Abstract
Immune responses against transgene products can compromise adeno-associated virus–mediated (AAV-mediated) gene transfer. Although several factors influencing this immunogenicity have been described, the early in vivo events driving CD8+ T cell activation remain poorly defined. Here, we examined antigen presentation kinetics following intramuscular AAV administration in mice. Strikingly, viral genomes were detected in draining lymph nodes as early as 1 hour after injection, and transgene-derived peptides were presented to CD8+ T cells from day 1, resulting in progressive activation and first cell divisions detected at day 4. Removal of the injection site demonstrated that AAV particles reaching draining lymph nodes within the first hour were sufficient to induce cytotoxic transgene-specific CD8+ T cells. Finally, AAV vectors incorporating different muscle-specific promoters and regulatory sequences were evaluated. Although muscle specific, all promoters exhibited variable transgene expression in dendritic cells in vitro, correlating with early T cell activation in vivo; notably, those associated with higher early antigen presentation induced robust T cell response, whereas reduced presentation correlated with absence of CD8+ T cells. These findings reveal an unexpectedly early onset of transgene-derived epitope presentation, modulated by promoter specificity, which critically shapes CD8+ T cell response. This provides a rationale for evaluating and mitigating AAV immunogenicity in gene therapy design.
Authors
Lindsay Jeanpierre, Coralie Pecquet, Hanadi Saliba, Pauline Finard, Stéphane Terry, Gianni Tavella, Inès Guesmia, Sylvie Boutin, Bérangère Bertin, Sofia Benkhelifa-Ziyyat, Giuseppe Ronzitti, David-Alexandre Gross
Abstract
Immunosenescence, the biological aging of the immune system, leads to dysregulated immune responses, increasing susceptibility to infections and reducing vaccine efficacy in older adults, as seen with flu vaccines. In contrast, the AS01-adjuvanted recombinant herpes zoster vaccine (RZV) maintains high and sustained efficacy, offering 82% protection against herpes zoster at 11 years after vaccination in individuals over 50. To identify factors affecting age-dependent vaccine efficacy, we conducted a randomized, partially placebo-controlled clinical study. Young adults (18–35 years, n = 84) were randomized 3:3:1:1 to receive either RZV, an inactivated quadrivalent seasonal influenza vaccine (IIV4), or a placebo for RZV or for IIV4, and older adults (≥60, n = 63) were randomized 1:1 to receive RZV or IIV4. RZV elicited robust antibody production, antigen-specific polyfunctional CD4+ T cell responses, and IFN-γ from PBMCs in both age groups, while IIV4 increased antibody responses but induced fewer antigen-specific CD4+ T cells and no elevation of IFN-γ from PBMCs. Interestingly, RZV reduced systemic inflammation in older adults, particularly after the second injection. Baseline inflammation negatively correlated with antibody production and IFN-γ response, especially after RZV. Our findings suggest that RZV may help overcome immunosenescence by enhancing cellular responses and potentially decreasing systemic inflammation, deserving further investigation into the underlying molecular mechanisms.
Authors
Gizem Kilic, Esther J.M. Taks, Leonie S. Helder, Elisabeth A. Dulfer, Büsra Geckin, Liesbeth van Emst, Heidi Lemmers, Stefano Berrè, Adhidev Biswas, Mumin Ozturk, Yutaka Negishi, Wivine Burny, Sofia M. Buonocore, Jaap ten Oever, Musa M. Mhlanga, Mihai G. Netea
Abstract
Identifying mechanisms of kidney disease commonly involves comparing diseased samples with healthy reference tissues; however, the effects of variability in tissue procurement, storage, and donor characteristics remain underexplored. In this study, we systematically evaluated 3 reference tissue types — tumor nephrectomy (TN), pretransplant biopsies from living donors (LD), and percutaneous biopsies from healthy control volunteers (HC) — to determine their impact on differential gene expression across 3 diabetic kidney disease states. We observed distinct injury markers, cell state proportions, and gene signatures associated with procurement method, sex, and donor age. Adjustment for these confounding factors significantly influenced pathway analysis results. Specifically, correcting for age and sex eliminated significant enrichment of IFN-γ response when comparing the diabetes mellitus–resilient group and HC group. Processes related to biological aging were enriched in older reference tissues, potentially confounding disease-specific interpretations. Importantly, TNF signaling via NF-κB remained enriched in LD and TN samples relative to HC, even after accounting for confounders. These results underscore the critical importance of selecting appropriate control tissues and rigorously adjusting for confounding variables to reliably discern the molecular mechanisms underlying kidney diseases.
Authors
Rajasree Menon, Paul L. Kimmel, Edgar A. Otto, Lalita Subramanian, Christopher L. O’Connor, Bradley Godfrey, Cathy Smith, Fadhl Alakwaa, Celine C. Berthier, Minnie M. Sarwal, E. Steve Woodle, Laura Pyle, Ye Ji Choi, Patricia Ladd, John R. Sedor, Sylvia E. Rosas, Sushrut S. Waikar, Abhijit S. Naik, Ricardo Melo Ferreira, Michael T. Eadon, Markus Bitzer, Petter Bjornstad, Jeffrey B. Hodgin, Matthias Kretzler, for the Kidney Precision Medicine Project (KPMP)
Abstract
HLA-E–restricted HIV-specific T cells offer exciting possibilities for immunotherapy. However, HLA-E binding peptides are rare. A recent study showed that in HLA-B*57:01–positive people with HIV, the peptide that dominates the T cell response, KAFSPEVIPMF (KF11), also stimulates HLA-E–restricted T cells, even though direct binding of this peptide to HLA-E could not be demonstrated. We therefore changed position 2 alanine for methionine in the peptide (referred to as KMF11), which greatly enhanced binding to HLA-E. This enabled the generation of stabilized HLA-E-KMF11 tetramers, which were used to select and then grow specific T cell clones from T cells of HLA-B*57:01–negative blood donors primed with this peptide in vitro. Approximately 20% of these T cell clones reacted with HLA-E–positive cells presenting the native KF11 peptide. Furthermore, these T cells inhibited replication of HIV-1 NL4-3 in CD4+ T cells in vitro. Therefore, this native peptide can be presented by HLA-E to CD8+ T cells, although priming in vivo may depend on cross-reactivities to classical MHC-Ia types. Nevertheless, such T cells could be exploitable for immunotherapy given the conservation of this HIV-1 peptide epitope and the non-polymorphism in HLA-E.
Authors
Hong Sun, Hongbing Yang, Max N. Quastel, Simon Brackenridge, Wanlin He, Anna E. Kliszczak, Margarida Rei, Persephone Borrow, Geraldine M. Gillespie, Andrew J. McMichael
Abstract
Small bowel transplantation (SBT) is the only curative treatment for intestinal failure due to short bowel syndrome (SBS); however, the 10-year graft survival rate after SBT remains below 50%. Therefore, alternative treatments are required. We developed a potentially new therapeutic strategy for intestinal failure involving in vivo intestinal regeneration using a decellularized scaffold in a rat model. A 3 cm segment of decellularized small intestine was anastomosed to the jejunum for in vivo regeneration. After 4 weeks of regeneration, the entire native intestine was resected to induce SBS, and the regenerated intestine was transplanted into the same rat. Histological analysis revealed regeneration of mucosa, nerves, muscular layer, and crypts, consistent with autologous cell infiltration. An indocyanine green test confirmed blood flow from the adjacent mesentery into the regenerated intestine. The regenerated intestine exhibited absorption of nutrients in vivo, and ex vivo assessments confirmed peristalsis and absorptive capacity comparable with native intestine. Transplantation of the regenerated intestine significantly improved postoperative nutritional status in SBS rats. Our method, autogenic-regenerated intestinal transplantation, showed the therapeutic potential for intestinal failure. This is the first study to our knowledge to demonstrate a functionally integrated regenerated intestine, providing a foundation for future regenerative therapy.
Authors
Kentaro Iwaki, Takamichi Ishii, Hidenobu Kojima, Fumiaki Munekage, Hiroshi Horie, Kenta Makino, Takuma Karasuyama, Yusuke Hanabata, Elena Yukie Uebayashi, Satoshi Ogiso, Etsuro Hatano
Abstract
Biallelic loss-of-function variants in adaptor protein complex 4 (AP-4) disrupt trafficking of transmembrane proteins at the trans-Golgi network, including autophagy-related protein 9A (ATG9A), leading to childhood-onset hereditary spastic paraplegia (AP-4-HSP). AP-4-HSP is characterized by features of both a neurodevelopmental and a degenerative neurological disease. To investigate the molecular mechanisms underlying AP-4-HSP and identify potential therapeutic targets, we conducted an arrayed CRISPR/Cas9 loss-of-function screen of 8,478 genes, targeting the “druggable genome,” in a human neuronal model of AP-4 deficiency. Through this phenotypic screen and subsequent experiments, key modulators of ATG9A trafficking were identified, and complementary pathway analyses provided insights into the regulatory landscape of ATG9A transport. Knockdown of ANPEP and NPM1 enhanced ATG9A availability outside the trans-Golgi network, suggesting that they regulate ATG9A localization. These findings deepen our understanding of ATG9A trafficking in the context of AP-4 deficiency and offer a framework for the development of targeted interventions for AP-4-HSP.
Authors
Marvin Ziegler, Cedric Günter, Julian E. Alecu, Xutong Xue, Hyo M. Kim, Afshin Saffari, Alexandra K. Davies, Mustafa Sahin, Darius Ebrahimi-Fakhari
Abstract
The sodium-dependent multivitamin transporter, encoded by SLC5A6, mediates cellular uptake of biotin and pantothenic acid, essential cofactors for energy metabolism. We identified 2 families with SLC5A6 mutations presenting with early-onset dilated cardiomyopathy (DCM). To investigate the link between vitamin deficiency and cardiomyopathy, we generated a cardiac-specific SLC5A6-knockout (Slc5a6cKO) mouse model and evaluated the impact of vitamin supplementation. Slc5a6cKO mice developed progressive cardiac dysfunction, culminating in cardiac pathology and premature death at 26 weeks; earlier stages exhibited cardiomyocyte hypertrophy, fibrosis, impaired coenzyme A synthesis, and metabolic imbalance, indicating progression toward cardiomyopathy. Cardiac magnetic resonance imaging and ECG confirmed progressive functional decline. Proteomic analysis revealed early mitochondrial metabolic disruption and extracellular matrix protein upregulation at 8 weeks, preceding overt cardiac dysfunction. Strikingly, vitamin supplementation from preconception onwards prevented the cardiac phenotype, preserving cardiac structure, function, morphology and survival. This paralleled the clinical outcome in one patient who received early vitamin treatment, compared with another who required a heart transplant without vitamin treatment. This study establishes a direct link between SLC5A6-mediated vitamin transport, mitochondrial function, and cardiac health. It highlights how vitamin deficiency contributes to cardiomyopathy pathogenesis and supports early vitamin supplementation as a potential therapeutic strategy for metabolic cardiomyopathies.
Authors
Millie O. Fullerton, Lauren C. Phillips, Rachael E. Redgrave, Luke Spray, Vincent Haufroid, George Merces, Scott T. Kerridge, Gavin D. Richardson, Nathalie Mercier, Dominique Roland, Rebecca Crossley, Andrew D.H. Morgan, Joseph P. Dewulf, John Burn, Simon D. Bamforth, Helen M. Phillips
Abstract
Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer, arising from both B and T cell lineages (B-ALL and T-ALL). Current therapy exploits ALL cells’ low expression of asparagine synthetase (ASNS) by using L-asparaginase, a bacterial enzyme that depletes circulating asparagine. However, resistance can emerge through induction of ASNS, mediated in part by the amino acid stress sensor GCN2. In this study, we addressed the efficacy of L-asparaginase in combination with genetic or pharmacological inhibition of GCN2 and the ASNS inhibitor ASX-173. Using a KrasG12D-driven mouse model of T-ALL, we found that GCN2 is dispensable for leukemogenesis. However, genetic inactivation or pharmacologic inhibition of GCN2 sensitized ALL cells to asparagine depletion, correlating with impaired ASNS induction. While GCN2 targeting enhanced sensitivity to asparagine depletion, a subset of Gcn2–/– T-ALL cells retained high ASNS expression and remained resistant to L-asparaginase. Likewise, some human T-ALL cells with elevated ASNS levels were refractory to GCN2 inhibition even under asparagine-depleted conditions. When combined with L-asparaginase, ASX-173 effectively eliminated ASNShi leukemic cells in vitro and in vivo. These findings suggest that direct targeting of ASNS provides therapeutic benefit in leukemias that express high levels of ASNS and are resistant to GCN2 inhibition under asparagine-depleted conditions.
Authors
Rodney Claude, Sankalp Srivastava, Kirk A. Staschke, Carlos Mellado-Fritz, Shaoxiong Chen, Lei Liu, Minghua Zhong, Harish Kothandaraman, Nadia A. Lanman, Utpal Davé, Sandeep Batra, Jiehao Zhou, Yue Fang, Chi Zhang, Reuben Kapur, Jing Fan, Ronald C. Wek, Ji Zhang
Abstract
Kawasaki disease (KD) is an acute febrile systemic vasculitis of unknown etiology and the leading cause of acquired heart disease among children. Complement activation has long been observed in patients with acute KD; however, its contribution to disease development remains unknown. Here, using publicly available datasets, we showed that patients with acute KD exhibited higher expression of complement products in whole blood, consistent with the activation of the complement pathway. Similarly, in the Lactobacillus casei cell wall extract (LCWE) murine model of KD, LCWE injection induced increased expression of complement products in cardiovascular tissues, suggestive of activation of the complement pathways. C3-deficient mice or WT mice treated with the complement C5a receptor 1 (C5ar1) antagonist developed significantly more severe LCWE-induced cardiovascular lesions and vasculitis. Furthermore, we observed that LCWE binds to serum C3, an opsonizing factor that labels microbial targets for clearance, and LCWE deposition in the liver was significantly higher in C3-deficient mice compared with WT mice. Overall, our data indicate that blocking the complement system significantly exacerbates LCWE-induced KD vasculitis, likely by impairing C3-mediated clearance of LCWE. These data suggest that the complement pathway may play a protective role in KD pathogenesis by promoting clearance of a potential bacterial or viral trigger of KD.
Authors
Asli E. Atici, Begüm Kocatürk, Benjamin L. Ross, Emily A. Aubuchon, Rebecca A. Porritt, Thacyana T. Carvalho, Takahiro Namba, Youngho Lee, Magali Noval Rivas, Moshe Arditi
Abstract
Spreading depolarizations (SDs) are propagating waves of near-complete breakdown of transmembrane ion gradients that occur during acute ischemic stroke and worsen outcome by driving calcium overload and glutamate release in neurons and astrocytes. The plasmalemmal sodium-calcium exchanger (NCX) plays a key role in such changes, in that the complex ionic disequilibrium during ischemia induces reverse-mode activity of NCX, leading to cellular calcium overload in exchange for sodium. However, the cell-type-specific roles of NCX in neurons and astrocytes during SDs remain unclear. Here, we used ion and glutamate reporters in an in vivo stroke model in mice carrying inducible, cell-specific deletions of NCX isoform 1. Neuronal NCX1 deletion reduced neuronal and astrocytic calcium transients, increased neuronal sodium transients, decreased extracellular glutamate levels, and raised SD initiation threshold. In contrast, astrocytic NCX1 deletion increased sodium transients in both neurons and astrocytes, and increased neuronal calcium as well as extracellular glutamate levels. A computational model of ischemia confirmed that these effects are consistent with reverse-mode NCX1 activity. Together, these findings indicate opposing roles of reverse-mode NCX1 during ischemia. Neuronal NCX1 promotes SD susceptibility, calcium overload, and glutamate release, whereas astrocytic NCX1 exerts protective effects by attenuating glutamate elevation and neuronal calcium accumulation.
Authors
Somayyeh Hamzei Taj, Pawan Kumar Thapaliya, Cordula Rakers, Niklas J. Gerkau, Christine R. Rose, Ghanim Ullah, Gabor C. Petzold
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