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Both, jawless and jawed vertebrates possess three lymphocyte lineages defined by highly diverse antigen receptors: Two T‐cell‐ and one B‐cell‐like lineage. In both phylogenetic groups, the theoretically possible number of individual antigen receptor specificities can even outnumber that of lymphocytes of a whole organism. Despite fundamental differences in structure and genetics of these antigen receptors, convergent evolution led to functional similarities between the lineages. Jawed vertebrates possess αβ and γδ T‐cells defined by eponymous αβ and γδ T‐cell antigen receptors (TCRs). “Conventional” αβ T‐cells recognize complexes of Major Histocompatibility Complex (MHC) class I and II molecules and peptides. Non‐conventional T‐cells, which can be αβ or γδ T‐cells, recognize a large variety of ligands and differ strongly in phenotype and function between species and within an organism. This review describes similarities and differences of non‐conventional T‐cells of various species and discusses ligands and functions of their TCRs. A special focus is laid on Vγ9Vδ2 T‐cells whose TCRs act as sensors for phosphorylated isoprenoid metabolites, so‐called phosphoantigens (PAg), associated with microbial infections or altered host metabolism in cancer or after drug treatment. We discuss the role of butyrophilin (BTN)3A and BTN2A1 in PAg‐sensing and how species comparison can help in a better understanding of this human Vγ9Vδ2 T‐cell subset.
About 1–5% of human blood T cells are Vγ9Vδ2 T cells. Their hallmark is the expression of T cell antigen receptors (TCR) whose γ-chains contain a rearrangement of Vγ9 with JP (TRGV9JP or Vγ2Jγ1.2) and are paired with Vδ2 (TRDV2)-containing δ-chains. These TCRs respond to phosphoantigens (PAg) such as (E)-4-hydroxy-3-methyl-but-2-enyl pyrophosphate (HMBPP), which is found in many pathogens, and isopentenyl pyrophosphate (IPP), which accumulates in certain tumors or cells treated with aminobisphosphonates such as zoledronate. Until recently, these cells were believed to be restricted to primates, while no such cells are found in rodents. The identification of three genes pivotal for PAg recognition encoding for Vγ9, Vδ2, and butyrophilin (BTN) 3 in various non-primate species identified candidate species possessing PAg-reactive Vγ9Vδ2 T cells. Here, we review the current knowledge of the molecular basis of PAg recognition. This not only includes human Vγ9Vδ2 T cells and the recent discovery of BTN2A1 as Vγ9-binding protein mandatory for the PAg response but also insights gained from the identification of functional PAg-reactive Vγ9Vδ2 T cells and BTN3 in the alpaca and phylogenetic comparisons. Finally, we discuss models of the molecular basis of PAg recognition and implications for the development of transgenic mouse models for PAg-reactive Vγ9Vδ2 T cells.
Background
The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS).
Methods
This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay.
Results
Most patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009).
Conclusions
COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.
While there is abounding literature on virus-induced pathology in general and coronavirus in particular, recent evidence accumulates showing distinct and deleterious brain affection. As the respiratory tract connects to the brain without protection of the blood–brain barrier, SARS-CoV-2 might in the early invasive phase attack the cardiorespiratory centres located in the medulla/pons areas, giving rise to disturbances of respiration and cardiac problems. Furthermore, brainstem regions are at risk to lose their functional integrity. Therefore, long-term neurological as well as psychiatric symptomatology and eventual respective disorders cannot be excluded as evidenced from influenza-A triggered post-encephalitic Parkinsonism and HIV-1 triggered AIDS–dementia complex. From the available evidences for coronavirus-induced brain pathology, this review concludes a number of unmet needs for further research strategies like human postmortem brain analyses. SARS-CoV-2 mirroring experimental animal brain studies, characterization of time-dependent and region-dependent spreading behaviours of coronaviruses, enlightening of pathological mechanisms after coronavirus infection using long-term animal models and clinical observations of patients having had COVID-19 infection are calling to develop both protective strategies and drug discoveries to avoid early and late coronavirus-induced functional brain disturbances, symptoms and eventually disorders. To fight SARS-CoV-2, it is an urgent need to enforce clinical, molecular biological, neurochemical and genetic research including brain-related studies on a worldwide harmonized basis.
Patienten mit einer HIV-Infektion werden mit antiretroviralen Medikamenten therapiert, um die Krankheitsprogression zu verhindern, die HIV-Replikation zu hemmen und klinische HIV-induzierte Symptome zu verbessern. Für HIV-assoziierte neurokognitive Störungen (HAND) als Folge einer Infektion mit HIV gibt es jedoch noch keine ausreichende Therapie. In dieser Arbeit wurden PBMC, Serum- und Liquorproben von Teilnehmern einer placebokontrollierten klinischen Studie analysiert, in der die Wirksamkeit einer Lithium-Therapie bei HIV-Patienten mit HAND untersucht wurde. Die Studienteilnehmer erhielten für sechs Monate zusätzlich zu ihrer antiretroviralen Medikation Lithiumcarbonat bzw. ein Placebo. Die Einschlusskriterien waren eine mindestens sechs Monaten bestehende antiretrovirale Therapie bei unterdrückter Viruslast und eine mittelschwere bis schwere Manifestation der HIV-assoziierten neurokognitiven Störung. Die Studie wurde in Primary Care Kliniken des öffentlichen Sektors in Kapstadt, Südafrika, durchgeführt. Als primärer Wirksamkeitsendpunkt wurde die Veränderung des Global Deficit Scores (GDS) von Beginn der Studie bis zum Ende der 24. Woche festgelegt. Es hatten insgesamt 66 Patienten an der Studie teilgenommen, davon bekamen 32 Patienten das Medikament Lithiumcarbonat und 34 Patienten ein Placebo. Den Patienten wurden zu den Zeitpunkten Baseline (V3) und 24. Woche (V12) Blut- und CSF-Proben entnommen. In der vorliegenden Arbeit wurden die Proben mittles Durchflusszytometrie und ELISA untersucht. Die Daten wurden mit dem GDS sowie weiteren Progressionsmarkern der HIV-Infektion wie Viruslast und CD4+ Zellzahl korreliert. Von den 66 Teilnehmern, die die Studie begonnen haben, schlossen insgesamt 61 Teilnehmer ab, darunter hatten 30 Patienten Lithiumcarbonat und 31 Patienten ein Placebo eingenommen. Das Durchschnittsalter lag bei 40 Jahren und die mittlere CD4+ T-Zellzahl umfasste 500 Zellen pro ml. Es traten sechs schwerwiegende unerwünschte Ereignisse auf, aber keines wurde in Zusammenhang mit dem Studienmedikament betrachtet. Die Patienten mit HAND, die zusätzlich zu einer antiretroviralen Therapie eine medikamentöse Behandlung mit Lithium erhielten, haben dieses klinisch gut vertragen. Jedoch konnte keine Verbesserung in Bezug auf neurokognitive Beeinträchtigungen für die Studienteilnehmer beobachtet werden. In der vorliegenden Arbeit konnte gezeigt werden, dass im zeitlichen Verlauf von V3 zu V12 ein signifikante Verbesserung des GDS innerhalb der Placebo-, sowie innerhalb der Lithium-Gruppe beobachtet werden konnte, wohingegen bei den Gruppen untereinander, Lithium versus Placebo, zu den jeweiligen Zeitpunkten V3 sowie V12, ähnliche Werte gemessen werden konnten und sich daher die Lithium-, und die Placebo-Gruppe nicht signifikant voneinander unterschieden. Aus den in dieser Arbeit gewonnenen Ergebnissen ließ sich zudem ableiten, dass ein signifikanter Abfall der BDNF Konzentration im Plasma zu verzeichnen war. Insgesamt war ein Trend erkennbar, dass Patienten mit blip eine höhere Immunaktivierung zeigten, als Patienten ohne blip. Jedoch hatte die Behandlung mit Lithium keinen Einfluss auf die Immunaktivierung der CD8+ T-Zellen. Des Weiteren zeigte sich unter der Lithium-Therapie ein signifikanter Abfall der CD4+ Zellzahlen.
N-Glykosylierungen spielen beim Env-Gen eine wichtige Rolle. Sie dienen nicht nur als „Escape-Phänomen“ zur Verhinderung einer Elimination des Virus durch neutralisierende Antikörper. Es hat sich gezeigt, dass bestimmte Menschen sich mit HIV infizieren können, aber es zu keinem Zeitpunkt zu AIDS-typischen Symptomen kommt, ohne die Einnahme antiretroviraler Therapie (ART). Solche Menschen werden als Elite Controller bezeichnet. Ihr Organismus kann selbst die Viruslast in sehr geringen Grenzen halten (< 50 Kopien/ml). Ziel dieser Arbeit ist es, den Einfluss von N-Glykosylierungen in der Entstehung von Elite Controller zu untersuchen und prozentuell eine Tendenz zu schaffen, inwieweit die Glykosylierungsdichte des Env-Proteins entscheidend ist.
Es konnte gezeigt werden, dass eine immunologische Kontrolle auch auf der B-Zellebene stattfinden kann. Als Hinweis dient die geringe Glykosylierungsdichte im Bereich CD4bs und MPER, die indirekt über MHC Klasse II zu einer erhöhten Produktion von Antikörpern führen kann. Bisher wurde bei Elite Controller die T-Zellebene als mögliche immunologische Kontrolle beschrieben, jedoch gibt diese Arbeit hinweise, dass auch eine immunologische Kontrolle mittels Antikörper möglich ist. Die glykosylierten Zielepitope können eine große Hilfe sein für das Aussehen eines späteren Impfstoffs.
In dieser Arbeit wurde der Einfluss des Zytokins OPN speziell auf CD4+ CD25+ Foxp3+- regulatorische bzw. CD4+ CD25- Foxp3-- konventionelle T-Zellen mithilfe v.a. durchflusszytometrischer Daten untersucht.
Es konnte gezeigt werden, dass rekombinantes OPN die Supprimierbarkeit von konventionellen T-Zellen aus OPN-Knock-out-Tieren durch regulatorische T-Zellen aus Wildtyp- oder OPN-KO-Tieren erhöht. Die Supprimierbarkeit von wildtypischen Tconv-Zellen wird durch OPN jedoch nicht beeinflusst.
Exon-4 Mutations in KRAS Affect MEK/ERK and PI3K/AKT Signaling in Human Multiple Myeloma Cell Lines
(2020)
Approximately 20% of multiple myeloma (MM) cases harbor a point mutation in KRAS. However, there is still no final consent on whether KRAS-mutations are associated with disease outcome. Specifically, no data exist on whether KRAS-mutations have an impact on survival of MM patients at diagnosis in the era of novel agents. Direct blockade of KRAS for therapeutic purposes is mostly impossible, but recently a mutation-specific covalent inhibitor targeting KRAS\(^{p.G12C}\) entered into clinical trials. However, other KRAS hotspot-mutations exist in MM patients, including the less common exon-4 mutations. For the current study, the coding regions of KRAS were deep-sequenced in 80 newly diagnosed MM patients, uniformely treated with three cycles of bortezomib plus dexamethasone and cyclophosphamide (VCD)-induction, followed by high-dose chemotherapy and autologous stem cell transplantation. Moreover, the functional impact of KRAS\(^{p.G12A}\) and the exon-4 mutations p.A146T and p.A146V on different survival pathways was investigated. Specifically, KRAS\(^{WT}\), KRAS\(^{p.G12A}\), KRAS\(^{p.A146T}\), and KRAS\(^{p.A146V}\) were overexpressed in HEK293 cells and the KRAS\(^{WT}\) MM cell lines JJN3 and OPM2 using lentiviral transduction and the Sleeping Beauty vector system. Even though KRAS-mutations were not correlated with survival, all KRAS-mutants were found capable of potentially activating MEK/ERK- and sustaining PI3K/AKT-signaling in MM cells.
Background: Integrase strand transfer inhibitors (INSTIs) are the latest addition to the array of antiretroviral compounds used to treat an infection with Human Immunodeficiency Virus (HIV). Due to their high efficacy and increased tolerability, INSTIs have become an integral part of first-line therapy in most high-income countries over the past years. However, little is known about HIV-1’s genetic inter- and intra-subtype diversity on the Integrase (IN)-gene and its impact on the emergence of INSTI-resistance. In the absence of a functional cure, long-term efficacy of first-line compounds remains paramount for reducing virological failure and curbing on-going HIV transmissions. South Africa, harbouring more than 20% of the global HIV burden (7.7 / 37.9 million people), requires international attention in order to globally pursue UNAIDS’ (Joint United Nations Programme on HIV/AIDS) 90-90-90 goals and the road to ending the HIV/AIDS (Acquired immunodeficiency syndrome) pandemic by 2030.
Methods: In this study, the prevalence of INSTI-resistance associated mutations (RAM) was investigated in a cohort of 169 archived drug-naïve blood samples from multiple collection sites around Cape Town, South Africa. Viral RNA was isolated from plasma samples, the integrase fragment amplified by RT-PCR and subsequently sequenced by Sanger-sequencing. Additionally, all publicly available drug-naïve, South African IN sequences, isolated before the availability of the first INSTIs in 2007, were retrieved from the Los Alamos HIV sequence database (n=284). All sequences were analysed for RAMs using the Stanford HIV Drug resistance database. The identification of polymorphism in the South African subtype C IN consensus sequence allowed for comparative analyses with global subtype B, as well as subtype C sequences, from countries other than South Africa.
Results: The IN gene could be amplified and sequenced in 95/169 samples (56%). Phylogenetic inference revealed close homology between three sequence-pairs, warranting the exclusion of 3/95 sequences from further analyses. Of the 92 samples used for mutational analyses, 86/92 (93.5%) belonged to subtype C, 5/92 (5.4%) to subtype B and 1/92 (1.1%) to subtype A. The prevalence of major and accessory INSTI RAMs was 0/92 (0%) and 1/91 (1.1%), respectively, similar to the observed rates of 8/284 (2.8%) and 8/284 (2.8%) in the database sequences (p = 0.2076 and p = 0.6944, Fisher’s exact test). Compared to subtype B IN sequences, 15 polymorphisms were significantly enriched in South African subtype C sequences (corrected p<0.0015. Fisher’s exact test, Bonferroni post-hoc procedure).
Compared to subtype C IN sequences isolated outside South Africa, four polymorphisms were significantly enriched in this study cohort (corrected p<0.0014, Fisher’s exact test, Bonferroni post-hoc procedure). The highest prevalence margin was observed for the polymorphism Met50Ile being present in 60.1% of South African subtype C sequences, compared to 37% in non-South African subtype C sequences.
Conclusions: The low prevalence of major and minor RAMs in all South African Integrase sequences predicts a high susceptibility to INSTIs, however, the presence of natural polymorphisms, in particular Met50Ile, in the majority of sequences warrants further monitoring under therapeutic pressure, as their role in mutational pathways leading to INSTI- resistance is yet to be determined. Additionally, this study revealed the presence of substantial inter- and intra-subtype diversity within the HIV-1 Subtype C IN-gene. These results implicate the need for more research on a regional, potentially patient-specific level, as mutational insights from other diverse backgrounds may not accurately represent the South African context. The implementation of a national pre-treatment INSTI-resistance screening program may provide necessary insights into the development of mutational pathways leading to INSTI-resistance under therapeutic pressure for the South African context and thereby bring South Africa one step closer to achieving UNAIDS 90-90-90 goals and ending the AIDS epidemic by 2030.
Genome-wide association studies revealed CLEC16A as a candidate gene for Type 1 Diabetes and multiple other autoimmune disorders. The function of CLEC16A remains unknown. However, previous work showed that the CLEC16A ortholog ema and the murine Clec16a were both implicated in autophagy, a process partially required for MHC class II loading and antigen presentation. Furthermore, studies could show that autophagy was required in thymic epithelial cells for antigen presentation during T cell selection, suggesting a possible role of CLEC16A in T cell selection in the thymus. Additionally, it was postulated that CLEC16A may function as an expression quantitative trait locus for its neighboring genes and that Clec16a KD was involved in pancreatic islet function and impaired insulin secretion and glucose homeostasis. Prior to this work, Schuster et al. had created a Clec16a KD NOD mouse, which was protected from spontaneous autoimmune diabetes.
For this work it was hypothesized that CLEC16A variation serves as a Type 1 Diabetes risk gene by affecting autophagy in thymic epithelial cells, which modulates antigen presentation and shapes the T cell repertoire. To expand and complement previous findings by Schuster et al., this thesis aimed to investigate how CLEC16A modifies the function of thymic epithelial cells. For this purpose, CLEC16A KD was induced in human cells via RNA interference and autophagy was studied through immunoblotting. Additionally, inflammation of pancreatic tissue in Clec16a KD NOD mice was scored using H.E. stained pancreatic sections. Thymic transplantation experiments were conducted to test whether the effects of Clec16a KD were T cell intrinsic. Also, intraperitoneal glucose tolerance tests were performed to study glucose homeostasis in Clec16a KD NOD animals. Finally, using qPCR, gene expression levels of neighboring genes such as Dexi and Socs1 were measured to study Clec16a as an expression quantitative trait locus.
In combination with the findings of Schuster et al., this thesis demonstrates that Clec16a KD reduces the severity of insulitis and protects from onset of spontaneous diabetes in the NOD mouse. Disease protection is conveyed by impaired autophagy in TEC, which leads to altered T cell selection and hyporeactive CD4+ T cells. The effects of Clec16a KD in the NOD mouse are thymus intrinsic. Glucose homeostasis remains unchanged in the Clec16a KD NOD mouse and plays no role in disease protection. Clec16a and Dexi presented similar expression levels, but further studies are required to investigate a clear link between these two genes. Finally, impaired autophagy could be replicated in human CLEC16A KD cells, which demonstrates a conserved function of CLEC16A and suggests a possible link between CLEC16A variation and risk of autoimmune disease in human.