Evaluation of the GenoType® NTM DR for subspecies identification and determination of drug resistance in clinical M. abscessus isolates

Introduction: A new line probe assay, the GenoType® NTM DR, has been developed for subspecies identification and detection of resistance to macrolides and aminoglycosides in clinical Mycobacterium abscessus isolates. We studied the performance of the test compared to DNA sequencing and phenotypic drug susceptibility testing (pDST). Methods: 49 clinical M. abscessus isolates collected between 2015 and 2016 were identified to the subspecies level and analysed for erm(41) genotype, rrl and rrs gene mutations by Sanger sequencing. Broth microdilution was performed for pDST of clarithromycin and amikacin. The results were compared to those of the GenoType® NTM DR assay. Discordant results were further analysed by repeat pDST and whole genome sequencing (WGS). Results: 35 isolates were identified as M. abscessus subsp. abscessus, 6 as M. abscessus subsp. bolletii, and 8 as M. abscessus subsp. massiliense based on rpoB sequences. Concordance of GenoType® NTM DR results with Sanger sequencing was 92% forsubspecies identification and 100% for erm(41), rrl, and rrs genotypes, respectively. GenoType® NTM DR and pDST results matched in 98% for clarithromycin resistance and in 96% for amikacin resistance when repeat pDST results were taken into account. Conclusion: The new GenoType® NTM DR assay is a valuable test for subspecies identification of M. abscessus isolates and detection of defined mutations conferring resistance to amikacin and clarithromycin. Discrepancies between the line probe assay and pDST mainly relate to variations in phenotypic test results

Identification of myocardial diffuse fibrosis by 11 heartbeat MOLLI T1 mapping: averaging to improve precision and correlation with collagen volume fraction

Objectives: Our objectives involved identifying whether repeated averaging in basal and mid left ventricular myocardial levels improves precision and correlation with collagen volume fraction for 11 heartbeat MOLLI T1 mapping versus assessment at a single ventricular level. Materials and methods: For assessment of T1 mapping precision, a cohort of 15 healthy volunteers underwent two CMR scans on separate days using an 11 heartbeat MOLLI with a 5(3)3 beat scheme to measure native T1 and a 4(1)3(1)2 beat post-contrast scheme to measure post-contrast T1, allowing calculation of partition coefficient and ECV. To assess correlation of T1 mapping with collagen volume fraction, a separate cohort of ten aortic stenosis patients scheduled to undergo surgery underwent one CMR scan with this 11 heartbeat MOLLI scheme, followed by intraoperative tru-cut myocardial biopsy. Six models of myocardial diffuse fibrosis assessment were established with incremental inclusion of imaging by averaging of the basal and mid-myocardial left ventricular levels, and each model was assessed for precision and correlation with collagen volume fraction. Results: A model using 11 heart beat MOLLI imaging of two basal and two mid ventricular level averaged T1 maps provided improved precision (Intraclass correlation 0.93 vs 0.84) and correlation with histology (R2 = 0.83 vs 0.36) for diffuse fibrosis compared to a single mid-ventricular level alone. ECV was more precise and correlated better than native T1 mapping. Conclusion: T1 mapping sequences with repeated averaging could be considered for applications of 11 heartbeat MOLLI, especially when small changes in native T1/ECV might affect clinical management

Epigenomic Profiling of Human CD4+ T Cells Supports a Linear Differentiation Model and Highlights Molecular Regulators of Memory Development

SummaryThe impact of epigenetics on the differentiation of memory T (Tmem) cells is poorly defined. We generated deep epigenomes comprising genome-wide profiles of DNA methylation, histone modifications, DNA accessibility, and coding and non-coding RNA expression in naive, central-, effector-, and terminally differentiated CD45RA+ CD4+ Tmem cells from blood and CD69+ Tmem cells from bone marrow (BM-Tmem). We observed a progressive and proliferation-associated global loss of DNA methylation in heterochromatic parts of the genome during Tmem cell differentiation. Furthermore, distinct gradually changing signatures in the epigenome and the transcriptome supported a linear model of memory development in circulating T cells, while tissue-resident BM-Tmem branched off with a unique epigenetic profile. Integrative analyses identified candidate master regulators of Tmem cell differentiation, including the transcription factor FOXP1. This study highlights the importance of epigenomic changes for Tmem cell biology and demonstrates the value of epigenetic data for the identification of lineage regulators