Recommendations for the introduction of metagenomic high-throughput sequencing in clinical virology, part I: Wet lab procedure

Metagenomic high-throughput sequencing (mHTS) is a hypothesis-free, universal pathogen detection technique for determination of the DNA/RNA sequences in a variety of sample types and infectious syndromes. mHTS is still in its early stages of translating into clinical application. To support the development, implementation and standardization of mHTS procedures for virus diagnostics, the European Society for Clinical Virology (ESCV) Network on Next-Generation Sequencing (ENNGS) has been established. The aim of ENNGS is to bring together professionals involved in mHTS for viral diagnostics to share methodologies and experiences, and to develop application recommendations. This manuscript aims to provide practical recommendations for the wet lab procedures necessary for implementation of mHTS for virus diagnostics and to give recommendations for development and validation of laboratory methods, including mHTS quality assurance, control and quality assessment protocols

Recommendations for the introduction of metagenomic high-throughput sequencing in clinical virology, part I: Wet lab procedure

Metagenomic high-throughput sequencing (mHTS) is a hypothesis-free, universal pathogen detection technique for determination of the DNA/RNA sequences in a variety of sample types and infectious syndromes. mHTS is still in its early stages of translating into clinical application. To support the development, implementation and standardization of mHTS procedures for virus diagnostics, the European Society for Clinical Virology (ESCV) Network on Next-Generation Sequencing (ENNGS) has been established. The aim of ENNGS is to bring together professionals involved in mHTS for viral diagnostics to share methodologies and experiences, and to develop application recommendations. This manuscript aims to provide practical recommendations for the wet lab procedures necessary for i

Die Bedeutung des Knochenmarkmikromilieus für Wachstum und Medikamentenresistenz des multiplen Myeloms unter besonderer Berücksichtigung von Interleukin-6

Das Knochenmarkmikromilieu produziert eine Reihe von unterschiedlichen Wachstumsfaktoren, die für das maligne Wachstum und die Medikamentenresistenz von Myelomzellen von grosser Bedeutung sind. Einer der wichtigsten Faktoren, der in manchen experimentellen Systemen sogar als essentiell für das Wachstum und Überleben von Myelomzellen beschrieben wurde, ist Interleukin-6. Aus diesem Grund könnte die Entwicklung von Substanzen, die die Wirkung von IL-6 oder dem IL-6 Rezeptor inhibieren von Bedeutung für die Therapie des Myeloms sein. In dieser Arbeit wurde die Wirkung des IL-6 Rezeptorantagonisten SANT7 auf das Überleben der IL-6 abhängigen Myelomzellinie INA-6 sowie primären Myelomzellen in Gegenwart oder Abwesenheit von primären humanen Knochenmarkstromazellen (KMSZ) untersucht. Von besonderem Interesse war hierbei die Frage ob SANT7 die wachstumsinhibitorische Wirkung von Dexamethson (Dex) und All-Trans-Retinolsäure (ATRA) verstärken kann. Keine der drei Substanzen, SANT7 eingeschlossen, konnte bei alleiniger Applikation in Gegenwart von primären humanen KMSZ eine nennenswerte Wachstumsinhibition induzieren. Wenn jedoch Dex und ATRA mit SANT7 kombiniert wurden konnte sowohl in INA-6 als auch primären Myelomzellen eine starke Wachstumsinhibition erzielt werden. Dieser Effekt beruht sowohl auf Apoptose als auch eines Zellzyklusarrests.The bone marrow microenvironment produces a number of different survival factors that are important for the malignant growth and drug resistance of multiple myeloma (MM) cells. One of the main factors reported to be essential for survival and growth of MM cells in some experimental systems is interleukin-6 (IL-6). Therefore, the development and testing of substances that interfere with IL-6 or IL-6 receptor (IL-6R) function might have a potential therapeutic value for the treatment of multiple myeloma. In this work the effect of the IL-6 receptor antagonist SANT7 on growth and survival of the IL-6 dependent MM cell lines INA-6 as well as primary MM cells in the presence or absence of bone marrow stromal cells (BMSC) was analyzed. Of particular interest was the question whether SANT7 might enhance the growth inhibitory effects of dexamethasone (Dex) and all-trans retinoic acid (ATRA). None of the drugs, when tested as a single substance, including SANT7, induced major growth inhibition if MM cells were co-cultured with primary human BMSCs. However, if Dex and ATRA were given in combination with SANT7 a strong growth inhibition was achieved in INA-6 and primary MM cells. This effect is due to cell cycle arrest and induction of apoptosis

The lewis-Y carbohydrate antigen is expressed by many human tumors and can serve as a target for genetically redirected T cells despite the presence of soluble antigen in serum

In this study we aimed to determine the suitability of the Lewis-Y carbohydrate antigen as a target for immunotherapy using genetically redirected T cells. Using the 3S193 monoclonal antibody and immunohistochemistry, Lewis-Y was found to be expressed on a range of tumors including 42% squamous cell lung carcinoma, 80% lung adenocarcinoma, 25% ovarian carcinoma, and 25% colorectal adenocarcinoma. Expression levels varied from low to intense on between 1% and 90% of tumor cells. Lewis- was also found in soluble form in sera from both normal donors and cancer patients using a newly developed enzyme-linked immunosorbent assay. Serum levels in patients was often less than 1á mg/mL, similar to normal donors, but approximately 30% of patients had soluble Lewis-Y levels exceeding 1áng/mL and up to 9á mg/mL. Lewis-Y-specific human T cells were generated by genetic modification with a chimeric receptor encoding a single-chain humanized antibody linked to the T-cell signaling molecules, T-cell receptor-zeta, and CD28. T cells responded against the Lewis-Y antigen by cytokine secretion and cytolysis in response to tumor cells. Importantly, the T-cell response was not inhibited by patient serum containing soluble Lewis-Y. This study demonstrates that Lewis-Y is expressed on a large number of tumors and Lewis-Y-specific T cells can retain antitumor function in the presence of patient serum, indicating that this antigen is a suitable target for this form of therapy

Persistence and efficacy of second generation CAR T Cell against the LeY Antigen in acute myeloid leukemia

In a phase I study of autologous chimeric antigen receptor (CAR) anti-LeY T-cell therapy of acute myeloid leukemia (AML), we examined the safety and postinfusion persistence of adoptively transferred T cells. Following fludarabine-containing preconditioning, four patients received up to 1.3 × 109 total T cells, of which 14-38% expressed the CAR. Grade 3 or 4 toxicity was not observed. One patient achieved a cytogenetic remission whereas another with active leukemia had a reduction in peripheral blood (PB) blasts and a third showed a protracted remission. Using an aliquot of In111-labeled CAR T cells, we demonstrated trafficking to the bone marrow (BM) in those patients with the greatest clinical benefit. Furthermore, in a patient with leukemia cutis, CAR T cells infiltrated proven sites of disease. Serial PCR of PB and BM for the LeY transgene demonstrated that infused CAR T cells persisted for up to 10 months. Our study supports the feasibility and safety of CAR-T-cell therapy in high-risk AML, and demonstrates durable in vivo persistence

Recommendations for the introduction of metagenomic next-generation sequencing in clinical virology, part II: bioinformatic analysis and reporting.

Metagenomic next-generation sequencing (mNGS) is an untargeted technique for determination of microbial DNA/RNA sequences in a variety of sample types from patients with infectious syndromes. mNGS is still in its early stages of broader translation into clinical applications. To further support the development, implementation, optimization and standardization of mNGS procedures for virus diagnostics, the European Society for Clinical Virology (ESCV) Network on Next-Generation Sequencing (ENNGS) has been established. The aim of ENNGS is to bring together professionals involved in mNGS for viral diagnostics to share methodologies and experiences, and to develop application guidelines. Following the ENNGS publication Recommendations for the introduction of mNGS in clinical virology, part I: wet lab procedure in this journal, the current manuscript aims to provide practical recommendations for the bioinformatic analysis of mNGS data and reporting of results to clinicians