Transcription factor NF-kB in the prognosis of outcomes for patients undergoing repeat keratoplasty

Background: Obtaining a clear graft after repeat keratoplasty is still a challenging task for corneal transplant surgeons. Corneal transplant rejection rate is significantly increased in repeat keratoplasty compared with first keratoplasty. Activation of nuclear factor kappa B (NF-kB) plays a key role in the pathogenesis of rejection of transplants of various organs and tissues, primarily due to production of proinflammatory cytokines (TNF, IL-1, etc.). Purpose: To assess the role of transcription factor NF-kB in lymphocyte subsets in the prognosis of outcomes for patients undergoing repeat keratoplasty. Material and Methods: Forty-six patients (46 eyes) who underwent repeat keratoplasty were included. Of these, 30 patients (group 1) developed an opacified graft, and 16 (group 2) obtained a clear graft. Patient age ranged from 32 to 88 years. Imaging flow cytometry (ImageStream Mark II – AMNIS) and Amnis NF-kB Translocation Kits (ACS10000, Millipore, Sigma) were used to assess percentages of the cells with translocation of the NF-kB p65 subunit for lymphocyte subsets. Statistical analyses were conducted using Statistica 13.0 (StatSoft, Tulsa, OK, USA) software. The Mann–Whitney test was used to assess significance of differences. Results: Percentages of the cells with translocation of the NF-kB p65 subunit were higher in group 1 compared with group 2, particularly, for T-helpers (26.5[17; 29] vs 12.2[11;21]; p=0.003), cytotoxic T-cells (24.0[17;28] vs 11.5[7;15]; p=0.006), NK cells (45.0[34;53] vs 18.2[16;39]; p=0.014), Th17 cells (23.9[18;31] vs 14.3[12;21]; p=0.002), regulatory T cells (30.4[21;34] vs 17.4[16;22]; p=0.001) and activated T helpers (21.918;28] vs 11.4[11;17]; p=0.002). Conclusion: There were substantially increased percentages of activated cells in lymphocyte subsets (with the most pronounced increase for NK cells) of patients who developed an opacified graft compared to those who obtained a clear graft following re-keratoplasty. Assessment of percentages of the cells with translocation of the NF-kB p65 subunit for lymphocyte subsets provides valuable information for predicting graft rejection following re-keratoplasty

Diagnostic value of anti-GP2 antibodies determined in serum and coprofiltrates in children with inflammatory bowel disease

Inflammatory bowel diseases (IBD), such  as Crohn’s disease (CD) and  ulcerative colitis (UC), are characterized by chronically recurring inflammation of intestinal wall and are associated with a significant decrease in the  quality  of life. A spectrum of genetic  variants  associated with  Crohn’s disease  is described. Intestinal dysbiosis (DB)  may be the triggering factor of the disease. Glycoprotein 2 (GP2), the main protein of pancreatic zymogen  granules, is secreted  into the intestines with digestive enzymes.  Anti-GP2 antibodies were found in the serum of patients with CD.  The aim of the present  study was to investigate  the levels of anti-GP2 antibodies in serum  and feces of children with IBD  compared with the DB group.  Serums  and coprofiltrates from 110 children (64 boys and 46 girls) at the age of 12.3 (2.6-17.9) years were studied; 36 patients with CD, 30 patients with UC.  A comparison group consisted of 44 patients with DB. IgG and IgA antibodies against GP2 were tested with ELISA. Nonparametric statistics methods are applied, the results are presented as percentages and medians (Me (Q0.25-Q0.75)). The serum levels of anti-GP2 IgA antibodies were 9.97 (3.35-13.45) U/ml for the CD patients, 6.08 (2.71-14.26) U/ml for UC and 2. 94 (2.29-6.41) U/ml for DB. The levels of anti-GP2 IgG antibodies in serum were 6.16 (3.26-18.4) U/ml for CD, 5.26 (2.97-7.52) U/ml for UC, and for DB 5.23 (2.53-8.85) U/ml. The cut-off  threshold concentration for anti-GP2 IgG antibodies was 13.8 U/ml, with sensitivity of 63.2%, specificity 100%, and for IgA 5.63 U/ml, with sensitivity of 60.5% and specificity of 78.8%, thus being lower than the calculated cut-off  for adults (20 U/ml). The levels of anti-GP2 IgG in coprofiltrates in children of comparison group  were 1.99 (1.26-3.04) U/ml; in the  patients with CD, 23.5 (16.15-29.3) U/ml, and  in children with UC, 20.45 (13.63-25.5) units/ml (p < 0.001). The cut-off  value amounted 8.0 U/ml, with 100% sensitivity  and  100% specificity.  Concentrations of anti-GP2 IgA in coprofiltrates of patients with IBD  did not significantly  differ from DB patients. Moreover, the concentration of sIgA in the coprofiltrates of patients with IBD  was significantly  higher than  their level in DB group. The anti-GP2 IgA/sIgA  ratio was significantly lower in patients with CD (0.326 (0.23-0.512)), and UC (0.327 (0.205-0.435)), than in patients with DB (2.332 (1.575-3.523)) (p < 0.001);  the cut-off  level was 0.784, with a sensitivity of 97.7% and specificity  of 98.6%. It is discussed, whether fecal anti-GP2 IgA antibodies should  be considered as protective, supporting intestinal homeostasis, whereas anti-GP2 IgG antibodies are pathogenetically significant  for development of IBD.  Thus, using a non-invasive method for determining anti-GP2 antibodies in stool, when exceeding the cut-off for IgG, and reduction of IgA/sIgA ratio below the cut-off, one may differentiate IBD from DB with a similar symptoms at the onset of disease, with 100% sensitivity and 100% specificity

INDIСATORS OF THE LYMPHOCYTE SUBSETS AS EFFICICIENCY PREDICTORS OF THERAPY WITH INHIBITORS OF TNFα IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE

(IBD), who were for the first time treated with TNFα blocker (infliximab). Our aim was to determine prognostic informative value of the immunological parameters in order to assess the treatment efficiency. A comprehensive research included seventy children with IBD from 12 to 18 years old in the course of specific treatment (49 children with CD, 21 children with UC).The comparison group consisted of fifty healthy children of similar age who were subjected to a similar detailed examination. The patients were divided into two groups, depending on their therapeutic response following 1 year of biological therapy: the first group showed a persistent positive effect of the drug, and the second group exhibited only unstable effects of the treatment. We determined the contents of major and small subpopulations of peripheral blood lymphocytes before the first administration of infliximab. Immunophenotyping was performed by multicolor flow cytometry (FC 500), using the CD45, CD3, CD4, CD8, CD19, CD16, CD56, HLA-DR, CD5, CD161, CD127, CD25, and CD294 markers.We have revealed that the content of B lymphocytes was significantly reduced in children with unstable effects of therapy. By contrast, the B lymphocyte levels in children with persistent positive therapeutic effect did not differ from the comparison group. Analysis of the composition of the B lymphocyte profile showed an imbalance in the B1-to-B2 cell ratio, with decreased of B1 cell counts in IBD patients against the comparison group. In addition, the patients with unstable therapeutic effect showed a significant decrease in B2 cell numbers compared with a group with persistent effect and comparison group. The numbers of NK cells in IBD patients were found to be reduced against the comparison group. Assessment of T lymphocytes subsets revealed a number of features in the patients with minimal therapeutic effects, i.e., an increased level of activated T helper cells (CD4+CD25+CD127high) and Th17 lymphocytes (CD3+CD4+CD161+), as compared to children with stable effect of treatment and to the comparison group. Moreover, in children with minimal effects of therapy, the levels of Tregs within T-helper cell subsets were significantly higher than in the comparison group. By means of ROC analysis, we have identified most informative parameters for the groups with minimal versus persistent therapeutic effect, and showed a good quality for a discrimination model involving relative amount of Th17 cells, activated T helper cells and B lymphocytes. The number of Тh17 lymphocytes (% CD3+CD4+ lymphocytes) allowed to predict the effect of therapy with a TNFα blocker with high probability. The present study enables us to propose cellular immunity testing, as a promising tool for monitoring clinical state of IBD patients

Dynamics of T helper subpopulations in the critical period of severe injury in children

Severe mechanical injury is one of the main reasons behind children’s disability and mortality. Severe injury induces a complex host immune response to tissue injury, a parallel pro- and anti-inflammatory state, bearing an elevated risk for infectious complications (IC) and/or multiple organ failure (MOF). This study aimed to determine the informative immunological criteria of traumatic injury severity and prognosis outcome in children (severe injury group (SInj, ISS ≥ 16), n = 87; mild/moderate injury group (MInj, ISS < 16), n = 34) based on the assessment of absolute cell count (abs) and percentage of such T helper subpopulations as regulatory T lymphocytes – CD4+CD127lowCD25high(Treg), Th17 lymphocytes – CD4+CD161+ and CD4+CD127higtCD25high T cells(T127hi) in severe injury cases grouped by the outcome (favorable, n = 47; unfavorable, n = 40) and depending on IC (n = 16) and the development of MOF (n = 11) on the 1st, 3d , 5th, 7th, 14th day after injury. The control group was comprised of 80 apparently healthy children comparable in age and sex. An inverse relationship between severity of injury, degree of blood loss and outcome of injury was revealed with the abs of all Th populations, but for Th abs and Treg abs the most significant correlation was found (Spearman’s R ≤ -0,70, p < 0.00001). For SInj group, a pronounced decrease of Th abs, Treg abs, T127hi abs and Th17 abs, in the acute post-traumatic period with an increase to 14 days was revealed. The values of in the first day for indicators of patients with MInj group correspond to the values of control group and significantly differ from SInj group. There are different kinetics of percentage Th subpopulations in peripheral blood of children with severe injuries. The Th17%CD4+ and T127hi%CD4+ significant increase in 1st-3d  and 3d -7th days after injury respectively in comparation with сontrol and MInj groups. There were no differences between groups in terms of Treg%CD4+. The lower-level Treg abs in trauma patients admitted to the ICU is significantly associated with develop the infectious complications and outcome of trauma. The Th17 abs is significantly reduced in 3-7th days after the injury in the SInj group with MOF. The results of the study indicate that in children levels of Treg, T127hi and Th17 is significantly associated with severity of injury and may be used to predict outcome of trauma and assess the risk of IC and MOF

Evaluation of the functional activity of CD39 ectonucleotidase in regulatory T cells in children with inflammatory bowel diseases

In connection with the increasing incidence and prevalence of inflammatory bowel disease (IBD), the search for prognostic markers of the effectiveness of therapy is an urgent problem. An imbalance between Th17 lymphocytes and regulatory T cells (Treg) is a major defect in the immune system leading to IBD. Extracellular ATP produced during tissue damage, rebound pro-inflammatory effects, and activates Th17 cell differentiation. Ectonucleotidase CD39 catalyzes the dephosphorylation of ATP to AMP, followed by conversion to adenosine by CD73. CD39 is expressed in various cell types, including Treg. Aim – evaluate the functional activity of CD39+ in Treg in children with IBD using the luciferin-luciferase method.68 children with IBD were examined. Of these, 28 children were in remission, 40 were in exacerbation. The number of Tregs (CD4+CD25highCD127low) expressing CD39 was estimated by flow cytometry. The ATP concentration in supernatants and cells was determined using the luciferin-luciferase test. Results are presented as median (Me) and quartiles (Q0.25-Q0.75). The significance of differences between groups was assessed using the nonparametric Mann–Whitney U test.The relative number of CD39+Treg in patients in remission of IBD was significantly higher than in patients in a state of exacerbation. A decrease in ATP concentration under the influence of CD39+Treg in patients with IBD occurred immediately upon the addition of exogenous ATP. ATP in patients in remission decreased by 44.5% (Me 54.5 (41.5-65.9)), in patients in exacerbation – by 32.5% (Me 67.5 (59.7-71.3)). At the same time, in patients in remission, the decrease in the ATP content after 5 minutes of the reaction was significantly higher than in patients in the state of exacerbation (p = 0.01), after 30 minutes of the reaction, no significant difference was found. It was shown that samples with a smaller number of cells and a lower intensity of CD39 expression in Treg had a higher activity of CD39 ectonucleotidase.For efficient ATP hydrolysis, in addition to the amount of CD39 in Treg, their functional activity is important. The assessment of the catalytic activity of CD39 in Treg in patients with IBD is most informative in the first minutes after the addition of exogenous ATP. In patients in remission, the catalytic activity of CD39 in Treg was higher than in patients in a state of exacerbation

Features of parameters of cellular immune depending on the activity of foci of demyelination in children with multiple sclerosis

MS is a common disease of the central nervous system that leads to disability and reduced quality of life. The debut of disease in 3-5% of patients occurs in childhood and has a less favorable course compared to adults. MS is caused by the activation of autoreactive T cells in the breakdown of peripheral tolerance, which is normally controlled by regulatory T cells (Tregs). It is promising to study expression of CD39 and CD73 in Treg and Th17 populations to assess their suppressive activity. Aim is to evaluate content of major and minor lymphocyte populations and expression of CD39 and CD73 in CD4+ lymphocyte population in children with MS. 111 children with MS were examined, 66 with contrast-negative lesions on MRI (Group 1), 45 with contrast-positive lesions (Group 2). The comparison group consisted of 46 healthy children (Group 3). Content of T, B, NK lymphocytes, Treg (CD4+CD25highCD127low), Thact (CD4+CD25highCD127high), Th17 cells (CD3+CD4+CD161+); expression of CD39 and CD73 in Treg, Th17 and Thact was performed by flow cytometry. An increase in content of T helpers, a decrease in NK cells in patients in group 2 was revealed. An increase in number of Thact and Th17 lymphocytes was obtained in patients of both groups with MS. Number of Tregs in group 1 was significantly higher than in group 3. Ratio of cells expressing CD39 and CD73 in MS patients depended on lymphocyte population as well as in the group 3. The highest content of CD39+ cells was observed in Treg population, and the lowest in Thact population. For CD73 expression, on the contrary, the highest expression of CD73 was observed in Thact cells, the lowest in Treg. When comparing groups of patients, it was found that in patients of group 1, number of cells expressing CD39 ectonucleotidase was significantly increased, and number of supTh17 was comparable with group 3. In both groups of MS patients, an increase in CD73 counts in Treg, Thact and Th17 was observed. Thus, informative populations of lymphocytes (CD4+ cells, Treg, CD39+Treg, supTh17) have been identified, which can be used to monitor condition of children with multiple sclerosis

Nuclear transcription factor kB (NF-kB) activity in lymphocyte populations in children with Wilson-Konovalov disease

Wilson's disease (WD) is a rare hereditary disease caused by a deficiency of the ATF7B transporter. The accumulation of copper can cause damage to organs and cells, mainly the liver. Copper exposure can modulate cytokine synthesis through molecular and cellular signaling pathways, including the nuclear transcription factor NF-kB pathway. NF-kB is the main regulator of inflammation and cell death, acts as a central link between liver damage, fibrosis and hepatocellular carcinoma. An excess of NF-kB-dependent cytokine response stimulates inflammatory reactions, but excessive inhibition of NF-kB can negatively affect the viability of hepatocytes. Method of flow cytometry with visualization — Amnis ImageStreamX allows to evaluate the activity of NF-kB (% of activated cells in cell populations). The aim: to evaluate the activity of NF-kB in lymphocyte populations in children with WD disease. Immunophenotyping of lymphocytes and assessment of the level of translocation of NF-kB were performed in 52 children with WD and in 25 children of comparison group. The mass concentration of copper in daily urine was determined by atomic absorption method using the AAnalyst 800 spectrometer. In children with WD, the content of cells with NF-kB translocation varied from 5 to 90% depending on the lymphocyte population; the highest level was detected in B cells — 57.5 (37-68) %. A significant difference in distributions of the number of cells with NF-kB translocation between WD and healthy children was shown (F-criterion, p < 0.01). In most cases, children with WD are characterized by a decrease in the activity of NF-kB in populations of B cells (in 43% of cases), T helper cells (48%), T cytotoxic (44%) and Th17 lymphocytes (41%). In children with WD, the concentration of copper varied from 9.7 to 2582 mcg/day, Me = 616 (210-1173). A direct relationship was obtained between the copper content in urine and the level of translocation of NF-kB in B lymphocytes, r = 0.34, p = 0.016. The activity of the NF-kB correlates with biochemical markers of the severity of liver damage (ALT, AST, GGT) and with copper content in urine. The study of the NF-kB signaling pathway seems promising for a better understanding of the pathogenetic mechanisms of the formation of inflammation and liver fibrosis in children with WD

The features of power activity within mitochondrions of peripheral blood lymphocytes among in children and teenagers with severe atopic dermatitis

This article presents the findings gained on the metabolic exchange of peripheral blood lymphocytes in children and teenagers with severe atopic dermatitis in the acute phase. It has been revealed that in severe atopic dermatitis accompanied by a decreased metabolic exchange (succinate dehydrogenase NADH-D enzymes activity,) lymphocytes demonstrate a depletion of energetic options (а-glycerophosphate dehydrogenase enzyme activity) used as the most economical way of obtaining power for all metabolic processes in cells.В статье представлены результаты исследования метаболического обмена лимфоцитов периферической крови у детей и подростков с тяжелым течением атопического дерматита в период обострения заболевания. Выявлено, что при тяжелом течении атопического дерматита на фоне снижения биоэнергетического обмена (активность фермента сукцинатдегидрогеназы, НАДН-диафоразы) в лимфоцитах наблюдается истощение энергетических возможностей (активность фермента а-глицерофосфатдегидрогеназа) наиболее экономичного пути получения питания для всех метаболических процессов, происходящих в клетках

Tumor inflating lymphocytes. Purification, expanding and cytotoxicity analisys on primary tumor cultures

Background. Tumor Infiltrating Lymphocytes (TILs) is one of the most promising sources of autologous cytotoxic T-cells for adoptive immunotherapy, which has already shown high efficiency in the treatment of metastatic melanoma. However, the isolation of TILs from solid tumors is technically difficult. A suppressive tumor microenvironment, in particular, a high level of expression of check-point inhibitors PD-1 CTLA4, tissue hypoxia and other factors cause that T cells isolated from the tumor do not proliferate well and do not exhibit cytotoxic properties. Aims. In this study, we isolated TILs from surgical material obtained by resection of solid tumors (primary and metastatic adenocarcinomas of various localization, melanoma, glioblastoma), studied their population composition and developed protocols for the purification expanding, and activation of CD4+, CD8+ cytotoxic antitumor lymphocytes. Methods. An urgent task is the activation of TILs, turning off immunosuppressive mechanisms and increasing their antitumor cytotoxic activity. Various approaches are used for this: activation by a cocktail of cytokines and antibodies, editing the lymphocyte genome by knocking out suppressor genes or, conversely, transduction of activating genes, coincubation with feeder cells, etc. Cells were obtained from samples of resected tumors in 16 patients; in each case we obtain an autologous pair: the primary tumor culture and the TILs culture. Results. We could isolate viable lymphocytes in 100% of cases. Isolated TILs were successfully expanded in our specialized medium using various combinations of IL-2, IL-15, IL-21, IL-7, anti-CD3 and anti-CD28. Immunophenotyping showed that the obtained TILs are a heterogeneous mixture of CD4+, CD8+ cells containing populations of CD3+CD8+CD45+(CTL) CD3+CD4+CD45+ (T-helpers), CD4+CD25+CD127- (Т-regulatory cells), CD3-CD56+CD45+ (NK-cells), CD3+CD56+CD45+ (Т-NK-cells). The initial cultures of TILs were also characterized by a high level of PD1 expression, indicating their low antitumor cytotoxicity. Using different protocols of isolation, expansion, and activation, we obtained a cell preparation containing 80% of CD8+ PD-1- activated TILs in an amount sufficient for adoptive therapy (500106 or more). An in vitro study of the cytotoxicity of obtained TILs in primary cultures of homologous tumors using RTCA Icelligence showed high cytotoxicity, providing almost 100% tumor cell death. Conclusion. Our developed protocol for the production and activation of TILs can be recommended for the phase III clinical trials of adoptive immunotherapy of recurrent, highly metastatic solid tumors

EXPRESSION OF CYTOKINES/CHEMOKINE IN PATIENTS UNDERGOING FEMTOSECOND LASER-ASSISTED CATARACT SURGERY VS. CONVENTIONAL PHACOEMULSIFICATION WITH DIFFERENT PREOPERATIVE NSAIDS PRETREATMENT

Purpose.  To  perform  a  comparative  analysis  of  11  cytokines concentration after femtosecond laser-assisted phacoemulsification (FLACS) and  before  conventional  phacoemulsification  (CPE)  with  preoperative instillations of various nonsteroidal anti-inflammatory drugs (NSAID).Material and methods. Prospective single center study was carried out. Aqueous humor samples were obtained in 24 patients immediately after FLACS or before CPE. Preoperatively in the first and second groups(FLACS) the patients were administered (QD and QID) with either topical bromfenac 0.09% (group I, 12 eyes) or indomethacin 0.1% (group II, 12 eyes). In two control (CPE) groups the same regimen of instillations of NSAIDs was used. The samples were aspirated from the anterior chamber through paracenthesis right at the beginning of the surgery. The analysis of cytokines was performed with the FlowCytomics FC 500 Pro 3.0 Software (Bender MedSystems).Results. An increase of IL-6 in the group I was revealed as compared with the group III, p<0.05. In the analysis of IL-6 in the group II, there were no statistically significant differences compared to the group IV. The construction of correlation networks with the establishment of a correlation coefficient threshold >0.7, revealed the absence of correlation dependence of IL-6 in relation to other cytokines in the group I. In the group II, there was the correlation relationship between IL-6 and the network of cytokines. In the groups III and IV the IL-6 had no correlation to cytokine network.Conclusion. NSAIDs may not be effective in neutralizing the activation of IL-6 in some cases. In particular, it was found that indomethacin 0.1% compared with bromfenac 0.09% has the lowest activity in neutralizing IL-6 and switching it off from the correlation network at a threshold of the correlation coefficient of >0.7