Modulation der Genexpression von Escherichia coli O157:H7 durch Norfloxacin

Shiga Toxin produzierende Escherichia coli (STEC) sind wichtige Erreger von Lebensmittelinfektionen und gelten als Hauptverursacher für die Ausbildung einer hämorrhagischen Colitis und dem lebensbedrohlichen hämolytisch-urämischen Syndrom. Als Hauptvirulenzfaktor und wichtigstes Charakteristikum der STEC wird die Fähigkeit angesehen, Shiga Toxine (Stx) zu produzieren. Die genetische Information für deren Produktion ist im Genom lambdoider Prophagen kodiert. Eine Antibiotikatherapie bei STEC-assoziierten Infektionen wird sehr kontrovers diskutiert, da sowohl die Produktion der Stx als auch die Freisetzung der Bakteriophagen in vitro durch antibiotisch wirkende Substanzen stimuliert werden kann. Der enterohämorrhagische E. coli O157:H7 Stamm EDL933 beherbergt insgesamt 18 lambdoide Prophagen und prophagenähnliche Elemente, darunter den Stx1-kodierenden Phagen CP-933V und den Stx2-kodierenden Phagen BP-933W. Ziel der vorliegenden Arbeit war es, den Einfluss des Gyrasehemmers Norfloxacin auf das Gesamttranskriptom von EDL933 mit Hilfe der DNA-Microarraytechnologie und unter Verwendung des MWG E. coli O157 Arrays umfassend zu untersuchen und insbesondere die Expression der Prophagengene zu analysieren. Hierfür wurde der E. coli O157:H7 Stamm EDL933 mit 200 ng/ml Norfloxacin inkubiert, Gesamt-RNA isoliert und diese mittels reverser Transkription in cDNA synthetisiert, wobei ein Einbau von fluoreszenzmarkierten Nukleotiden erfolgte. Diese cDNA wurde mit den auf dem E. coli O157 Array befindlichen Oligonukleotiden hybridisiert. Die Auswertung der Fluoreszenzintensitäten ermöglicht eine Analyse der Genexpression. Infolge der Induktion von EDL933 mit 200 ng/ml Norfloxacin zeigten 118 Spots eine Hochregulation und 122 eine Deregulation von Genen an. Bei genauerer Betrachtung resultierte auf Grund der Inkubation mit Norfloxacin eine erhöhte Expression von 52 Genen der Stx-kodierenden Phagen CP-933V und BP-933W. Insbesondere erfolgte eine erhöhte Regulation von Genen der späten Region des BP-933W. Das stxA2-Gen wurde dabei im Vergleich zur nicht-induzierten Kultur 158-fach stärker exprimiert. Im Falle des Stx1-Phagen wiesen nur einige Gene der frühen Region eine gesteigerte Genaktivität auf. Auffallend war die Hochregulation einzelner Gene der nicht Stx-kodierenden Phagen. Gene des Primärstoffwechsels, u. a. Gene der Aminosäurebiosynthese, des Energiehaushaltes und der Zellteilung zeigten eine verminderte Genaktivität nach Induktion. Diese Ergebnisse weisen darauf hin, dass die verwendete Konzentration von Norfloxacin große Auswirkungen auf das Gesamttranskriptom des untersuchten Stammes haben und insbesondere die Genexpression von zehn im Genom des EDL933 befindlichen Prophagen erhöht wurde. Die durch die Microarrayversuche erhaltenen Expressionsraten wurden durch Quantifizierung der cDNA mittels RT Real-Time PCR Untersuchungen überprüft. Zusammenfassend ist festzustellen, dass Norfloxacin neben der antibiotischen Wirkung in der hier verwendeten geringen Konzentration multiple Effekte auf E. coli O157:H7 ausübt und die Auswirkungen in Zukunft noch detaillierter untersucht werden müssen. Die DNA-Microarraytechnologie und der kommerziell erhältliche E. coli O157 Array ermöglichen diese umfassenden Analyse des Transkriptionsprofils. Im Rahmen dieser Arbeit konnte diese Technologie für Untersuchungen der Genexpression von E. coli O157 etabliert und validiert werden.Infection with Shiga toxin producing Escherichia coli (STEC) is a serious cause of bloody diarrhea and sporadic cases and outbreaks of food-related diseases such hemorrhagic colitis and the hemolytic uremic syndrome (HUS) worldwide. The use of antibiotics in therapy of STEC-associated diseases has been discussed controversially. Release of phage-encoded Shiga toxins is the major virulence factor of enterhemorrhagic Escherichia coli (EHEC). The genome of the EHEC strain E. coli O157:H7 EDL933 contains 18 prophages or prophages elements, including the Stx1- and Stx2-encoding phages CP-933V and BP-933W. Stx-production and Stx-prophage induction can be stimulated by certain antibiotics, e.g. mitomycinC or UV light. The aim of this study was to investigate the influence of a low concentration of the gyrase inhibitor norfloxacin on the whole transcriptom of E. coli O157:H7 strain EDL933 and particularly on the gene expression of prophages using the DNA-microarraytechnology and the commercial available MWG E. coli O157 Array. To determine this, E. coli O157:H7 cultures were incubated with 200 ng/ml norfloxacin. Total RNA was isolated and labelled with fluorescence dyes during reverse transcription. Following this, the labelled cDNA was hybridized with the commercial E. coli O157 Arrays and the fluorescence intensities were measured, analysed and evaluated with appropriate software. Results of this study have indicated that a low concentration of norfloxacin have profound effects on the trancriptome of E. coli O157:H7. Under the conditions applied (200 ng/ml norfloxacin) and an incubation time of 120 minutes, 118 spots indicated a transcriptional upregulation and 122 spots a transcriptional downregulation of E. coli O157:H7 genes present on the array. In detail, 85 spots could be ascribed to EDL933 phage genes. Fifty-two of them could be assigned to the Shiga toxin encoding phages CP-933V and BP-933W, the others belonged to the non-Stx encoding phages or prophages elements existing in the EDL933 genome. Conspicuous, genes present in the late region of the BP-933W prophage were induced most strongly, up to 158-fold in the case of stxA2. Only some genes present in the early region of the Stx1 encoding phage CP-933V were induced upon induction with norfloxacin. Notably, only some genes of the non-Stx phages of EDL933 appeared to be induced after induction. The additional upregulated genes were related to recombination and stress functions and to E. coli O157:H7 RIMD0509952 genes. The majority of downregulated genes belonging to primary metabolism, such as amino acid biosynthesis, cell division and energy metabolism. In conclusion, an induction of E. coli O157:H7 strain EDL933 with 200 ng/ml norfloxacin has profound effects on the transcriptome of E. coli O157:H7, in particular on the global gene expression of more then ten prophages. The DNA-microarray technology and especially the E. coli O157 Array offer a modern tool for analysis of transcription profiles of the serious pathogen EHEC O157 in response to stress, e.g. antibiotics. In the context of this work, the DNA-microarraytechnology could be established and validated to provide the opportunity for further studies about the global effects on the whole transcriptome of E. coli O157

Case Report: ANXA2 Associated Life-Threatening Coagulopathy With Hyperfibrinolysis in a Patient With Non-APL Acute Myeloid Leukemia

Patients with acute promyelocytic leukemia (APL) often present with potentially lifethreatening hemorrhagic diathesis. The underlying pathomechanisms of APLassociated coagulopathy are complex. However, two pathways considered to be APLspecific had been identified: 1) annexin A2 (ANXA2)-associated hyperfibrinolysis and 2) podoplanin (PDPN)-mediated platelet activation and aggregation. In contrast, since disseminated intravascular coagulation (DIC) is far less frequent in patients with non- APL acute myeloid leukemia (AML), the pathophysiology of AML-associated hemorrhagic disorders is not well understood. Furthermore, the potential threat of coagulopathy in non- APL AML patients may be underestimated. Herein, we report a patient with non-APL AML presenting with severe coagulopathy with hyperfibrinolysis. Since his clinical course resembled a prototypical APL-associated hemorrhagic disorder, we hypothesized pathophysiological similarities. Performing multiparametric flow cytometry (MFC) and immunofluorescence imaging (IF) studies, we found the patient’s bone-marrow mononuclear cells (BM-MNC) to express ANXA2 - a biomarker previously thought to be APL-specific. In addition, whole-exome sequencing (WES) on sorted BM-MNC (leukemiaassociated immunophenotype (LAIP)1: ANXAlo, LAIP2: ANXAhi) demonstrated high intratumor heterogeneity. Since ANXA2 regulation is not well understood, further research to determine the coagulopathy-initiating events in AML and APL is indicated. Moreover, ANXA2 and PDPN MFC assessment as a tool to determine the risk of life-threatening DIC in AML and APL patients should be evaluated

Postcoital Bioavailability and Antiviral Activity of 0.5% PRO 2000 Gel: Implications for Future Microbicide Clinical Trials

The pharmacokinetics and pharmacodynamics of vaginal microbicides are typically assessed among sexually abstinent women. However, the physical act of sex may modulate gel distribution, and preclinical studies demonstrate seminal plasma interferes with the antiviral activity of several microbicides. This study compared the biological activity and concentration of PRO 2000 in cervicovaginal lavage (CVL) collected in the absence or following coitus.CVL samples were collected from ten heterosexual couples at baseline, after sex, after a single dose of 0.5% PRO 2000 gel and sex, and after gel application without sex. The impact of CVL on HIV-1 infection of TZM-bl cells and HSV-2 infection of CaSki cells was monitored by luciferase and plaque assay, respectively. PRO 2000 concentrations were measured by fluorescence.CVL collected after PRO 2000 application significantly inhibited HIV-1 and HSV-2 (p = 0.01). However, the antiviral activity was reduced following sex and no significant protective effect was observed in postcoital CVL obtained in the presence compared to the absence of PRO 2000 for HIV (p = 0.45) or HSV-2 (p = 0.56). Less PRO 2000 was recovered in postcoital CVL, which, in conjunction with interference by seminal plasma, may have contributed to lower antiviral activity.Postcoital responses to PRO 2000 differ from precoital measures and the results obtained may provide insights into the clinical trial findings in which there was no significant protection against HIV-1 or HSV-2. Postcoital studies should be incorporated into clinical studies before embarking on large-scale efficacy trials

Exploiting the glioblastoma peptidome to discover novel tumour-associated antigens for immunotherapy

Peptides presented at the cell surface reflect the protein content of the cell; those on HLA class I molecules comprise the critical peptidome elements interacting with CD8 T lymphocytes. We hypothesize that peptidomes from ex vivo tumour samples encompass immunogenic tumour antigens. Here, we uncover >6000 HLA-bound peptides from HLA-A*02+ glioblastoma, of which over 3000 were restricted by HLA-A*02. We prioritized in-depth investigation of 10 glioblastoma-associated antigens based on high expression in tumours, very low or absent expression in healthy tissues, implication in gliomagenesis and immunogenicity. Patients with glioblastoma showed no T cell tolerance to these peptides. Moreover, we demonstrated specific lysis of tumour cells by patients' CD8+ T cells in vitro. In vivo, glioblastoma-specific CD8+ T cells were present at the tumour site. Overall, our data show the physiological relevance of the peptidome approach and provide a critical advance for designing a rational glioblastoma immunotherapy. The peptides identified in our study are currently being tested as a multipeptide vaccine (IMA950) in patients with glioblastom

A Randomized Trial to Assess Anti-HIV Activity in Female Genital Tract Secretions and Soluble Mucosal Immunity Following Application of 1% Tenofovir Gel

Preclinical and early phase clinical microbicide studies have not consistently predicted the outcome of efficacy trials. To address this gap, candidate biomarkers of microbicide pharmacodynamics and safety were evaluated in a double-blind, placebo-controlled trial of tenofovir gel, the first microbicide to demonstrate significant protection against HIV acquisition.30 women were randomized to apply a single daily dose of tenofovir or placebo gel for 14 consecutive days. Anti-HIV activity was measured in cervicovaginal lavage (CVL) on Days 0, 3, 7, 14 and 21 by luciferase assay as a surrogate marker of pharmacodynamics. Endogenous activity against E. coli and HSV-2 and concentrations of immune mediators were quantified in CVL as candidate biomarkers of safety. Tenofovir levels were measured in CVL and blood.A significant increase in anti-HIV activity was detected in CVL from women who applied tenofovir gel compared to their endogenous anti-HIV activity in genital tract secretions on Day 0 and compared to activity in CVL from women in the placebo group. The activity correlated significantly with CVL concentration of tenofovir (r = 0.6, p<0.001) and fit a sigmoid E(max) pharmacodynamic model. Anti-HIV activity in CVL from women who applied tenofovir persisted when virus was introduced in semen, whereas endogenous anti-HIV activity decreased. Tenofovir did not trigger an inflammatory response or induce sustained loss in endogenous antimicrobial activity or immune mediators.Tenofovir gel had no deleterious impact on soluble mucosal immunity. The increased anti-HIV activity in CVL, which persisted in the presence of semen and correlated with tenofovir concentration, is consistent with the efficacy observed in a recent clinical trial. These results promote quantified CVL anti-HIV activity as a surrogate of tissue pharmacodynamics and as a potential biomarker of adherence to product. This simple, feasible and inexpensive bioassay may promote the development of models more predictive of microbicide efficacy.ClinicalTrials.gov NCT00594373

Current laboratory and clinical practices in reporting and interpreting anti?nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey

Background: The International Consensus on Antinuclear Antibody (ANA) Patterns (ICAP) has recently proposed nomenclature in order to harmonize ANA indirect immunofluorescence (IIF) pattern reporting. ICAP distinguishes competent-level from expert-level patterns. A survey was organized to evaluate reporting, familiarity, and considered clinical value of ANA IIF patterns. Methods: Two surveys were distributed by European Autoimmunity Standardization Initiative (EASI) working groups, the International Consensus on ANA Patterns (ICAP) and UK NEQAS to laboratory professionals and clinicians. Results: 438 laboratory professionals and 248 clinicians from 67 countries responded. Except for dense fine speckled (DFS), the nuclear competent patterns were reported by>85% of the laboratories. Except for rods and rings, the cytoplasmic competent patterns were reported by>72% of laboratories. Cytoplasmic IIF staining was considered ANA positive by 55% of clinicians and 62% of laboratory professionals, with geographical and expertise-related differences. Quantification of fluorescence intensity was considered clinically relevant for nuclear patterns, but less so for cytoplasmic and mitotic patterns. Combining IIF with specific extractable nuclear antigens (ENA)/dsDNA antibody testing was considered most informative. Of the nuclear competent patterns, the centromere and homogeneous pattern obtained the highest scores for clinical relevance and the DFS pattern the lowest. Of the cytoplasmic patterns, the reticular/mitochondria-like pattern obtained the highest scores for clinical relevance and the polar/Golgi-like and rods and rings patterns the lowest. Conclusion: This survey confirms that the major nuclear and cytoplasmic ANA IIF patterns are considered clinically important. There is no unanimity on classifying DFS, rods and rings and polar/Golgi-like as a competent pattern and on reporting cytoplasmic patterns as ANA IIF positive

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment