Th1/17 Hybrid CD4 + Cells Are Expanded in Bronchial Alveolar Lavage Fluid from Leukemia Patients with Checkpoint Inhibitor-Induced Pneumonitis

2017 ◽  
Vol 17 (10) ◽  
pp. S10 ◽  
Author(s):  
Sang Kim ◽  
Vickie Shannon ◽  
Ajay Sheshadri ◽  
Hagop Kantarjian ◽  
Guillermo Garcia-Manero ◽  
...  
2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 204-204
Author(s):  
Sang Kim ◽  
Vickie Shannon ◽  
Ajay Sheshadri ◽  
Hagop M. Kantarjian ◽  
Guillermo Garcia-Manero ◽  
...  

204 Background: Immune checkpoint inhibitor (ICI)-based therapies are showing encouraging results for acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). 20% of AML or MDS patients receiving an ICI develop lung inflammation (herein, pneumonitis), one of fatal immune related adverse events (irAEs). The mechanisms of pneumonitis, the most important step for risk stratification and early detection, remain elusive. Methods: We analyzed bronchial alveolar lavage (BAL) fluid from 8 AML or MDS patients, who received an ICI, developed respiratory symptoms, and underwent a standard-of-care bronchoscopy. As a control, we analyzed BAL fluid from 5 AML or MDS patients who had never received an ICI or had received last ICI more than 16 weeks prior to the bronchoscopy. We also analyzed matched blood within 72 hours after the bronchoscopy. We stained CD4+ cells with lineage specific markers, including CXCR3, CXCR5, CD25, CD127, CCR4, and CCR6. Proportion of the CD4+ cell subsets within total CD4+ lymphocytes in BAL and blood were compared between the pneumonitis and controls. Results: Th1 (CXCR3hi) CD4+ cells were expanded in controls in BAL (pneumonitis versus control, 4.2 ± 2.5 % versus 17.2 ± 6.3 % within total CD4+ lymphocytes, P= 0.04) and blood (pneumonitis versus control, 0.5 ± 0.3 % versus 4.0 ± 1.3 % within total CD4+ lymphocytes, P= 0.01). In contrast, Th1/17 (CXCR3hi CCR6hi) hybrid CD4+ cells, known to be pathogenic in autoimmune diseases, were expanded in BAL from the pneumonitis group (pneumonitis versus control, 40.3 ± 8.4 % versus 13.7 ± 4.5 % within total CD4+ lymphocytes, P= 0.03). Th1/17 hybrid CD4+ cells were also PD-1hi Ki67hi, suggesting their hyperactive status. Though not reached statistical significance, regulatory T cells were decreased in BAL from pneumonitis group (pneumonitis versus control, 20.8 ± 4.9 % versus 26.2 ± 9.2 % within total CD4+ lymphocytes). Conclusions: These results suggest that Th1/17 hybrid CD4+ cells may play a central role in pneumonitis. Understanding of the Th1/17 hybrid CD4+ cell biology will provide therapeutic targets and reliable biomarkers for pneumonitis.


2012 ◽  
Vol 67 (11) ◽  
pp. 22-28 ◽  
Author(s):  
V. V. Erokhin ◽  
L. N. Lepekha ◽  
M. V. Erokhina ◽  
I. V. Bocharova ◽  
A. V. Kurynina ◽  
...  

Pulmonary surfactant is necessary component for maintenance of high level of phagocytic activity of alveolar macrophages. Tuberculosis inflammation reduces the production of surfactant by type II cells and phagocytic activity of alveolar macrophages. The effects of exogenous pulmonary surfactant on the ultrastructural changes of various subpopulations of alveolar macrophages were studied by TEM-method. For investigations the bronchial alveolar lavage fluid from guinea pigs infected of M. tuberculosis and treated by isoniazid or isoniazid + exogenous pulmonary surfactant were used. It was shown that isoniazid + exogenous pulmonary surfactant normalizes the heterogeneous population of alveolar macrophages providing stimulating effects on their maturation and phagocytic activity more effectively than isoniazid therapy. 


2020 ◽  
Author(s):  
Yuan Zhang ◽  
Qiuping Huang ◽  
Zhigang Zhou ◽  
Yun Xie ◽  
Xianchen Li ◽  
...  

Abstract Background and Objectives The influence of virus detected in BALF is still debating. This study aimed to compare the prognosis of lower respiratory tract infected patients with virus detected in bronchial alveolar lavage fluid (BALF) and patients with virus undetected by using metagenomic next-generation sequencing technology.Methods This was a retrospective cohort study. 53 patients with lower respiratory tract infection were enrolled. BALF samples were collected from each patient and sent to perform mNGS pathogenic test in the study. According to the results of mNGS test, patients were divided into virus-detected group and virus-undetected group. In the meanwhile, patients’ clinical information, medical history, disease severity scores, parameters of organ function at the day of ICU admission, prognosis, hospital length of stay, ICU length of stay and needs for medical support were also collected.Results 39.6 percent (21/53) of the BALF samples were virus nucleic acid positive. Mortality rate, tracheotomy rate, mechanical ventilation supporting time, blood transfusion rate were significantly higher in virus-detected group than that in virus-undetected group. Virus-detected was closely related to hospital and ICU survival time.Conclusions Patients with virus detected in BALF were prone to a poorer prognosis. The detection of virus was a high-risk factor of death for LRTI patients. Virus-detected patients required more medical resources.


PLoS ONE ◽  
2009 ◽  
Vol 4 (9) ◽  
pp. e7047 ◽  
Author(s):  
David Wunschel ◽  
Bobbie-Jo Webb-Robertson ◽  
Charles W. Frevert ◽  
Shawn Skerrett ◽  
Nat Beagley ◽  
...  

1997 ◽  
Vol 41 ◽  
pp. 256-256
Author(s):  
Padmani Karna ◽  
Faisal Rawas ◽  
Deborah Randall-Hlubek ◽  
Thomas Huard

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2374-2374
Author(s):  
Christopher W Dougher ◽  
Alexander Buffone ◽  
Mehrab Nasirikenari ◽  
Joseph T. Lau

Abstract The dynamic interaction of hematopoietic stem and progenitor cells (HSPC) with niche environments and delivery of soluble extrinsic signals are the principal driving factors determining cell fate decisions for self renewal, expansion, and differentiation. Here we present evidence that a systemic glycosyltransferase originating from the liver is one such extrinsic signal that acts by remodeling hematopoietic progenitor cell surfaces. There is mounting evidence that sialyl- and fucosyl-glycan structures mediate adhesive interactions critical to stem cell differentiation (Alisson-Silva et al. Glycobiology, 2014). Our lab has discovered that the absence of a single type of sialic acid linkage on HSPC cell surface profoundly augments the ability of hematopoietic progenitors to produce myeloid cells. This single sialic acid linkage, the Sia(alpha2,6) linkage on Gal(beta1,4)-GlcNAc termini, is constructed by the blood-borne glycosyltransferase ST6Gal-1. Mice with diminished circulatory ST6Gal-1 levels have more severe inflammatory responses, secondary to elevated production of granulocytic inflammatory cells in the marrow. Less clear, however, are the consequences of elevated systemic ST6Gal-1 on HSPC homeostasis. Here, we show that ST6Gal-1 acts as a cell-signaling rheostat by blunting the response of granulocytic progenitors to cytokines. Accordingly, ex vivo ST6Gal-1 treated human CD34+ cells showed stunted growth response to a myeloid-differentiation cocktail consisting of SCF, IL-3, and G-CSF (Fig. 1). Blinded cytochemical myeloperoxidase evaluation noted a substantial decrease in myeloid differentiation in ST6Gal-1 treated cells. To study these effects in vivo, we utilized a transplantable murine melanoma (B16-S6G) transduced to stably express excess soluble ST6Gal-1 into circulation in mice. We subjected naïve B16-S6G, B16-cntl, and C57BL/6 (WT) animals to a Th1 inflammatory challenge with intra-tracheal lipopolysaccharide (LPS) and monitored inflammatory cell infiltrates in the bronchial alveolar lavage fluid (BALF). The mutant dP1 mouse, which is deficient in the circulatory pool of extracellular ST6Gal-1, was included as positive control for enhanced inflammation (Nasirikenari et al. Journal of Leukocyte Biology, 2010). On average, around 1.5x106 neutrophils were recoverable in the bronchial alveolar lavage fluid in B16-S6G mice 24 hours after LPS challenge. This represents about half the recovered cells from B16-cntl and WT mice, and over a 3-fold reduction from dP1 animals. Although total cellularity in the marrow was not perturbed amongst the different models, we found the marrow to be drastically depleted (>50% of normal) of CD11b+Ly6G+ PMNs. Higher order marrow progenitors within the Lin-, c-kit+, Sca-1- (LK) population, namely common myeloid progenitor (CMP; LK, CD41-), pre-granulocyte macrophage progenitor (Pre-GM; LK, CD41-FcgRII/III-Endoglin-CD150-), and pro-granulocyte macrophage progenitor (pro-GMP; LK, CD41-FcgRII/III+) numbers remained similar across control and transduced tumor-bearing mice. However, enhanced surface sialylation segregated markedly with granulocytic precursors, and ex vivo primary marrow culture revealed ST6Gal-1 blunted granulocytic differentiation at the level of the granulocyte-macrophage progenitor (GMP). Taken together, our data show that ST6Gal-1 action conveys instructive cues critical for late-stage granulocytic development. These findings have important implications for instances in which suppression of an overactive innate response may be clinically desirable. Disclosures No relevant conflicts of interest to declare.


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