Post-mortem neuropathologic examination of a 6-case series of CAR T-cell treated patients.

Introduction: Chimeric antigen receptor (CAR) T-cell therapy is a promising immunotherapy for the treatment of refractory hematopoietic malignancies. Adverse events are common, and neurotoxicity is one of the most important. However, the physiopathology is unknown and neuropathologic information is scarce. Materials and methods: Post-mortem examination of 6 brains from patients that underwent CAR T-cell therapy from 2017 to 2022. In all cases, polymerase chain reaction (PCR) in paraffin blocks for the detection of CAR T cells was performed. Results: Two patients died of hematologic progression, while the others died of cytokine release syndrome, lung infection, encephalomyelitis, and acute liver failure. Two out of 6 presented neurological symptoms, one with extracranial malignancy progression and the other with encephalomyelitis. The neuropathology of the latter showed severe perivascular and interstitial lymphocytic infiltration, predominantly CD8+, together with a diffuse interstitial histiocytic infiltration, affecting mainly the spinal cord, midbrain, and hippocampus, and a diffuse gliosis of basal ganglia, hippocampus, and brainstem. Microbiological studies were negative for neurotropic viruses, and PCR failed to detect CAR T -cells. Another case without detectable neurological signs showed cortical and subcortical gliosis due to acute hypoxic-ischemic damage. The remaining 4 cases only showed a mild patchy gliosis and microglial activation, and CAR T cells were detected by PCR only in one of them. Conclusions: In this series of patients that died after CAR T-cell therapy, we predominantly found non-specific or minimal neuropathological changes. CAR T-cell related toxicity may not be the only cause of neurological symptoms, and the autopsy could detect additional pathological findings.

Productivity and flavor of diverse genotypes of Ustilago maydis "cuitlacoche" for human consumption.

Maize plants infected by Ustilago maydis develop galls known as "cuitlacoche", a food product appreciated in the Mexican gastronomy. The virulence of different U. maydis isolates was assessed, as well as the development of the infection on one commercial maize variety. Sporidia were isolated of wild galls collected in Mexico. Sexual compatibility patterns were determined using the Fuzz reaction, showing a 1:1:1:1 segregation of mating type specificities. Ten U. maydis compatible strains were selected on the basis of their virulence, namely: four wild-type compatible sporidia, one multi-teliosporic strain, two hybrids between wild-type and tester strains, and three tester strains. Maize plants of a commercial hybrid (Tornado XR™) were inoculated with these strains of U. maydis, using a randomized complete block experimental design. Phenological and phenotypic characteristics of plants, as well as production, quality and sensory attributes of the resulting galls, were evaluated. Greater yields of galls were recorded in tester strains (incidence >90 %, severity >80 %, productivity >12 t/ha), a hybrid strain (EM1-6 × FB1) [incidence 82.6 %, severity 51.8 %, productivity 5.6 t/ha] and a wild-type strain (EM4-10 × EM2-4) [incidence 68.2 %, severity 44.0 %, productivity 4.8 t/ha]. Wild-type strains showed better flavor, characterized by less bitterness and acidity, but prevailing sweet, umami and maize flavor.

Percutaneous renal biopsy of native kidneys: efficiency, safety and risk factors associated with major complications.

INTRODUCTION: The use of an automated biopsy device and real-time ultrasound (current technology) for percutaneous renal biopsies (PRBs) has improved the likelihood of obtaining adequate tissue for diagnosis and has reduced the complications associated with renal biopsies. Our objective was to evaluate the efficacy and safety of the current PRB procedure and identify possible risk factors for the development of major complications. MATERIAL AND METHODS: We collected all native kidney PRBs performed with current technology in our institute from January 1998 to April 2008. Studied variables were collected from the patient's chart at the time of the biopsy. RESULTS: We analyzed 623 (96.4%) of 646 renal biopsies performed with the current automated procedure guided by real-time ultrasound. Although the effectiveness was 97.6%, there were 110 complications. Fourteen (2.24%) of these complications were major: 9 cases of renal hematoma, 2 cases with macroscopic hematuria (which needed blood transfusion), 1 case of intestinal perforation (which required exploratory laparotomy), 1 nephrectomy and 1 case of a dissecting hematoma. The logistic regression analysis demonstrated the following risk factors for developing major complications: diastolic blood pressure ≥ 90 mmHg, RR 7.6 (95% CI 1.35-43); platelet count ≤ 120×10(3)/µl; RR 7.0 (95% CI 1.9-26.2); and blood urea nitrogen (BUN) ≥ 60 mg/dl, RR 9.27 (95% CI 2.8-30.7). CONCLUSIONS: The observed efficacy and safety of the current technique in the present study were similar to observations in previous studies. Diastolic blood pressure ≥ 90 mmHg, platelets ≤ 120×10(3)/µl and BUN ≥ 60 mg/dl were independent risk factors for the development of major complications following PRB.