Flow Cytometric Measurements Research Articles

Low Target Antigen Expression Mediates Resistance to BCMA CAR T Cell Therapy

Introduction: BCMA-targeted CAR T cell therapies have shown promising responses, but many patients have residual disease post therapy, and relapses are common. Prior studies with CD19-targeted CAR T cells have shown that antigen density is an important determinant of response, with CARs requiring several hundred (Mansilla-Soto et al. Nat Med 2021) to a few thousand (Spiegel et al. Nat Med 2021) target molecules per cell for effective tumor recognition and control. Methods: To determine how antigen levels affect response to BCMA-directed CAR T-cell therapy, we performed quantitative flow cytometric measurements of BCMA antibody binding capacity (ABC) on fresh tumor samples from patients with rel/refractory multiple myeloma (RRMM), including 27 patients treated with idecabtagene vicleucel or ciltacabtagene autoleucel. ABC of GPRC5d was measured as control. To model the impact of antigen levels on CAR T cell response, we generated CRISPR-Cas9 edited leukemia (NALM6) and myeloma (MM1s) clones with varying levels of CD19 and BCMA antigen expression, respectively, and quantitatively assessed CAR T cell function against these target antigen-titrated lines in vitro and in vivo. Results: Antigen levels were measured in a cohort of 32 patients with RRMM with a median of 6 (range 3-12) prior lines of therapy, including seven patients previously treated with BCMA targeted antibody-drug conjugates. Median BCMA ABC was 670 mol/cell (range undetectable - 2460 mol/cell), consistent with prior estimates (Salem et al. Leuk Res 2018). Among patients treated with commercial BCMA-targeted CAR T-cell therapy (n=27), median BCMA expression was 670 (IQR 380-850) mol/cell prior to treatment. At the time of measurable residual disease or progression, median antigen abundance had decreased to 390 (IQR 290-490) mol/cell (15 patients, p = 0.011). The majority of relapsed patients displayed low-level detectable BCMA. Expression of control antigen GPRC5d was unchanged pre- and post-treatment. In vitro modeling showed that CAR T cell tumor lysis and cytokine production (IFNγ, IL-2) were gradually impaired as antigen levels decreased from 2000 to 200 mol/cell, and were absent at < 50 mol/cell. In an in vivo xenograft model, BCMA-directed CAR T cells cured an unmodified MM1s line expressing > 5,000 BCMA mol/cell, whereas animals bearing an MM1s.13 antigen low cell line expressing 600 (+/- 150) mol/cell initially controlled tumor but relapsed by day 40. Conclusion: BCMA expression in patients with RRMM is lower than CD19 expression typically seen in patients with B cell malignancies. Furthermore, while complete loss of BCMA after CAR T cell therapy is uncommon, resistant or relapsed disease frequently expresses low levels of antigen. In vitro and in vivo modeling show that these levels are below the threshold required for optimal CAR T cell function. These data suggest that low antigen expression may be an important mechanism of relapse in BCMA CAR T cell therapy for multiple myeloma.

Subclinical hypothyroidism in pregnancy – assessment of offspring thyroid status and mitochondrial robustness to stress

Subclinical hypothyroidism’s clinical implications on pregnancy are controversial. Consequently, thyrotropin (TSH) cutoff-values for pregnancy are continuously a subject for debate. In subclinical hypothyroidism, altered levels of thyroid hormones may affect mitochondrial function. Objectives were i) to analyze thyroid hormone levels in offspring of women with and without subclinical hypothyroidism ii) to analyze mitochondrial “robustness” in terms of MTG/TMRM ratio in pregnant women and their offspring in relation to thyroid function and iii) to perform differentiate analyses on different TSH thresholds to determine the importance of cutoff-values to results. Pregnant women were included by blood collections prior to a planned cesarean section, and cord samples were collected after delivery. Thyroid status (analyzed by Siemens Healthcare Diagnostics by an electrochemical luminescent immunoassay based on LOCI-technology) grouped the women and their offspring in euthyroid or subclinical hypothyroid, with groups established from previous recommended third-trimester cutoff-value (TSH > 3.0 mIU/L) and the recently recommended cutoff-value in Denmark (TSH > 3.7 mIU/L). Flow cytometric measurements of mitochondrial function in mononuclear blood cells with the fluorophores TetraMethylRhodamine Methyl Ester (TMRM) and Mitotracker Green (MTG) were used to evaluate mitochondrial robustness as the MTG/TMRM ratio. No significant differences in mitochondrial robustness between euthyroid and subclinical hypothyroid cohorts were observed, irrespective of TSH-cutoff applied. Maternal and cord MTG/TMRM ratios were positively correlated. Cord-TSH was elevated in subclinical hypothyroid offspring, independent of TSH cutoff applied. Cord-TSH was associated with maternal TSH-level, maternal smoking and cord arterial-pH.

Acetone extracts of Berberis vulgaris and Cornus mas L. induce apoptosis in MCF-7 breast cancer cells.

This study aimed to determine the proliferation and apoptotic effects of extracts from Cornus mas L. and Berberis vulgaris fruits on human breast cancer cells (MCF-7). The Cornus mas L. and Berberis vulgaris fruits, which constitute the herbal material of the study, were turned into 80% acetone extract after washing. The total phenolic content in Berberis vulgaris fruit extracts was determined calorimetrically using Folin-Ciocalteu reagent. The spectrophotometric method was used to determine the total flavonoid amount of the extracts. In order to measure the antioxidant capacity of Cornus mas L. and Berberis vulgaris fruits and extracts, DPPH Radical Scavenging Power test and Cu (II) ion reducing antioxidant capacity method were applied. Cell viability rates were determined by the XTT method. Flow cytometric measurement was performed to examine the apoptotic role of the extracts in the cell by using the Annexin-V/7-AAD commercial kit. According to the data, Berberis vulgaris fruit extract appeared more effective on MCF-7 breast cancer cells in both 24 and 48 hours of exposure. Analyses made to examine the phenolic component and antioxidant capacity properties of the fruits used in the study and the results we encountered when we exposed the cell were found to be compatible with each other. Annexin-V/7-AAD method showed that the apoptotic effects of the extracts in 48 hour exposures were more effective. It has been determined that Cornus mas L. and Berberis vulgaris fruits, which are rich in phenolic components with high flavonoid content and high antioxidant capacities, support the apoptosis of cancer cells.

Lymphoma of Nervous System or the Great Imitator in Neurology

Background: Lymphoma of the central nervous system (CNS), both primary and secondary, represents a very rare part of patients with non-Hodgkin lymphoma. Methods: Exams included a neurological exam, laboratory blood tests, МRI, biopsy, and electromyography. Results: Three different clinical cases of patients with lymphoma of the nervous system are presented. The first patient is a 44-year-old male admitted to the emergency room because of neck stiffness, with MRI data for a tumour in the left cavernous sinus area. Biopsy was performed 3 months prior to hospitalisation, showing connective tissue, partially hyalinised. Lumbar tap was performed to exclude CNS infection. Cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis, atypical cells in different phases of mitosis, and the result did not confirm lymphocytic choriomeningitis. Flow cytometric measurement (FCM) of CSF led to the diagnosis of T-lymphoblastic lymphoma of CNS. The second patient is a 50-year-old female hospitalised in the authors’ neurological department because of lower limb weakness and decreased sensation, dysphagia, and facial nerve palsy. Brain MRI showed no abnormal lesions. Guillain–Barré syndrome was considered after performing electromyography and electroneurography. CSF showed lymphocytic pleocytosis and 47% of them were atypical. FCM of CSF helped the authors diagnose the patient with B-lymphoblastic lymphoma. The third case presents a 63-year-old male with right sided hemiparesis and progressive cognitive impairment. Previously performed CTs and MRIs of the brain showed both hemispheres and left cerebellar peduncle diffuse lesions. Ischaemic stroke, tumour, and CNS infectious disease were considered. Most of these were excluded because CSF showed no pathological findings. Brain tissue biopsy of one of the lesions was performed, and the patient was diagnosed with diffuse large B cell lymphoma. Conclusion: Lymphoma of the CNS is rare disease. Differential diagnoses include different conditions. FCM of CSF and biopsy could be useful in complicated patients and unknown diagnosis affecting the CNS.

Two palladium (II) complexes derived from halogen-substituted Schiff bases and 2-picolylamine induce parthanatos-type cell death in sensitive and multi-drug resistant CCRF-CEM leukemia cells

The use of cisplatin and its derivatives in cancer treatment triggered the interest in metal-containing complexes as potential novel anticancer agents. Palladium (II)-based complexes have been synthesized in recent years with promising antitumor activity. Previously, we described the synthesis and cytotoxicity of palladium (II) complexes containing halogen-substituted Schiff bases and 2-picolylamine. Here, we selected two palladium (II) complexes with double chlorine-substitution or double iodine-substitution that displayed the best cytotoxicity in drug-sensitive CCRF-CEM and multidrug-resistant CEM/ADR5000 leukemia cells for further biological investigation. Surprisingly, these compounds did not significantly induce apoptotic cell death. This study aims to reveal the major mode of cell death of these two palladium (II) complexes. We performed annexin V-FITC/PI staining and flow cytometric mitochondrial membrane potential measurement followed by western blotting, immunofluorescence microscopy, and alkaline single cell electrophoresis (comet assay). J4 and J6 still induced neither apoptosis nor necrosis in both leukemia cell lines. They also insufficiently induced autophagy as evidenced by Beclin and p62 detection in western blotting. Interestingly, J4 and J6 induced a novel mode of cell death (parthanatos) as mainly demonstrated in CCRF-CEM cells by hyper-activation of poly(ADP-ribose) polymerase 1 (PARP) and poly(ADP-ribose) (PAR) using western blotting, flow cytometric measurement of mitochondrial membrane potential collapse, nuclear translocation of apoptosis-inducing factor (AIF) by immunofluorescence microscopy, and DNA damage by alkaline single cell electrophoresis (comet assay). AIF translocation was also observed in CEM/ADR5000 cells. Thus, parthanatos was the predominant mode of cell death induced by J4 and J6, which explains the high cytotoxicity in CCRF-CEM and CEM/ADR5000 cells. J4 and J6 may be interesting drug candidates and deserve further investigations to overcome resistance of tumors against apoptosis. This study will promote the design of further novel palladium (II)-based complexes as chemotherapeutic agents.

Characterisation of a Spontaneous Mutant of Lemna gibba G3 (Lemnaceae).

A spontaneous mutant of the duckweed Lemna gibba clone no. 7796 (known as strain G3, WT) was discovered. In this mutant clone, L. gibba clone no. 9602 (mt), the morphological parameters (frond length, frond width, root length, root diameter) indicated an enlarged size. A change in the frond shape was indicated by the decreased frond length/width ratio, which could have taxonomic consequences. Several different cell types in both the frond and the root were also enlarged. Flow cytometric measurements disclosed the genome size of the WT as 557 Mbp/1C and that of the mt strain as 1153 Mbp/1C. This represents the results of polyploidisation of a diploid clone to a tetraploid one. The mutant clone flowered under the influence of long day-treatment in half-strength Hutner's medium in striking contrast to the diploid WT. Low concentration of salicylic acid (<1 µM) induced flowering in the tetraploid mutant but not in the diploid plants. The transcript levels of nuclear-encoded genes of the photosynthetic apparatus (CAB, RBCS) showed higher abundance in light and less dramatic decline in darkness in the mt than in WT, while this was not the case with plastid-encoded genes (RBCL, PSAA, PSBA, PSBC).

Role of SHP2 (PTPN11) in glycoprotein VI-dependent thrombus formation: Improved platelet responsiveness by the allosteric drug SHP099 in Noonan syndrome patients

IntroductionThe protein tyrosine phosphatase SHP2 (PTPN11) is a negative regulator of glycoprotein VI (GPVI)-induced platelet signal under certain conditions. Clinical trials with derivatives of the allosteric drug SHP099, inhibiting SHP2, are ongoing as potential therapy for solid cancers. Gain-of-function mutations of the PTPN11 gene are observed in part of the patients with the Noonan syndrome, associated with a mild bleeding disorder. Assessment of the effects of SHP2 inhibition in platelets from controls and Noonan syndrome patients. Materials and methodsWashed human platelets were incubated with SHP099 and stimulated with collagen-related peptide (CRP) for stirred aggregation and flow cytometric measurements. Whole-blood microfluidics assays using a dosed collagen and tissue factor coating were performed to assess shear-dependent thrombus and fibrin formation. Effects on clot formation were evaluated by thromboelastometry. ResultsPharmacological inhibition of SHP2 did not alter GPVI-dependent platelet aggregation under stirring, but it enhanced integrin αIIbβ3 activation in response to CRP. Using whole-blood microfluidics, SHP099 increased the thrombus buildup on collagen surfaces. In the presence of tissue factor and coagulation, SHP099 increased thrombus size and reduced time to fibrin formation. Blood from PTPN11-mutated Noonan syndrome patients, with low platelet responsiveness, after ex vivo treatment with SHP099 showed a normalized platelet function. In thromboelastometry, SHP2 inhibition tended to increase tissue factor-induced blood clotting profiles with tranexamic acid, preventing fibrinolysis. ConclusionPharmacological inhibition of SHP2 by the allosteric drug SHP099 enhances GPVI-induced platelet activation under shear conditions with a potential to improve platelet functions of Noonan syndrome patients.

Genetic tracing of thymic T cell differentiation

Abstract Thymic T cell differentiation is controlled by stereotyped processes that remain obscure. Here we develop a novel mouse genetic tool to trace thymic T cells during T cell antigen receptor (TCR) rearrangement. Briefly, we insert inducible CreER into the Rag1 locus that is transiently expressed at early thymic T cell differentiation. In the presence of Rosa reporters, Rag1-CreER mice enable us to irreversibly label T cells between the double negative (DN) and double positive (DP) stages upon acute tamoxifen treatment. In the physiological setting and absence of the perturbations historically used to investigate thymic T cell differentiation, our genetic tracing in combination with flow cytometric measurement of cell fates and functional states maps the kinetics, stoichiometry, and cell fate determination of thymic T cells. We further integrate genetic tracing experiments with unbiased single cell RNA sequencing, TCR sequencing, and the expression of cell surface markers, linking thymic T cell differentiation stages to dynamic gene expression. In particular, we show that regulatory T cells acquire CD73 expression over time as a potential consequence of persistent TCR signaling and expression of lineage determinant Foxp3, marking a maturation process during lineage commitment and functional adaptation. Taken together, our integrated genetic tracing of thymic T cells resolves complex differentiation processes coupled with the alterations of gene expression, selection, and cell fate determination. Our results also serve as a foundation for further exploration of the thymic T cell states, developmental pathways, drivers, and modulators involved in these crucial biological processes. R21 AI146614

Tumor Progression Locus 2 Promotes Mouse Plasmacytoid Dendritic Cell Cytokine Secretion and Signaling

Abstract The autoimmune disorder systemic lupus erythematosus is thought to be caused by the inefficient clearance of dying cells. This releases nucleic acid debris that stimulates type I interferon (T1 IFN) secretion. Plasmacytoid dendritic cells (pDCs) are the major source of T1 IFNs, which are causally linked to lupus pathogenesis. Both T1 IFNs and pDCs are thus the focus of intense studies for immunotherapies. The serine-threonine kinase, tumor progression locus 2 (TPL2), negatively regulates T1 IFN secretion by conventional dendritic cells (cDCs) and macrophages in response to Toll-like receptor 9 (TLR9) stimulation in vitro. In contrast, we and others have shown that TPL2 is required for T1 IFN production in TLR9-stimulated pDCs. The goal of this study is to validate TPL2-dependent regulation of pDC function in vivoand to delineate the mechanisms responsible. Both cDCs and pDCs develop normally in Tpl2−/−mice, but Tpl2−/−mice show defective secretion of T1 IFNs and proinflammatory cytokines in response to administration of CpG (TLR9) or R848 (TLR7) in vivo. The same defect in T1 IFN and proinflammatory cytokine production was observed in bone marrow-derived pDCs and cDCs in vitro. A modest defect in TLR-induced expression of maturation markers CD80, CD86 and MHC class II was seen in Tpl2−/−pDCs, suggesting impaired NFkB activation. Flow cytometric measurement of phosphoproteins demonstrated that TPL2 is also required for TLR-induced activation of MAPK and ribosomal S6 kinase pathways in pDCs. Ongoing studies are examining the role of TPL2 in TLR trafficking and lupus pathogenesis. These data establish TPL2-dependent regulation of pDC functions, which may be exploited for therapeutic intervention in lupus or other IFN-related diseases. Supported by grants from NIH/NIAMS (R21 AR075317) titled "Tpl2 regulation of pDC function and SLE pathogenesis"

Abstract 1995: 2C5-surface modified nanocarriers targeting neutrophil extracellular traps

Abstract Background: Neutrophil extracellular traps (NETs) are composed of processed chromatin bound to granular and selected cytoplasmic proteins and released by neutrophils. NETs consist of smooth filaments composed of stacked nucleosomes. Fully hydrated NETs have a cloud-like appearance and occupy a space 10-15-fold larger than the volume of the cells they originate from. DNases are the enzymes that cleave extracellular DNA including NETs. Together with their protective role in microbial infections, NETs are involved in multiple pathological processes and represent key events in a variety of pathologies including cancer, autoimmunity, and cardiovascular disease. Sites of NETs concentration are dangerous for the host if the process of NETs formation becomes chronic or the mechanism of NETs removal does not work. NETosis has been linked to the development of periodontitis, cystic fibrosis, type 2 diabetes, COVID-19 or rheumatoid arthritis as well as cancer progression. Purpose: Thus, the destruction of NETs is of primary significance in many pathologies. In our approach, we are focusing on mimicking one of the natural mechanisms of destroying excessive NETs by delivering deoxyribonuclease I to the specific site of pathological NETs accumulation by modifying the nanoparticles using an anti-nucleosome monoclonal antibody (2C5). The antibody is specific to nucleosomes and can recognize histones in NETs. DNase I is U.S. Food and Drug Administration (FDA)-approved active component and is commonly used in therapeutic methods of modern medicine for cystic fibrosis to clear extracellular DNA fibers in the lungs and systemic lupus erythematosus. Recent findings have also shown the effectiveness of DNase I in the digestion of NETs. However, the low serum stability and fast deactivation by environmental stimuli have been considered as the limiting factors for clinical applications of DNase I, which can be overcome by its targeted specific delivery in pharmaceutical nanocarriers. Methods: In this study, we generate NETs in vitro using human neutrophils and HL-60 cells differentiated into granulocyte-like cells. We used interleukin-8, lipopolysaccharide from E.Coli (LPS), phorbol myristate acetate (PMA), and calcium ionophore A23187 (CI) to generate the NETs. We confirmed the specificity of 2C5 toward NETs by ELISA, which showed that it binds to NETs with the specificity like that for purified nucleohistone substrate. We further utilized that feature to create two delivery systems (liposomes and micelles) for DNAse I enzyme to destroy NETs, which was confirmed by staining NETs with SYTOX Green dye and followed by flow cytometric measurements and microscopic images. Conclusions: Our results suggest that 2C5 could be used to identify and visualize NETs and serve as a ligand for NET-targeted diagnostics and therapies. Also, we proved that our carrier can successfully deliver DNase to NETs to provide their degradation. Citation Format: Nina Filipczak, Xiang Li, Gaurav Rajan Saawant, Diptanshu Pardeshi, Bharat Ashok Rajmalani, Satya Siva Kishan Yalamarty, Vladimir P. Torchilin. 2C5-surface modified nanocarriers targeting neutrophil extracellular traps [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1995.

New estimates of genome size in Orthoptera and their evolutionary implications.

Animal genomes vary widely in size, and much of their architecture and content remains poorly understood. Even among related groups, such as orders of insects, genomes may vary in size by orders of magnitude-for reasons unknown. The largest known insect genomes were repeatedly found in Orthoptera, e.g., Podisma pedestris (1C = 16.93 pg), Stethophyma grossum (1C = 18.48 pg) and Bryodemella holdereri (1C = 18.64 pg). While all these species belong to the suborder of Caelifera, the ensiferan Deracantha onos (1C = 19.60 pg) was recently found to have the largest genome. Here, we present new genome size estimates of 50 further species of Ensifera (superfamilies Gryllidea, Tettigoniidea) and Caelifera (Acrididae, Tetrigidae) based on flow cytometric measurements. We found that Bryodemella tuberculata (Caelifera: Acrididae) has the so far largest measured genome of all insects with 1C = 21.96 pg (21.48 gBp). Species of Orthoptera with 2n = 16 and 2n = 22 chromosomes have significantly larger genomes than species with other chromosome counts. Gryllidea genomes vary between 1C = 0.95 and 2.88 pg, and Tetrigidae between 1C = 2.18 and 2.41, while the genomes of all other studied Orthoptera range in size from 1C = 1.37 to 21.96 pg. Reconstructing ancestral genome sizes based on a phylogenetic tree of mitochondrial genomic data, we found genome size values of >15.84 pg only for the nodes of Bryodemella holdereri / B. tuberculata and Chrysochraon dispar / Euthystira brachyptera. The predicted values of ancestral genome sizes are 6.19 pg for Orthoptera, 5.37 pg for Ensifera, and 7.28 pg for Caelifera. The reasons for the large genomes in Orthoptera remain largely unknown, but a duplication or polyploidization seems unlikely as chromosome numbers do not differ much. Sequence-based genomic studies may shed light on the underlying evolutionary mechanisms.

Comparison of P-glycoprotein function in peripheral blood mononuclear cells ex vivo in stable Black and White male and female kidney transplant recipients.

Kidney allograft survival remains poorer in Black compared to White recipients due to racial differences in calcineurin inhibitor (CNI) pharmacology. P-glycoprotein (P-gp), an ABC efflux transporter expressed in peripheral blood mononuclear cells (PBMCs), modulates CNI pharmacokinetics and intracellular pharmacology. This study investigated P-gp function in PBMC ex vivo at 0 (trough), 4, 8, and 12 h in stable Black and White male and female kidney transplant recipients (n=67) receiving tacrolimus and mycophenolic acid. Tacrolimus doses were adjusted to troughs of 4-10ng/ml. P-gp function was quantified with flow cytometric measurement of cyclosporine (CYA; 2.5μM)-reversible efflux of P-gp substrate, 3,3'-Diethyloxacarbocyanine iodide by determining the percentage change of mean fluorescent intensity (MFI) with CYA (% ΔMFI). The composite parameter of area under the concentration versus time (AUC)0-12h % ΔMFI estimated P-gp function. Data analysis examined race, sex, and race-sex associations to P-gp function. A secondary aim analyzed ABCB1 genotypes: 1236C>T (rs1128503), 2677G>T/A (rs2032582), 3435C>T (rs1045642), and P-gp function. P-gp function (% ΔMFI) was higher in White patients at troughs (p=0.031) compared to Black counterparts with similar trends at 4 and 8h. Reduced AUC0-12h % ΔMFI was noted in Black recipients (N=32) compared with Whites (N=35, p=0.029) with notable pairwise adjusted differences between Black and White women (p=0.021). Higher AUC0-12h % ΔMFI was associated with ABCB1 2677 TT compared to GG variants (p=0.035). The AUC0-12h % ΔMFI was greater in White than Black subjects. P-gp function was higher at troughs in White subjects and differed between race-sex groups. P-gp function in PBMC may influence intracellular tacrolimus exposure and inter-relating pharmacodynamic responses which may support race and sex pharmacologic differences.

Synthesis, Characterization, and Application of Muscarinergic M3 Receptor Ligands Linked to Fluorescent Dyes.

Through the linkage of two muscarinergic M3 receptor ligands to fluorescent tetramethylrhodamine- and cyanine-5-type dyes, two novel tool compounds, OFH5503 and OFH611, have been developed. Based on the suitable binding properties and kinetics related to the M3 subtype, both ligand-dye conjugates were found to be useful tools to determine binding affinities via flow cytometric measurements. In addition, confocal microscopy underlined the comparably low unspecific binding and the applicability for studying M3 receptor expression in cells. Along with the proven usefulness regarding studies on the M3 subtype, the conjugates OFH5503 and OFH611 could, due to their high affinity to the M1 receptor, evolve as even more versatile tools in the field of research on muscarinergic receptors.

Immune Checkpoint Molecules Regulate Paroxysmal Nocturnal Hemoglobinuria Clonal Evolution

In paroxysmal nocturnal hemoglobinuria (PNH), the acquisition of somatic PIGA mutations provides a selection advantage to hematopoietic stem cells from aplastic anemia (AA) immune attack. In addition to this immune evasion mechanism, HLA mutations, deletions, and somatic UPD involving 6p21 locus have been also described in AA, all of which implicated in such adaptive clonal escape. It is well-known that blood cells derived from a PIGA-mutant clone lack membrane-bound complement regulators (e.g., CD55, CD59) and exhibit an increased vulnerability to complement attack. Nevertheless, PIGA-mutant cells may still be susceptible targets for AA T cell-mediated immune attack. In conjunction with mutational analysis, HLA protein expression may be investigated by flow cytometry to identify a haploinsufficient (clonal) vs. possible adaptive down-modulation. Indeed, the absence of these otherwise constitutionally expressed proteins represents an excellent marker of clonality. Additionally, in an attempt to further hinder the creation of a successful immunological synapsis, other mechanisms, including modulation of immune checkpoints expression, may be also involved in such AA/PNH intertwine. Whether these immune escape mechanisms are convergent or instead represent alternative pathways is a subject of intense research. Here, we comprehensively explore the dynamics governing PNH immune ontogenesis by combining HLA/PIGA genomics and flow cytometric measurements of HLA (A, B, C, DQ, DR, DP) and the immune checkpoint B7/CD28H family (PD1, PDL1, PDL2, VISTA, B7-H6, HHLA2, CD28H), stimulatory (GITR, CD30L) and inhibitory immune checkpoints (CD47) in CD45+CD15+CD59+ and CD59- fractions. A deep targeted sequencing panel covering HLA classical loci along with an in-house developed pipeline was also applied to assess fine HLA aberrations (mutational and copy number events), whereas multi-amplicon deep sequencing was deployed to identify PIGA mutational status. A total of 27 PNH patients classified as fully blown hemolytic PNH (n=15) or PNH/AA overlap (n=12) were included in this study with additional 4 healthy controls (HC). Overall, 41% of our patients harboured concomitant myeloid clones (most common hits were in DNMT3A, TET2, ASXL1, BCOR), while 58% of cases carried somatic HLA alterations, involving allelic losses or mutations. The latter were nonsense (33%), missense (11%), or 5’ or 3’ UTR (56%) hits with a median VAF of 11% (3-95%). Somatic lesions (including losses) were found in HLA-A (10%), B (30%), DQA1 (10%), or DQB1 (50%) loci. Since HLA aberrations may constitute the extreme pole of immune evasion and a marker of enhanced immune selection, we performed sorting/sequencing experiments on CD59+vs CD59- cells. A similar distribution and clonal burden of HLA-mutant subclones was found between the 2 fractions, indicating that PNH cells do not provide absolute immune privilege.1 Next, we compared the expression of HLA and other immunomodulatory molecules across HC, CD59+ cells from PNH patients and their corresponding CD59- cells (GPI+ and GPI-, respectively). Using MFI as a readout, GPI- cells showed similar expression levels of HLA-DP, -DR, PDL2, HHLA2 and GITR as compared to HC cells, while these molecules were significantly 1.5 to 5-fold upregulated on corresponding GPI+ cells consistent with their trigger/target function. This conclusion was also supported by the higher levels of CD28H found on GPI+ cells vs. GPI-(median MFI, 13.3 vs. 6.0; p<0.0001). Of note is that GPI- cells exhibited lower levels of HLA-DQ (0 vs. 7.0, p=0.01), B7H6 (0 vs. 39, p<0.0001) and CD30L (0 vs. 41, p <0.0001) vs. HC cells and upregulation of VISTA (460 vs. 227, p=0.006), suggesting that PNH clones may exhibit additional (to PNH phenotype) immune deterrence pathways. HLA alterations resulted in downregulation of HLA-DQ (0 vs. 29, p=.03), -DR (20 vs. 136, p=.03), B7H6 (0 vs. 45, p=.02), and CD30L (7.5 vs. 52, p=.02), as well as upregulation of HLA-B (2671 vs. 1909, p=.03) and VISTA (561 vs. 291, p=.02) in GPI- vs. GPI+, while no difference was noted in HLAWT cases. In conclusion, differential expression of immunomodulatory molecules on PNH vs. residual phenotypically normal cells in PNH patients and HC highlights various stimulatory and immune escape mechanisms operating in this disease. Understanding these processes may enable the identification of therapeutically relevant immune pathways.

Mixed-Ploidy and Dysploidy in Hypericum perforatum: A Karyomorphological and Genome Size Study.

Karyomorphology and genome size of 15 St John's wort (Hypericum perforatum L.) populations are reported for the first time. Root tips and fresh young leaves were used for karyological studies and flow cytometric (FCM) measurements, respectively. The chromosome length varied from 0.81 µm to 1.16 µm, and chromosome types were determined as "m". Eight different somatic chromosome numbers were found (2n = 16, 22, 24, 26, 28, 30, 32, 38). Based on the observed basic (x) chromosome numbers of x = 8, 11, 13, 14, 15, 19, this may correspond to diploid (2x), triploid (3x), tetraploid (4x), respectively. Interestingly, we found mixoploidy (3x - 4x) in the root tips of one of the populations. Hybridization, polyploidy and dysploid variation may be the main factors associated with the chromosome number evolution of this species. FCM showed that 2C DNA contents vary from 0.87 to 2.02 pg, showing more than a 2-fold variation. The mean amount of 2C DNA/chromosome and the mean of monoploid genome size were not proportional to ploidy.

CD20 Expression as a Possible Novel Prognostic Marker in CLL: Application of EuroFlow Standardization Technique and Normalization Procedures in Flow Cytometric Expression Analysis.

Simple SummaryUp to 50% of patients with chronic lymphocytic leukemia relapse within four years after anti-CD20-directed treatment with a need for a subsequent treatment, which can potentially include anti-CD20 agents again. To retrospectively study the influence of CD20 expression in CLL patients receiving anti-CD20 directed therapy on therapy response, we designed and evaluated a bead-based normalization approach for the analysis of CD20 expression levels to reduce variation of flow cytometric measurements due to technical issues. Normalization significantly reduced the variability of median fluorescence intensities of fluorochrome-conjugated beads without artificially rendering the instruments’ performances, and longitudinal biological variations of marker expression based on MFI values could be robustly assessed. In a cross-trial comparison, strong MRD response correlated with the CD20 expression level before therapy started in patients receiving Ofatumumab, but not in patients receiving Obinutuzumab.Background: CD20 expression is a controversial issue regarding response prediction to anti-CD20 therapy in chronic lymphocytic leukemia (CLL). Methods: Median fluorescence intensities (MFIs) of standard fluorescence beads from the daily calibration of flow cytometers according to EuroFlow protocols were used to establish a normalization approach to study CD20 expression on CLL cells. CD20 MFI was retrospectively assessed prior to and during treatment from flow cytometric measurements of peripheral blood in patients with different depths of molecular response in the four phase-II CLL2-BXX trials (BIG; BAG; BIO; BCG; N = 194) administering either Obinutuzumab or Ofatumumab in combination with targeted agents. Results: No significant difference was observed between the normalized and measured MFIs of CD19 and CD20 on CLL cells. During treatment, CD20 expression levels on CLL cells did not significantly differ between the four investigated different treatment schemes, but a strong molecular response to Ofatumumab seemed to correlate with higher CD20 expression prior to therapy. Conclusions: Standardized staining and instrument monitoring enable a robust assessment of longitudinal biological variations of marker expression based on MFI values. Obinutuzumab showed a higher proportion of patients with a strong MRD response independent from initial CD20 expression, whereas high pre-therapeutic CD20 expression levels seem to correlate with a profound response to Ofatumumab.

One-point flow cytometric MRD measurement to identify children with excellent outcome after intermediate-risk BCP-ALL: results of the ALL-MB 2008 study.

Measurement of minimal residual disease (MRD) with multicolor flow cytometry (MFC) has become an important tool in childhood acute lymphoblastic leukemia (ALL), mainly to identify rapid responders and reduce their therapy intensity. Protocols of the Moscow-Berlin (MB) group use a comparatively low (for standard risk; SR) or moderate (for intermediate risk; ImR) treatment intensity from the onset, based on initial patient characteristics. Recently, we reported that 90% of SR patients-50% B cell precursor (BCP-ALL)-MFC-MRD negative at end of induction (EOI)-had 95% event-free survival (EFS). METHODS: In the present study, we applied this method to children with initial ImR features. In study MB 2008, 1105 children-32% of BCP-ALL patients-were assigned to the ImR group. Of these, 227 were treated in clinics affiliated with MFC laboratories of the MB group network, and included in this MFC-MRD pilot study. A single-point MFC-MRD measurement at the EOI with the threshold of 0.01% identified 65% of patients-20% of all BCP-ALL patients-with EFS of 93.5%. Taking both studies together, the combination of clinical parameters and a one-point MRD measurement identifies 70% of BCP-ALL patients with an excellent outcome after low- or moderate-intensity therapy and avoids overtreatment of a significant proportion of patients.

In-Vitro Use of Verteporfin for Photodynamic Therapy in Glioblastoma

BackgroundStummer et al. established fluorescence-guided surgery (FGS) for glioblastoma (GBM) using 5-aminolevulinic acid (5-ALA). Its metabolite, protoporphyrin IX (PPIX), is also a photosensitizer and can be used for photodynamic therapy (PDT) using a laser beam of 635 nm. The porphyrin derivate verteporfin (VP) was discovered to have properties to penetrate the brain, pharmacologically target glioma cells, and is approved for PDT of choroidal neovascularization in wet age-related macular degeneration at 689 nm. ObjectiveTo elucidate whether GBM cell lines are susceptible to PDT with second-generation photosensitizer VP. MethodsHuman glioma cell lines LN229, HSR-GBM1, and a low-passage patient-derived GBM cell line P1 were treated with variable concentrations of VP for 24 h, followed by PDT at 689 nm using a diode laser light. Cell viability was measured using the MTT assay and VP uptake was measured using a desktop cytometer. ResultsSignificantly higher cell death following PDT with VP compared to VP treatment alone or no treatment was detected in all cell models (LN229, HSR-GBM1, P1). Flowcytometric measurements revealed a concentration-dependent cellular uptake of VP after 24 h incubation up to 99% at 10 µM (HSR-GBM1). ConclusionThis study demonstrates that PDT with VP causes cell death in GBM cells at marginal concentrations. Additionally, red spectrum fluorescence was detected at therapeutic concentrations in all cell lines, validating the cellular uptake of VP in GBM cells. VP, therefore, is not only a potential drug for targeting GBM pharmacologically but can be used as an optical imaging dye in surgery and photosensitizer to make GBM susceptible to PDT.

Leukocyte-Rich Platelet-Rich Plasma as an Effective Source of Molecules That Modulate Local Immune and Inflammatory Cell Responses.

Autologous platelet-rich plasma (PRP) injection is a safe biological method used to treat various musculoskeletal diseases. By downregulation of inflammatory cytokines and stimulation of synovial fibroblasts, PRP injection is a promising adjunctive treatment for patients with chronic autoimmune inflammatory diseases such as rheumatoid arthritis. A major problem in comparing the results of clinical trials in this area is the considerable variability in the cytokine content of PRP. We presented the profile of selected growth factors and inflammatory cytokines in the obtained PRP samples and compared them with baseline serum levels to assess the efficacy of PRP as a source of those paracrine molecules. Additionally, we wanted to determine whether the difference is only quantitative, which would suggest the use of a cheaper alternative by injecting a large amount of autologous serum. For this purpose, we analyzed whole blood and PRP samples prepared using the Mini GPS III Platelet Concentration System (Biomet Inc., USA) in 31 subjects aged 35-60 years. Cellular content, seven selected growth factors, and 13 human inflammatory cytokines were evaluated. Multiplex bead immunoassays that use fluorescence-encoded beads LEGENDplex™ (BioLegend, USA) and flow cytometer measurements were used. As a result, we found a statistically significant increase in four of the growth factors tested and eight of the inflammatory cytokines tested in PRP compared to blood serum. The difference is not only quantitative but also in the composition of paracrine molecules. In conclusion, the study confirmed that PRP is an efficient source of several growth factors and some inflammatory cytokines. These data provide additional insight into the potential mechanisms of PRP's effects on cellular metabolism and inflammatory response and may contribute to a better understanding of its clinical efficacy.

Sperm Chromatin Structure Assay (SCSA®) for Fertility Assessment.

The Sperm Chromatin Structure Assay (SCSA® ) is a federally registered protocol for simultaneous flow cytometric measures of sperm DNA integrity and chromatin structure. Fresh or frozen/thawed raw semen samples are diluted in buffer to a sperm concentration of ∼1-2×106 /ml and then treated with a pH 1.20 buffer for 30 s to open the DNA strands at sites of DNA strand breaks. The sperm are then stained with acridine orange (AO) that intercalates into double-strand DNA and fluoresces green (515-530 BP filter) and stacks on single-strand DNA that fluoresces red (630 LP filter) upon excitation from a 488 nm laser. The extent of single and double DNA strand breaks (DNA fragmentation index, %DFI) and level of excess nuclear histones (high DNA stainable sperm, %HDS) are simultaneously measured in individual sperm. From the time a fresh or frozen/thawed semen sample is received at the site of a flow cytometer (FCM) programmed for the SCSA protocol, data can be obtained within about 10 min on 5-10×103 sperm. The %DFI and %HDS can be determined by computer-gated regions on the green versus red cytogram. Alternatively, a determination is made by transforming the green versus red cytogram to a total DNA stainability (red + green fluorescence) versus red/red + green fluorescence cytogram from which a frequency histogram is produced and the %DFI calculated from it. The clinical threshold for human natural or IUI fertilization is 25% DFI at which point the ART lab should consider moving to ICSI fertilization. The clinical threshold for HDS is also 25%; values above this level may result in early embryo death due to abnormal gene readout caused by the abnormal tertiary structure of chromatin. Numerous lifestyle and environmental factors cause sperm DNA fragmentation. Reactive oxygen species (ROS) play a significant role in DNA breakage. © 2022 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Sperm Chromatin Structure Assay (SCSA®) Basic Protocol 2: SCSA data analysis: Calculations of %DFI and %HDS of semen samples by one of two methods Support Protocol 1: SCSA sample collection and shipping Support Protocol 2: Flow cytometer set up Support Protocol 3: Selection and use of reference samples.