Assessment of anti-CD20 antibody pre-treatment for augmentation of CAR-T cell therapy in SIV-infected rhesus macaques.

During chronic HIV and SIV infections, the majority of viral replication occurs within lymphoid follicles. In a pilot study, infusion of SIV-specific CD4-MBL-CAR-T cells expressing the follicular homing receptor, CXCR5, led to follicular localization of the cells and a reduction in SIV viral loads in rhesus macaques. However, the CAR-T cells failed to persist. We hypothesized that temporary disruption of follicles would create space for CAR-T cell engraftment and lead to increased abundance and persistence of CAR-T cells. In this study we treated SIV-infected rhesus macaques with CAR-T cells and preconditioned one set with anti-CD20 antibody to disrupt the follicles. We evaluated CAR-T cell abundance and persistence in four groups of SIVmac239-infected and ART-suppressed animals: untreated, CAR-T cell treated, CD20 depleted, and CD20 depleted/CAR-T cell treated. In the depletion study, anti-CD20 was infused one week prior to CAR-T infusion and cessation of ART. Anti-CD20 antibody treatment led to temporary depletion of CD20+ cells in blood and partial depletion in lymph nodes. In this dose escalation study, there was no impact of CAR-T cell infusion on SIV viral load. However, in both the depleted and non-depleted animals, CAR-T cells accumulated in and around lymphoid follicles and were Ki67+. CAR-T cells increased in number in follicles from 2 to 6 days post-treatment, with a median 15.2-fold increase in follicular CAR-T cell numbers in depleted/CAR-T treated animals compared to an 8.1-fold increase in non-depleted CAR-T treated animals. The increase in CAR T cells in depleted animals was associated with a prolonged elevation of serum IL-6 levels and a rapid loss of detectable CAR-T cells. Taken together, these data suggest that CAR-T cells likely expanded to a greater extent in depleted/CAR-T cell treated animals. Further studies are needed to elucidate mechanisms mediating the rapid loss of CAR-T cells and to evaluate strategies to improve engraftment and persistence of HIV-specific CAR-T cells. The potential for an inflammatory cytokine response appears to be enhanced with anti-CD20 antibody treatment and future studies may require CRS control strategies. These studies provide important insights into cellular immunotherapy and suggest future studies for improved outcomes.

Eva Augusta Vescelius: Life and Music Career Before 1900.

Eva Augusta Vescelius was a prominent woman who contributed to the development of music therapy practice in the United States. From the turn of the twentieth century, she worked to establish the use of music for health, starting with her first public paper presentation in 1900. Vescelius was the first known person in the United States to collectively experiment on the effects of music and health, establish a music therapy practice, found the first music therapy association, and disseminate the first journal dedicated to music therapy. Little is known about Vescelius's lifetime of experiences before 1900 that contributed to her mark on the development of music therapy. Furthermore, the dominant historical narrative of the professionalization process of music therapy in the United States, which was formally organized nearly a half a century after Vescelius began advocating, has not fully considered the contributions of Vescelius and other founding women. The purpose of this historical study was to expand knowledge about Vescelius's life before 1900 and what contributed to her career transition as a professional vocalist. The analysis of primary and secondary sources contributed to the development of the presented biography. Results demonstrate the viability of historical research across the entire continuum of music therapy development and provide an expanded narrative of an important female founder. Ongoing historical research about founding women music therapists is needed in order to counter the existing dominant historical narrative that Vescelius and other women before 1950 minimally contributed to the development of music therapy.

CAR/CXCR5-T cell immunotherapy is safe and potentially efficacious in promoting sustained remission of SIV infection.

During chronic human immunodeficiency virus (HIV) or simian immunodeficiency virus (SIV) infection prior to AIDS progression, the vast majority of viral replication is concentrated within B cell follicles of secondary lymphoid tissues. We investigated whether infusion of T cells expressing an SIV-specific chimeric antigen receptor (CAR) and the follicular homing receptor, CXCR5, could successfully kill viral-RNA+ cells in targeted lymphoid follicles in SIV-infected rhesus macaques. In this study, CD4 and CD8 T cells from rhesus macaques were genetically modified to express antiviral CAR and CXCR5 moieties (generating CAR/CXCR5-T cells) and autologously infused into a chronically infected animal. At 2 days post-treatment, the CAR/CXCR5-T cells were located primarily in spleen and lymph nodes both inside and outside of lymphoid follicles. Few CAR/CXCR5-T cells were detected in the ileum, rectum, and lung, and no cells were detected in the bone marrow, liver, or brain. Within follicles, CAR/CXCR5-T cells were found in direct contact with SIV-viral RNA+ cells. We next infused CAR/CXCR5-T cells into ART-suppressed SIV-infected rhesus macaques, in which the animals were released from ART at the time of infusion. These CAR/CXCR5-T cells replicated in vivo within both the extrafollicular and follicular regions of lymph nodes and accumulated within lymphoid follicles. CAR/CXR5-T cell concentrations in follicles peaked during the first week post-infusion but declined to undetectable levels after 2 to 4 weeks. Overall, CAR/CXCR5-T cell-treated animals maintained lower viral loads and follicular viral RNA levels than untreated control animals, and no outstanding adverse reactions were noted. These findings indicate that CAR/CXCR5-T cell treatment is safe and holds promise as a future treatment for the durable remission of HIV.

Identification of a mechanogenetic link between substrate stiffness and chemotherapeutic response in breast cancer.

Mechanical feedback from the tumor microenvironment regulates an array of processes underlying cancer biology. For example, increased stiffness of mammary extracellular matrix (ECM) drives malignancy and alters the phenotypes of breast cancer cells. Despite this link, the role of substrate stiffness in chemotherapeutic response in breast cancer remains unclear. This is complicated by routine culture and adaptation of cancer cell lines to unnaturally rigid plastic or glass substrates, leading to profound changes in their growth, metastatic potential and, as we show here, chemotherapeutic response. We demonstrate that primary breast cancer cells undergo dramatic phenotypic changes when removed from the host microenvironment and cultured on rigid surfaces, and that drug responses are profoundly altered by the mechanical feedback cells receive from the culture substrate. Conversely, primary breast cancer cells cultured on substrates mimicking the mechanics of their host tumor ECM have a similar genetic profile to the in situ cells with respect to drug activity and resistance pathways. These results suggest substrate stiffness plays a significant role in susceptibility of breast cancer to clinically-approved chemotherapeutics, and presents an opportunity to improve drug discovery efforts by integrating mechanical rigidity as a parameter in screening campaigns.

A Descriptive Analysis of the Educational Perceptions, Professional Identity, and Professional Practices of Dual-Trained Music Therapists as Counselors.

BACKGROUND: Given the rise in music therapy master's programs that offer dual degrees in music therapy and counseling or programs that satisfy state mental health counseling licensure laws, the professional counseling field is playing an increased role in the advanced education and professional practices of music therapists. OBJECTIVE: To identify factors that lead music therapists to pursue advanced education with an emphasis in professional counseling, perceptions about benefits and drawbacks for three advanced degree options (i.e., music therapy, counseling, and music therapy/counseling dual degree), and describe the professional practices and identity of dual-trained music therapists as counselors. METHODS: A convenience sample of music therapists (n = 123) who held board certification, and held a master's degree or higher that emphasized professional counseling, completed an online survey. We used descriptive statistics to analyze categorical and numeric survey data. RESULTS: Eligibility for licensure as a professional counselor was the most important decisional factor in selecting a specific master's degree program. Respondents also reported favorable perceptions of the dual degree in music therapy and counseling. With regard to professional practice and identity, respondents reported high use of verbal processing techniques alongside music therapy interventions, and dual-trained music therapists retained their professional identity as a music therapist. CONCLUSIONS: The reported view of licensure in a related field as beneficial and frequent use of verbal processing techniques warrants future study into the role of counseling in the advanced training of music therapists. Given contradictory findings across studies, we recommend investigators also explore how a degree in a related field affects career longevity of music therapists.

Stretch-dependent changes in molecular conformation in fibronectin nanofibers.

Fibronectin (FN) is an extracellular matrix (ECM) glycoprotein that plays an important role in a wide range of biological processes including embryonic development, wound healing, and fibrosis. Recent evidence has demonstrated that FN is mechanosensitive, where the application of force induces conformational changes within the FN molecule to expose otherwise cryptic binding domains. However, it has proven technically challenging to dynamically monitor how the nanostructure of FN fibers changes as a result of force-induced extension, due in part to the inherent complexity of FN networks within tissue and cell-generated extracellular matrix (ECM). This has limited our understanding of FN matrix mechanobiology and the complex bi-directional signaling between cells and the ECM, and de novo FN fiber fabrication strategies have only partially addressed this. Towards addressing this need, we have developed a modified surface-initiated assembly (SIA) technique to engineer FN nanofibers that we can uniaxially stretch to >7-fold extensions and subsequently immobilize them in the stretched state for high resolution atomic force microscopy (AFM) imaging. Using this approach, we analyzed how the nanostructure of FN molecules within the nanofibers changed with stretch. In fully contracted FN nanofibers, we observed large, densely packed, isotropically-oriented nodules. With intermediate extension, uniaxially-aligned fibrillar regions developed and nodules became progressively smaller. At high extension, the nanostructure consisted of highly aligned fibrils with small nodules in a beads-on-a-string arrangement. In summary, we have established a methodology to uniaxially stretch FN fibers and monitor changes in nanostructure using AFM. Our results provide new insight into how FN fiber extension can affect the morphology of the constituent FN molecules.

Patterning on Topography for Generation of Cell Culture Substrates with Independent Nanoscale Control of Chemical and Topographical Extracellular Matrix Cues.

The cell microenvironment plays an important role in many biological processes, including development and disease progression. Key to this is the extracellular matrix (ECM), a complex biopolymer network serving as the primary insoluble signaling network for physical, chemical, and mechanical cues. In vitro, the ability to engineer the ECM at the micro- and nanoscales is a critical tool to systematically interrogate the influence of ECM properties on cellular responses. Specifically, both topographical and chemical surface patterning has been shown to direct cell alignment and tissue architecture on biomaterial surfaces, however, it has proven challenging to independently control these surface properties. This protocol describes a method termed Patterning on Topography (PoT) to engineer 2D nanopatterns of ECM proteins onto topographically complex substrates, which enables independent control of physical and chemical surface properties. Applications include interrogation of fundamental cell-surface interactions and engineering interfaces that can direct cell and/or tissue function. © 2017 by John Wiley & Sons, Inc.

Smooth muscle architecture within cell-dense vascular tissues influences functional contractility.

The role of vascular smooth muscle architecture in the function of healthy and dysfunctional vessels is poorly understood. We aimed at determining the relationship between vascular smooth muscle architecture and contractile output using engineered vascular tissues. We utilized microcontact printing and a microfluidic cell seeding technique to provide three different initial seeding conditions, with the aim of influencing the cellular architecture within the tissue. Cells seeded in each condition formed confluent and aligned tissues but within the tissues, the cellular architecture varied. Tissues with a more elongated cellular architecture had significantly elevated basal stress and produced more contractile stress in response to endothelin-1 stimulation. We also found a correlation between the contractile phenotype marker expression and the cellular architecture, contrary to our previous findings in non-confluent tissues. Taken with previous results, these data suggest that within cell-dense vascular tissues, smooth muscle contractility is strongly influenced by cell and tissue architectures.