Citations

Iron is an essential element for cellular homeostasis and functionality. Increased iron in the lung is associated with aging and asthma in the elderly (AIE). Using human airway smooth muscle cells from young versus elderly versus AIE patients, we found that dysregulated iron metabolism (more than iron accumulation), resulting in activation of antioxidant systems and increased susceptibility to ferroptosis, occurs in AIE, contributing to cell hyperplasia and matrix remodeling of aging and AIE.

Importance Elevated low-density lipoprotein cholesterol (LDL-C) is a modifiable risk factor for cardiovascular disease, the leading cause of premature death worldwide. Assessing the LDL-C–related burden is critical for guiding prevention and treatment strategies. Objectives To estimate the global, regional, and national burden of ischemic heart disease and ischemic stroke attributable to elevated LDL-C (relative to 35-54 mg/dL) from 1990 to 2023 and to quantify the contributions of population growth, aging, risk-deleted burden, and exposure changes to burden trends. Design, Setting, and Population This comparative risk assessment, part of the Global Burden of Disease Study 2023, estimated population-level LDL-C exposure and associated health loss in 204 countries and territories. Mean LDL-C levels were estimated using spatiotemporal gaussian process regression based on 806 studies across 161 countries. Relative risks were derived from meta-analyses of 38 randomized clinical trials. Population-attributable fractions for deaths and disability-adjusted life-years (DALYs) were estimated by age and sex for adults aged 25 years or older from 1990 to 2023, with 95% uncertainty intervals. Exposure Population-level LDL-C concentrations. Main Outcomes and Measures Population-attributable fractions, counts, and rates (all ages and age standardized per 100 000) of LDL-C–attributable deaths and DALYs from ischemic heart disease and ischemic stroke, with uncertainty intervals. Results In 2023, elevated LDL-C accounted for 3.6 million deaths (95% uncertainty interval, 2.2-5.4 million; 6.0% of global mortality) and 90.7 million DALYs (95% uncertainty interval, 58.9-123.3 million; 3.2% of DALYs). Although global all-ages rates remained stable, age-standardized death and DALY rates decreased by 45.6% and 39.5%, respectively, since 1990. In 2023, age-standardized LDL-C–attributable DALY rates were highest in Eastern Europe and lowest in high-income Asia-Pacific. One-third of the global LDL-C burden occurred in India and China. Population growth and aging drove the increasing burden, with notable regional disparities in LDL-C exposure and risk-deleted DALY rates shifting toward middle-sociodemographic settings. Conclusions and Relevance Despite declining age-standardized rates, the absolute LDL-C burden has increased since 1990 due to demographic changes and has shifted toward middle-sociodemographic countries. Measurement and surveillance gaps persist. Strengthened prevention, diagnosis, and treatment access strategies are essential to mitigate the health burden of LDL-C.

Abstract Objectives Embedded pragmatic clinical trials (ePCTs) are conducted as part of routine clinical care and therefore use data collected from real-world data sources, such as electronic health record systems and administrative claims. A common approach for using these types of data across all phases of trial conduct is to create a computable phenotype (an explicitly defined data query data, including specified data types, data codes, and logical parameters) to capture patients with a clinical condition, exposure, symptom, characteristic, treatment, or outcome of interest. Materials and Methods The Electronic Health Record (EHR) Core Working Group of the NIH Pragmatic Trials Collaboratory captured the experiences of investigators in developing, adapting, and applying computable phenotype definitions in their studies. Results Four case studies describe different approaches to developing and using computable phenotypes in pragmatic trials. Discussion We recommend: (1) developing computable phenotypes as part of a team with multiple areas of expertise; (2) appropriate validation; (3) dissemination of salient details regarding phenotype creation; and (4) capturing and reporting any modifications made to phenotypes during the conduct of the trial. Conclusion A range of issues and decisions influence how computable phenotypes are developed and used in pragmatic clinical trials. Multidisciplinary teams that understand the context of the data, including the reason the data are collected and potential sources of bias, are best suited for the development and validation of phenotypes for ePCTs.

Abstract Introduction Checkpoint blockade revolutionized cancer therapy. However, only a small proportion of cancers respond to checkpoint blockade. B7-H3 is a member of the B7 superfamily, which includes both co-inhibitory and co-stimulatory receptors. B7-H3 is upregulated by many tumors which is generally associated with a worse prognosis. However, the exact mechanism by which B7-H3 suppresses the immune response remains elusive. Methods We transfected human HEK293T cells and assessed the binding to recombinant Siglecs via flow cytometry. We generated monoclonal antibody F7 against human B7-H3 and tested its blocking function using B7-H3 transfected HEK293T cells. We examined the extent of degranulation and NK cell-mediated killing on B7-H3 expressing HEK293T cells in vitro, as well as the CART19 cells mediated killing in relapse model of B7-H3 expressing CD19+ leukemia Nalm6 cells NSG mice. Results We demonstrated that sialylated B7-H3 binds to the inhibitory receptor Siglec-9 on immune cells but not to the related protein Siglec-7. A high affinity monoclonal antibody (mAb) F7 against B7-H3 blocks Siglec-9 binding. Functionally, F7 enhances NK cell killing of B7-H3 expressing target cells in vitro. F7 also dramatically enhances CART19 mediated killing of B7-H3 expressing Nalm6 cells in a relapse model in NSG mice in vivo. Conclusion We have now shown for the first time that B7-H3 binds to the inhibitory receptor Siglec-9 and generated a novel monoclonal antibody F7 that target a unique sequence in B7-H3 as compared to other monoclonal antibodies being examined for clinical efficacy. F7 can promote NK cell killing of B7-H3 expressing target cells in vitro and synergize with CART19 to enhance killing of B7-H3 expressing tumor cells in vivo. As B7-H3 is overexpressed in many human cancers, this work is critical toward understanding how B7-H3 mediates immune evasion through Siglec-9 for enhancing anti-tumor immunity. Funding Source R01CA243545-01A1 Topic Categories Tumor Immunology: Checkpoints, Prevention, and Treatment (TIPT)

Abstract Introduction Generation of T cells requires dynamic epigenetic alteration of histones to control gene expression at each developmental stage. Histone acetyltransferases (HATs) and histone deacetylases (HDACs) facilitate addition or removal of various acyl groups from lysine residues, including acetylation (KAc) and crotonylation (KCr). The Class I deacetylases HDAC1, HDAC2, and HDAC3 have been shown to have 3 functions: adaptor, decrotonylase, and deacetylase activity. The relative importance of each function in T cells is not known. Genetic knockout of HDAC3 in mice using CD2icre results in a severe block in T cell development and spontaneous development of severe colitis. Our lab determined that HDAC3 is required for three different aspects of this process: CD4+CD8 + (DP) cell survival, positive selection, and CD4+ lineage commitment. We generated a novel mouse model with CD2icre-mediated deletion of endogenous HDAC3 and linked re-expression of HDAC3 “VRPP” mutant mice, which maintained adaptor function but lacks enzymatic activity. Strikingly, these mice do not develop spontaneous colitis even up to one year of age. Methods We used flow cytometry to assess T cell development and maturation in the thymus, spleen, mLN, and colon of HDAC3 cKO vs. HDAC3 VRPP mice. CUT&RUN was utilized to determine differences in H3K9Ac, H3K27Ac, and H3K18Cr across CD8 and CD4 lineage genes. H&E was utilized to assess structural changes in thymus and colon. Results Similar to CD2icre HDAC3 cKO mice, HDAC3 VRPP mice have a block in positive selection due to failure to down regulate RORγt and decreased DP cell survival due to increased expression of P2RX7. Although fewer T cells are produced in HDAC3 VRPP mice, CD4+ lineage commitment is restored, likely mitigating the development of spontaneous colitis. Conclusion Our results demonstrate that HDAC3 enzymatic activity is necessary for several aspects of T cell development, while HDAC3 adaptor function is sufficient to restore CD4+ lineage commitment. Funding Source NIAID RO1 AI150100, T32 AI170478 Topic Categories Hematopoiesis and Immune System Development (HEM)

Abstract Introduction The mitochondrial transporter ABCB7 is essential for exporting iron-sulfur (Fe-S) clusters, a function known to be critical in B cells. This study was conducted to investigate the broader, previously unknown roles of ABCB7 in regulating the overall lymphocyte development and homeostasis. Methods The study utilized conditional knockout (cKO) mouse models (CD2-iCre and Mb1-Cre) to create a specific deficiency of ABCB7 in certain immune populations. To determine if the observed effects were due to ABCB7 deletion in myeloid cells, two further models (CD2i-Cre ABCB7 cKO/C/EBPα and CD2-iCre LSL TMT ABCB7 cKO) were developed. The effects of blocking the cytokine G-CSF were also examined to understand its role in the observed myelopoiesis. Results ABCB7 deficiency was found to dramatically impair erythropoiesis while simultaneously driving emergency myelopoiesis. We confirmed that the myeloid expansion was not a direct result of ABCB7 loss in myeloid cells. A significant autoimmune phenotype also developed, characterized by hyperactivated T cells and a sharp decrease in peripheral regulatory T cells (Tregs). This Treg instability was linked to decreased thymic expression of key stability genes (like CD28 and PD-1) and reduced O-GlcNAc modification in T cells, a process crucial for maintaining Treg lineage. Conclusion The findings establish ABCB7 as a pivotal regulator of hematopoietic balance, linking mitochondrial function to both myeloid expansion and Treg stability. Funding Source T32AI170478 Topic Categories Hematopoiesis and Immune System Development (HEM)

Abstract Introduction The H-2Db class I restricted CD8 T cell response is critical for clearance of neurotropic Theiler’s virus encephalomyelitis virus (TMEV) infection. However, the key central nervous system cell types required to present H-2Db for CD8 T cell trafficking and expansion in the brain are not known. Mural cells are a critical cellular component of the neurovascular unit for maintaining vascular integrity which also express MHC class I molecules. However, the importance of mural cell antigen-restricted engagement by CD8 T cells has not been investigated. Methods To determine the function of mural cell MHC Class I antigen presentation, we crossed the Pdgfrβ-creERT2 mouse to our novel H-2Db LoxP mouse developed by our laboratory. This transgenic mouse approach enabled us to target mural cells during neuroinflammation. Results We observed robust knockdown of H-2Db on mural cells during acute TMEV infection. Conditional H-2Db knockdown in mural cells resulted in increased brain infiltration of CD8 T cells specific to the immunodominant Db:VP2 121-130 epitope of TMEV, demonstrating an important role of mural cells for immune cell recruitment. Conclusion To our knowledge, this is the first study demonstrating MHC class I antigen presentation by mural cells impacts CD8 T cell recruitment during neuroinflammation. Funding Source R01-NS103212, T32-AI170478 Topic Categories Neuroimmunology (NEUR)

Abstract Introduction T cell activation is a dynamic process governed by the strength and duration of antigen recognition via the T cell receptor (TCR). The timing of in vivo TCR signaling— when and how strongly memory CD8+ T cells become reactivated in the inflamed brain following antigen exposure— is a fundamental mechanism that remains unclear. The Nr4a3-Tocky reporter (Tocky) mouse employs a fluorescent timer that shifts from blue to red after TCR-driven Nr4a3 activation, which allows researchers to track activation kinetics through two parameters: the Timer Angle (recency of T cell activation), and the Timer Intensity (strength of signaling). Methods To understand CD8+ T cell activation during this neuroinflammation, we generated memory CD8+ T cells by intracranial Theiler’s murine encephalomyelitis virus infection of these Tocky mice. After viral clearance, we reactivated memory CD8+ T cells by intravenously injecting their cognate antigen. Tissues were collected 0-72 hours post-injection and profiled by flow cytometry. An R pipeline was constructed to transform event-level flow data to quantify the TCR activation. Data were analyzed with a Metropolis—Hastings MCMC algorithm to model activation dynamics and estimate probabilistic transitions between biologically defined states (newly activated, persistent, arrested states). Results These empirical transition probabilities enabled Bayesian comparison of antigen-specific versus nonspecific CD8+ T cells. It was revealed that antigen-specific CD8+ T cells rapidly transition to a high-intensity activation state within 24 hours and maintain persistent signaling compared to nonspecific populations. Conclusion This establishes a biologically grounded, in vivo framework for modeling and comparing TCR signaling during neuroinflammation. Funding Source R01 - NS103212 Topic Categories Neuroimmunology (NEUR)

Abstract Introduction Glioblastoma (GBM) is the most aggressive primary brain tumor in adults with an incident rate of 12,000 cases in the United States every year. Current treatment options for these patients include surgical resection, radiation, and chemotherapy. Despite these conventional treatments, patients have a dismal prognosis mostly due to the inability to deliver therapeutic agents across the blood-brain barrier. In recent years, the use of oncolytic picornavirus has been employed as a novel virotherapy for GBM. We hypothesized that we could enhance antibody delivery to the brain through harnessing the immune response associated with this oncolytic virus. Prior work from our lab has shown that CD8 T cell engagement with MHC class I on brain endothelium induces CNS vascular permeability which is dependent on perforin. We therefore asked if picornavirus antigen specific CD8 T cells could enhance antibody delivery to the brain. Methods To test this, we evaluated the potential of activating MHC class I restricted CD8 T cells in vivo through intravenous administration of their cognate picornavirus antigens. Results We determined that this approach enhanced delivery of antibody to brain parenchyma. Importantly, antibody delivery to the brain was still enhanced when CD8 T cells lacked perforin expression which significantly reduced the toxicity of this combination approach. Conclusion These findings demonstrate that theCD8 T cell response towards virotherapy can be harnessed to promote delivery of therapeutic antibody to the brain. Funding Source NCI — R01 CA 94953 NINDS — R01 NS122174 NINDS —R01 NS103212 Mayo Clinic Graduate School of Biomedical sciences Topic Categories Tumor Immunology: Checkpoints, Prevention, and Treatment (TIPT)

Abstract Introduction CD8 T cells are key immune cells in viral clearance, targeting infected cells following recognition of MHC class I restricted antigen presentation. Previous work has determined that microglia and perivascular macrophages are essential for normal CD8 T cell responses against neurotropic viral infection, indicating that cells at the neurovascular unit can act as antigen-presenting cells. However, the specific importance of microglia MHC class I restricted antigen presentation to brain-infiltrating CD8 T cells has been difficult to define. Methods To address this question, our laboratory generated novel single MHC Class I conditional knockout mice in which H-2Kb or H-2Db can be deactivated specifically in Tmem119+ microglia with tamoxifen administration. Recombinant Theiler’s murine encephalomyelitis virus (TMEV) encoding the model OVA antigen enabled analysis of virus antigen-specific CD8 T cells restricted to H-2Kb class I molecules while Daniel’s strain TMEV H-2Db class I molecules enabled analysis of Db:VP2 specific CD8 T cells. Results Our results revealed profound differences in the response of CD8 T cells upon deletion of MHC class I molecules on microglia. Conditional knockout of H-2Kb in Tmem119+ microglia reduced Kb:OVA epitope specific CD8 T cells in the brain compared to Cre negative littermate controls, and BrdU staining revealed differences in T cell proliferation. Meanwhile, mice with deletion of Db in Tmem119+ microglia had reduced levels of perforin in Db:VP2 CD8 T cells. Furthermore, in a model of CNS vascular disease, the deletion of H-2Db of Tmem119+ microglia reduced CD8 T cell numbers in the brain, as well as the blood-brain barrier (BBB) breakdown observed by a FITC albumin assay. Conclusion These findings demonstrate discrete roles for specific MHC Class I molecules on microglia during CNS viral infection. This data will further our understanding of brain infiltrating CD8 T cell responses in neurologic diseases as well as the regulation of BBB by microglia. Funding Source R01 NS 103212 R01 NS122174 Topic Categories Neuroimmunology (NEUR)