Immune heterogeneity in small-cell lung cancer and vulnerability to immune checkpoint blockade

Atezolizumab (anti-PD-L1), combined with carboplatin and etoposide (CE), is now a standard of care for extensive-stage small-cell lung cancer (ES-SCLC). A clearer understanding of therapeutically relevant SCLC subsets could identify rational combination strategies and improve outcomes. We conduct transcriptomic analyses and non-negative matrix factorization on 271 pre-treatment patient tumor samples from IMpower133 and identify four subsets with general concordance to previously reported SCLC subtypes (SCLC-A, -N, -P, and -I). Deeper investigation into the immune heterogeneity uncovers two subsets with differing neuroendocrine (NE) versus non-neuroendocrine (non-NE) phenotypes, demonstrating immune cell infiltration hallmarks. The NE tumors with low tumor-associated macrophage (TAM) but high T-effector signals demonstrate longer overall survival with PD-L1 blockade and CE versus CE alone than non-NE tumors with high TAM and high T-effector signal. Our study offers a clinically relevant approach to discriminate SCLC patients likely benefitting most from immunotherapies and highlights the complex mechanisms underlying immunotherapy responses.

Clinical and research applications of multiplexed immunohistochemistry and in situ hybridization

Over the past decade, invention and adoption of novel multiplexing technologies for tissues have made increasing impacts in basic and translational research and, to a lesser degree, clinical medicine. Platforms capable of highly multiplexed immunohistochemistry or in situ RNA measurements promise evaluation of protein or RNA targets at levels of plex and sensitivity logs above traditional methods - all with preservation of spatial context. These methods promise objective biomarker quantification, markedly increased sensitivity, and single-cell resolution. Increasingly, development of novel technologies is enabling multi-omic interrogations with spatial correlation of RNA and protein expression profiles in the same sample. Such sophisticated methods will provide unprecedented insights into tissue biology, biomarker science, and, ultimately, patient health. However, this sophistication comes at significant cost, requiring extensive time, practical knowledge, and resources to implement. This review will describe the technical features, advantages, and limitations of currently available multiplexed immunohistochemistry and spatial transcriptomic platforms. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

A liver Hif-2α-Irs2 pathway sensitizes hepatic insulin signaling and is modulated by Vegf inhibition

Insulin initiates diverse hepatic metabolic responses, including gluconeogenic suppression and induction of glycogen synthesis and lipogenesis^1,2. The liver possesses a rich sinusoidal capillary network with increased hypoxia and decreased gluconeogenesis in the perivenous zone³. Here, diverse vascular endothelial growth factor (VEGF) inhibitors improved glucose tolerance in normal or diabetic db/db mice, potentiating hepatic insulin signaling, decreasing gluconeogenic gene expression, increasing glycogen storage and suppressing hepatic glucose production (HGP). VEGF inhibition induced hepatic hypoxia via sinusoidal vascular regression and sensitized liver insulin signaling through hypoxia inducible factor-2α (HIF-2α) stabilization. Notably, liver-specific constitutive activation of HIF-2α, but not HIF-1α, was sufficient to augment hepatic insulin signaling via direct and indirect induction of insulin receptor substrate 2 (IRS2), an essential insulin receptor adaptor protein^4–6. Further, liver IRS2 was both necessary and sufficient to mediate HIF-2α and VEGF inhibition effects on glucose tolerance and hepatic insulin signaling. These results demonstrate an unsuspected intersection between HIF-2α–mediated hypoxic signaling and hepatic insulin action via IRS2 induction, which can be co-opted by VEGF inhibitors to modulate glucose metabolism. These studies also indicate distinct roles in hepatic metabolism for HIF-1α, which promotes glycolysis^7–9, versus HIF-2α, which suppresses gluconeogenesis, and suggest novel treatment approaches for type 2 diabetes mellitus.

Cross-talk between hypoxia and insulin signaling through Phd3 regulates hepatic glucose and lipid metabolism and ameliorates diabetes

Signaling initiated by hypoxia and insulin powerfully alters cellular metabolism. The protein stability of hypoxia-inducible factor-1 alpha (Hif-1α) and Hif-2α is regulated by three prolyl hydroxylase domain-containing protein isoforms (Phd1, Phd2 and Phd3). Insulin receptor substrate-2 (Irs2) is a critical mediator of the anabolic effects of insulin, and its decreased expression contributes to the pathophysiology of insulin resistance and diabetes. Although Hif regulates many metabolic pathways, it is unknown whether the Phd proteins regulate glucose and lipid metabolism in the liver. Here, we show that acute deletion of hepatic Phd3, also known as Egln3, improves insulin sensitivity and ameliorates diabetes by specifically stabilizing Hif-2α, which then increases Irs2 transcription and insulin-stimulated Akt activation. Hif-2α and Irs2 are both necessary for the improved insulin sensitivity, as knockdown of either molecule abrogates the beneficial effects of Phd3 knockout on glucose tolerance and insulin-stimulated Akt phosphorylation. Augmenting levels of Hif-2α through various combinations of Phd gene knockouts did not further improve hepatic metabolism and only added toxicity. Thus, isoform-specific inhibition of Phd3 could be exploited to treat type 2 diabetes without the toxicity that could occur with chronic inhibition of multiple Phd isoforms.

DNA double-strand breaks activate a multi-functional genetic program in developing lymphocytes

DNA double-strand breaks are generated by genotoxic agents and by cellular endonucleases as intermediates of several important physiological processes. The cellular response to genotoxic DNA breaks includes the activation of transcriptional programs known primarily to regulate cell-cycle checkpoints and cell survival. DNA double-strand breaks are generated in all developing lymphocytes during the assembly of antigen receptor genes, a process that is essential for normal lymphocyte development. Here we show that in murine lymphocytes these physiological DNA breaks activate a broad transcriptional program. This program transcends the canonical DNA double-strand break response and includes many genes that regulate diverse cellular processes important for lymphocyte development. Moreover, the expression of several of these genes is regulated similarly in response to genotoxic DNA damage. Thus, physiological DNA double-strand breaks provide cues that can regulate cell-type-specific processes not directly involved in maintaining the integrity of the genome, and genotoxic DNA breaks could disrupt normal cellular functions by corrupting these processes.

Effects of feeding distillers dried grains with solubles, high-protein distillers dried grains, and corn germ to growing-finishing pigs on pig performance, carcass quality, and the palatability of pork

An experiment was conducted to investigate pig performance, carcass quality, and palatability of pork from pigs fed distillers dried grains with solubles (DDGS), high-protein distillers dried grains (HPDDG), and corn germ. Eighty-four pigs (initial BW, 22 +/- 1.7 kg) were allotted to 7 dietary treatments with 6 replicates per treatment and 2 pigs per pen. Diets were fed for 114 d in a 3-phase program. The control treatment was based on corn and soybean meal. Two treatments were formulated using 10 or 20% DDGS in each phase. Two additional treatments contained HP-DDG in amounts sufficient to substitute for either 50 or 100% of the soybean meal used in the control treatment. An additional 2 treatments contained 5 or 10% corn germ, which was calculated to provide the same amount of fat as 10 or 20% DDGS. Results showed that for the entire experiment, pig performance was not affected by DDGS or HP-DDG, but final BW increased (linear, P < 0.05) as corn germ was included in the diets. Carcass composition and muscle quality were not affected by DDGS, but LM area and LM depth decreased (linear, P < 0.05) as HP-DDG was added to the diets. Lean meat percentage increased and drip loss decreased as corn germ was included in the diets (quadratic, P < 0.05). There was no effect of DDGS on fat quality except that belly firmness decreased (linear, P < 0.05) as dietary DDGS concentration increased. Including HP-DDG or corn germ in the diets did not affect fat quality, except that the iodine value increased (linear, P < 0.05) in pigs fed HP-DDG diets and decreased (linear, P < 0.05) in pigs fed corn germ diets. Cooking loss, shear force, and bacon distortion score were not affected by the inclusion of DDGS, HP-DDG, or corn germ in the diets, and the overall palatability of the bacon and pork chops was not affected by dietary treatment. In conclusion, feeding 20% DDGS or high levels of HP-DDG to growing-finishing pigs did not negatively affect overall pig performance, carcass composition, muscle quality, or palatability but may decrease fat quality. Feeding up to 10% corn germ did not negatively affect pig performance, carcass composition, carcass quality, or pork palatability but increased final BW of the pigs and reduced the iodine value of belly fat.

Energy, phosphorus, and amino acid digestibility of high-protein distillers dried grains and corn germ fed to growing pigs1

Three experiments were conducted to measure energy, P, and AA digestibility in 2 novel co-products from the ethanol industry [i.e., high-protein distillers dried grains (HP DDG) and corn germ]. These products are produced by dehulling and degerming corn before it enters the fermentation process. Experiment 1 was an energy balance experiment conducted to measure DE and ME in HP DDG, corn germ, and corn. Six growing pigs (initial BW, 48.9 +/- 1.99 kg) were placed in metabolism cages and fed diets based on corn, corn and HP DDG, or corn and corn germ. Pigs were allotted to a replicated, 3 x 3 Latin square design. The DE and ME in corn (4,056 and 3,972 kcal/kg of DM, respectively) did not differ from the DE and ME in corn germ (3,979 and 3,866 kcal/kg of DM, respectively). However, HP DDG contained more (P < 0.05) energy (4,763 kcal of DE/kg of DM and 4,476 kcal of ME/kg of DM) than corn or corn germ. Experiment 2 was conducted to measure apparent total tract digestibility (ATTD) and true total tract digestibility of P in HP DDG and corn germ. Thirty growing pigs (initial BW, 33.2 +/- 7.18 kg) were placed in metabolism cages and fed a diet based on HP DDG or corn germ. A P-free diet was used to measure endogenous P losses. Pigs were assigned to treatments in a randomized complete block design, with 10 replications per treatment. The ATTD and the retention of P were calculated for the diets containing HP DDG and corn germ, and the endogenous loss of P was estimated from pigs fed the P-free diet. The ATTD was lower (P < 0.05) in corn germ (28.6%) than in the HP DDG (59.6%). The retention of P was also lower (P < 0.05) in pigs fed corn germ (26.7%) than in pigs fed HP DDG (58.9%). The endogenous loss of P was estimated to be 211 +/- 39 mg per kg of DMI. The true total tract digestibility of P for HP DDG and corn germ was calculated to be 69.3 and 33.7%, respectively. In Exp. 3, apparent ileal digestibility and standardized ileal digestibility values of CP and AA in HP DDG and corn germ were measured using 6 growing pigs (initial BW, 78.2 +/- 11.4 kg) allotted to a replicated, 3 x 3 Latin square design. The apparent ileal digestibility for CP and all AA except Arg and Pro, and the standardized ileal digestibility for CP and all AA except Arg, Lys, Gly, and Pro were greater (P < 0.05) in HP DDG than in corn germ. It was concluded that HP DDG has a greater digestibility of energy, P, and most AA than corn germ.

Genomic Comparison of cag pathogenicity island (PAI)-positive and -negative Helicobacter pylori strains: identification of novel markers for cag PAI-positive strains

In an analysis of Helicobacter pylori genomic DNA by macroarray methodology, genomic DNA from a panel of cag pathogenicity island (PAI)-negative H. pylori clinical isolates failed to hybridize with 27 genes located outside the cag PAI in a cag PAI-positive reference strain. PCR analyses confirmed that HP0217 (encoding a lipopolysaccharide biosynthetic protein) and HP1079 (encoding a protein of unknown function) were present significantly more frequently in cagA-positive strains than in cagA-negative strains. A low G+C content of these two genes suggests they were acquired by horizontal transfer events.

Alanine-scanning mutations in domain 4 of anthrax toxin protective antigen reveal residues important for binding to the cellular receptor and to a neutralizing monoclonal antibody

A panel of variants with alanine substitutions in the small loop of anthrax toxin protective antigen domain 4 was created to determine individual amino acid residues critical for interactions with the cellular receptor and with a neutralizing monoclonal antibody, 14B7. Substituted protective antigen proteins were analyzed by cellular cytotoxicity assays, and their interactions with antibody were measured by plasmon surface resonance and analytical ultracentrifugation. Residue Asp683 was the most critical for cell binding and toxicity, causing an approximately 1000-fold reduction in toxicity, but was not a large factor for interactions with 14B7. Substitutions in residues Tyr681, Asn682, and Pro686 also reduced toxicity significantly, by 10-100-fold. Of these, only Asn682 and Pro686 were also critical for interactions with 14B7. However, residues Lys684, Leu685, Leu687, and Tyr688 were critical for 14B7 binding without greatly affecting toxicity. The K684A and L685A variants exhibited wild type levels of toxicity in cell culture assays; the L687A and Y688A variants were reduced only 1.5- and 5-fold, respectively.

Mother-infant separation in group-living rhesus macaques: a hormonal analysis

Adrenocortical responsiveness to separation in group-living rhesus macaque mother-infant pairs was determined. Cortisol evaluations were complemented by behavioral observations of mother-infant interactions and group social behavior. Infants, but not their mothers, showed cortisol elevations that could be attributed specifically to separation. Steroid-behavior relationships suggested that the infants of high dominant mothers evinced the greatest adrenocortical response to separation. These data exemplify the complexities involved in determining endocrine/behavior relationships in a group-living situation.