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Timing of antiretroviral therapy initiation affects intact HIV reservoirs following analytical treatment interruption. 开始抗逆转录病毒治疗的时机会影响分析性治疗中断后的完整艾滋病毒储库。
Pub Date : 2024-10-15 DOI: 10.1172/jci181632
Maegan R Manning,Jana Blazkova,Jesse S Justement,Victoria Shi,Brooke D Kennedy,M Ali Rai,Catherine A Seamon,Kathleen Gittens,Michael C Sneller,Susan Moir,Tae-Wook Chun
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引用次数: 0
TREM2 aggravates sepsis by inhibiting fatty acid oxidation via the SHP1/BTK axis. TREM2 通过 SHP1/BTK 轴抑制脂肪酸氧化,从而加重败血症。
Pub Date : 2024-10-15 DOI: 10.1172/jci159400
Siqi Ming,Xingyu Li,Qiang Xiao,Siying Qu,Qiaohua Wang,Qiongyan Fang,Pingping Liang,Yating Xu,Jingwen Yang,Yongqiang Yang,Xi Huang,Yongjian Wu
Impaired fatty acid oxidation (FAO) and the therapeutic benefits of FAO restoration have been revealed in sepsis. However, the regulatory factors contributing to FAO dysfunction during sepsis remain inadequately clarified. In this study, we identified a subset of lipid-associated macrophages characterized by high expression of trigger receptor expressed on myeloid cells 2 (TREM2) and demonstrated that TREM2 acted as a suppressor of FAO to increase the susceptibility to sepsis. TREM2 expression was markedly up-regulated in sepsis patients and correlated with the severity of sepsis. Knock out of TREM2 in macrophages improved the survival rate and reduced inflammation and organ injuries of sepsis mice. Notably, TREM2-deficient mice exhibited decreased triglyceride accumulation and an enhanced FAO rate. Further observations showed that the blockade of FAO substantially abolished the alleviated symptoms observed in TREM2 knockout mice. Mechanically, we demonstrated that TREM2 interacted with the phosphatase SHP1 to inhibit Bruton tyrosine kinas (BTK)-mediated FAO in sepsis. Our findings expand the understanding of FAO dysfunction in sepsis and reveal TREM2 as a critical regulator of FAO, which may provide a promising target for the clinical treatment of sepsis.
脓毒症患者的脂肪酸氧化(FAO)功能受损,恢复 FAO 有助于治疗。然而,导致脓毒症期间脂肪酸氧化功能障碍的调节因素仍未得到充分阐明。在这项研究中,我们发现了以髓系细胞上表达的触发受体 2(TREM2)高表达为特征的脂质相关巨噬细胞亚群,并证明 TREM2 可抑制 FAO,从而增加对脓毒症的易感性。TREM2在败血症患者中的表达明显上调,并与败血症的严重程度相关。敲除巨噬细胞中的TREM2可提高脓毒症小鼠的存活率,减少炎症和器官损伤。值得注意的是,TREM2缺陷小鼠的甘油三酯积累减少,FAO率提高。进一步观察表明,阻断FAO大大缓解了TREM2基因敲除小鼠的症状。从机理上讲,我们证实 TREM2 与磷酸酶 SHP1 相互作用,抑制了脓毒症中布鲁顿酪氨酸激酶(BTK)介导的 FAO。我们的研究结果拓展了对脓毒症中FAO功能障碍的认识,并揭示了TREM2是FAO的一个关键调节因子,它可能为脓毒症的临床治疗提供一个有前景的靶点。
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引用次数: 0
EMC3 regulates trafficking and pulmonary toxicity of the SFTPCI73T mutation associated with interstitial lung disease. EMC3调节与间质性肺病相关的SFTPCI73T突变的迁移和肺毒性。
Pub Date : 2024-10-15 DOI: 10.1172/jci173861
Xiaofang Tang,Wei Wei,Yuqing Sun,Timothy E Weaver,Ernesto S Nakayasu,Geremy Clair,John M Snowball,Cheng-Lun Na,Karen S Apsley,Emily P Martin,Darrell N Kotton,Konstantinos-Dionysios Alysandratos,Jiuzhou Huo,Jeffery D Molkentin,William A Gower,Xinhua Lin,Jeffrey A Whitsett
The most common mutation in surfactant protein C gene (SFTPC), SFTPCI73T, causes interstitial lung disease with few therapeutic options. We previously demonstrated that EMC3, an important component of the multiprotein endoplasmic reticulum membrane complex (EMC), is required for surfactant homeostasis in alveolar type 2 epithelial (AT2) cells at birth. In the present study, we investigated the role of EMC3 in the control of SFTPCI73T metabolism and its associated alveolar dysfunction. Using a knock-in mouse model phenocopying the I73T mutation, we demonstrated that conditional deletion of Emc3 in AT2 cells rescued alveolar remodeling/simplification defects in neonatal and adult mice. Proteomic analysis revealed that Emc3 depletion reversed the disruption of vesicle trafficking pathways and rescued the mitochondrial dysfunction associated with I73T mutation. Affinity purification-mass spectrometry analysis identified potential EMC3 interacting proteins in lung AT2 cells, including Valosin Containing Protein (VCP) and its interactors. Treatment of SftpcI73T knock-in mice and SFTPCI73T expressing iAT2 cells derived from SFTPCI73T patient-specific iPSCs with the specific VCP inhibitor CB5083 restored alveolar structure and SFTPCI73T trafficking respectively. Taken together, the present work identifies the EMC complex and VCP in the metabolism of the disease-associated SFTPCI73T mutant, providing novel therapeutical targets for SFTPCI73T-associated interstitial lung disease.
表面活性物质蛋白 C 基因(SFTPC)最常见的突变 SFTPCI73T 可导致间质性肺病,但治疗方法却很少。我们曾证实,多蛋白内质网膜复合物(EMC)的重要组成部分 EMC3 是肺泡 2 型上皮细胞(AT2)出生时表面活性物质平衡所必需的。在本研究中,我们研究了 EMC3 在控制 SFTPCI73T 代谢及其相关肺泡功能障碍中的作用。我们利用一个表型为 I73T 突变的基因敲入小鼠模型证明,在 AT2 细胞中有条件地缺失 Emc3 可挽救新生小鼠和成年小鼠的肺泡重塑/简化缺陷。蛋白质组分析表明,Emc3的缺失逆转了囊泡运输途径的破坏,并挽救了与I73T突变相关的线粒体功能障碍。亲和纯化-质谱分析确定了肺AT2细胞中潜在的与EMC3相互作用的蛋白质,包括含缬氨酸蛋白(VCP)及其相互作用体。用特异性 VCP 抑制剂 CB5083 处理 SftpcI73T 基因敲入小鼠和 SFTPCI73T 表达的 iAT2 细胞(来源于 SFTPCI73T 患者特异性 iPSCs),可分别恢复肺泡结构和 SFTPCI73T 转运。综上所述,本研究发现了 EMC 复合物和 VCP 在与疾病相关的 SFTPCI73T 突变体的新陈代谢中的作用,为 SFTPCI73T 相关的间质性肺病提供了新的治疗靶点。
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引用次数: 0
Calcineurin inhibitor blocks tolerance by suppressing donor T cell terminal exhaustion after allogeneic hematopoietic cell transplantation. 钙神经蛋白抑制剂通过抑制异体造血细胞移植后供体 T 细胞终末衰竭来阻止耐受。
Pub Date : 2024-10-15 DOI: 10.1172/jci184332
Hajime Senjo,Daigo Hashimoto,Takanori Teshima
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引用次数: 0
Distinguishing between help and harm: Helper T cell subsets and immune-related adverse events. 区分帮助与伤害:辅助性 T 细胞亚群与免疫相关不良事件。
Pub Date : 2024-10-15 DOI: 10.1172/jci184310
Alexandra M Haugh,Adil I Daud
The precise conditions by which cytokines drive cancer is relevant to improving immune checkpoint inhibition (ICI) responses while decreasing toxicity. In this issue of the JCI, Kao et al. investigated T helper cell pathways in patients with solid tumors receiving ICI. The authors evaluated T cell populations, cytokine signatures, immune related adverse events (irAEs), and survival outcomes. Patients with a history of autoimmune disorders were more likely to develop irAEs. Notably, blood samples from patients on treatment showed that elevations in IL-5, IL-6, IL-17f, and TNF-α were associated with an increased risk for grade 2 or higher irAEs. Moreover, IL-6 was associated with decreased objective response rate and worse cancer-specific and all-cause mortality. These findings may help guide decisions for optimizing ICI efficacy while minimizing toxicity and suggest that IL-6 blockade may improve response and decrease toxicity in solid tumors.
细胞因子驱动癌症的确切条件与改善免疫检查点抑制剂(ICI)反应同时降低毒性息息相关。在本期 JCI 杂志上,Kao 等人研究了接受 ICI 治疗的实体瘤患者的 T 辅助细胞通路。作者评估了T细胞群、细胞因子特征、免疫相关不良事件(irAEs)和生存结果。有自身免疫性疾病病史的患者更容易出现irAEs。值得注意的是,接受治疗的患者血液样本显示,IL-5、IL-6、IL-17f和TNF-α的升高与2级或2级以上irAEs风险的增加有关。此外,IL-6还与客观反应率下降、癌症特异性死亡率和全因死亡率升高有关。这些发现可能有助于指导优化 ICI 疗效同时最大限度降低毒性的决策,并表明 IL-6 阻断可改善实体瘤的反应并降低毒性。
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引用次数: 0
Autoinflammation in patients with leukocytic CBL loss of heterozygosity is caused by constitutive ERK-mediated monocyte activation. 白细胞 CBL 杂合子缺失患者的自身炎症是由组成型 ERK 介导的单核细胞活化引起的。
Pub Date : 2024-10-15 DOI: 10.1172/jci181604
Jonathan Bohlen,Ivan Bagarić,Taja Vatovec,Masato Ogishi,Syed F Ahmed,Axel Cederholm,Lori Buetow,Steicy Sobrino,Corentin Le Floc'h,Carlos A Arango-Franco,Luis Seabra,Marine Michelet,Federica Barzaghi,Davide Leardini,Francesco Saettini,Francesca Vendemini,Francesco Baccelli,Albert Catala,Eleonora Gambineri,Marinella Veltroni,Yurena Aguilar de la Red,Gillian I Rice,Filippo Consonni,Laureline Berteloot,Laetitia Largeaud,Francesca Conti,Cécile Roullion,Cécile Masson,Boris Bessot,Yoann Seeleuthner,Tom Le Voyer,Darawan Rinchai,Jérémie Rosain,Anna-Lena Neehus,Lucia Erazo-Borrás,Hailun Li,Zarah Janda,En-Jui Cho,Edoardo Muratore,Camille Soudée,Candice Lainé,Eric Delabesse,Claire Goulvestre,Cindy S Ma,Anne Puel,Stuart G Tangye,Isabelle André,Christine Bole-Feysot,Laurent Abel,Miriam Erlacher,Shen-Ying Zhang,Vivien Béziat,Chantal Lagresle-Peyrou,Emmanuelle Six,Marlène Pasquet,Laia Alsina,Alessandro Aiuti,Peng Zhang,Yanick J Crow,Nils Landegren,Riccardo Masetti,Danny T Huang,Jean-Laurent Casanova,Jacinta Bustamante
Patients heterozygous for germline CBL loss-of-function (LOF) variants can develop myeloid malignancy, autoinflammation, or both, if some or all of their leukocytes become homozygous for these variants through somatic loss of heterozygosity (LOH) via uniparental isodisomy. We observed an upregulation of the inflammatory gene expression signature in whole blood from these patients, mimicking monogenic inborn errors underlying autoinflammation. Remarkably, these patients had constitutively activated monocytes that secreted 10 to 100 times more inflammatory cytokines than those of healthy individuals and CBL LOF heterozygotes without LOH. CBL-LOH hematopoietic stem and progenitor cells (HSPCs) outgrew the other cells, accounting for the persistence of peripheral monocytes homozygous for the CBL LOF variant. ERK pathway activation was required for the excessive production of cytokines by both resting and stimulated CBL-LOF monocytes, as shown in monocytic cell lines. Finally, we found that about 1 in 10,000 individuals in the UK Biobank were heterozygous for CBL LOF variants and that these carriers were at high risk of hematological and inflammatory conditions.
种系CBL功能缺失(LOF)变体的杂合子患者,如果其部分或全部白细胞通过单亲同源异位切除术发生体细胞杂合子缺失(LOH)而成为这些变体的同源变体,就会患上髓系恶性肿瘤、自身炎症或两者兼而有之。我们在这些患者的全血中观察到炎症基因表达特征的上调,模拟了自身炎症的单基因先天性错误。值得注意的是,与健康人和无 LOH 的 CBL LOF 杂合子相比,这些患者的构成性活化单核细胞分泌的炎症细胞因子要多 10 到 100 倍。CBL-LOH 造血干细胞和祖细胞(HSPCs)超越了其他细胞,这就是CBL LOF变体同源的外周单核细胞持续存在的原因。正如在单核细胞系中所显示的,静息和受刺激的 CBL-LOF 单核细胞都需要激活 ERK 通路,才能产生过多的细胞因子。最后,我们发现英国生物库中每一万人中就有一人是CBL LOF变体的杂合子,这些携带者患血液病和炎症的风险很高。
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引用次数: 0
HOPE springs eternal: lack of HIV superinfection in HIV Organ Policy Equity Act kidney transplants. 希望永存:《艾滋病器官政策公平法案》肾移植中未出现艾滋病超级感染。
Pub Date : 2024-10-15 DOI: 10.1172/jci184326
Christine M Durand,Andrew D Redd
Kidney transplantation from donors with HIV to recipients with HIV (HIV D+/R+) is an emerging practice that has shown substantial clinical benefit. Sustained HIV superinfection, whereby a transplant recipient acquires a new strain of HIV from their organ donor, is a theoretical risk, which might increase chances of viral failure. In this issue of the JCI, Travieso, Stadtler, and colleagues present phylogenetic analysis of HIV from kidney tissue, urine, plasma, and cells from 12 HIV D+/R+ kidney transplants out to five years of follow-up. Early after transplant, donor HIV was transiently detected in five of 12 recipients, primarily from donors with untreated HIV and high-level viremia, consistent with a viral inoculum. Long-term, donor HIV was not detected in any recipients, demonstrating no sustained HIV superinfection. These reassuring data support earlier findings from South Africa and the United States and further confirm the safety of HIV D+/R+ transplantation.
由感染 HIV 的供体向感染 HIV 的受体(HIV D+/R+)进行肾移植是一种新兴的做法,已显示出巨大的临床益处。持续的 HIV 超级感染,即移植受者从器官捐献者那里获得新的 HIV 菌株,是一种理论上的风险,可能会增加病毒失败的几率。在本期 JCI 杂志上,Travieso、Stadtler 及其同事介绍了对 12 例 HIV D+/R+ 肾移植随访五年的肾组织、尿液、血浆和细胞中 HIV 的系统发育分析。移植后早期,12 例受者中有 5 例短暂检测到供体艾滋病病毒,主要来自未治疗艾滋病病毒和高水平病毒血症的供体,与病毒接种体一致。长期来看,没有在任何受者体内检测到供体艾滋病病毒,表明没有持续的艾滋病病毒超级感染。这些令人欣慰的数据支持了南非和美国早前的研究结果,并进一步证实了 HIV D+/R+ 移植的安全性。
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引用次数: 0
Conversations with JCI editors in chief. 与 JCI 主编对话。
Pub Date : 2024-10-15 DOI: 10.1172/jci187017
Ushma S Neill
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引用次数: 0
Epigenetic therapies targeting histone lysine methylation: complex mechanisms and clinical challenges. 针对组蛋白赖氨酸甲基化的表观遗传疗法:复杂机制与临床挑战。
Pub Date : 2024-10-15 DOI: 10.1172/jci183391
Sarah Gold,Ali Shilatifard
As epigenetic therapies continue to gain ground as potential treatment strategies for cancer and other diseases, compounds that target histone lysine methylation and the enzyme complexes represent a major frontier for therapeutic development. Clinically viable therapies targeting the activities of histone lysine methyltransferases (HKMT) and demethylases (HKDMs) have only recently begun to emerge following FDA approval of the EZH2 inhibitor tazemetostat in 2020 and remain limited to compounds targeting the well-studied SET domain-containing HKMTs and their opposing HKDMs. These include the H3K27 methyltransferases EZH2/EZH1, the singular H3K79 methyltransferase DOT1L, and the H3K4 methyltransferase MLL1/COMPASS as well as H3K9 and H3K36 methyltransferases. They additionally include the H3K4/9-preferential demethylase LSD1 and the H3K4-, H3K27-, and H3K36-preferential KDM5, KDM6, and KDM2 demethylase subfamilies, respectively. This Review discusses the results of recent clinical and preclinical studies relevant to all of these existing and potential therapies. It provides an update on advancements in therapeutic development, as well as more basic molecular understanding, within the past 5 years approximately. It also offers a perspective on histone lysine methylation that departs from the long-predominant "histone code" metaphor, emphasizing complex-disrupting inhibitors and proximity-based approaches rather than catalytic domain inhibitors in the outlook for future therapeutic development.
随着表观遗传疗法作为癌症和其他疾病的潜在治疗策略的地位不断提高,以组蛋白赖氨酸甲基化和酶复合物为靶点的化合物成为治疗开发的主要前沿。在美国食品及药物管理局于 2020 年批准 EZH2 抑制剂 tazemetostat 之后,针对组蛋白赖氨酸甲基转移酶(HKMT)和去甲基化酶(HKDMs)活性的临床上可行的疗法最近才开始出现,而且仍然仅限于针对已被充分研究的含 SET 结构域的 HKMTs 及其对立的 HKDMs 的化合物。其中包括 H3K27 甲基转移酶 EZH2/EZH1、奇异的 H3K79 甲基转移酶 DOT1L 和 H3K4 甲基转移酶 MLL1/COMPASS,以及 H3K9 和 H3K36 甲基转移酶。此外,它们还包括 H3K4/9 偏好去甲基化酶 LSD1 和分别偏好 H3K4、H3K27 和 H3K36 的 KDM5、KDM6 和 KDM2 去甲基化酶亚家族。本综述讨论了与所有这些现有和潜在疗法相关的最新临床和临床前研究结果。它提供了过去 5 年中治疗开发的最新进展以及更基本的分子认识。它还从组蛋白赖氨酸甲基化的角度,提出了一种不同于长期以来占主导地位的 "组蛋白密码 "隐喻的观点,在展望未来的治疗开发时,强调复合干扰抑制剂和基于邻近性的方法,而不是催化域抑制剂。
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引用次数: 0
An emerging multi-omic understanding of the genetics of opioid addiction. 对阿片类药物成瘾遗传学的多原子新认识。
Pub Date : 2024-10-15 DOI: 10.1172/jci172886
Eric O Johnson,Heidi S Fisher,Kyle A Sullivan,Olivia Corradin,Sandra Sanchez-Roige,Nathan C Gaddis,Yasmine N Sami,Alice Townsend,Erica Teixeira Prates,Mirko Pavicic,Peter Kruse,Elissa J Chesler,Abraham A Palmer,Vanessa Troiani,Jason A Bubier,Daniel A Jacobson,Brion S Maher
Opioid misuse, addiction, and associated overdose deaths remain global public health crises. Despite the tremendous need for pharmacological treatments, current options are limited in number, use, and effectiveness. Fundamental leaps forward in our understanding of the biology driving opioid addiction are needed to guide development of more effective medication-assisted therapies. This Review focuses on the omics-identified biological features associated with opioid addiction. Recent GWAS have begun to identify robust genetic associations, including variants in OPRM1, FURIN, and the gene cluster SCAI/PPP6C/RABEPK. An increasing number of omics studies of postmortem human brain tissue examining biological features (e.g., histone modification and gene expression) across different brain regions have identified broad gene dysregulation associated with overdose death among opioid misusers. Drawn together by meta-analysis and multi-omic systems biology, and informed by model organism studies, key biological pathways enriched for opioid addiction-associated genes are emerging, which include specific receptors (e.g., GABAB receptors, GPCR, and Trk) linked to signaling pathways (e.g., Trk, ERK/MAPK, orexin) that are associated with synaptic plasticity and neuronal signaling. Studies leveraging the agnostic discovery power of omics and placing it within the context of functional neurobiology will propel us toward much-needed, field-changing breakthroughs, including identification of actionable targets for drug development to treat this devastating brain disease.
阿片类药物滥用、成瘾以及与之相关的用药过量死亡仍是全球性的公共卫生危机。尽管对药物治疗的需求巨大,但目前的选择在数量、使用和有效性方面都很有限。我们对阿片类药物成瘾生物学的认识需要有根本性的飞跃,以指导开发更有效的药物辅助疗法。本综述将重点关注与阿片类药物成瘾相关的分子生物学特征。最近的全球基因组研究已开始发现强有力的遗传关联,包括 OPRM1、FURIN 和 SCAI/PPP6C/RABEPK 基因簇中的变异。越来越多对死后人类脑组织的 omics 研究检查了不同脑区的生物特征(如组蛋白修饰和基因表达),发现了与阿片类药物滥用者过量死亡相关的广泛基因失调。通过荟萃分析和多组学系统生物学,并借鉴模式生物研究,阿片类药物成瘾相关基因富集的关键生物通路正在形成,其中包括与突触可塑性和神经元信号传导相关的信号传导通路(如Trk、ERK/MAPK、orexin)相联系的特定受体(如GABAB受体、GPCR和Trk)。利用 omics 不可知论的发现能力,并将其置于功能神经生物学的背景下进行研究,将推动我们取得急需的、改变领域的突破,包括确定用于药物开发的可行靶点,以治疗这种毁灭性的脑部疾病。
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引用次数: 0
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The Journal of Clinical Investigation
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