Blood Samples Of Healthy Donors Research Articles

First Evidence of Pathogenic HERV-W Envelope Expression in T Lymphocytes in Association with the Respiratory Outcome of COVID-19 Patients

Background: Despite an impressive effort in clinical research, no standard therapeutic approach for coronavirus disease 2019 (COVID-19) patients has been established, highlighting the need to identify early biomarkers for predicting disease progression and new therapeutic intervention for patient management. The present study aimed to evaluate the involvement of the human endogenous retrovirus -W envelope (HERV-W ENV) in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection considering recent findings that HERVs are activated in response to infectious agents and lead to various immunopathological effects. We analysed HERV-W ENV expression in blood cells of COVID-19 patients in correlation with clinical characteristics and have discussed its potential role in the outcome of the disease.Methods: We analysed HERV-W ENV expression in blood samples of Covid-19 patients and healthy donors by flow cytometry and quantitative reverse transcriptase PCR analysis, and evaluated its correlation with clinical signs, inflammatory markers, cytokine expression, and disease progression.Findings: HERV-W ENV was highly expressed in the leukocytes of COVID-19 patients but not in those of healthy donors. Its expression correlated with the markers of T-cell differentiation and exhaustion and blood cytokine levels. The percentage of HERV-W ENV-positive lymphocytes correlated with inflammatory markers and pneumonia severity in COVID-19 patients. Notably, HERV-W ENV expression reflects the respiratory outcome of patients during hospitalization.Interpretation: Given the known immuno- and neuro-pathogenicity of HERV-W ENV protein, it could promote certain pathogenic features of COVID-19 and therefore serve as a biomarker to predict clinical progression of disease and as a potential therapeutic target.Funding: Genero InnovationDeclaration of Interests: C.M. reports grant from Gilead, outside the submitted work; L.S. reports personal fees and other from Merck, Gilead, and Abbvie, grants from Gilead, outside the submitted work; HP and BC receive compensation for their work by Geneuro-Innovation. The other authors declare no competing interests.Ethics Approval Statement: Ethical approval for the collection and use of human samples was obtained from the ethical board of the Hospital, COronaVIrus Disease: Safety and Efficacy of Experimental Treatment (COVID_SEET prot.7562/2020, 9th April 2020, experimental register 46.20).

Architectural and Ultrastructural Variations of Human Leukocyte-Rich Platelet-Rich Fibrin and Injectable Platelet-Rich Fibrin.

Background:Platelet-rich fibrin (PRF) architecture and ultrastructure plays a crucial role in regulating and coordinating the cellular functions and provides a physical architecture, mechanical stability, and biochemical cues necessary for tissue morphogenesis and homeostasis. No study consciously reported the variation in architecture, ultrastructure, and morphology of leukocyte-rich PRF (L-PRF) and injectable PRF (i-PRF).Objective:Hence, the present study was aimed to evaluate the fibrin architecture, ultrastructure, and cell contents of autologous L-PRF and i-PRF.Materials and Methods:The autologous L-PRF and i-PRF were prepared from blood samples of healthy donors. The morphological and structural variations were assessed by histopathology, atomic force microscopy, confocal laser scanning microscope, and field emission scanning electron microscope.Results:Disparity was found on architecture and ultrastructure of L-PRF and i-PRF fibrin network. The variation in platelet and leukocyte concentration attributed to the fibrin conformational changes. L-PRF shows thick fibrins with rough surface, whereas in i-PRF, smooth thin fibrins.Conclusions:The current study revealed that there is heterogeneity between L-PRF and i-PRF fibrin matrix architecture, ultrastructure, platelets, leukocytes, and the fibrin content. These speculate that the diameter, width, roughness, and smoothness of fibrin fibers, pore size, and shapes of L-PRF and i-PRF matrix may initiate and mediate the scaffold functions differently.

152. rapid Ultra-high Enrichment of Bacterial Pathogens at Low Concentration from Blood for Species ID and AMR Prediction Using Nanopore Sequencing

BackgroundEach year in the United States there are over 1.7 million cases of sepsis that account for a third of hospital deaths. A key to reducing morbidity and mortality rates is early, appropriate antibiotic therapy. Most new diagnostic approaches still suffer from insufficient sensitivity to low bacterial loads in blood and limited sets of detection targets for bacterial species identification (ID) and antimicrobial resistance (AMR) determination. As such, blood culture remains the gold standard for diagnosing bacteremia despite limitations such as > 2-day turnaround time (TAT), incompatibility with fastidious organisms, and frequent inability to recover causative pathogens.Methods31 clinically relevant bacterial pathogens, made up of 17 gram-positive and 14 gram-negative bacterial species, were spiked into 2 to 4 healthy donor blood samples at 1 to 5 CFU/mL. The samples were run through our proprietary Blood2Bac™ pipeline, sequenced on a nanopore platform, and data were passed through Keynome®, our proprietary machine learning algorithm to determine species ID and AMR.ResultsBy assessing the efficiency of pathogen DNA enrichment and genome coverage post sequencing, we report high performance of 3 CFU/mL for 3 bacterial species and ≤ 2 CFU/mL for the 28 remaining species, which includes S. aureus, E. coli, and Streptococcus spp., three of the leading causes of sepsis.For all 31 bacterial species tested, Keynome called species ID with 100% accuracy. In addition, Keynome also predicted the AMR profile of pathogens with 100% accuracy for 19 drug/species AMR combinations, including ciprofloxacin for E. coli, clindamycin for S. aureus, and aztreonam for K. pneumoniae.ConclusionBlood2Bac is able to enrich a wide range of bacterial pathogens directly from blood and enable bacterial whole genome sequencing with an estimated TAT of 12 hours. When coupled with Keynome, our process provides accurate species ID and AMR calls for key BSI pathogens even at single-digit CFU/mL concentrations. Our species-agnostic and culture-free process enables detection of a diverse range of bacterial species with high sensitivity, providing a robust and comprehensive diagnostic.DisclosuresChiahao Tsui, n/a, Day Zero Diagnostics (Employee, Shareholder) Lisa S. Cunden, PhD, Day Zero Diagnostics (Shareholder) Nicole Billings, PhD, Day Zero Diagnostics (Employee) Imaly A. Nanayakkara, PhD, Day Zero Diagnostics (Employee, Shareholder) Ian Herriott, BS, Day Zero Diagnostics (Employee, Shareholder) Rachel R. Martin, n/a, Day Zero DIagnostics (Employee) Michelle Chen, MS, Day Zero Diagnostics (Employee, Shareholder) Febriana Pangestu, n/a, Day Zero Diagnostics (Employee, Shareholder) Paul Knysh, PhD, Day Zero Diagnostics (Employee) Cabell Maddux, n/a, Day Zero Diagnostics (Employee, Shareholder) Zachary Munro, n/a, Day Zero Diagnostics Inc. (Employee, Shareholder) Miriam Huntley, PhD, Day Zero Diagnostics (Employee, Shareholder)

Improved Standardization of Flow Cytometry Diagnostic Screening of Primary Immunodeficiency by Software-Based Automated Gating.

BackgroundMultiparameter flow cytometry (FC) is essential in the diagnostic work-up and classification of primary immunodeficiency (PIDs). The EuroFlow PID Orientation tube (PIDOT) allows identification of all main lymphocyte subpopulations in blood. To standardize data analysis, tools for Automated Gating and Identification (AG&I) of the informative cell populations, were developed by EuroFlow. Here, we evaluated the contribution of these innovative AG&I tools to the standardization of FC in the diagnostic work-up of PID, by comparing AG&I against expert-based (EuroFlow-standardized) Manual Gating (MG) strategy, and its impact on the reproducibility and clinical interpretation of results.MethodsFC data files from 44 patients (13 CVID, 12 PID, 19 non-PID) and 26 healthy donor (HD) blood samples stained with PIDOT were analyzed in parallel by MG and AG&I, using Infinicyt™ software (Cytognos). For comparison, percentage differences in absolute cell counts/µL were calculated for each lymphocyte subpopulation. Data files showing differences >20% were checked for their potential clinical relevance, based on age-matched percentile (p5-p95) reference ranges. In parallel, intra- and inter-observer reproducibility of MG vs AG&I were evaluated in a subset of 12 samples.ResultsThe AG&I approach was able to identify the vast majority of lymphoid events (>99%), associated with a significantly higher intra- and inter-observer reproducibility compared to MG. For most HD (83%) and patient (68%) samples, a high degree of agreement (<20% numerical differences in absolute cell counts/µL) was obtained between MG and the AG&I module. This translated into a minimal impact (<5% of observations) on the final clinical interpretation. In all except three samples, extended expert revision of the AG&I approach revealed no error. In the three remaining samples aberrant maturation and/or abnormal marker expression profiles were seen leading in all three cases to numerical alarms by AG&I.ConclusionAltogether, our results indicate that replacement of MG by the AG&I module would be associated with a greater reproducibility and robustness of results in the diagnostic work-up of patients suspected of PID. However, expert revision of the results of AG&I of PIDOT data still remains necessary in samples with numerical alterations and aberrant B- and T-cell maturation and/or marker expression profiles.

The involvement of toll-like receptors 2 and 4 in human platelet signalling pathways

In addition to haemostasis, platelets play an essential role in mechanisms of inflammation and in immunological reactions. Platelets express various toll-like receptors (TLR) on their surface, among them TLR2 and TLR4, which are important for the recognition of bacterial patterns. This study compared TLR2- and TLR4-dependent platelet signalling and their effect on platelet function.Platelet-rich-plasma and washed platelets were prepared from peripheral blood samples of healthy donors. Pam3CSK4 or LPS (lipopolysaccharides from Escherichia coli) were used for stimulation of TLR2 and TLR4. Intracellular signalling pathways were investigated by Western blot. TLR2- and TLR4-mediated specific transcription factor DNA binding activity was measured by the nuclear factor kappa B (NFκB) transcription factor assay kit. Platelet adhesion and glycoprotein Ib function were assessed by immunofluorescence staining and analysis of ristocetin-induced agglutination.Both, Pam3CSK4 and LPS were able to induce NFκB-mediated and classical activating platelet signalling with a higher stimulatory capacity of TLR2. In addition, TLR2 and TLR4 activation led to a similar activation of inhibitory pathways. In contrast to TLR2, stimulation of TLR4 resulted in decreased Akt/protein kinase B phosphorylation conditioned by enhanced protein phosphatase 2A activity. TLR4-mediated signalling induced platelet adhesion and facilitated ristocetin-induced platelet agglutination.In conclusion, Pam3CSK4 directly induces aggregation via classical activation cascades, whereas LPS enhances platelet adhesion and glycoprotein receptor Ib-dependent platelet agglutination.

Point-of-Care Analysis of Blood Ammonia with a Gas-Phase Sensor.

Elevated blood ammonia (hyperammonemia) may cause delirium, brain damage, and even death. Effective treatments exist, but preventing permanent neurological sequelae requires rapid, accurate, and serial measurements of blood ammonia. Standard methods require volumes of 1 to 3 mL, centrifugation to isolate plasma, and a turn-around time of 2 h. Collection, handling, and processing requirements mean that community clinics, particularly those in low resource settings, cannot provide reliable measurements. We describe a method to measure ammonia from small-volume whole blood samples in 2 min. The method alkalizes blood to release gas-phase ammonia for detection by a fuel cell. When an inexpensive first-generation instrument designed for 100 μL of blood was tested on adults and children in a clinical study, the method showed a strong correlation (R2 = 0.97) with an academic clinical laboratory for plasma ammonia concentrations up to 500 μM (16 times higher than the upper limit of normal). A second-generation hand-held instrument designed for 10-20 μL of blood showed a near-perfect correlation (R2 = 0.99) with healthy donor blood samples containing known amounts of added ammonium chloride up to 1000 μM. Our method can enable rapid and inexpensive measurement of blood ammonia, transforming diagnosis and management of hyperammonemia.

Results of seroepidemiological examination of healthy population of Lviv region and representatives of the proffesional risk group for leptospirosis

The objective – a seroepidemiological investigation of population and professional risk group with detection of IgG antibodies to leptospira.Material and methods. Using of enzyme-linked immunosorbent assay (ELISA) for detection of IgG antibodies to leptospira was made. Blood samples of healthy donors and Vodokanal workers were analyzed. Statistical analysis was made by with using of Epitools software.Results. The blood samples of 124 people were examined. 90 samples were collected from healthy donors of Lviv Regional Blood Service Center and 34 samples - from employees of Lviv Vodokanal different units. Among the blood donors, 70 (77.8%) were residents of the regions of Lvivska oblast and 20 (22.2%) residents of Lviv. Among the residents of Lvivska oblast (excluding Lviv city), the number of seropositive persons was 8.57%. The highest percentage of seropositive persons was detected in the Starosambirsky district (20%). Against our expectations, no IgG antibodies were detected in any staff member of Lviv Vodokanal and any residents of Lviv city.Conclusion. The number of people with positive IgG titres to leptospira in the Lviv region is 8.57% (excluding Lviv city), which may indicate past Leptospira infection. The informativeness of ELISA test systems for the detection of anti-leptospirosis IgG antibodies for use in seroepidemiological studies needs further investigation.

Sickle Cell Anemia Patients Display an Intricate Cellular and Serum Biomarker Network Highlighted by TCD4+CD69+ Lymphocytes, IL-17/MIP-1β, IL-12/VEGF, and IL-10/IP-10 Axis.

Background Sickle cell anemia (SCA) is associated with a chronic proinflammatory state characterized by elevated leukocyte count, mortality from severe recurrent infections, and subsequent vasoocclusive complications with leukocyte adhesion to the endothelium and increased plasma levels of inflammatory cytokines. The immune system has a close connection with morbidity in SCA, but further studies are needed to uncover the involvement of innate and adaptive immunities in modulating the SCA physiopathology. We performed measurements of the frequency of innate and adaptive immunity cells, cytokines, chemokines, and growth factors and immunophenotyping of Toll-like receptor and adhesion molecule expression in the blood of SCA patients and healthy donors to evaluate the different profiles of these biomarkers, the relationship among them, and their correlation to laboratory records and death risk. Material and Methods. Immunophenotyping of cells, Toll-like receptors, and adhesion molecules were performed from peripheral blood samples of SCA patients and healthy donors by flow cytometry and cytokine/chemokine/growth factor measurement by the Luminex technique performed from the serum of the same subjects. Results Cells of adaptive immunity such as IL-12, IL-17, and IL-10 cytokines; IL-8, IP-10, MIP-1α, MIP-1β, and RANTES chemokines; and VEGF, FGF-basic, and GM-CSF growth factors were higher in SCA patients than healthy donors regardless of any laboratorial and clinical condition. However, high death risk appears to have relevant biomarkers. Conclusion In the SCA pathophysiology at steady state, there is a broad immunological biomarker crosstalk highlighted by TCD4+CD69+ lymphocytes, IL-12 and IL-17 inflammatory and IL-10 regulatory cytokines, MIP-1α, MIP-1β, and IP-10 chemokines, and VEGF growth factor. High expression of TLR2 in monocytes and VLA-4 in TCD8+ lymphocytes and high levels of MIP-1β and RANTES appear to be relevant in high death risk conditions. The high reticulocytosis and high death risk conditions present common correlations, and there seems to be a balance by the Th2 profile.

Abstract B04: Identification of T-cell receptors targeting mutant KRAS in pancreatic cancer

Abstract Pathologic somatic gene mutations within the KRAS proto-oncogene occur in greater than 90% of pancreatic ductal adenocarcinomas (PDA). These mutations are often conserved involving the codon 12 position and most frequently result in G12D, G12V, or G12R transitions. Unfortunately, no mutant KRAS (mKRAS)-targeted therapies exist to date. We hypothesize conserved hot-spot KRAS mutations may serve as cancer neoantigens for targeted immune-based therapeutic approaches. Using a validated in silico epitope prediction pipeline, we identified mKRAS epitopes with predicted strong binding affinity to the highly prevalent MHC class I alleles HLA-A*03:01, HLA-A*11:01, and HLA-B*07:02. We then confirmed the processing, presentation, and binding of putative mKRAS epitopes using HPLC-tandem mass spectrometry and competitive peptide-binding assays. The immunogenicity of bona fide mKRAS epitopes was confirmed by the in vitro generation of mKRAS-specific CD8+ T cell responses using healthy donor blood samples that were restricted to HLA-A*03:01, -A*11:01, or -B*07:02 as determined by cytokine release assay and peptide/MHC multimer staining. Following T-cell receptor (TCR) sequencing, transgenic expression of mKRAS-specific TCRs on primary CD8+ T cells conferred cytotoxic potential against KRAS-mutated tumor cell lines expressing target HLA/mKRAS combinations. Importantly, mKRAS-specific CD8+ T cells did not cross-react with wild-type or alternatively mutated KRAS epitopes as measured by cytokine release or cytotoxicity assays. Based on these data, we initiated an adjuvant vaccine clinical study at the University of Pennsylvania Abramson Cancer Center targeting mKRAS in patients with resected PDA. The objective of this clinical study is to identify further mKRAS-specific TCR sequences for future adoptive T-cell therapy applications. To date, a total of 7 subjects have been enrolled, and 3 subjects have been vaccinated against targeted mKRAS short peptides utilizing a dendritic cell-based platform. Results from the first vaccinated subject have demonstrated the generation of a KRAS G12V-specific CD8+ T-cell response restricted to HLA-A*11:01 following vaccination with &amp;gt;10% mKRAS-specific T cells isolated following primary in vitro expansion of CD8+ T cells using antigen-pulsed dendritic cells as measured by peptide/MHC multimer staining. TCR sequencing has been completed and functional studies to validate antigen specificity and tumor cytotoxicity are in process. The results of these studies will serve to develop a widely applicable T-cell therapy for PDA patients, and will have implications for the large number of patients with other KRAS-mutated cancers. Citation Format: Adham S. Bear, Andrew J. Rech, Lee P. Richman, Mark H. O'Hara, Gerald P. Linette, Beatriz M. Carreno, Robert H. Vonderheide. Identification of T-cell receptors targeting mutant KRAS in pancreatic cancer [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2019 Sept 6-9; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2019;79(24 Suppl):Abstract nr B04.

Identification of Matrix Metalloproteinase 11 as a Prognostic Biomarker in Pancreatic Cancer.

The aim of this study was to investigate matrix metalloproteinase 11 (MMP11) as a promising biomarker in human pancreatic cancer. A consecutive eliminating method was used to select biomarker candidates in pancreatic cancer. mRNA and protein expression levels of candidates were determined in tissues and whole blood samples of healthy donors and pancreatic cancer patients. The prognostic value of MMP11 was determined using various data-sets and Liptak's Z analysis. Analysis using Gene Expression Omnibus (GEO) database showed significantly higher MMP11 mRNA expression in pancreatic cancer tissues compared to that in various normal tissues. MMP11 protein was specifically expressed in pancreatic cancer tissues, but not in various normal or other cancer tissues. Secreted MMP11 levels could be measured using easily accessible techniques and whole blood samples of pancreatic cancer. In addition, high levels of MMP11 were associated with poor prognosis of pancreatic cancer patients. MMP11 may be a promising prognostic biomarker for pancreatic cancer patients.

Impact of blood storage and sample handling on quality of high dimensional flow cytometric data in multicenter clinical research

Obtaining reliable and reproducible high quality data in multicenter clinical research settings requires design of optimal standard operating procedures. While the need for standardization in sample processing and data analysis is well-recognized, the impact of sample handling in the pre-analytical phase remains underestimated. We evaluated the impact of sample storage time (≈transport time) and temperature, type of anticoagulant, and limited blood volume on reproducibility of flow cytometric studies.EDTA and Na-Heparin samples processed with the EuroFlow bulk lysis protocol, stained and stored at 4 °C showed fairly stable expression of cell surface markers and distribution of the major leukocyte populations for up to 72 h. Additional sample fixation (1% PFA, Fix & Perm) did not have any beneficial effects. Blood samples stored for <24 h at room temperature before processing and staining seemed suitable for reliable immunophenotyping, although losses in absolute cell numbers were observed. The major losses were observed in myeloid cells and monocytes, while lymphocytes seemed less affected. Expression of cell surface markers and population distribution were more stable in Na-Heparin blood than in EDTA blood. However, storage of Na-Heparin samples was associated with faster decrease in leukocyte counts over time. Whole blood fixation strategies (Cyto-Chex, TransFix) improved long-term population distribution, but were detrimental for expression of cellular markers. The main conclusions from this study on healthy donor blood samples were successfully confirmed in EDTA clinical (patient) blood samples with different time delays until processing. Finally, we recognized the need for adjustments in bulk lysis in case of insufficient blood volumes.Despite clear overall conclusions, individual markers and cell populations had different preferred conditions. Therefore, specific guidelines for sample handling should always be adjusted to the clinical application and the main target leukocyte population.

Diversity and heterogeneity of extracellular RNA in human plasma

Extracellular RNAs (exRNAs) are secreted by nearly all cell types and are now known to play multiple physiological roles. In humans, exRNA populations are found in nearly any physiological liquid and are attracting growing interest as a potential source for biomarker discovery. Human plasma, a readily available sample for biomedical analysis, reported to contain various subpopulations of exRNA, some of which are most likely components of plasma ribonucleoproteins (RNPs), while others are encapsulated into extracellular vesicles (EVs) of different size, origin and composition. This variation explains the extreme complexity of the human exRNA fraction in plasma. In this work, we aimed to characterize exRNA species from blood samples of healthy human donors to achieve the most comprehensive overview of the species, sizes and origins of the exRNA present in plasma fractions. Unbiased analysis of exRNA composition was performed with prefractionation of plasma exRNA followed by library preparation, sequencing and bioinformatics analysis. Our results demonstrate that, in addition to “mature”, adaptor ligation-competent RNA species (5′-P/3′-OH), human plasma contains a substantial proportion of degraded RNA fragments (5′-OH/3′-P or cycloP), which can be made competent for ligation using appropriate treatments. These degraded RNAs represent the major fraction in the overall population and mostly correspond to rRNA, in contrast to mature products, which mostly contain miRNAs and hY4 RNA fragments. Precipitation polyethylene glycol (PEG)-based kits for EV isolation yield a fraction that is highly contaminated by large RNPs and by RNA loosely bound to EVs. Purer EV preparations are obtained by using proteinase K and RNase A treatment, as well as by size-exclusion chromatography (SEC). These samples have rather distinct RNA compositions compared to PEG-precipitated EV preparations and contain a substantial proportion of exRNA of non-human origin, arising from human skin and gut microbiota, including viral microbiota. These exogenous exRNAs represent up to 75–80% of total RNA reads in highly purified extracellular vesicles, paving the way for biomedical exploitation of these non-human biomarkers.

MODELING OF COMBINED EFFECTS OF THE EXPOSURE TO CHEMICALS (ALUMINUM) AND REGULATORY IMMUNE AND ENDOCRINE FACTORS IN RESEARCH ON CYTOKINES PRODUCTION IN EXPERIMENTS IN VITRO

Introduction. Analysis of individual components of the network of regulatory neuroendocrine and immune interactions, as well as their possible combination with the use of mathematical modeling technology, makes it possible to identify the likely consequences of the negative impact of man-made environmental factors on public health and to determine optimal strategies for reducing morbidity. The aim of the work is to simulate cytokines production in vitro under the combined effect of chemical factors (aluminium) and regulatory immune and endocrine mediators. Material and methods. The experiment was performed on peripheral blood samples of healthy donors (n=68). An immune cell suspension was used, isolated by centrifugation in a ficoll-verografin density gradient. Viral load modeling was performed with a complex mitogen. The following factors were used: IL-1 β, cortisol, aluminum. The concentration of cytokines IL-8, IL-10, IL-17 was determined by enzyme immunoassay. Statistical analysis was performed using Statistica 6.0. Results. A significant change in the production of IL-8 and IL-10 was found in groups with different levels of experimental IL-1 exposure. The combined effect of IL-1 and high levels of cortisol and aluminum increased the levels of IL-8 and IL-10. In the study of the production of IL-17 inhibitory effects with increasing concentrations of IL-1 were revealed. The nonlinear equations of the concentrations dependences of the studied cytokines on the content of IL-1, cortisol and aluminum were determined with checking the models adequacy to the experimental data by the method of dispersion analysis. Discussion. The study of characteristics of the changes in immune cytokine mediators under the influence of physiological and chemical factors has revealed the interaction mechanism of a specific chemical environment and immune-endocrine regulation system components during the course of immunological processes in the body. Conclusion. The results of the study showed interrelations in the system of cytokine immune mediators associated with the increased production of IL-8 and IL-10 and a decrease in IL-17 under conditions of increasing concentrations of IL-1, as well as with the combined effect of cortisol and aluminum. Mathematical modeling has determined the nonlinear nature of the identified patterns.

Abstract A124: Preclinical characterization of AB154, a fully humanized anti-TIGIT antibody, for use in combination therapies

Abstract TIGIT (T-cell immunoreceptor with Ig and ITIM domains) is an inhibitory receptor that is expressed on natural killer (NK) cells, CD8+ T-cells, and immunosuppressive regulatory T-cells (Treg). DNAM-1 (DNAX Accessory Molecule-1; CD226) is an activating receptor found on NK cells, monocytes and a subset of T-cells. TIGIT and DNAM-1 are paired receptors that compete for shared ligands CD155 (PVR) and CD112 (Nectin-2) expressed by tumor and antigen-presenting cells. TIGIT binding to CD155 or CD112 results in immune suppression, whereas binding of DNAM-1 to the same ligands mediates immune activation. As malignancies progress, high TIGIT expression often occurs alongside the upregulation of other immune checkpoint proteins and markers of T-cell exhaustion such as PD-1 (Programmed Death-1). We have developed AB154 to inhibit TIGIT and shift the balance in the tumor microenvironment towards a more productive anticancer response. Blockade of multiple immune checkpoint proteins can confer effective and durable responses in the treatment of cancer. Data assembled from TCGA (The Cancer Genome Atlas) identified numerous tumor types in which TIGIT is co-expressed with PD-1. In these tumors, TIGIT and PD-1 were significantly upregulated compared to normal adjacent tissue. Immunophenotyping performed on human tumor infiltrating lymphocytes demonstrated a strong correlation between TIGIT and PD-1 co-expression on specific immune cells including CD8+ T-cells and Treg cells. AB154 is a fully humanized antibody that blocks human TIGIT with sub-nanomolar affinity, as determined using a CHO.hTIGIT over-expressing cell line and primary human T-cells. Functional consequences of blocking TIGIT/CD155 interactions in combination with anti-PD-1 or anti-PD-L1 were evaluated using mixed lymphocyte reactions (MLR). Briefly, we show here that co-cultures of GM-CSF/IL-4-differentiated CD155+ PD-L1+ monocytes and TIGIT+ CD4+ T-cells, in the presence of AB154, significantly increased IFN-gamma secretion when combined with anti-PD-1 or anti-PD-L1 blocking antibodies relative to each monotherapy. Understanding pharmacokinetic (PK) and pharmacodynamic (PD) relationships enables the choice of a dosing regimen that provides adequate target coverage. To evaluate the PD effects of AB154 in clinical samples, we developed a multicolor flow cytometry-based assay that utilizes an anti-TIGIT antibody that is competitive with AB154 to determine receptor occupancy. In human whole blood, ex vivo addition of AB154 achieved complete inhibition of TIGIT. Analysis of blood mononuclear cells, including CD8+ and CD4+ T-cells, Treg and NK cells, demonstrated target engagement by AB154 suitable for clinical development. In addition, we examined TIGIT receptor occupancy of AB154 (added to whole blood ex vivo) in a small cohort of non-small cell lung cancer (NSCLC) patients treated with anti-PD-1 antibody pembrolizumab. In these samples, TIGIT receptor occupancy by AB154 was comparable to that obtained with healthy donor blood samples. The data presented here provide: 1) rationale for combining AB154 with our in-house developed anti-PD-1 antibody (AB122) in upcoming clinical trials, and 2) methodology to evaluate TIGIT receptor occupancy in the upcoming AB154 dose escalation studies. AB154 is expected to enter clinical trials in 2018. Citation Format: Amy E. Anderson, Annette Becker, FangFang Yin, Hema Singh, Xiaoning Zhao, Lisa Seitz, Rick Stanton, Nigel P.C. Walker, Joanne B.L. Tan. Preclinical characterization of AB154, a fully humanized anti-TIGIT antibody, for use in combination therapies [abstract]. In: Proceedings of the Fourth CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; Sept 30-Oct 3, 2018; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2019;7(2 Suppl):Abstract nr A124.

Analytical validation of the CellMax platform for early detection of cancer by enumeration of rare circulating tumor cells

The CellMax (CMx®) platform was developed to enrich for epithelial circulating tumor cells (CTCs) in the whole blood. This report provides assay performance data, including accuracy, linearity, limit of blank, limit of detection (LOD), specificity, and precision of enumeration of cancer cell line cells (CLCs) spiked in cell culture medium or healthy donor blood samples. Additionally, assay specificity was demonstrated in 32 young healthy donors and clinical feasibility was demonstrated in a cohort of 47 subjects consisting of healthy donors and patients who were colonoscopy verified to have colorectal cancer, adenomas, or a negative result. The CMx platform demonstrated high accuracy, linearity, and sensitivity for the enumeration of all CLC concentrations tested, including the extremely low range of 1 to 10 cells in 2 mL of blood, which is most relevant for early cancer detection. Theoretically, the assay LOD is 0.71 CTCs in 2 mL of blood. The analytical specificity was 100% demonstrated using 32 young healthy donor samples. We also demonstrated precision across multiple days and multiple operators, with good reproducibility of recovery efficiency. In a clinical feasibility study, the CMx platform identified 8 of 10 diseased subjects as positive (80% clinical sensitivity) and 4 of 5 controls as negative (80% clinical specificity). We also compared processing time and transportation effects for similar blood samples from two different sites and assessed an artificial intelligence-based counting method. Finally, unlike other platforms for which captured CTCs are retained on ferromagnetic beads or tethered to the slide surface, the CMx platform’s unique airfoam-enabled release of CTCs allows captured cells to be transferred from a microfluidic chip to an Eppendorf tube, enabling a seamless transition to downstream applications such as genetic analyses and live cell manipulations.

Determination of spontaneous dicentric frequencies and establishment of dose-response curves after expose of human peripheral blood lymphocytes to low- and high-dose rate 60Co gamma rays – the basis for cytogenetic biodosimetry in Vietnam

Purpose: The purposes of this study are to investigate spontaneous dicentric frequencies and dose–response curves of dicentrics induced by gamma 60Co for replenishing the data sets used for biodosimetry in Vietnam.Materials and methods: One hundred and four healthy donor blood samples were collected for chromosome aberrations background study, 03 healthy donor blood samples were used for generating the dose–response curves at 1.96 mGy/min and 275 mGy/min. Blood collection, in vitro irradiation, cell culture and harvest, slide preparation and metaphase scoring were performed according to IAEA standard protocol (2011). Blind exposed samples were scored for verifying each curve.Results: The dicentric, fragment and chromatid break frequencies in 106,310 metaphases of 104 donors were 0.023% ± 0.005%, 0.045% ± 0.007% and 0.101% ± 0.011%, respectively. The dose–response curve for low-dose rate was y = C + (0.0137 ± 0.0055)D + (0.0912 ± 0.0142)D2 and for high-dose rate was y = C + (0.0337 ± 0.0046)D + (0.0539 ± 0.0031)D2, where both of them were verified.Conclusion: The data of this study were established for biological dose assessment in cases with low LET of accidental or occupational radiation exposures in the dose range of 0.1–5.0 Gy.

CRISPR/Cas9-Mediated Disruption of PD-L1 Reduces the T Cell Suppressive Effect of Wharton's Jelly Mesenchymal Stromal Cells and Their Extracellular Vesicles

BackgroundMesenchymal stem/stromal cells (MSCs) are a promising treatment for acute graft-versus-host disease and other inflammatory diseases. MSCs express programmed death-ligand 1 (PD-L1) that has been reported to contribute to MSC-mediated immune suppression through T-cell receptor (TCR)-mediated inhibitory signaling. MSCs actively secrete extracellular vesicles (EVs) that have immune modulatory properties resembling their cell of origin. Although the release of EVs by MSCs has been extensively reported, the presence and functional impact of immune inhibitory checkpoint molecules in MSC-derived EVs is still being determined. We sought to determine if PD-L1 and other immune inhibitory checkpoint molecules are enriched in MSC-derived EVs. In this study we report that PD-L1 is enriched in MSC-EVs, and that PD-L1(+) EVs and PD-L1(-) EVs differ in their T cell immune suppressive capacity.MethodsUmbilical cords and healthy donor blood samples were collected on separate IRB-approved protocols after written informed consent (HSC#1546/HSC#5929). Umbilical cord Wharton's jelly-MSCs (WJMSC) were isolated from umbilical cords under GMP conditions and characterized by morphology, multiparameter flow cytometry (MPFC), and differentiation capacity. Three clinical-grade WJMSC cell lines were cultured at low passage (2-5) in EV-depleted media. EVs were isolated from the media by differential ultracentrifugation and the 100K pellets enriched with exosomes were characterized by Western blot (WB), nanoparticle tracking analysis (NTA), and electron microscopy (EM). To further identify EV-enriched immune proteins, the WJMSC and EV proteomes were characterized by Tandem Mass Tag (TMT) labeling and LC MS/MS, using isobaric labels to compare protein quantities between samples. Gene disruption of PD-L1 was performed through site-specific CRISPR/Cas9 introducing a single cysteine nucleotide deletion in exon 3; the genetic mutation was confirmed by Sanger sequencing. The absence of PD-L1 transcript was confirmed by RT-PCR, and the absence of PD-L1 protein was confirmed by WB, immunofluorescence, MPFC, and IFNγ-response. PBMC were isolated from healthy donor blood samples; T cells were activated by CD3/CD28 beads and induced CD154 was measured on CD4(+) T cells by MPFC. Alternatively, CMV-experienced T cells were activated with CMV-pp65 peptide and induced IFNγ was measured on CD8(+) T cells by MPFC. Activated T cells were treated with PD-L1(+) and PD-L1(-) WJMSCs or their derived EVs. Phospho-Zap-70 (Tyr319)/Syk (Tyr352) MPFC was used to analyze T-cell receptor (TCR)-mediated signaling.ResultsWJMSCs were CD73(+), CD90(+), CD105(+), and CD34(-), CD45(-), CD11b(-), CD19(-) and HLA-DR(-); and inhibited proliferation in a mixed lymphocyte reaction. WJMSCs-derived EVs were cup-shaped 100-200nm nanoparticles by EM and were CD9(+), CD81(+), CD73(+), CD90(+), and CD105(+) by WB. Quantitative proteomic profiling revealed a total of 1,634 proteins across WJMSC-derived EV preparations. Proteins that were highly enriched in MSC-derived EVs and that were classified under “negative regulation of lymphocyte activation” (Gene Ontology Biological Processes; GOBP) included PDL1, CD276, DLG1, TNR6, ERBB2, TGFβ1, LYN, and HMGB3. Both WJMSCs and EVs suppressed CD4(+) T cell activation by CD3/CD28 beads and CD8(+) T cell activation by CMV peptide. CRISPR/Cas9 edited WJMSC exhibited normal morphology and differentiation characteristics. PD-L1 gene disruption efficiently reduced PD-L1 protein expression on WJMSC and their derived EVs, and reduced the ability of both to suppress T cell activation. Similarly, blocking PD-L1 with a specific internalization antibody decreased WJMSC and EV-mediated T cell activation.ConclusionProteomic analyses reveal that PD-L1 is enriched in WJMSC-derived EVs. CRISPR/Cas9-mediated disruption of PD-L1 in WJMSCs alone did not affect the release of EVs in vitro. Gene-edited WJMSCs stably generate PD-L1(-) EVs. The PD-L1(-) EVs generated from PD-L1(-) WJMSC did not suppress T cell activation in co-culture. These findings indicate that PD-L1 is enriched in WJMSC EVs and is biologically active. WJMSC-EVs can deliver membrane-bound PD-L1 to T cells, resulting in attenuated TCR signaling. DisclosuresMcGuirk:Fresenius Biotech: Research Funding; Bellicum Pharmaceuticals: Research Funding; Astellas Pharma: Research Funding; Pluristem Ltd: Research Funding; Gamida Cell: Research Funding; Kite Pharma: Honoraria, Other: travel accommodations, expenses, speaker ; Novartis Pharmaceuticals Corporation: Honoraria, Other: speaker, Research Funding.

An Optically Induced Dielectrophoresis (ODEP)-Based Microfluidic System for the Isolation of High-Purity CD45neg/EpCAMneg Cells from the Blood Samples of Cancer Patients-Demonstration and Initial Exploration of the Clinical Significance of These Cells.

Circulating tumour cells (CTCs) in blood circulation play an important role in cancer metastasis. CTCs are generally defined as the cells in circulating blood expressing the surface antigen EpCAM (epithelial cell adhesion molecule). Nevertheless, CTCs with a highly metastatic nature might undergo an epithelial-to-mesenchymal transition (EMT), after which their EpCAM expression is downregulated. In current CTC-related studies, however, these clinically important CTCs with high relevance to cancer metastasis could be missed due to the use of the conventional CTC isolation methodologies. To precisely explore the clinical significance of these cells (i.e., CD45neg/EpCAMneg cells), the high-purity isolation of these cells from blood samples is required. To achieve this isolation, the integration of fluorescence microscopic imaging and optically induced dielectrophoresis (ODEP)-based cell manipulation in a microfluidic system was proposed. In this study, an ODEP microfluidic system was developed. The optimal ODEP operating conditions and the performance of live CD45neg/EpCAMneg cell isolation were evaluated. The results demonstrated that the proposed system was capable of isolating live CD45neg/EpCAMneg cells with a purity as high as 100%, which is greater than the purity attainable using the existing techniques for similar tasks. As a demonstration case, the cancer-related gene expression of CD45neg/EpCAMneg cells isolated from the blood samples of healthy donors and cancer patients was successfully compared. The initial results indicate that the CD45neg/EpCAMneg nucleated cell population in the blood samples of cancer patients might contain cancer-related cells, particularly EMT-transformed CTCs, as suggested by the high detection rate of vimentin gene expression. Overall, this study presents an ODEP microfluidic system capable of simply and effectively isolating a specific, rare cell species from a cell mixture.

Scanning Electron Microscopy of Circulating Tumor Cells and Tumor-Derived Extracellular Vesicles.

To explore morphological features of circulating tumor cells (CTCs) and tumor-derived extracellular vesicles (tdEVs), we developed a protocol for scanning electron microscopy (SEM) of CTCs and tdEVs. CTCs and tdEVs were isolated by immunomagnetic enrichment based on their Epithelial Cell Adhesion Molecule (EpCAM) expression or by physical separation through 5 μm microsieves from 7.5 mL of blood from Castration-Resistant Prostate Cancer (CRPC) patients. Protocols were optimized using blood samples of healthy donors spiked with PC3 and LNCaP cell lines. CTCs and tdEVs were identified among the enriched cells by fluorescence microscopy. The positions of DNA+, CK+, CD45− CTCs and DNA−, CK+, CD45− tdEVs on the CellSearch cartridges and microsieves were recorded. After gradual dehydration and chemical drying, the regions of interest were imaged by SEM. CellSearch CTCs retained their morphology revealing various shapes, some of which were clearly associated with CTCs undergoing apoptosis. The ferrofluid was clearly distinguishable, shielding major portions of all isolated objects. CTCs and leukocytes on microsieves were clearly visible, but revealed physical damage attributed to the physical forces that cells exhibit while entering one or multiple pores. tdEVs could not be identified on the microsieves as they passed through the pores. Insights on the underlying mechanism of each isolation technique could be obtained. Complete detailed morphological characteristics of CTCs are, however, masked by both techniques.

Abstract 3674: Pharmacodynamic assessment in whole blood for the BET bromodomain inhibitor CPI-0610 of target engagement in patients with progressive lymphoma

Abstract Defining the relationship between small molecule exposure, clinical efficacy and target engagement via pharmacodynamic (PD) biomarkers is a key element of phase 1 clinical development. CPI-0610 is an orally bioavailable inhibitor of the bromodomain and extra-terminal (BET) domain family of proteins currently being evaluated in a number of phase I trials. To support the clinical development of CPI-0610, we sought to identify BET target genes in whole blood that function as PD markers for target engagement in patients. The utilization of whole blood rather than tumor samples for PD assessments allows for a high level of compliance for sample collection and assessment of serial samples to understand the kinetics of optimal gene regulation. This is important for the mechanism of action of BET bromodomain inhibitors, as it has been shown that target gene suppression is rapidly reversible upon removal of drug. A preliminary list of BET target genes was first identified after ex vivo treatment of healthy donor blood samples with a BET inhibitor followed by transcriptional profiling. Further characterization was carried out using blood samples recovered from in vivo studies in mice, as well as rat and dog toxicology studies for CPI-0610. Blood samples collected from patients with progressive lymphoma participating in a Phase I clinical study (NCT01949883) were analyzed for changes in the BET target genes and correlated with CPI-0610 dose, pharmacokinetic (PK) exposure and clinical activity. This enabled further refinement of the BET target gene signature to identify the most robust gene expression changes in patient samples. IL8 and CCR1 were the most strongly regulated genes, showing an exposure-dependent downregulation in patient samples. Using these target genes, we were able to identify a minimum threshold of exposure required for BET target engagement as well as show that BET target engagement can be achieved at doses below the maximum tolerated dose. Furthermore, ≥50% downregulation of IL8 was consistent with anti-lymphoma activity in patients from our trial. CCR2, FN1, CSF1R and THBS1 were identified and validated preclinically but in patient samples were difficult to interpret due to lack of robust regulation or low basal levels of expression. In summary, a BET target gene signature assay using whole blood samples was established and implemented in a Phase I lymphoma study which demonstrated that CPI-0610 regulates direct BET target genes in blood cells in a robust and dose-dependent manner. Citation Format: Jennifer A. Mertz, Kristie A. Blum, Anas Younes, Jeremy S. Abramson, Michael B. Maris, Ian W. Flinn, Andre Goy, Darrell R. Borger, Michael R. Cooper, Robert J. Sims. Pharmacodynamic assessment in whole blood for the BET bromodomain inhibitor CPI-0610 of target engagement in patients with progressive lymphoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3674.