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Tumors produce glucocorticoids by metabolite recycling, not synthesis, and activate Tregs to promote growth
Matthew D. Taves, … , Margaret C. Cam, Jonathan D. Ashwell
Matthew D. Taves, … , Margaret C. Cam, Jonathan D. Ashwell
Published July 20, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI164599.
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Tumors produce glucocorticoids by metabolite recycling, not synthesis, and activate Tregs to promote growth

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Abstract

Glucocorticoids are steroid hormones with potent immunosuppressive properties. Their primary source is the adrenals, where they are generated via de novo synthesis from cholesterol. In addition, many tissues have a recycling pathway in which glucocorticoids are regenerated from inactive metabolites by the enzyme 11β-HSD1 (encoded by Hsd11b1). Here we find that multiple tumor types express Hsd11b1 and produce active glucocorticoids. Genetic ablation of Hsd11b1 in such cells had no effect on in vitro growth but reduced in vivo tumor progression, which corresponded with increased frequencies of tumor-infiltrating CD8+ T cells (TIL) expressing activation markers and producing effector cytokines. Tumor-derived glucocorticoids were found to promote signatures of Treg activation and suppress signatures of Tconv activation in tumor-infiltrating Treg. Indeed, CD8+ T cell activation was restored and tumor growth reduced in mice with Treg-specific glucocorticoid receptor deficiency. Importantly, pharmacologic inhibition of 11β-HSD1 reduced tumor growth to the same degree as gene knockout, and rendered immunotherapy-resistant tumors susceptible to PD-1 blockade. Given that HSD11B1 expression is upregulated in many human tumors and that inhibition of 11β-HSD1 is well-tolerated in clinical studies, these data suggest that targeting 11β-HSD1 may be a beneficial adjunct in cancer therapy.

Authors

Matthew D. Taves, Shizuka Otsuka, Michaela A. Taylor, Kaitlynn M. Donahue, Thomas J. Meyer, Margaret C. Cam, Jonathan D. Ashwell

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The predominant PAR4 variant in individuals of African ancestry worsens murine and human stroke outcomes
Frederik Denorme, … , Paul F. Bray, Robert A. Campbell
Frederik Denorme, … , Paul F. Bray, Robert A. Campbell
Published July 20, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI169608.
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The predominant PAR4 variant in individuals of African ancestry worsens murine and human stroke outcomes

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Abstract

Protease activated receptor (PAR) 4 (gene: F2RL3) harbors a functional dimorphism, rs773902 A/G (encoding Thr120/Ala120, respectively) and is associated with greater platelet aggregation. The A allele frequency is more common in Black individuals, and Black individuals have a higher incidence of ischemic stroke than White individuals. However, it is not recognized whether the A allele is responsible for worse stroke outcomes. To directly test the in vivo effect of this variant on stroke, we generated mice where F2rl3 was replaced by F2RL3, thereby expressing human PAR4 (hPAR4) with either Thr120 or Ala120. Compared to hPAR4 Ala120 mice, hPAR4 Thr120 mice had worse stroke outcomes, mediated in part by enhanced platelet activation and platelet-neutrophil interactions. Analyses of 7620 Black subjects with 487 incident ischemic strokes demonstrated the AA genotype was a risk for incident ischemic stroke and worse functional outcomes. In humanized mice, ticagrelor with or without aspirin improved stroke outcomes in hPAR4 Ala120 mice, but not in hPAR4 Thr120 mice. P-selectin blockade improved stroke outcomes and reduced platelet-neutrophil interactions in hPAR4 Thr120 mice. Our results may explain some of the racial disparity in stroke and support the need for studies of non-standard anti-platelet therapies for patients expressing PAR4 Thr120.

Authors

Frederik Denorme, Nicole D. Armstrong, Michelle L. Stoller, Irina Portier, Emilia A. Tugolukova, Rikki M. Tanner, Emilie Montenont, Seema Bhatlekar, Mark Cody, John L. Rustad, Abigail Ajanel, Neal D. Tolley, Darian C. Murray, Julie L. Boyle, Marvin T. Nieman, Steven E. McKenzie, Christian Con Yost, Leslie A. Lange, Mary Cushman, Marguerite R. Irvin, Paul F. Bray, Robert A. Campbell

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No evidence of durable trained immunity after two doses of adenovirus-vectored or mRNA COVID-19 vaccines
Natalie E. Stevens, … , Nigel Curtis, David J. Lynn
Natalie E. Stevens, … , Nigel Curtis, David J. Lynn
Published July 20, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI171742.
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No evidence of durable trained immunity after two doses of adenovirus-vectored or mRNA COVID-19 vaccines

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Abstract

Authors

Natalie E. Stevens, Feargal J. Ryan, Nicole L. Messina, Stephen J. Blake, Todd S. Norton, Susie Germano, Jane James, Georgina L. Eden, Yee C. Tee, Miriam A. Lynn, Rochelle Botten, Simone E. Barry, Nigel Curtis, David J. Lynn

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Autoimmunity to synovial extracellular matrix proteins in patients with post-infectious lyme arthritis
Korawit Kanjana, … , James J. Moon, Allen C. Steere
Korawit Kanjana, … , James J. Moon, Allen C. Steere
Published July 20, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI161170.
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Autoimmunity to synovial extracellular matrix proteins in patients with post-infectious lyme arthritis

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Abstract

BACKGROUND. Autoimmune diseases often have strong genetic associations with specific HLA-DR alleles. The synovial lesion in chronic inflammatory forms of arthritis shows marked up-regulation of HLA-DR molecules, including in post-infectious Lyme arthritis (LA). However, the identity of HLA-DR-presented peptides and therefore, the reasons for these associations have frequently remained elusive. METHODS. Using immunopeptidomics to detect HLA-DR-presented peptides from synovial tissue, we identified T cell epitopes from 3 extracellular matrix (ECM) proteins in patients with post-infectious LA, identified potential Borreliella burgdorferi (Bb)-mimic epitopes, and characterized T and B cell responses to these peptides or proteins. RESULTS. Of 24 post-infectious LA patients, 58% had CD4+ T cell responses to ≥1 epitope of 3 ECM proteins, fibronectin-1, laminin B2, and/or collagen Vα1, and 17% of 52 such patients had antibody responses to >1 of these proteins. Patients with autoreactive T cell responses had significantly increased frequencies of HLA-DRB1*04 or DRB1*1501 alleles and more prolonged arthritis. When tetramer reagents were loaded with ECM or corresponding Bb-mimic peptides, binding was only with the autoreactive T cells. A high percentage of ECM-autoreactive CD4+ T cells in synovial fluid were T-bet-expressing Th1 cells, a small percentage were RoRyt-expressing Th17 cells, and a minimal percentage were FoxP3-expressing Treg cells. CONCLUSION. Autoreactive, proinflammatory CD4+ T cells and autoantibodies develop to ECM proteins in a subgroup of post-infectious LA patients who have specific HLA-DR alleles. Rather than the traditional molecular mimicry model, we propose that epitope spreading provides the best explanation for this example of infection-induced autoimmunity.

Authors

Korawit Kanjana, Klemen Strle, Robert B. Lochhead, Annalisa Pianta, Laura M. Mateyka, Qi Wang, Sheila L. Arvikar, David E. Kling, Cameron A. DeAngelo, Lucy Curham, Alan G. Barbour, Catherine E. Costello, James J. Moon, Allen C. Steere

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Cell-free high-density lipoprotein-specific phospholipid efflux assay predicts incident cardiovascular disease
Masaki Sato, … , Uwe J.F. Tietge, Alan T. Remaley
Masaki Sato, … , Uwe J.F. Tietge, Alan T. Remaley
Published July 20, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI165370.
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Cell-free high-density lipoprotein-specific phospholipid efflux assay predicts incident cardiovascular disease

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Abstract

BACKGROUND. Cellular cholesterol efflux capacity (CEC) is a better predictor of cardiovascular disease (CVD) events than High Density Lipoprotein-Cholesterol (HDL-C) but is not suitable as a routine clinical assay. METHODS. We developed an HDL-specific phospholipid efflux (HDL-SPE) assay to assess HDL functionality based on whole plasma HDL apolipoprotein-mediated solubilization of fluorescent phosphatidylethanolamine from artificial lipid donor particles. We first assessed the association of HDL-SPE with prevalent coronary artery disease (CAD); Study I: NIH severe-CAD (n=50) and non-CAD (n=50) subjects, frequency matched for gender, BMI, Type 2-diabetes mellitus and smoking; Study II: Japanese CAD (n=70) and non-CAD (n=154) subjects. We also examined the association of HDL-SPE with incident CVD events in the Prevention of Renal and Vascular End-stage Disease (PREVEND) study comparing 340 cases to 340 controls individually matched for age, sex, smoking and HDL-C levels. RESULTS. Receiver operating characteristic curves revealed stronger associations of HDL-SPE with prevalent CAD. AUC in Study I: HDL-SPE, 0.68; apoA-I, 0.62; HDL-C, 0.63; CEC, 0.52. AUC in Study II: HDL-SPE, 0.83; apoA-I, 0.64; HDL-C, 0.53. Also longitudinally, HDL-SPE was significantly associated with incident CVD events independent of traditional risk factors with odds ratios ˂ 0.2 per SD increment in the PREVEND study (p<0.001). CONCLUSION. HDL-SPE could serve as a routine clinical assay for improving CVD risk assessment and drug discovery. TRIAL REGISTRATION. ClinicalTrials.gov: NCT01621594; Jichi Medical University study protocols C17-R007, 122, 142 and 158; University Medical Center Groningen, Netherlands study approval number: MEC96/01/022. FUNDING. This work was supported by the NIH, NHLBI Intramural Research Program.

Authors

Masaki Sato, Edward B. Neufeld, Martin P. Playford, Yu Lei, Alexander V. Sorokin, Angel M. Aponte, Lita A. Freeman, Scott M. Gordon, Amit K. Dey, Kianoush Jeiran, Masato Hamasaki, Maureen L. Sampson, Robert D. Shamburek, Jingrong Tang, Marcus Y. Chen, Kazuhiko Kotani, Josephine L.C. Anderson, Robin P.F. Dullaart, Nehal N. Mehta, Uwe J.F. Tietge, Alan T. Remaley

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SF3B1 mutation and ATM deletion co-drive leukemogenesis via centromeric R-loop dysregulation
Martina Cusan, … , Ren-Jang Lin, Lili Wang
Martina Cusan, … , Ren-Jang Lin, Lili Wang
Published July 18, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI163325.
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SF3B1 mutation and ATM deletion co-drive leukemogenesis via centromeric R-loop dysregulation

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Abstract

RNA splicing factor SF3B1 is recurrently mutated in various cancers, particularly in hematological ma-lignancies. We previously reported that co-expression of Sf3b1 mutation and Atm deletion in B cells, but not either lesion alone, leads to the onset of chronic lymphocytic leukemia (CLL) with CLL cells harbor-ing chromosome amplification. However, the exact role of Sf3b1 mutation and Atm deletion in chromo-somal instability (CIN) remains unclear. Here, we demonstrate that SF3B1 mutation promotes centro-meric R-loop (cen-R-loop) accumulation, leading to increased chromosome oscillation, impaired chromo-some segregation, altered spindle architecture and aneuploidy, which can be alleviated by removal of cen-R-loop and exaggerated by deletion of ATM. Aberrant splicing of key genes involved in R-loop processing underlies augmentation of cen-R-loop as overexpression of the normal isoform, but not the altered form, mitigates mitotic stress in SF3B1 mutant cells. Our study underscores the critical role of novel splice variants in linking RNA splicing dysregulation and CIN, and highlights cen-R-loop augmen-tation as a key mechanism for leukemogenesis.

Authors

Martina Cusan, Haifeng Shen, Bo Zhang, Aijun Liao, Lu Yang, Meiling Jin, Mike Fernandez, Prajish Iyer, Yiming Wu, Kevyn L. Hart, Catherine Gutierrez, Sara Nik, Shondra M. Pruett-Miller, Jeremy Stark, Esther A. Obeng, Teresa V. Bowman, Catherine J. Wu, Ren-Jang Lin, Lili Wang

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Blood-derived lysophospholipid sustains hepatic phospholipids and fat storage necessary for hepatoprotection in overnutrition
Cheen Fei Chin, … , Federico Torta, David L. Silver
Cheen Fei Chin, … , Federico Torta, David L. Silver
Published July 18, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI171267.
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Blood-derived lysophospholipid sustains hepatic phospholipids and fat storage necessary for hepatoprotection in overnutrition

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Abstract

The liver has a high demand for phosphatidylcholine (PC) particularly in overnutrition where reduced phospholipid levels have been implicated in the development of non-alcoholic fatty liver disease (NAFLD). Whether other pathways exist in addition to de novo PC synthesis that contribute to hepatic PC pools remains unknown. Here, we identified the lysophosphatidylcholine (LPC) transporter Mfsd2a as critical for maintaining hepatic phospholipid pools. Hepatic Mfsd2a expression was induced in patients having NAFLD and in mice in response to dietary fat via glucocorticoid receptor action. Mfsd2a liver-specific deficiency in mice (L2aKO) led to a robust NASH-like phenotype within just two weeks of dietary fat challenge associated with reduced hepatic phospholipids containing linoleic acid. Reducing dietary choline intake in L2aKO mice exacerbated liver pathology and deficiency of liver phospholipids containing polyunsaturated fatty acids (PUFA). Treating hepatocytes with LPC containing oleate and linoleate, two abundant blood-derived LPCs, specifically induced lipid droplet biogenesis and contributed to phospholipid pools, while LPC containing the omega-3 fatty acid DHA promoted lipid droplet formation and suppressed lipogenesis. This study revealed that PUFA containing LPCs drive both hepatic lipid droplet formation, suppress lipogenesis and sustain hepatic phospholipid pools--processes that are critical for protecting the liver from excess dietary fat.

Authors

Cheen Fei Chin, Dwight L.A. Galam, Liang Gao, Bryan C. Tan, Bernice H. Wong, Geok-Lin Chua, Randy Y.J. Loke, Yen Ching Lim, Markus R. Wenk, Miao Shan Lim, Wei-Qiang Leow, George B.B. Goh, Federico Torta, David L. Silver

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The latent reservoir of inducible, infectious HIV-1 does not decrease despite decades of antiretroviral therapy
Natalie F. McMyn, … , Robert Siliciano, Janet M. Siliciano
Natalie F. McMyn, … , Robert Siliciano, Janet M. Siliciano
Published July 18, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI171554.
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The latent reservoir of inducible, infectious HIV-1 does not decrease despite decades of antiretroviral therapy

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Abstract

HIV-1 persists in a latent reservoir in resting CD4+ T cells despite antiretroviral therapy (ART). The reservoir decays slowly over the first seven years of ART (t1/2 = 44 months). However, whether decay continues with long-term ART is unclear. Recent integration site studies indicate gradual selection against inducible, intact proviruses, raising speculation that decades of ART might allow treatment interruption without viral rebound. Therefore, we measured the reservoir in 42 people on long-term ART (mean 22 years) using a quantitative viral outgrowth assay. After seven years of ART, there was no long-term decrease in the frequency of inducible, replication-competent proviruses but rather an increase with an estimated doubling time of 23 years. Another reservoir assay, the intact proviral DNA assay, confirmed that reservoir decay with t1/2 of 44 months did not continue with long-term ART. The lack of decay reflected infected cell proliferation. Most (79.8%) inducible, replication-competent viruses had env sequences identical to other isolates from the same sample. Thus, although integration site analysis indicates changes in reservoir composition, the proliferation of CD4+ T cells counteracts decay, maintaining the frequency of inducible, replication-competent proviruses at roughly constant levels over the long term. These results reinforce the need for lifelong ART.

Authors

Natalie F. McMyn, Joseph Varriale, Emily J. Fray, Carolin Zitzmann, Hannah J MacLeod, Jun Lai, Anushka Singhal, Milica Moskovljevic, Mauro A. Garcia, Brianna M. Lopez, Vivek Hariharan, Kyle Rhodehouse, Kenneth Lynn, Pablo Tebas, Karam Mounzer, Luis J. Montaner, Erika Benko, Colin Kovacs, Rebecca Hoh, Francesco R. Simonetti, Gregory M. Laird, Steven G. Deeks, Ruy M. Ribeiro, Alan S. Perelson, Robert Siliciano, Janet M. Siliciano

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Inflammatory ER stress responses dictate the immunopathogenic progression of systemic candidiasis
Deepika Awasthi, … , Tobias M. Hohl, Juan R. Cubillos-Ruiz
Deepika Awasthi, … , Tobias M. Hohl, Juan R. Cubillos-Ruiz
Published July 11, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI167359.
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Inflammatory ER stress responses dictate the immunopathogenic progression of systemic candidiasis

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Abstract

Recognition of pathogen-associated molecular patterns can trigger the IRE1α arm of the endoplasmic reticulum (ER) stress response in innate immune cells. This process maintains ER homeostasis and also coordinates diverse immunomodulatory programs during bacterial and viral infections. However, the role of innate IRE1α signaling in response to fungal pathogens remains elusive. Here, we report that systemic infection with the human opportunistic fungal pathogen Candida albicans induces proinflammatory IRE1α hyperactivation in myeloid cells that leads to fatal kidney immunopathology. Mechanistically, simultaneous activation of the TLR/IL-1R adaptor protein MyD88 and the C-type lectin receptor Dectin-1 by C. albicans induced NADPH oxidase-driven generation of reactive oxygen species that caused ER stress and IRE1α-dependent overexpression of key inflammatory mediators such as IL-1β, IL-6, CCL5, PGE2 and TNFα. Selective ablation of IRE1α in leukocytes, or treatment with an IRE1α pharmacological inhibitor, mitigated kidney inflammation and prolonged the survival of mice with systemic C. albicans infection. Therefore, controlling IRE1α hyperactivation may be useful for impeding the immunopathogenic progression of disseminated candidiasis.

Authors

Deepika Awasthi, Sahil Chopra, Byuri A. Cho, Alexander Emmanuelli, Tito A. Sandoval, Sung-Min Hwang, Chang-Suk Chae, Camilla Salvagno, Chen Tan, Liliana Vasquez-Urbina, Jose J. Fernandez Rodriguez, Sara F. Santagostino, Takao Iwawaki, E. Alfonso Romero-Sandoval, Mariano Sanchez Crespo, Diana K. Morales, Iliyan D. Iliev, Tobias M. Hohl, Juan R. Cubillos-Ruiz

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Allosteric modulator potentiates β2AR agonist-promoted bronchoprotection in asthma models
Seungkirl Ahn, … , Alem W. Kahsai, Robert J. Lefkowitz
Seungkirl Ahn, … , Alem W. Kahsai, Robert J. Lefkowitz
Published July 11, 2023
Citation Information: J Clin Invest. 2023. https://doi.org/10.1172/JCI167337.
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Allosteric modulator potentiates β2AR agonist-promoted bronchoprotection in asthma models

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Abstract

Asthma is a chronic inflammatory disease associated with episodic airway narrowing. Inhaled β2-adrenergic receptor (β2AR) agonists (β2-agonists) promote bronchodilation in asthma, but have limited efficacy. All β2-agonists are canonical orthosteric ligands that bind the same site as endogenous epinephrine. We recently isolated a β2AR-selective positive allosteric modulator (PAM), compound-6 (Cmpd-6), which binds outside of the orthosteric site and modulates orthosteric ligand functions. With the emerging therapeutic potential of GPCR allosteric ligands, we investigated the impact of Cmpd-6 on β2AR-mediated bronchoprotection. Consistent with our findings using human β2ARs, Cmpd-6 allosterically potentiated β2-agonist binding to, and downstream signaling of, guinea pig β2ARs. In contrast, Cmpd-6 had no such effect on murine β2ARs which lack a crucial amino acid in the Cmpd-6 allosteric binding site. Importantly, Cmpd-6 enhanced β2-agonist-mediated bronchoprotection against methacholine-induced bronchoconstriction in guinea pig lung slices, but – in line with the binding studies – not in mice. Moreover, Cmpd-6 robustly potentiated β2-agonist-mediated bronchoprotection against allergen-induced airway constriction in lung slices obtained from a guinea pig model of allergic asthma. Cmpd-6 similarly enhanced β2-agonist-mediated bronchoprotection against methacholine-induced bronchoconstriction in human lung slices. Our results highlight the potential of β2AR-selective PAMs in the treatment of airway narrowing in asthma and other obstructive respiratory diseases.

Authors

Seungkirl Ahn, Harm Maarsingh, Julia K.L. Walker, Samuel W. Liu, Akhil Hegde, Hyeje C. Sumajit, Alem W. Kahsai, Robert J. Lefkowitz

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