Development of biomimetic platforms to investigate the influence of the extra-cellular environment on immunological responses

The immune system comprises highly sophisticated networks of cells and signalling molecules which function in concert to protect the body against pathogens. Within this system a role for the extra-cellular microenvironment as a crucial mediator of immune responses is becoming increasingly apparent. Conventional in vitro cultures lack physiologically relevant extra-cellular cues, such as extracellular matrix (ECM) and shear flow. Tissue engineering can be used to simulate features of the natural microenvironment for the development of biologically relevant platforms. It is anticipated that this will enable the study of the influence of the extra-cellular environment on immune responses. This thesis describes the development and characterisation of tissue-engineered platforms for immune cell culture which incorporate the ECM and shear flow. This work goes on to apply these platforms for the study of the effect of the extra-cellular environment on dendritic cells and their interactions with T cells in the context of immunological stimulation. The ECM defines the three-dimensional architecture of the natural microenvironment. It provides structural support and also promotes cell motility in tissues. This is important for the function of the immune system as it directs the organisation and interactions of immune cells which ultimately contributes to the modulation of immune responses. Candidate synthetic and natural biomaterials were assessed for their suitability to provide an in vitro extracellular matrix (ECM) platform for human immune cell culture. The suitability of these materials to provide an artificial ECM platform was based on the viability, resting immune state and immune competence of the cells. The synthetic biomaterials tested were a thermo-responsive colloidal gel and electrospun PET and PLGA scaffolds coated with a thermo-responsive polymer. An important finding from the work done with the colloidal gel was that the human dendritic cells, which were incorporated into the gel at the beginning of the experiment, could not be separated from the material for flow cytometric analysis. Therefore, characterisation of the colloidal gel for immune cell culture could not be completed. Regarding the characterisation of the electrospun PET and PLGA scaffolds, although they did not significantly impair cell viability of dendritic cells they were found to induce cell maturation. As a result, none of the synthetic biomaterials were found to be a suitable ECM surrogate. A semi-natural biomaterial, gelatin methacryloyl (GelMA) hydrogel, was included in the investigation. The results from the characterisation of GelMA for human immune cell culture indicated that the hydrogel induced a pro-inflammatory immune response due to the profile of secreted cytokines. Based on this, GelMA was also discounted as an appropriate material for the development of the ECM platform. The final ECM candidate was a collagen hydrogel, which is a naturally-derived biomaterial. The collagen hydrogel was shown to support immune cell survival and human dendritic cells maintained an immature phenotype in culture. In addition, typical responses to immunological stimuli by human dendritic cells and T cells were observed in collagen hydrogel cultures. This work demonstrated that out of the biomaterials which were characterised, the collagen hydrogel was the most suitable biomaterial for the development of the ECM platform. The influence of the collagen hydrogel ECM platform on antigen-specific immune responses was investigated in the context of autologous human dendritic cell and T cell co-cultures stimulated with the model antigen Mycobacterium tuberculosis purified protein derivative, also referred to as PPD. The results from these experiments indicated that the presence of the collagen hydrogel increased the sensitivity and specificity of the immune response, compared to conventional tissue culture conditions. An attempt was made at utilising the ECM platform to investigate immune responses to chemical sensitisers to address the requirement for in vitro alternatives to replace current animal testing methods. In this work, innate and adaptive immune responses to sensitisers were detected using the ECM platform. However, the reproducibility of these experiments was low due to large donor variation. Therefore the effect of the ECM platform on immune responses to sensitisers could not be evaluated. This difficulty likely reflects the complexity of the molecular and cellular mechanisms which lead to the acquisition of chemical sensitisation. Shear flow is a type of physiological stress to which immune cells are exposed in vivo due to the movement of blood and lymph fluid. Recent studies have implicated flow as an immunologically relevant stimulus, capable of inducing changes in the expression of receptors and chemokines involved in regulating immune cell migration, and activating immune receptor signalling. A fluidic cell culture platform was developed to recapitulate the effect of shear flow. Two different prototypes were constructed, one of which was taken forward and characterised for immune cell culture applications. The fluidic platform taken forward had a paper-based cell culture scaffold which was coated with collagen hydrogel. The scaffold was found to induce maturation of human dendritic cells which was attributed to the possibility of incomplete coverage of the scaffold by the collagen hydrogel. The viability of dendritic cells was slightly impaired by flow, however not significantly. Interestingly, when exposed to shear flow, dendritic cells maintained a less mature phenotype compared to their static counterparts. Antigen-specific immune responses were studied on the fluidic platform by setting up co-cultures comprising PPD-stimulated autologous human dendritic cells and T cells. Typical T cell activation was observed on the platform and the sensitivity and specificity of immune responses was found to be greater under flow conditions, compared with static cultures. In conclusion, this thesis demonstrates the value of developing biomimetic platforms for studying the influence of the extra-cellular environment on immune responses. Finally, the ability to mimic extra-cellular cues to which cells are exposed in vivo has the potential to generate more realistic immune responses in the lab. This presents huge opportunities for advancing understanding in immunology. It also has implications for methods used in research, drug discovery and safety testing, where currently only animals provide a representative system for the study of immune reactions. It is anticipated that enhancing the physiological relevance of in vitro cell culture will ultimately contribute to the reduction of animals used in research and testing

Development of biomimetic platforms to investigate the influence of the extra-cellular environment on immunological responses

The immune system comprises highly sophisticated networks of cells and signalling molecules which function in concert to protect the body against pathogens. Within this system a role for the extra-cellular microenvironment as a crucial mediator of immune responses is becoming increasingly apparent. Conventional in vitro cultures lack physiologically relevant extra-cellular cues, such as extracellular matrix (ECM) and shear flow. Tissue engineering can be used to simulate features of the natural microenvironment for the development of biologically relevant platforms. It is anticipated that this will enable the study of the influence of the extra-cellular environment on immune responses. This thesis describes the development and characterisation of tissue-engineered platforms for immune cell culture which incorporate the ECM and shear flow. This work goes on to apply these platforms for the study of the effect of the extra-cellular environment on dendritic cells and their interactions with T cells in the context of immunological stimulation. The ECM defines the three-dimensional architecture of the natural microenvironment. It provides structural support and also promotes cell motility in tissues. This is important for the function of the immune system as it directs the organisation and interactions of immune cells which ultimately contributes to the modulation of immune responses. Candidate synthetic and natural biomaterials were assessed for their suitability to provide an in vitro extracellular matrix (ECM) platform for human immune cell culture. The suitability of these materials to provide an artificial ECM platform was based on the viability, resting immune state and immune competence of the cells. The synthetic biomaterials tested were a thermo-responsive colloidal gel and electrospun PET and PLGA scaffolds coated with a thermo-responsive polymer. An important finding from the work done with the colloidal gel was that the human dendritic cells, which were incorporated into the gel at the beginning of the experiment, could not be separated from the material for flow cytometric analysis. Therefore, characterisation of the colloidal gel for immune cell culture could not be completed. Regarding the characterisation of the electrospun PET and PLGA scaffolds, although they did not significantly impair cell viability of dendritic cells they were found to induce cell maturation. As a result, none of the synthetic biomaterials were found to be a suitable ECM surrogate. A semi-natural biomaterial, gelatin methacryloyl (GelMA) hydrogel, was included in the investigation. The results from the characterisation of GelMA for human immune cell culture indicated that the hydrogel induced a pro-inflammatory immune response due to the profile of secreted cytokines. Based on this, GelMA was also discounted as an appropriate material for the development of the ECM platform. The final ECM candidate was a collagen hydrogel, which is a naturally-derived biomaterial. The collagen hydrogel was shown to support immune cell survival and human dendritic cells maintained an immature phenotype in culture. In addition, typical responses to immunological stimuli by human dendritic cells and T cells were observed in collagen hydrogel cultures. This work demonstrated that out of the biomaterials which were characterised, the collagen hydrogel was the most suitable biomaterial for the development of the ECM platform. The influence of the collagen hydrogel ECM platform on antigen-specific immune responses was investigated in the context of autologous human dendritic cell and T cell co-cultures stimulated with the model antigen Mycobacterium tuberculosis purified protein derivative, also referred to as PPD. The results from these experiments indicated that the presence of the collagen hydrogel increased the sensitivity and specificity of the immune response, compared to conventional tissue culture conditions. An attempt was made at utilising the ECM platform to investigate immune responses to chemical sensitisers to address the requirement for in vitro alternatives to replace current animal testing methods. In this work, innate and adaptive immune responses to sensitisers were detected using the ECM platform. However, the reproducibility of these experiments was low due to large donor variation. Therefore the effect of the ECM platform on immune responses to sensitisers could not be evaluated. This difficulty likely reflects the complexity of the molecular and cellular mechanisms which lead to the acquisition of chemical sensitisation. Shear flow is a type of physiological stress to which immune cells are exposed in vivo due to the movement of blood and lymph fluid. Recent studies have implicated flow as an immunologically relevant stimulus, capable of inducing changes in the expression of receptors and chemokines involved in regulating immune cell migration, and activating immune receptor signalling. A fluidic cell culture platform was developed to recapitulate the effect of shear flow. Two different prototypes were constructed, one of which was taken forward and characterised for immune cell culture applications. The fluidic platform taken forward had a paper-based cell culture scaffold which was coated with collagen hydrogel. The scaffold was found to induce maturation of human dendritic cells which was attributed to the possibility of incomplete coverage of the scaffold by the collagen hydrogel. The viability of dendritic cells was slightly impaired by flow, however not significantly. Interestingly, when exposed to shear flow, dendritic cells maintained a less mature phenotype compared to their static counterparts. Antigen-specific immune responses were studied on the fluidic platform by setting up co-cultures comprising PPD-stimulated autologous human dendritic cells and T cells. Typical T cell activation was observed on the platform and the sensitivity and specificity of immune responses was found to be greater under flow conditions, compared with static cultures. In conclusion, this thesis demonstrates the value of developing biomimetic platforms for studying the influence of the extra-cellular environment on immune responses. Finally, the ability to mimic extra-cellular cues to which cells are exposed in vivo has the potential to generate more realistic immune responses in the lab. This presents huge opportunities for advancing understanding in immunology. It also has implications for methods used in research, drug discovery and safety testing, where currently only animals provide a representative system for the study of immune reactions. It is anticipated that enhancing the physiological relevance of in vitro cell culture will ultimately contribute to the reduction of animals used in research and testing

The impact of patient age and aortic size on the results of aortobifemoral bypass grafting1 1Competition of interest: none.Published online Mar 6, 2003

AbstractObjectives: On the basis of the widespread belief that aortobifemoral bypass (ABF) represents the optimal mode of revascularization for patients with diffuse aortoiliac disease, vascular surgeons are often aggressive about its application in young adults. We undertook this retrospective evaluation of ABFs performed from 1980 to 1999 to determine whether the results justify this approach. Patients of less than 50 years of age (n = 45) were compared with those aged 50 to 59 years (n = 93) and those aged more than 60 years (n = 146).Results: Younger patients were more likely to undergo operation for claudication than were older patients (72% versus 59% and 55%; P < .04). Younger patients were significantly more likely to be smokers (87%) but less likely to have diabetes, hypertension, or cerebrovascular disease. Bypasses were constructed in an end-to-end fashion in 71.1% of patients of less than 50 years versus 68.8% and 71.2% of older patients (P = not significant). The mean diameter of aortic grafts was significantly smaller in younger patients (14.6 mm) than in older patients (15.6 mm and 15.5 mm; P < .01). The need for a subsequent infrainguinal reconstruction was highest in the youngest patients (24% versus 17% and 7%; P < .01). Surgical mortality rates were low in all groups (0%, 1%, and 2.0% for increasing age groups; P = not significant). Five-year primary and secondary patency rates increased significantly with each increase in age interval: 5-year primary patency rate: less than 50 years, 66% ± 8%; 50 to 59 years, 87% ± 5%; more than 60 years, 96% ±2% (P < .05 for all comparisons). Five-year secondary patency rates were: less than 50 years, 79% ± 7%; 50 to 59 years, 91% ± 4%; more than 60 years, 98% ± 2% (P < .05 for all comparisons). Five-year survival rate was comparable in all three groups: less than 50 years, 93% ± 5%; 50 to 59 years, 92% ± 4%; more than 60 years, 87% ± 4% (P = not significant).Conclusion: Increased virulence of aortic disease, smaller aortic size, and more progressive infrainguinal disease may all negatively impact the results of ABF in younger patients. Although 5-year results are acceptable, increased caution is warranted in the routine application of ABF in young patients without limb-threatening ischemia

Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database.

PURPOSE: A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. The extent of blame attribution in safety incident reports, which may reflect the underlying safety culture of health care systems, is unknown. This study set out to explore the nature of blame in family practice safety incident reports. METHODS: We characterized a random sample of family practice patient safety incident reports from the England and Wales National Reporting and Learning System. Reports were analyzed according to prespecified classification systems to describe the incident type, contributory factors, outcomes, and severity of harm. We developed a taxonomy of blame attribution, and we then used descriptive statistical analyses to identify the proportions of blame types and to explore associations between incident characteristics and one type of blame. RESULTS: Health care professionals making family practice incident reports attributed blame to a person in 45% of cases (n = 975 of 2,148; 95% CI, 43%-47%). In 36% of cases, those who reported the incidents attributed fault to another person, whereas 2% of those reporting acknowledged personal responsibility. Blame was commonly associated with incidents where a complaint was anticipated. CONCLUSIONS: The high frequency of blame in these safety, incident reports may reflect a health care culture that leads to blame and retribution, rather than to identifying areas for learning and improvement, and a failure to appreciate the contribution of system factors in others' behavior. Successful improvement in patient safety through the analysis of incident reports is unlikely without achieving a blame-free culture

A paper-based in vitro model for on-chip investigation of the human respiratory system

Culturing cells at the air–liquid interface (ALI) is essential for creating functional in vitro models of lung tissues. We present the use of direct-patterned laser-treated hydrophobic paper as an effective semi-permeable membrane, ideal for ALI cell culture. The surface properties of the paper are modified through a selective CO2 laser-assisted treatment to create a unique porous substrate with hydrophilic regions that regulate fluid diffusion and cell attachment. To select the appropriate model, four promising hydrophobic films were compared with each other in terms of gas permeability and long-term strength in an aqueous environment (wet-strength). Among the investigated substrates, parchment paper showed the fastest rate of oxygen permeability (3 times more than conventional transwell cell culture membranes), with the least variation in its dry and wet tensile strengths (124 MPa and 58 MPa, remaining unchanged after 7 days of submersion in PBS).The final paper-based platform provides an ideal, robust, and inexpensive device for generating monolayers of lung epithelial cells on-chip in a high-throughput fashion for disease modelling and in vitro drug testing

Infant lung function tests as endpoints in the ISIS multicenter clinical trial in cystic fibrosis

BACKGROUND: The Infant Study of Inhaled Saline (ISIS) in CF was the first multicenter clinical trial to utilize infant pulmonary function tests (iPFTs) as an endpoint. METHODS: Secondary analysis of ISIS data was conducted in order to assess feasibility of iPFT measures and their associations with respiratory symptoms. Standard deviations were calculated to aid in power calculations for future clinical trials. RESULTS: Seventy-three participants enrolled, 70 returned for the final visit; 62 (89%) and 45 (64%) had acceptable paired functional residual capacity (FRC) and raised volume measurements, respectively. Mean baseline FEV0.5, FEF75 and FRC z-scores were 0.3 (SD: 1.2), -0.2 (SD: 2.0), and 1.8 (SD: 2.0). CONCLUSIONS: iPFTs are not appropriate primary endpoints for multicenter clinical trials due to challenges of obtaining acceptable data and near-normal average raised volume measurements. Raised volume measures have potential to serve as secondary endpoints in future clinical CF trials

Downregulation of the serum response factor/miR-1 axis in the quadriceps of patients with COPD

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the licenseRATIONALE: Muscle atrophy confers a poor prognosis in patients with chronic obstructive pulmonary disease (COPD), yet the molecular pathways responsible are poorly characterised. Muscle-specific microRNAs and serum response factor (SRF) are important regulators of muscle phenotype that contribute to a feedback system to regulate muscle gene expression. The role of these factors in the skeletal muscle dysfunction that accompanies COPD is unknown. METHODS: 31 patients with COPD and 14 healthy age-matched controls underwent lung and quadriceps function assessments, measurement of daily activity and a percutaneous quadriceps muscle biopsy. The expression of muscle-specific microRNAs, myosin heavy chains and components of the serum response factor signalling pathway were determined by qPCR. RESULTS: A reduction in expression of miR-1 (2.5-fold, p=0.01) and the myocardin-related transcription factors (MRTFs) A and B was observed in patients compared with controls (MRTF-A mRNA: twofold, p=0.028; MRTF-B mRNA: fourfold, p=0.011). miR-1 expression was associated with smoking history, lung function, fat-free mass index, 6 min walk distance and percentage of type 1 fibres. miR-133 and miR-206 were negatively correlated with daily physical activity. Insulin-like growth factor 1 mRNA was increased in the patients and miR-1 was negatively correlated with phosphorylation of the kinase Akt. Furthermore, the protein levels of histone deacetylase 4, another miR-1 target, were increased in the patients. CONCLUSIONS: Downregulation of the activity of the MRTF-SRF axis and the expression of muscle-specific microRNAs, particularly miR-1, may contribute to COPD-associated skeletal muscle dysfunction.BBSRC, Wellcome Trust and the National Institute for Health Research (NIHR) Respiratory Biomedical Unit at the Royal Brompton Hospital and Imperial College. AL is a BBSRC PhD student, SAN received a Wellcome Trust Fellowship, AD received a NIHR Respiratory Biomedical Unit fellowship and WM is a NIHR Clinician Scientist. NSH is a HEFCE Clinical Senior Lecturer. MIP's salary is part funded by the NIHR Respiratory Biomedical Unit at the Royal Brompton Hospital and National Heart & Lung Institute

Infant lung function tests as endpoints in the ISIS multicenter clinical trial in cystic fibrosis

The Infant Study of Inhaled Saline (ISIS) in CF was the first multicenter clinical trial to utilize infant pulmonary function tests (iPFTs) as an endpoint

Reverse genetics with a full-length infectious cDNA of the Middle East respiratory syndrome coronavirus

The identification of a novel, emerging human coronavirus with ∼50% mortality, designated Middle East respiratory syndrome coronavirus (MERS-CoV), emphasizes the importance of the rapid development of reagents that can be used to (i) characterize the replication and pathogenesis of emerging pathogens and (ii) develop therapeutics for treatment. In this report, we describe the development of a cassette-based infectious cDNA clone of MERS-CoV and verify that it functions similarly to the wild-type isolate in terms of replication, protein and RNA expression, and spike attachment protein processing. We also show that the virus replicates preferentially in differentiated primary lung cells

ASIME 2018 White Paper. In-Space Utilisation of Asteroids: Asteroid Composition -- Answers to Questions from the Asteroid Miners

In keeping with the Luxembourg government's initiative to support the future use of space resources, ASIME 2018 was held in Belval, Luxembourg on April 16-17, 2018. The goal of ASIME 2018: Asteroid Intersections with Mine Engineering, was to focus on asteroid composition for advancing the asteroid in-space resource utilisation domain. What do we know about asteroid composition from remote-sensing observations? What are the potential caveats in the interpretation of Earth-based spectral observations? What are the next steps to improve our knowledge on asteroid composition by means of ground-based and space-based observations and asteroid rendez-vous and sample return missions? How can asteroid mining companies use this knowledge? ASIME 2018 was a two-day workshop of almost 70 scientists and engineers in the context of the engineering needs of space missions with in-space asteroid utilisation. The 21 Questions from the asteroid mining companies were sorted into the four asteroid science themes: 1) Potential Targets, 2) Asteroid-Meteorite Links, 3) In-Situ Measurements and 4) Laboratory Measurements. The Answers to those Questions were provided by the scientists with their conference presentations and collected by A. Graps or edited directly into an open-access collaborative Google document or inserted by A. Graps using additional reference materials. During the ASIME 2018, first day and second day Wrap-Ups, the answers to the questions were discussed further. New readers to the asteroid mining topic may find the Conversation boxes and the Mission Design discussions especially interesting.Comment: Outcome from the ASIME 2018: Asteroid Intersections with Mine Engineering, Luxembourg. April 16-17, 2018. 65 Pages. arXiv admin note: substantial text overlap with arXiv:1612.0070