Citations

Abstract Rationale Lung fibroblasts (FBs) play a pivotal role in airway remodeling in asthma. During profibrotic and inflammatory conditions, FB undergoes myofibroblast differentiation, which contributes to airway wall thickening, stiffness, and airflow obstruction. Myofibroblast differentiation is a process in which fibroblasts transform into highly contractile fibers in response to profibrotic mediators such as transforming growth factor-beta 1 (TGF-β1). This transition is characterized by increased production of alpha-smooth muscle actin (α-SMA), and the formation of actin stress fibers, which are crucial for contractile machinery. Our previous findings identified the important role of Kisspeptin/KISS1R (Kp/KISS1R) in airway smooth muscle remodeling. However, there is no information about the expression and function of Kp/KISS1R in the lung FB. This study investigates the expression of Kp/KISS1R in lung FB and their role in myofibroblast transition. Methods Primary human lung FBs were isolated from surgical lung resections (Mayo IRB-approved) and cultured in DMEM-high glucose medium with 10% fetal bovine serum and 1% antibiotic/antimycotic. Upon reaching ∼90% confluence, cells were serum-deprived and treated with kisspeptin-10 (Kp-10, 1 µM) in the presence or absence of TGF-β1 (10 ng/mL). Expression of Kisspeptin, KISS1R and α-SMA in FB cells were assessed by western blotting and confocal microscopy. FB filamentous (F)-actin formation was analyzed by staining with phalloidin. In addition, collagen gel contraction assays were performed to study fibroblast contractility. Results We found the ubiquitous expression of kisspeptin and KISS1R in human FB. Notably, we observed that KISS1R expression was significantly reduced in asthmatic FB compared to non-asthmatic FB cells. Consistent with this observation, exposure of profibrotic mediator TGF-β1 effectively reduced the expression of KISS1R in non-asthmatic FB. Furthermore, TGF-β1 exposure significantly increased the α-SMA expression in human FB cells, a myofibroblast marker. Treatment with Kp-10 significantly reduced TGF-β1-induced α-SMA expression in FB cells. TGF-β1 stimulation in human FB increased the F-actin formation. Kp-10 significantly attenuated TGF-β1-induced F-actin formation in FB cells. Additionally, chronic TGF-β1 exposure enhanced collagen gel contraction by FBs, while Kp-10 treatment effectively reduced this contraction. Conclusion This study demonstrates that activation of Kp/KISS1R signaling attenuates TGF-β1-induced myofibroblast differentiation in lung FB, suggesting KISS1R as a potential therapeutic target against airway remodeling. This abstract is funded by: NIH grant R01-HL146705 (Venkatachalem)

Abstract Purpose: The role of tumor-infiltrating lymphocytes (TIL) remains unclear in hormone receptor (HR)–positive/HER2-negative breast cancer, particularly in young patients, whose immune microenvironment could be altered by age-related host and tumor differences. Experimental Design: Patients with stage I to III HR-positive/HER2-negative tumors were identified from a prospective cohort study of patients with breast cancer diagnosed at age ≤40 years. Multiplexed immunofluorescence and semiautomated quantitative software measured cytotoxic T, non–CD8 T, T regulatory, exhausted T, and PDL1+ cells in stroma and tumor. Univariate analyses assessed differences in clinicopathologic characteristics by high versus low immune infiltration, divided based on median. TIL subtypes were evaluated as a continuous variable per 10% increase in Cox regression analyses for invasive breast cancer–free survival, distant disease–free survival (DDFS), and overall survival, adjusted for clinicopathologic parameters. Results: Among 390 patients, high immune infiltration was associated with increasing age, Black race, grade 3 tumors, and metaplastic or micropapillary histologic subtypes. Over a median follow-up of 8 years, higher stromal and intratumoral non–CD8 T-cell infiltration, T regulatory–cell infiltration, and PDL1 expression were associated with improved invasive breast cancer–free survival. Higher intratumoral non–CD8 T-cell infiltration, T regulatory–cell infiltration, and PDL1 expression were associated with improved DDFS; higher stromal PDL1 expression was also associated with improved DDFS. Higher intratumoral cytotoxic T-cell infiltration and PDL1 expression were associated with improved overall survival. Conclusions: Characterization of immune subpopulations could help refine the prognostic value of TILs in young patients with HR-positive breast cancer, who may benefit from risk stratification for treatment individualization. See related commentary by Salgado and Kok, p. 2133

Introduction: Throughout the lifetime of an asthmatic, the lung undergoes changes in the composition of its extracellular matrix (ECM) and becomes more fibrotic, a characteristic feature of airway remodeling. Due to this, lung functionality decreases as the lung becomes less elastic and airway resistance increases. The ECM proteins constantly network with their respective mechanosensory receptors and regulatory proteins on the cell membrane. These signaling interactions allow for continuous interactions and feedback between the ECM and airway smooth muscle cells (ASM). ASM cells are one of the major structural cells that regular airway remodeling and are the primary target for treating asthma. In this study, we investigated the specific alterations that occur in the ECM of ASM cells treated with TGF-β1. Methods: Human primary airway smooth muscle (ASM) cells were grown to confluency in DMEM/F-12 with 10% FBS and 1% AbAm in standard conditions. Cells were serum deprived for 48 hours prior to experiments. Cells were treated with TGF-β1 (2 ng/mL) in serum free media. Cells were harvested after 48 hours and 200 µg of protein lysate was prepared. Data-independent acquisition (DIA) mass spectrometry was performed at IDeA National Resource for Quantitative Proteomics. Fold changes for ECM class proteins were collected from DIA results. Pathway analysis was then done using Qiagen ingenuity pathway analysis. Furthermore, expression patterns of select proteins were confirmed via western blotting. Results: The effects of TGF-β1 on specific types of collagens, integrins, laminins, and additional ECM proteins were analyzed. Western blotting confirmed similar changes in expression as measured by DIA. TGF-β1 exposure upregulated LAMA4, LAMB2, and LAMC1 which is likely to increase the prevalence of Laminins 221 and 421. TGF-β1 augmented integrin signaling by upregulating ITGA7, ITGA11, ITGA1, ITGB1 and downregulating ITGA2 and ITGB8. TGF-β1 increased expression of TSP1, TSP2, TSP3, TNS-C, FB, Elastin and Versican while downregulating TNS-X. Several interactions between ECM proteins and their sensors and receptors were highlighted for their enrichment. Conclusion: The DIA analysis shows an upregulation of proteins involved in airway remodeling by TGF-β1 in ASM cells. These findings substantiate our previous results as well as provide insights into a more targeted approach in studying ECM-Cell interactions. NIH R01HL171245 (Venkatachalem), R01HL146705 (Venkatachalem), R01HL142061 (Pabelick, Prakash). and IDeA National Resource for Quantitative Proteomics (R24GM137786). This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.

Abstract Background: Kisspeptins (Kp) are a group of hypothalamic peptides that aid in regulating pubertal development and sex hormone signaling. In our recent studies, we observed the important role of Kp-10 (Kp peptide) and its receptor KISS1R signaling in regulating the airway smooth muscle (ASM) structure and function. In these studies, we observed significantly reduced expression of KISS1R during asthma pathophysiology suggesting a loss of protective mechanism and exogeneous Kp-10 may be protective in the context of asthma. Studies have shown that specific modifications to the amino acids of Kp peptides can result in increased binding efficiency and receptor activation. Accordingly, we developed three novel Kp peptides, named KpSATs (13A, 13B, and 13C), and tested the potential effects/efficiency on ASM cell remodeling. Methods: The Molecular docking of the KpSAT peptides (13A, 13B and 13C) with the receptor KISS1R were performed using HPEPDOCK. KpSATs were synthesized by GenScript (New Jersey, US) with purity of ≥97%. Primary human ASM cells isolated from surgical lung resections (Mayo Clinic IRB-approved) were cultured in DMEM-F12. Cells were treated with PDGF (2ng/mL) and/or TGF-β (2ng/mL) with/without treatments of KpSATs (13A, 13B, and 13C: 250nM-1µM) and Kp-10 (1µM). ASM cell proliferation was measured using MTT. Extracellular matrix (ECM) deposition (fibronectin and collagen-I/III) studies were performed using In-Cell Western (LiCor-odyssey). The mechanistic signaling pathway (phospho-PKC-δ) were measured using Western blot analysis. Results: In the novel KpSATs, we substituted three amino acids in the endogenous Kp-13 sequence, Y10W and P12T for KpSAT-13A; S6A and P12T for KpSAT-13B; and S6A and Y10W for KpSAT-13C. The peptides dock in the orthosteric ligand binding pocket attained with docking scores ranging from -250 to -280. The MTT assay indicated a reduction in PDGF-induced ASM cell proliferation upon exposure to KpSATs. Notably, we found that KpSAT-13A and KpSAT-13B had significant effects in reducing proliferation at lower concentrations of 500nM compared to 1µM of Kp-10. Furthermore, ECM deposition studies showed a significant reduction of TGF-β1-induced collagen-I/III and fibronectin in ASM cells exposed to KpSAT-13A and 13B. In addition, we observed significant inhibition of PDGF-induced phospho-PKC-δ by KpSAT-13A and 13B. Conclusion: Overall, these findings highlight that modification in amino acid sequence in endogenous Kp-13 sequence significantly increases the potency of synthesized novel KpSATs on ASM cells. In addition, KpSATs showed better inhibitory effects with a lower concentration compared to Kp-10 and could be considered as a promising therapeutic strategy to mitigate asthma.

Abstract Rationale: Within the asthmatic lung, inflammatory signaling alters the contractile capacity of airway smooth muscle (ASM). In chronic inflammation, ASM become hypercontractile and are a key contributor toward airway hyperresponsiveness (AHR). As a heterogenous disorder, several asthmatic endotypes have been defined. A severe ASM endotype is partly defined as being glucocorticoid insensitive. We have reported the role of Kisspeptin (Kp)/KISS1R signaling in the lung in the context of airway fibrosis. In this study, KISS1R and Kp-10 were investigated for a potential interactions with intracellular calcium [Ca2+]i signaling and ASM contractility in the in vitro setting of severe asthmatic endotypes. Methods: Primary ASM were obtained from non-pathological samples from the Mayo Clinic. ASM cells were treated with inflammatory cytokines (TNFα 20 ng/ml, or IL-13 50 ng/mL)± Kp-10 (1 μM). The steroid-insensitive asthma endotype was investigated using pro-inflammatory cytokines (TNFα 20 ng/ml and IFN-γ 25 ng/mL) ± a corticosteroid (Fluticasone Propionate 100 nM). Β2-Adrenergic Receptor (β2-AR) desensitized endotypes were developed by treating cells with a β2-AR agonist (Salbutamol 1 μM) for 24 hours prior to and along with cytokine treatments (TNFα 20 ng/ml and IFN-γ 25 ng/mL or IL-13 50 ng/mL) ± Kp-10. [Ca2+]i was measured via Fura-2AM (4 μM) labeling on an Olympus Fluoview 300 microscope. Myosin light chain (MLC) phosphorylation studies were used to quantify downstream mechanics of ASM contractility. Results: KISS1R activation in IL-13 treated cells reduced [Ca2+]i in response to histamine. In contrast, TNFα treated cells were responsive to Kp-10 for acute treatments, however this effect was lost after 24 hours of Kp-10 treatment. TNFα and IFN-γ treated cells showed a robust [Ca2+]i response to histamine, and both fluticasone (∼20% reduction) and Kp-10 (∼10% reduction) alone had a minimal effect in reducing [Ca2+]i. Fluticasone and Kp-10 co-exposure significantly reduced [Ca2+]i and significantly reduced the effect of TNFα/IFN-γ (∼45% reduction). In B2-AR desensitized cells, Kp-10 exposure maintained the effect of reducing [Ca2+]i, suggesting Kp-10/KISS1R signaling works through an alternate or independent pathway. Kp-10 treatments on cytokine exposed cells reduced p-MLC in response to histamine, suggesting a role in ASM contractility. Conclusion: The increase of [Ca2+]i in inflamed cells is associated with AHR; Kp-10/KISS1R signaling showed varying efficacy in reducing [Ca2+]i within inflammatory endotypes. These results also highlight that Kp-10 acts synergistically with the current therapeutics available for asthma.

ABSTRACT Background Facet Joint Septic Arthritis (FJSA) is an infection of the spinal facet joints, for which previously described imaging findings are non‐specific. We present MRI findings of 20 patients who underwent facet biopsy for possible FJSA. Materials and Methods An internal database was reviewed for cases who underwent image‐guided spinal facet biopsy for possible infection and had pre‐biopsy contrast‐enhanced MRI. Cases were categorized as biopsy FJSA positive or negative and MRI was reviewed for synovitis, bone marrow enhancement, epidural phlegmon/abscess, and paraspinal muscle enhancement. The MRI findings were considered extensive if the involvement of the posterior paraspinal muscles spanned at least two vertebral bodies in the craniocaudal direction and at least half the length of the muscles in the anterior‐posterior direction. Results Twenty patients were included. Nine patients were FJSA positive, all of whom had synovitis, bone marrow enhancement of the facet joints, and epidural phlegmon. No patients had epidural abscess, but five patients had a paraspinal abscess. All nine patients demonstrated extensive paraspinal muscular enhancement. Eleven biopsy cases that were negative for FSJA were included. Their MRI findings demonstrated all with synovitis, six with bone marrow enhancement of the facet joints, six with epidural phlegmon, none with epidural abscess, and none with paraspinal abscess. Only one FJSA negative case had extensive paraspinal muscle enhancement. Conclusion The MRI appearance of FJSA has rarely been described in the literature; however, the diagnosis has a significant clinical impact. Facet enhancement with florid posterior paraspinal muscle enhancement should raise suspicion for FSJA.

AbstractObjectivesTo report lessons from integrating the methods and perspectives of clinical informatics (CI) and implementation science (IS) in the context of Improving the Management of symPtoms during and following Cancer Treatment (IMPACT) Consortium pragmatic trials.Materials and MethodsIMPACT informaticists, trialists, and implementation scientists met to identify challenges and solutions by examining robust case examples from 3 Research Centers that are deploying systematic symptom assessment and management interventions via electronic health records (EHRs). Investigators discussed data collection and CI challenges, implementation strategies, and lessons learned.ResultsCI implementation strategies and EHRs systems were utilized to collect and act upon symptoms and impairments in functioning via electronic patient-reported outcomes (ePRO) captured in ambulatory oncology settings. Limited EHR functionality and data collection capabilities constrained the ability to address IS questions. Collecting ePRO data required significant planning and organizational champions adept at navigating ambiguity.DiscussionBringing together CI and IS perspectives offers critical opportunities for monitoring and managing cancer symptoms via ePROs. Discussions between CI and IS researchers identified and addressed gaps between applied informatics implementation and theory-based IS trial and evaluation methods. The use of common terminology may foster shared mental models between CI and IS communities to enhance EHR design to more effectively facilitate ePRO implementation and clinical responses.ConclusionImplementation of ePROs in ambulatory oncology clinics benefits from common understanding of the concepts, lexicon, and incentives between CI implementers and IS researchers to facilitate and measure the results of implementation efforts.