Lorenzo, Silvana De

Abstract Purpose: Germ cell tumors (GCTs) pose significant diagnostic challenges due to the limited sensitivity and specificity of current tumor markers. Hereby we utilize phage immunoprecipitation sequencing (PhIP-Seq) technique to develop a unique immunosignature panel (iSIGN) with high sensitivity and specificity to improve the diagnosis and differentiation of GCTs. Patients and Methods: Serum samples from patients with confirmed gonadal or extragonadal GCTs and controls were collected from Mayo Clinic repositories. Controls included benign testicular lesions, autoimmune diseases, neurodegenerative disorders, and other cancers. Samples were randomized into development and validation cohorts. PhIP-Seq identified antigen-autoantibody interactions, and enrichment scores were calculated to develop a biomarker panel distinguishing GCT from non-GCT cases. A second biomarker panel was developed to predict seminoma from nonseminoma cases. Results: A total of 427 serum samples were analyzed, including 150 from GCT patients and 277 controls. For our primary model to distinguish GCT cases (GCT-iSIGN), 24 peptides from 16 antigens were identified based on significant differential autoantibody binding enrichment in GCT patients (p < 0.05), ≥2 peptides per antigen, and enrichment scores ≥ 2.5-fold. GCT-iSIGN was highly sensitive (93%) and specific (99%) for identifying GCT cases from controls with an area under curve (AUC) of 0.93 and 9% Unknown Case Rate (UCR). The secondary panel (Sem-iSIGN) included 17 peptides corresponding to 5 unique proteins with high specificity (93%), moderate sensitivity (65%) and AUC of 0.77 to distinguish seminoma from nonseminoma GCT cases. Conclusion: This study demonstrates the potential use of PhIP-Seq to identify unique immunosignature panels that can serve as reliable biomarkers for GCT. These panels address the limitations of traditional markers and other proteomic techniques. This immunosignature model represents a cost-effective, stable, and scalable approach to enhancing GCT diagnosis and management. Citation Format: M Bakri Hammami, Andrew Knight, Haidara Kherbek, Brian Costello, Silvana De Lorenzo, Bradley C. Leibovich, John C. Cheville, Yong Guo, Jessica Sagen, Janet E. Olson, Alicia Algeciras-Schimnich, Sean J. Pittock, John R. Mills, Surendra Dasari, Divyanshu Dubey. iSIGN panel identifies germ cell tumors via whole-proteome phage immunoprecipitation sequencing [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Mechanisms of Cancer Immunity and Cancer-related Autoimmunity; 2025 Sep 24-27; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Immunol Res 2025;13(9 Suppl):Abstract nr B027.

Abstract Renal artery stenosis is common in the elderly population; biomarkers that predict response to restoration of blood flow have not been previously established. Methods We have previously shown in murine model that cuff removal 7 days (7D Cuff-off) after initial placement on the renal artery results in reversible injury whereas cuff removal 14 days (14D Cuff-off) after placement results in irreversible renal injury, when assessed at 28 days after initial surgery. Positive and negative controls consisted of cuff placement for 28 days (28D) and sham surgeries respectively. We performed RNASeq on whole renal cortex to identify innate immune pathways that correlate with reversible versus irreversible injury. Data were normalized to appropriate sham controls in all the groups. Induction of greater than log2 ratio > 2 and p < 0.00001 were considered significant (following adjustment for multiple comparisons). Results As assessed by RNASeq, progression of renal disease (14D Cuff-off & 28D mice) was associated with persistent upregulation of genes associated with T cell signaling and macrophage polarization compared to reversible injury (7D Cuff off). Upregulated genes included but not limited to: CCL5, CCR5, CCL2, CXCL1, CXCL9, CXCL10, CXCR3, TLR2, KLF6, CD74, CD4, CD14, CD44, CD83, CD84, IL1R1, IL1B, SPP1, AIF1, SLC7A2, TRAF1, S100A4, SLC9A9, CRIP1, CLEC7A, CLEC10A, EGR2, MGL2, SOCS2, CTLA2B, and FCGR1. Conclusion We have identified genes associated with T cell and macrophage activation that were down regulated in the 7D Cuff-off versus 14D Cuff-off and 28D mice; future studies in isolated T cells and macrophages will determine whether these genes represents biomarker(s) of renal disease progression in 2K-1C renovascular hypertension.

KLFs (Kruppel‐like factors) comprise a family of over 17 distinct transcription factors that have been shown to regulate cell metabolism and renal function, including podocyte differentiation and maintenance of the glomerular filtration barrier. In non‐renal systems, KLF11 has been shown to regulate fibrosis. However, no previous studies have established a potential role for KLF11 in renal pathophysiology. We sought to test the hypothesis that KLF11 regulates renal fibrosis in unilateral ureteral obstruction, a well‐established murine model of renal fibrosis. Mice with homozygous deletion of the KLF11 gene (KO) and wild‐type (WT) mice were subjected to unilateral ureteral obstruction (UUO; n=8 per group); sham controls (n=4 per group) were subjected to manipulation of the ureter without ligation. Kidneys were harvested at 9 days following surgery,. Semiquantitative histopathologic analysis of interstitial fibrosis, tubular atrophy, and interstitial inflammation was performed in a blinded fashion. Analysis of gene expression was performed on renal cortex using Pathway Detect RNA arrays and by RNASeq. Histopathologic analysis of sham controls revealed no significant alterations. However, expression of several elements of the TGF‐beta signaling pathway was significantly higher in KLF11 KO sham mice, compared to WT mice, including TGF‐beta receptors type I and type II, Smad2, Smad 7, Bmpr1B, and Bmpr2R, and the KLF‐related transcription factor Sp1 (all p<0.05). In mice subjected to UUO, interstitial fibrosis, tubular atrophy, and interstitial inflammation were significantly greater in KLF11 KO mice compared to WT mice. Interstitial inflammation was associated with influx of alternatively activated macrophages, as assessed by quantitative analysis of CD206+ infiltrating cells (p<0.05); no significant increase in CD3+ T cell numbers were noted. Expression of several members of the TGF‐beta signaling pathway were significantly increased in KLF11 KO UUO mice, compared to WT UUO mice, including TGF‐beta 1, TGF‐beta‐2, and TGF‐beta3, TGF‐beta receptors type I and type II, and Smad 1,2,3,4, and 5 (all p<0.05). Conversely, expression of the transcription factor JunB was markedly increased in WT UUO mice compared to WT sham mice (12.2 ‐fold; p<0.0001). However, JunB expression was markedly decreased in KLF11 KO mice (both sham and UUO). Although MMP expression was not significantly different in KO versus WT mice, TIMP3 expression was higher in KO mice compared to WT mice. In conclusion, we found that renal damage is exacerbated in KLF11 KO mice subjected to UUO, compared to WT UUO mice and is associated with influx of potentially pro‐fibrotic, alternatively activated M2 macrophages. KLF11 appears to be a critical regulator of TGF‐beta signaling, as KLF11 deficiency is associated with increased expression of TGF‐beta and signaling intermediates of this fibrogenic pathway.