Microbiology & Immunology - Research Publications

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    Guidelines for the use of flow cytometry and cell sorting in immunological studies (third edition)
    Cossarizza, A ; Chang, H-D ; Radbruch, A ; Abrignani, S ; Addo, R ; Akdis, M ; Andrae, I ; Andreata, F ; Annunziato, F ; Arranz, E ; Bacher, P ; Bari, S ; Barnaba, V ; Barros-Martins, J ; Baumjohann, D ; Beccaria, CG ; Bernardo, D ; Boardman, DA ; Borger, J ; Boettcher, C ; Brockmann, L ; Burns, M ; Busch, DH ; Cameron, G ; Cammarata, I ; Cassotta, A ; Chang, Y ; Chirdo, FG ; Christakou, E ; Cicin-Sain, L ; Cook, L ; Corbett, AJ ; Cornelis, R ; Cosmi, L ; Davey, MS ; De Biasi, S ; De Simone, G ; del Zotto, G ; Delacher, M ; Di Rosa, F ; Di Santo, J ; Diefenbach, A ; Dong, J ; Doerner, T ; Dress, RJ ; Dutertre, C-A ; Eckle, SBG ; Eede, P ; Evrard, M ; Falk, CS ; Feuerer, M ; Fillatreau, S ; Fiz-Lopez, A ; Follo, M ; Foulds, GA ; Froebel, J ; Gagliani, N ; Galletti, G ; Gangaev, A ; Garbi, N ; Garrote, JA ; Geginat, J ; Gherardin, NA ; Gibellini, L ; Ginhoux, F ; Godfrey, DI ; Gruarin, P ; Haftmann, C ; Hansmann, L ; Harpur, CM ; Hayday, AC ; Heine, G ; Hernandez, DC ; Herrmann, M ; Hoelsken, O ; Huang, Q ; Huber, S ; Huber, JE ; Huehn, J ; Hundemer, M ; Hwang, WYK ; Iannacone, M ; Ivison, SM ; Jaeck, H-M ; Jani, PK ; Keller, B ; Kessler, N ; Ketelaars, S ; Knop, L ; Knopf, J ; Koay, H-F ; Kobow, K ; Kriegsmann, K ; Kristyanto, H ; Krueger, A ; Kuehne, JF ; Kunze-Schumacher, H ; Kvistborg, P ; Kwok, I ; Latorre, D ; Lenz, D ; Levings, MK ; Lino, AC ; Liotta, F ; Long, HM ; Lugli, E ; MacDonald, KN ; Maggi, L ; Maini, MK ; Mair, F ; Manta, C ; Manz, RA ; Mashreghi, M-F ; Mazzoni, A ; McCluskey, J ; Mei, HE ; Melchers, F ; Melzer, S ; Mielenz, D ; Monin, L ; Moretta, L ; Multhoff, G ; Munoz, LE ; Munoz-Ruiz, M ; Muscate, F ; Natalini, A ; Neumann, K ; Ng, LG ; Niedobitek, A ; Niemz, J ; Almeida, LN ; Notarbartolo, S ; Ostendorf, L ; Pallett, LJ ; Patel, AA ; Percin, GI ; Peruzzi, G ; Pinti, M ; Pockley, AG ; Pracht, K ; Prinz, I ; Pujol-Autonell, I ; Pulvirenti, N ; Quatrini, L ; Quinn, KM ; Radbruch, H ; Rhys, H ; Rodrigo, MB ; Romagnani, C ; Saggau, C ; Sakaguchi, S ; Sallusto, F ; Sanderink, L ; Sandrock, I ; Schauer, C ; Scheffold, A ; Scherer, HU ; Schiemann, M ; Schildberg, FA ; Schober, K ; Schoen, J ; Schuh, W ; Schueler, T ; Schulz, AR ; Schulz, S ; Schulze, J ; Simonetti, S ; Singh, J ; Sitnik, KM ; Stark, R ; Starossom, S ; Stehle, C ; Szelinski, F ; Tan, L ; Tarnok, A ; Tornack, J ; Tree, TIM ; van Beek, JJP ; van de Veen, W ; van Gisbergen, K ; Vasco, C ; Verheyden, NA ; von Borstel, A ; Ward-Hartstonge, KA ; Warnatz, K ; Waskow, C ; Wiedemann, A ; Wilharm, A ; Wing, J ; Wirz, O ; Wittner, J ; Yang, JHM ; Yang, J (WILEY, 2021-12)
    The third edition of Flow Cytometry Guidelines provides the key aspects to consider when performing flow cytometry experiments and includes comprehensive sections describing phenotypes and functional assays of all major human and murine immune cell subsets. Notably, the Guidelines contain helpful tables highlighting phenotypes and key differences between human and murine cells. Another useful feature of this edition is the flow cytometry analysis of clinical samples with examples of flow cytometry applications in the context of autoimmune diseases, cancers as well as acute and chronic infectious diseases. Furthermore, there are sections detailing tips, tricks and pitfalls to avoid. All sections are written and peer-reviewed by leading flow cytometry experts and immunologists, making this edition an essential and state-of-the-art handbook for basic and clinical researchers.
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    A phase 1b open-label dose-finding study of ustekinumab in young adults with type 1 diabetes
    Marwaha, AK ; Chow, S ; Pesenacker, AM ; Cook, L ; Sun, A ; Long, SA ; Yang, JHM ; Ward-Hartstonge, KA ; Williams, E ; Domingo-Vila, C ; Halani, K ; Harris, KM ; Tree, TIM ; Levings, MK ; Elliott, T ; Tan, R ; Dutz, JP (OXFORD UNIV PRESS, 2022-01-01)
    OBJECTIVES: We assessed the safety of ustekinumab (a monoclonal antibody used in psoriasis to target the IL-12 and IL-23 pathways) in a small cohort of recent-onset (<100 days of diagnosis) adults with type 1 diabetes (T1D) by conducting a pilot open-label dose-finding and mechanistic study (NCT02117765) at the University of British Columbia. METHODS: We sequentially enrolled 20 participants into four subcutaneous dosing cohorts: (i) 45 mg loading weeks 0/4/16, (ii) 45 mg maintenance weeks 0/4/16/28/40, (iii) 90 mg loading weeks 0/4/16, and (iv) 90 mg maintenance weeks 0/4/16/28/40. The primary endpoint was safety as assessed by an independent data and safety monitoring board (DSMB) but we also measured mixed meal tolerance test C-peptide, insulin use/kg, and HbA1c. Immunophenotyping was performed to assess immune cell subsets and islet antigen-specific T cell responses. RESULTS: Although several adverse events were reported, only two (bacterial vaginosis and hallucinations) were thought to be possibly related to drug administration by the study investigators. At 1 year, the 90 mg maintenance dosing cohort had the smallest mean decline in C-peptide area under the curve (AUC) (0.1 pmol/ml). Immunophenotyping showed that ustekinumab reduced the percentage of circulating Th17, Th1, and Th17.1 cells and proinsulin-specific T cells that secreted IFN-γ and IL-17A. CONCLUSION: Ustekinumab was deemed safe to progress to efficacy studies by the DSMB at doses used to treat psoriasis in adults with T1D. A 90 mg maintenance dosing schedule reduced proinsulin-specific IFN-γ and IL-17A-producing T cells. Further studies are warranted to determine if ustekinumab can prevent C-peptide AUC decline and induce a clinical response.
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    Lasting Changes to Circulating Leukocytes in People with Mild SARS-CoV-2 Infections
    Kennedy, AE ; Cook, L ; Breznik, JA ; Cowbrough, B ; Wallace, JG ; Huynh, A ; Smith, JW ; Son, K ; Stacey, H ; Ang, J ; McGeer, A ; Coleman, BL ; Larche, M ; Larche, M ; Hambly, N ; Nair, P ; Ask, K ; Miller, MS ; Bramson, J ; Levings, MK ; Nazy, I ; Svenningsen, S ; Mukherjee, M ; Bowdish, DME (MDPI, 2021-11)
    Survivors of severe SARS-CoV-2 infections frequently suffer from a range of post-infection sequelae. Whether survivors of mild or asymptomatic infections can expect any long-term health consequences is not yet known. Herein we investigated lasting changes to soluble inflammatory factors and cellular immune phenotype and function in individuals who had recovered from mild SARS-CoV-2 infections (n = 22), compared to those that had recovered from other mild respiratory infections (n = 11). Individuals who had experienced mild SARS-CoV-2 infections had elevated levels of C-reactive protein 1-3 months after symptom onset, and changes in phenotype and function of circulating T-cells that were not apparent in individuals 6-9 months post-symptom onset. Markers of monocyte activation, and expression of adherence and chemokine receptors indicative of altered migratory capacity, were also higher at 1-3 months post-infection in individuals who had mild SARS-CoV-2, but these were no longer elevated by 6-9 months post-infection. Perhaps most surprisingly, significantly more T-cells could be activated by polyclonal stimulation in individuals who had recently experienced a mild SARS-CoV-2, infection compared to individuals with other recent respiratory infections. These data are indicative of prolonged immune activation and systemic inflammation that persists for at least three months after mild or asymptomatic SARS-CoV-2 infections.
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    Impaired Th17 immunity in recurrent C. difficile infection is ameliorated by fecal microbial transplantation
    Cook, L ; Rees, WD ; Wong, MQ ; Wang, X ; Peters, H ; Oliveira, L ; Lau, T ; Mah, R ; Bressler, B ; Gomez, R ; Chow, I-T ; James, EA ; Kwok, WW ; Levings, MK ; Steiner, TS ( 2020-06-10)
    Background & Aims: Clostridioides difficile is a leading cause of infectious diarrhea and an urgent antimicrobial resistant threat. Symptoms are caused by its toxins, TcdA and TcdB, with many patients developing recurrent C. difficile infection (CDI), requiring fecal microbiota transplant (FMT). Antibody levels have not been useful in predicting patient outcomes, which is an unmet need. We aimed to characterize T cell-mediated immunity to C. difficile toxins and assess how these responses were affected by FMT. Methods: We obtained blood samples from patients with newly acquired CDI, recurrent CDI (with a subset receiving FMT), inflammatory bowel disease with no history of CDI, and healthy individuals (controls). Toxin-specific CD4+ T cell responses were analysed using a whole blood flow cytometry antigen-induced marker assay. Serum antibodies were measured by ELISA. Tetramer guided mapping was used to identify HLA-II-restricted TcdB epitopes and DNA was extracted from TcdB-specific CD4+ T cells for TCR repertoire analysis by Sanger sequencing. Results: CD4+ T cell responses to C. difficile toxins were functionally diverse. Compared to controls, individuals with CDI, or inflammatory bowel disease had significantly higher frequencies of TcdB-specific CD4+ T cells. Subjects with recurrent CDI had reduced proportions of TcdB-specific CD4+ Th17 cells, FMT reversed this deficit and increased toxin-specific antibody production. Conclusions: These data suggest that effective T cell immunity to C. difficile requires the development of Th17 cells. In addition, they show that an unknown aspect of the therapeutic effect of FMT may be enhanced T and B cell-mediated immunity to TcdB.
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    Recurrent Clostridioides difficile Infection Is Associated With Impaired T Helper Type 17 Immunity to C difficile Toxin B
    Cook, L ; Rees, WD ; Wong, MQ ; Kwok, WW ; Levings, MK ; Steiner, TS (W B SAUNDERS CO-ELSEVIER INC, 2021-03)
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    An inulin-type fructan enriched exclusive enteral nutrition formula suppresses colitis through gut microbiome modulation and promoting expansion of anti-inflammatory T cell subsets
    Healey, GR ; Tsai, K ; Lisko, DJ ; Cook, L ; Vallance, BA ; Jacobson, K ( 2021-02-02)
    Background & Aims: Exclusive enteral nutrition (EEN) is used to treat pediatric Crohn’s disease (CD), but therapeutic benefits are not long lasting. Due to reported lower efficacy EEN is not routinely used to treat pediatric ulcerative colitis (UC). Inulin-type fructans (IN) beneficially modulate the gut microbiome and promote expansion of anti-inflammatory immune cells. We hypothesized that enriching EEN with IN (EENIN) would enhance treatment efficacy. To test this, we examined the effects of EEN-IN on colitis development, the gut microbiome and CD4+ T cells using an adoptive T cell transfer model of colitis. Methods: TCR-ß deficient mice were randomized to one of four groups: 1) Control, 2) Chow, 3) EEN and 4) EEN-IN, and naïve CD4+ T cells were adoptively transferred into groups 2-4, after which mice were monitored for 5-weeks prior to experimental endpoint. Results: Mice fed EEN-IN showed greater colitis protection, with colonic shortening, goblet cell and crypt density loss reduced over that of EEN fed mice and reduced disease activity and immune cell infiltration compared to chow fed mice, and less crypt hyperplasia and higher survival compared to both groups. EENIN mice maintained colonic mucus layer thickness and had increased levels of Foxp3+IL-10+ and Rorγt+IL- 22+ and reduced levels of Tbet+
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    Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection Enhances Adaptive Immunity to C difficile Toxin B
    Cook, L ; Rees, WD ; Wong, MQ ; Peters, H ; Levings, MK ; Steiner, TS (Elsevier, 2021-05-01)
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    Lasting changes to circulating leukocytes in people with mild SARS-CoV-2 infections
    Kennedy, AE ; Cook, L ; Breznik, JA ; Cowbrough, B ; Wallace, JG ; Huynh, A ; Smith, JW ; Son, K ; Stacey, H ; Ang, J ; McGeer, A ; Coleman, BL ; Larché, M ; Larché, M ; Hambly, N ; Nair, P ; Ask, K ; Miller, MS ; Bramson, J ; Levings, MK ; Nazy, I ; Svenningsen, S ; Mukherjee, M ; Bowdish, DME ( 2021)
    Abstract: Survivors of severe SARS-CoV-2 infections frequently suffer from a range of post-infection sequelae. Whether survivors of mild or asymptomatic infections can expect any long-term health consequences is not yet known. Herein we investigated lasting changes to soluble inflammatory factors and cellular immune phenotype and function in individuals who had recovered from mild SARS-CoV-2 infections (n=22) compared to those that had recovered from other mild respiratory infections (n=11). Individuals who had mild SARS-CoV-2 infections had elevated levels of C-reactive protein 1-3 months after symptom onset, and changes in phenotype and function of circulating T cells that were not apparent in individuals 6-9 months post-symptom onset. Markers of monocyte activation and expression of adherence and chemokine receptors indicative of altered migratory capacity were also higher at 1-3 months post-infection in individuals who had mild SARS-CoV-2, but these were no longer elevated by 6-9 months post-infection. Perhaps most surprisingly, polyclonal activation of T cells was higher in individuals who had recently experienced a mild SARS-CoV-2 infection compared to individuals with other recent respiratory infections. These data are indicative of prolonged immune activation and systemic inflammation that persists for up to three months after mild or asymptomatic SARS-CoV-2 infections.
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    Characterization of Adaptive-like γδ T Cells in Ugandan Infants during Primary Cytomegalovirus Infection
    Tuengel, J ; Ranchal, S ; Maslova, A ; Aulakh, G ; Papadopoulou, M ; Drissler, S ; Cai, B ; Mohsenzadeh-Green, C ; Soudeyns, H ; Mostafavi, S ; van den Elzen, P ; Vermijlen, D ; Cook, L ; Gantt, S (MDPI, 2021-10)
    Gamma-delta (γδ) T cells are unconventional T cells that help control cytomegalovirus (CMV) infection in adults. γδ T cells develop early in gestation, and a fetal public γδ T cell receptor (TCR) clonotype is detected in congenital CMV infections. However, age-dependent γδ T cell responses to primary CMV infection are not well-understood. Flow cytometry and TCR sequencing was used to comprehensively characterize γδ T cell responses to CMV infection in a cohort of 32 infants followed prospectively from birth. Peripheral blood γδ T cell frequencies increased during infancy, and were higher among CMV-infected infants relative to uninfected. Clustering analyses revealed associations between CMV infection and activation marker expression on adaptive-like Vδ1 and Vδ3, but not innate-like Vγ9Vδ2 γδ T cell subsets. Frequencies of NKG2C+CD57+ γδ T cells were temporally associated with the quantity of CMV shed in saliva by infants with primary infection. The public γδ TCR clonotype was only detected in CMV-infected infants <120 days old and at lower frequencies than previously described in fetal infections. Our findings support the notion that CMV infection drives age-dependent expansions of specific γδ T cell populations, and provide insight for novel strategies to prevent CMV transmission and disease.
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    Prebiotic Enriched Exclusive Enteral Nutrition Suppresses Colitis via Gut Microbiome Modulation and Expansion of Anti-inflammatory T Cells in a Mouse Model of Colitis
    Lunken, GR ; Tsai, K ; Schick, A ; Lisko, DJ ; Cook, L ; Vallance, BA ; Jacobson, K (ELSEVIER INC, 2021)
    BACKGROUND & AIMS: Exclusive enteral nutrition (EEN) is used to treat pediatric Crohn's disease (CD), but therapeutic benefits are variable, and EEN can lead to microbial dysbiosis. Because of reported lower efficacy EEN is not routinely used to treat pediatric ulcerative colitis (UC). Inulin-type fructans (IN) beneficially modulate the gut microbiome and promote expansion of anti-inflammatory immune cells. We hypothesized that enriching EEN with IN (EEN IN) would enhance treatment efficacy. To test this, we examined the effects of EEN IN on colitis development, the gut microbiome, and CD4+ T cells using an adoptive T-cell transfer model of colitis. METHODS: TCR-β deficient (-/-) mice were randomized to 1 of 4 groups: (1) Control, (2) Chow, (3) EEN, and (4) EEN IN, and naive CD4+ T cells were adoptively transferred into groups 2-4, after which mice were monitored for 5 weeks before experimental endpoint. RESULTS: Mice fed EEN IN showed greater colitis protection, with colonic shortening, goblet cell, and crypt density loss reduced compared with EEN fed mice and reduced disease activity and immune cell infiltration compared with chow fed mice, and less crypt hyperplasia and higher survival compared with both groups. EEN IN mice had less deterioration in the colonic mucus layer and had increased levels of Foxp3+IL-10+ and Rorγt+IL-22+ and reduced levels of Tbet+IFNγ+ and Tbet+TNF+ CD4+ T cells. EEN IN also led to higher butyrate concentrations, Bifidobacterium spp. and Anaerostipes caccae relative abundance, and lower [Clostridium] innocuum group spp. and Escherichia-Shigella spp. relative abundance. CONCLUSIONS: The EEN IN group showed reduced colitis development as compared with the chow and EEN groups. This highlights the potential benefits of EEN IN as a novel induction therapy for pediatric CD and UC patients.