopic cryobiopsy for the diagnosis of diffuse parenchymal lung disease. PLoS One 2013; 8:e78674. [PMID: 24265706 PMCID: PMC3827078 DOI: 10.1371/journal.pone.0078674] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 09/13/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although in some cases clinical and radiographic features may be sufficient to establish a diagnosis of diffuse parenchymal lung disease (DPLD), surgical lung biopsy is frequently required. Recently a new technique for bronchoscopic lung biopsy has been developed using flexible cryo-probes. In this study we describe our clinical experience using bronchoscopic cryobiopsy for diagnosis of diffuse lung disease. METHODS A retrospective study of subjects who had undergone bronchoscopic cryobiopsy for evaluation of DPLD at an academic tertiary care center from January 1, 2012 through January 15, 2013 was performed. The procedure was performed using a flexible bronchoscope to acquire biopsies of lung parenchyma. H&E stained biopsies were reviewed by an expert lung pathologist. RESULTS Twenty-five eligible subjects were identified. With a mean area of 64.2 mm(2), cryobiopsies were larger than that typically encountered with traditional transbronchial forceps biopsy. In 19 of the 25 subjects, a specific diagnosis was obtained. In one additional subject, biopsies demonstrating normal parenchyma were felt sufficient to exclude diffuse lung disease as a cause of dyspnea. The overall diagnostic yield of bronchoscopic cryobiopsy was 80% (20/25). The most frequent diagnosis was usual interstitial pneumonia (UIP) (n = 7). Three of the 25 subjects ultimately required surgical lung biopsy. There were no significant complications. CONCLUSION In patients with suspected diffuse parenchymal lung disease, bronchoscopic cryobiopsy is a promising and minimally invasive approach to obtain lung tissue with high diagnostic yield.
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Affiliation(s)
- Jonathan A. Kropski
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Jason M. Pritchett
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Wendi R. Mason
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Lakshmi Sivarajan
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Linda A. Gleaves
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Joyce E. Johnson
- Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Lisa H. Lancaster
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - William E. Lawson
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- Department of Veterans Affairs Medical Center, Nashville, Tennessee, United States of America
| | - Timothy S. Blackwell
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- Departments of Cell and Development Biology and Cancer Biology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- Department of Veterans Affairs Medical Center, Nashville, Tennessee, United States of America
| | - Mark P. Steele
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - James E. Loyd
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Otis B. Rickman
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
- Department of Thoracic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, Unites States of America
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Johnson JE, Macklin C, Slichter DH, Vijay R, Weingarten EB, Clarke J, Siddiqi I. Heralded state preparation in a superconducting qubit. Phys Rev Lett 2012; 109:050506. [PMID: 23006157 DOI: 10.1103/physrevlett.109.050506] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Indexed: 06/01/2023]
Abstract
We demonstrate high-fidelity, quantum nondemolition, single-shot readout of a superconducting flux qubit in which the pointer state distributions can be resolved to below one part in 1000. In the weak excitation regime, continuous measurement permits the use of heralding to ensure initialization to a fiducial state, such as the ground state. This procedure boosts readout fidelity to 93.9% by suppressing errors due to spurious thermal population. Furthermore, heralding potentially enables a simple, fast qubit reset protocol without changing the system parameters to induce Purcell relaxation.
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Affiliation(s)
- J E Johnson
- Department of Physics, University of California, Berkeley, 94720, USA
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Baudoux AC, Hendrix RW, Lander GC, Bailly X, Podell S, Paillard C, Johnson JE, Potter CS, Carragher B, Azam F. Genomic and functional analysis of Vibrio phage SIO-2 reveals novel insights into ecology and evolution of marine siphoviruses. Environ Microbiol 2012; 14:2071-86. [PMID: 22225728 PMCID: PMC3338904 DOI: 10.1111/j.1462-2920.2011.02685.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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: 02/05/2023]
Abstract
We report on a genomic and functional analysis of a novel marine siphovirus, the Vibrio phage SIO-2. This phage is lytic for related Vibrio species of great ecological interest including the broadly antagonistic bacterium Vibrio sp. SWAT3 as well as notable members of the Harveyi clade (V.harveyi ATTC BAA-1116 and V.campbellii ATCC 25920). Vibrio phage SIO-2 has a circularly permuted genome of 80598 bp, which displays unusual features. This genome is larger than that of most known siphoviruses and only 38 of the 116 predicted proteins had homologues in databases. Another divergence is manifest by the origin of core genes, most of which share robust similarities with unrelated viruses and bacteria spanning a wide range of phyla. These core genes are arranged in the same order as in most bacteriophages but they are unusually interspaced at two places with insertions of DNA comprising a high density of uncharacterized genes. The acquisition of these DNA inserts is associated with morphological variation of SIO-2 capsid, which assembles as a large (80 nm) shell with a novel T=12 symmetry. These atypical structural features confer on SIO-2 a remarkable stability to a variety of physical, chemical and environmental factors. Given this high level of functional and genomic novelty, SIO-2 emerges as a model of considerable interest in ecological and evolutionary studies.
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Affiliation(s)
- A-C Baudoux
- Scripps Institution of Oceanography, Marine Biology Research Division, University of California San Diego, La Jolla, CA 92093, USA.
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Erickson JJ, Gilchuk P, Hastings AK, Tollefson SJ, Johnson M, Downing MB, Boyd KL, Johnson JE, Kim AS, Joyce S, Williams JV. Viral acute lower respiratory infections impair CD8+ T cells through PD-1. J Clin Invest 2012; 122:2967-82. [PMID: 22797302 DOI: 10.1172/jci62860] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 06/07/2012] [Indexed: 12/25/2022] Open
Abstract
Viruses are leading causes of severe acute lower respiratory infections (LRIs). These infections evoke incomplete immunity, as individuals can be repeatedly reinfected throughout life. We report that acute viral LRI causes rapid pulmonary CD8+ cytotoxic T lymphocyte (TCD8) functional impairment via programmed death-1/programmed death ligand-1 (PD-1/PD-L1) signaling, a pathway previously associated with prolonged antigenic stimulation during chronic infections and cancer. PD-1-mediated TCD8 impairment occurred acutely in mice following infection with human metapneumovirus or influenza virus. Viral antigen was sufficient for PD-1 upregulation, but induction of PD-L1 was required for impairment. During secondary viral infection or epitope-only challenge, memory TCD8 rapidly reexpressed PD-1 and exhibited severe functional impairment. Inhibition of PD-1 signaling using monoclonal antibody blockade prevented TCD8 impairment, reduced viral titers during primary infection, and enhanced protection of immunized mice against challenge infection. Additionally, PD-1 and PD-L1 were upregulated in the lungs of patients with 2009 H1N1 influenza virus, respiratory syncytial virus, or parainfluenza virus infection. These results indicate that PD-1 mediates TCD8 functional impairment during acute viral infection and may contribute to recurrent viral LRIs. Therefore, the PD-1/PD-L1 pathway may represent a therapeutic target in the treatment of respiratory viruses.
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Affiliation(s)
- John J Erickson
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
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Affiliation(s)
- Joyce E Johnson
- Robert Wood Johnson University Hospital, New Brunswick, N.J., USA
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Johnson JE. RWJUH--New Brunswick wins quality award. N J Nurse 2012; 42:6. [PMID: 22916575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Johnson JE, Patterson DA, Martins EG, Cooke SJ, Hinch SG. Quantitative methods for analysing cumulative effects on fish migration success: a review. J Fish Biol 2012; 81:600-631. [PMID: 22803726 DOI: 10.1111/j.1095-8649.2012.03369.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
It is often recognized, but seldom addressed, that a quantitative assessment of the cumulative effects, both additive and non-additive, of multiple stressors on fish survival would provide a more realistic representation of the factors that influence fish migration. This review presents a compilation of analytical methods applied to a well-studied fish migration, a more general review of quantitative multivariable methods, and a synthesis on how to apply new analytical techniques in fish migration studies. A compilation of adult migration papers from Fraser River sockeye salmon Oncorhynchus nerka revealed a limited number of multivariable methods being applied and the sub-optimal reliance on univariable methods for multivariable problems. The literature review of fisheries science, general biology and medicine identified a large number of alternative methods for dealing with cumulative effects, with a limited number of techniques being used in fish migration studies. An evaluation of the different methods revealed that certain classes of multivariable analyses will probably prove useful in future assessments of cumulative effects on fish migration. This overview and evaluation of quantitative methods gathered from the disparate fields should serve as a primer for anyone seeking to quantify cumulative effects on fish migration survival.
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Affiliation(s)
- J E Johnson
- Fisheries and Oceans Canada, Cooperative Resource Management Institute, School of Resource and Environmental Management, Simon Fraser University, Burnaby, BC, Canada.
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Taylor AR, Gifondorwa DJ, Robinson MB, Strupe JL, Prevette D, Johnson JE, Hempstead BL, Oppenheim RW, Milligan CE. Motoneuron programmed cell death in response to proBDNF. Dev Neurobiol 2012; 72:699-712. [PMID: 21834083 PMCID: PMC3233653 DOI: 10.1002/dneu.20964] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Motoneurons (MN) as well as most neuronal populations undergo a temporally and spatially specific period of programmed cell death (PCD). Several factors have been considered to regulate the survival of MNs during this period, including availability of muscle-derived trophic support and activity. The possibility that target-derived factors may also negatively regulate MN survival has been considered, but not pursued. Neurotrophin precursors, through their interaction with p75(NTR) and sortilin receptors have been shown to induce cell death during development and following injury in the CNS. In this study, we find that muscle cells produce and secrete proBDNF. ProBDNF through its interaction with p75(NTR) and sortilin, promotes a caspase-dependent death of MNs in culture. We also provide data to suggest that proBDNF regulates MN PCD during development in vivo.
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Affiliation(s)
- AR Taylor
- Department of Neurobiology and Anatomy, Wake Forest University School of Medicine Winston-Salem, NC
| | - DJ Gifondorwa
- Department of Neurobiology and Anatomy, Wake Forest University School of Medicine Winston-Salem, NC
| | - MB Robinson
- Department of Neurobiology and Anatomy, Wake Forest University School of Medicine Winston-Salem, NC
| | - JL Strupe
- Department of Neurobiology and Anatomy, Wake Forest University School of Medicine Winston-Salem, NC
| | - D Prevette
- Department of Neurobiology and Anatomy, Wake Forest University School of Medicine Winston-Salem, NC
| | - JE Johnson
- Department of Neurobiology and Anatomy, Wake Forest University School of Medicine Winston-Salem, NC
| | - BL Hempstead
- Department of Medicine Cornell University Medical Center, NY
| | - RW Oppenheim
- Department of Neurobiology and Anatomy, Wake Forest University School of Medicine Winston-Salem, NC
- Interdisciplinary Neuroscience Program, Wake Forest University School of Medicine Winston-Salem, NC
- ALS Center, Wake Forest University School of Medicine Winston-Salem, NC
| | - CE Milligan
- Department of Neurobiology and Anatomy, Wake Forest University School of Medicine Winston-Salem, NC
- Interdisciplinary Neuroscience Program, Wake Forest University School of Medicine Winston-Salem, NC
- ALS Center, Wake Forest University School of Medicine Winston-Salem, NC
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Ciambrone RM, Zavotsky KE, Souto K, Baron K, Joseph VD, Johnson JE, Mastro KA. Redesign of an urban academic emergency department: action research can make a difference. J Emerg Nurs 2012; 38:531-6. [PMID: 22245398 DOI: 10.1016/j.jen.2011.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 11/01/2011] [Accepted: 11/05/2011] [Indexed: 10/14/2022]
Affiliation(s)
- Regina M Ciambrone
- Emergency Services, Robert Wood Johnson University Hospital, New Brunswick, NJ 08903, USA
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Doyle KR, Mitchell MA, Roberts CL, James S, Johnson JE, Zhou Y, von Mehren M, Lev D, Kipling D, Broccoli D. Validating a gene expression signature proposed to differentiate liposarcomas that use different telomere maintenance mechanisms. Oncogene 2012; 31:265-6; author reply 267-8. [PMID: 21706060 PMCID: PMC3602663 DOI: 10.1038/onc.2011.225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Johnson JE, Billingsley M. Move your organization from good to great. Nurs Manag (Harrow) 2011; 42:44-47. [PMID: 22124302 DOI: 10.1097/01.numa.0000407587.25854.ff] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Butler SM, Melillo JM, Johnson JE, Mohan J, Steudler PA, Lux H, Burrows E, Smith RM, Vario CL, Scott L, Hill TD, Aponte N, Bowles F. Soil warming alters nitrogen cycling in a New England forest: implications for ecosystem function and structure. Oecologia 2011; 168:819-28. [PMID: 21983640 PMCID: PMC3277705 DOI: 10.1007/s00442-011-2133-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [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: 10/30/2009] [Accepted: 09/08/2011] [Indexed: 11/15/2022]
Abstract
Global climate change is expected to affect terrestrial ecosystems in a variety of ways. Some of the more well-studied effects include the biogeochemical feedbacks to the climate system that can either increase or decrease the atmospheric load of greenhouse gases such as carbon dioxide and nitrous oxide. Less well-studied are the effects of climate change on the linkages between soil and plant processes. Here, we report the effects of soil warming on these linkages observed in a large field manipulation of a deciduous forest in southern New England, USA, where soil was continuously warmed 5°C above ambient for 7 years. Over this period, we have observed significant changes to the nitrogen cycle that have the potential to affect tree species composition in the long term. Since the start of the experiment, we have documented a 45% average annual increase in net nitrogen mineralization and a three-fold increase in nitrification such that in years 5 through 7, 25% of the nitrogen mineralized is then nitrified. The warming-induced increase of available nitrogen resulted in increases in the foliar nitrogen content and the relative growth rate of trees in the warmed area. Acer rubrum (red maple) trees have responded the most after 7 years of warming, with the greatest increases in both foliar nitrogen content and relative growth rates. Our study suggests that considering species-specific responses to increases in nitrogen availability and changes in nitrogen form is important in predicting future forest composition and feedbacks to the climate system.
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Affiliation(s)
- S M Butler
- The Ecosystems Center, Marine Biological Laboratory, Woods Hole, MA USA.
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King MS, Eisenberg R, Newman JH, Tolle JJ, Harrell FE, Nian H, Ninan M, Lambright ES, Sheller JR, Johnson JE, Miller RF. Constrictive bronchiolitis in soldiers returning from Iraq and Afghanistan. N Engl J Med 2011; 365:222-30. [PMID: 21774710 PMCID: PMC3296566 DOI: 10.1056/nejmoa1101388] [Citation(s) in RCA: 181] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In this descriptive case series, 80 soldiers from Fort Campbell, Kentucky, with inhalational exposures during service in Iraq and Afghanistan were evaluated for dyspnea on exertion that prevented them from meeting the U.S. Army's standards for physical fitness. METHODS The soldiers underwent extensive evaluation of their medical and exposure history, physical examination, pulmonary-function testing, and high-resolution computed tomography (CT). A total of 49 soldiers underwent thoracoscopic lung biopsy after noninvasive evaluation did not provide an explanation for their symptoms. Data on cardiopulmonary-exercise and pulmonary-function testing were compared with data obtained from historical military control subjects. RESULTS Among the soldiers who were referred for evaluation, a history of inhalational exposure to a 2003 sulfur-mine fire in Iraq was common but not universal. Of the 49 soldiers who underwent lung biopsy, all biopsy samples were abnormal, with 38 soldiers having changes that were diagnostic of constrictive bronchiolitis. In the remaining 11 soldiers, diagnoses other than constrictive bronchiolitis that could explain the presenting dyspnea were established. All soldiers with constrictive bronchiolitis had normal results on chest radiography, but about one quarter were found to have mosaic air trapping or centrilobular nodules on chest CT. The results of pulmonary-function and cardiopulmonary-exercise testing were generally within normal population limits but were inferior to those of the military control subjects. CONCLUSIONS In 49 previously healthy soldiers with unexplained exertional dyspnea and diminished exercise tolerance after deployment, an analysis of biopsy samples showed diffuse constrictive bronchiolitis, which was possibly associated with inhalational exposure, in 38 soldiers.
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Affiliation(s)
- Matthew S King
- Division of Pulmonary and Critical Care Medicine, Meharry Medical College, Nashville, TN, USA
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Abstract
Shortages of nurses are expected to continue throughout the coming decade. To meet the demand, nursing leaders must develop creative approaches for nurturing and sustaining nursing talent. Traditionally, nursing has embraced a variety of development strategies to enhance the leadership abilities of nurses and to fill the leadership ranks with top talent. We describe the rationale, design, and impact of a 3-pronged organizational approach to mentoring nursing talent at Georgetown University Hospital, the first Magnet hospital in Washington, District of Columbia. The design of these programs was driven by the demographics of our nursing staff. Analysis of length of tenure revealed a modified "U-shaped curve" with the majority of new nurses with tenure less than 5 years, few in the middle between 5 and 15 years, and a moderate number with 15 or more years. Investment in all our nurses' leadership development required integrating a diverse developmental process into our organizational culture, which values personal growth and mastery. A strong mentoring program makes good business sense in terms of employee job satisfaction, improved cost control, and better patient outcomes. Our experience suggests that voluntary mentoring programs work synergistically to further the development of a mentoring culture in today's hospitals.
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Affiliation(s)
- Joyce E Johnson
- Robert Wood Johnson Hospital, Rutgers University College of Nursing, New Brunswick, New Jersey 08903, USA.
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Abstract
The influence of repeated staphylococcal infection of rabbit skin upon the characteristics of the experimentally induced lesion was studied. It was found that the repeated infection was associated with the development of delayed hypersensitivity unaccompanied by the appearance of demonstrable serum antibody. The delayed hypersensitivity to the staphylococcus resulted in an increased infectivity of the organism in skin of the sensitized animal, characterized by intensification of the lesions seen with large bacterial inocula and the induction of abscesses with inocula incapable of producing any lesion in normal rabbit skin. Similarly, the severity of experimentally induced pyoarthrosis was greater in sensitized than in normal rabbits. Induction of delayed hypersensitivity by vaccination of rabbits with washed heat-killed staphylococci resulted in the same increased severity of the infection and an increase in infectivity of the microorganism. In contrast to the observations of cutaneous and joint infection, the sensitized animals appeared to be less susceptible to severe infection of the anterior chamber of the eye. The role of immunity and hypersensitivity in staphylococcal infection is discussed and the possibility that non-specific inflammation may influence staphylococcal infection in the same way as specific hypersensitivity is indicated. Studies to further elucidate this are presented in the following pages.
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Affiliation(s)
- J E Johnson
- Division of Allergy and Infectious Disease, Department of Medicine, The Johns Hopkins University School of Medicine and Hospital, Baltimore
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Goshi K, Cluff LE, Johnson JE. STUDIES ON THE PATHOGENESIS OF STAPHYLOCOCCAL INFECTION : III. THE EFFECT OF TISSUE NECROSIS AND ANTITOXIC IMMUNITY. ACTA ACUST UNITED AC 2010; 113:259-70. [PMID: 19867187 PMCID: PMC2137349 DOI: 10.1084/jem.113.2.259] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Necrosis of rabbit skin produced by thermal injury was found to result in a striking increase in local infectivity of staphylococci that were coagulase-positive and hemolytic, but no local increase in the infectivity of non-pathogenic staphylococci. Infection produced in necrotic burns extended beyond the area of burn and was characterized by hemorrhage, edema, and necrosis of contiguous normal skin. Such infections, however, never resulted in bacteriemia or metastatic abscesses, and there was no effect of the necrotic burn upon the infectivity of staphylococci injected into normal skin of the burned animal. Recovery of rabbits from severe burn infections was associated with the development of high titers of serum antibody to the alpha hemolysin or dermonecrotoxin of the staphylococcus. Thirty to 100 days after the initial burn infection, it was found that rabbits could no longer be infected in a necrotic burn, although infection induced in normal skin of these resistant animals was no different from that in normal rabbits. Immunity to infection by pathogenic staphylococci in necrotic burns could be induced by vaccination with potent alpha hemolysin toxoid, and this immunity was passively transferable with rabbit antiserum. No strain specificity was detected for this immunity in that immunization with toxoid prepared from bacteriophage type 52/42B/80/81 staphylococci protected animals against infection in a necrotic burn by other typable and non-typable staphylococci. Histopathological study of infected necrotic burns in normal rabbits showed extensive necrosis, hemorrhage, edema, and many masses of bacteria but leucocytic infiltration was observed only at the margin of the infection. In contrast, the infected necrotic burns in animals immunized with alpha hemolysin toxoid showed few bacteria and marked leucocytic infiltration throughout the burn. These experiments have, therefore, demonstrated a significant immunity to infection by pathogenic staphylococci in necrotic tissue but not in normal skin, associated with serum antibody to the alpha hemolysin or dermonecrotoxin of the bacteria. The implications of these findings are discussed.
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Affiliation(s)
- K Goshi
- Division of Allergy and Infectious Disease, Department of Medicine, The Johns Hopkins University School of Medicine and Hospital, Baltimore
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Crossno PF, Polosukhin VV, Blackwell TS, Johnson JE, Markin C, Moore PE, Worrell JA, Stahlman MT, Phillips JA, Loyd JE, Cogan JD, Lawson WE. Identification of early interstitial lung disease in an individual with genetic variations in ABCA3 and SFTPC. Chest 2010; 137:969-73. [PMID: 20371530 DOI: 10.1378/chest.09-0790] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
A man with usual interstitial pneumonia (age of onset 58 years) was previously found to have an Ile73Thr (I73T) surfactant protein C (SFTPC) mutation. Genomic DNA from the individual and two daughters (aged 39 and 43 years) was sequenced for the I73T mutation and variations in ATP-binding cassette A3 (ABCA3). All three had the I73T SFTPC mutation. The father and one daughter (aged 39 years) also had a transversion encoding an Asp123Asn (D123N) substitution in ABCA3. The daughters were evaluated by pulmonary function testing and high-resolution CT (HRCT). Neither daughter had evidence of disease, except for focal subpleural septal thickening on HRCT scan in one daughter (aged 39 years). This daughter underwent bronchoscopy with transbronchial biopsies revealing interstitial fibrotic remodeling. These findings demonstrate that subclinical fibrotic changes may be present in family members of patients with SFTPC mutation-associated interstitial lung disease and suggest that ABCA3 variants could affect disease pathogenesis.
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Affiliation(s)
- Peter F Crossno
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, T-1218 MCN, Nashville, TN 37232-2650, USA
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Ryder AB, Tollefson SJ, Podsiad AB, Johnson JE, Williams JV. Soluble recombinant human metapneumovirus G protein is immunogenic but not protective. Vaccine 2010; 28:4145-52. [PMID: 20417260 DOI: 10.1016/j.vaccine.2010.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 12/17/2009] [Accepted: 04/07/2010] [Indexed: 11/28/2022]
Abstract
Human metapneumovirus (HMPV) expresses the major surface glycoproteins F and G. We evaluated the protective efficacy of immunization with G. We generated a recombinant form of G ectodomain (GDeltaTM) that was secreted from mammalian cells and purified by affinity chromatography. We tested the immunogenicity of GDeltaTM in cotton rats. Animals were immunized with PBS, GDeltaTM alone or adjuvanted, or were infected once with HMPV, and challenged with live HMPV at 28 days. Animals vaccinated with adjuvanted and non-adjuvanted GDeltaTM developed high levels of serum antibodies to both recombinant and native G protein; however, vaccinated animals did not develop neutralizing antibodies and were not protected against virus challenge. Unlike the analogous non-fusion glycoproteins of other human paramyxoviruses, HMPV G does not appear to be a protective antigen. This represents an unusual feature of HMPV.
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Affiliation(s)
- Alex B Ryder
- Vanderbilt University Medical Center, School of Medicine, Nashville, TN 37232-2581, USA
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Kolquist KA, Vnencak-Jones CL, Swift L, Page DL, Johnson JE, Denison MR. Fatal Fat Embolism Syndrome in a Child with Undiagnosed Hemoglobin S/β+Thalassemia: A Complication of Acute Parvovirus B19 Infection. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/15513819609168662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chen CX, Liu B, Hu Y, Johnson JE, Tang YW. Subacute fulminant hepatic failure with intermittent fever. Hepatobiliary Pancreat Dis Int 2009; 8:657-9. [PMID: 20007088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Viral hepatitis B accounts for over 80% of acute hepatic failures in China and the patients die mainly of its complications. A patient with hepatic failure and fever is not uncommon, whereas repeated fever is rare. METHODS A 32-year-old female was diagnosed with subacute hepatic failure and hepatitis B viral infection because of hyperbilirubinemia, coagulopathy, hepatic encephalopathy, serum anti-HBs-positive without hepatitis B vaccination, and typical intrahepatic pathological features of chronic hepatitis B. Plasma exchange was administered twice and she awoke with hyperbilirubinemia and discontinuous fever. RESULTS Urethritis was confirmed and medication-induced fever and/or spontaneous bacterial peritonitis (Gram-negative bacillus infection) was suspected. The patient was treated with antibiotics, steroids and a Chinese herbal medicine, matrine, for three months and she recovered. CONCLUSION The survival rate of patients with hepatic failure might be improved with comprehensive supporting measures and appropriate, timely management of complications.
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Affiliation(s)
- Cong-Xin Chen
- Department of Infectious Diseases, 105th Hospital, Hefei 230031, China.
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Basinger MA, Forti RL, Burka LT, Jones MM, Mitchell WM, Johnson JE, Gibbs SJ. Phenolic chelating agents as antidotes for acute uranyl acetate intoxication in mice. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/15287398309530338] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kwon OY, Tuttle LJ, Johnson JE, Mueller MJ. Muscle imbalance and reduced ankle joint motion in people with hammer toe deformity. Clin Biomech (Bristol, Avon) 2009; 24:670-5. [PMID: 19535185 PMCID: PMC2751588 DOI: 10.1016/j.clinbiomech.2009.05.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Revised: 05/14/2009] [Accepted: 05/17/2009] [Indexed: 02/07/2023]
Abstract
BACKGROUND Multiple factors may contribute to hammer toe deformity at the metatarsophalangeal joint. The purposes of this study were to (1) compare the ratio of toe extensor/flexor muscle strength in toes 2-4 among groups with and without hammer toe deformity, (2) to determine correlations between the ratio of toe extensor/flexor muscle strength in toes 2-4, and metatarsophalangeal joint deformity (3) to determine if other clinical measures differ between groups and if these measures are correlated with metatarsophalangeal joint angle. METHODS Twenty-seven feet with visible hammer toe deformity and 31 age matched feet without hammer toe deformity were tested. Toe muscle strength was measured using a dynamometer and the ratio of toe extensor muscle strength to flexor muscle strength was calculated. Metatarsophalangeal joint angle was measured from a computerized tomography image. Ankle and subtalar joint range of motion, and tibial torsion were measured using goniometry. FINDINGS Extensor/flexor toe muscle strength ratio was 2.3-3.0 times higher in the hammer toe group compared to the non-hammer toe group, in toes 2-4. The ratios of extensor/flexor toe muscle strength for toes 2-4 and metatarsophalangeal joint angle were highly correlated (r=0.69-0.80). Ankle dorsiflexion and metatarsophalangeal joint angle were negatively correlated for toes 2-4 (r=-0.38 to -0.56) as were eversion and metatarsophalangeal joint angle. INTERPRETATION These results provide insight into potential risk factors for the development of hammer toe deformity. Additional research is needed to determine the causal relationship between hammer toe deformity and the ratio of toe extensor/flexor muscle strength in toes 2-4.
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Affiliation(s)
- OY Kwon
- Department of Physical Therapy, College of Health Science, Yonsei University, South Korea
| | - LJ Tuttle
- Movement Science Program, Washington University, St. Louis, MO
| | - JE Johnson
- Department of Orthopaedic Surgery, Washington University, St. Louis, MO
| | - MJ Mueller
- Movement Science Program, Washington University, St. Louis, MO,Program in Physical Therapy, Washington University, St. Louis, MO
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Maynard JA, Johnson JE, Marshall PA, Eakin CM, Goby G, Schuttenberg H, Spillman CM. A strategic framework for responding to coral bleaching events in a changing climate. Environ Manage 2009; 44:1-11. [PMID: 19434447 DOI: 10.1007/s00267-009-9295-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 03/02/2009] [Accepted: 03/12/2009] [Indexed: 05/27/2023]
Abstract
The frequency and severity of mass coral bleaching events are predicted to increase as sea temperatures continue to warm under a global regime of rising ocean temperatures. Bleaching events can be disastrous for coral reef ecosystems and, given the number of other stressors to reefs that result from human activities, there is widespread concern about their future. This article provides a strategic framework from the Great Barrier Reef to prepare for and respond to mass bleaching events. The framework presented has two main inter-related components: an early warning system and assessment and monitoring. Both include the need to proactively and consistently communicate information on environmental conditions and the level of bleaching severity to senior decision-makers, stakeholders, and the public. Managers, being the most timely and credible source of information on bleaching events, can facilitate the implementation of strategies that can give reefs the best chance to recover from bleaching and to withstand future disturbances. The proposed framework is readily transferable to other coral reef regions, and can easily be adapted by managers to local financial, technical, and human resources.
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Affiliation(s)
- J A Maynard
- Applied Environmental Decision Analysis CERF Hub, School of Botany, University of Melbourne, Parkville, VIC, Australia.
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Allen SS, Evans W, Carlisle J, Hajizadeh R, Nadaf M, Shepherd BE, Pride DT, Johnson JE, Drake WP. Superoxide dismutase A antigens derived from molecular analysis of sarcoidosis granulomas elicit systemic Th-1 immune responses. Respir Res 2008; 9:36. [PMID: 18439270 PMCID: PMC2383887 DOI: 10.1186/1465-9921-9-36] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Accepted: 04/25/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sarcoidosis is an idiopathic granulomatous disease with pathologic and immunologic features similar to tuberculosis. Routine histologic staining and culture fail to identify infectious agents. An alternative means for investigating a role of infectious agents in human pathogenesis involves molecular analysis of pathologic tissues for microbial nucleic acids, as well as recognition of microbial antigens by the host immune system. Molecular analysis for superoxide dismutase A (sodA) allows speciation of mycobacteria. SodA is an abundantly secreted virulence factor that generates cellular immune responses in infected hosts. The purpose of this study is to investigate if target antigens of the sarcoidosis immune response can be identified by molecular analysis of sarcoidosis granulomas. METHODS We detected sodA amplicons in 12 of 17 sarcoidosis specimens, compared to 2 of 16 controls (p = 0.001, two-tailed Fisher's exact test), and 3 of 3 tuberculosis specimens (p = 0.54). Analysis of the amplicons revealed sequences identical to M. tuberculosis (MTB) complex, as well as sequences which were genetically divergent. Using peripheral blood mononuclear cells (PBMC) from 12 of the 17 sarcoidosis subjects, we performed enzyme-linked immunospot assay (ELISPOT) to assess for immune recognition of MTB sodA peptides, along with PBMC from 26 PPD- healthy volunteers, and 11 latent tuberculosis subjects. RESULTS Six of 12 sarcoidosis subjects recognized the sodA peptides, compared to one of 26 PPD- controls (p = 0.002), and 6/11 PPD+ subjects (p = .68). Overall, 10 of the 12 sarcoidosis subjects from whom we obtained PBMC and archival tissue possessed molecular or immunologic evidence for sodA. CONCLUSION Dual molecular and immunologic analysis increases the ability to find infectious antigens. The detection of Th-1 immune responses to sodA peptides derived from molecular analysis of sarcoidosis granulomas reveals that these are among the target antigens contributing to sarcoidosis granulomatous inflammation.
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Affiliation(s)
- Shannon S Allen
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Whitney Evans
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - James Carlisle
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Rana Hajizadeh
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Michele Nadaf
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Bryan E Shepherd
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - David T Pride
- Department of Medicine, Division of Infectious Diseases, Stanford School of Medicine, Palo Alto, CA, USA
| | - Joyce E Johnson
- Department of Pathology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Wonder P Drake
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA
- Department of Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA
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