Gut microbiome correlates of response and toxicity following anti-CD19 CAR T cell therapy.

Anti-CD19 chimeric antigen receptor (CAR) T cell therapy has led to unprecedented responses in patients with high-risk hematologic malignancies. However, up to 60% of patients still experience disease relapse and up to 80% of patients experience CAR-mediated toxicities, such as cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome. We investigated the role of the intestinal microbiome on these outcomes in a multicenter study of patients with B cell lymphoma and leukemia. We found in a retrospective cohort (n = 228) that exposure to antibiotics, in particular piperacillin/tazobactam, meropenem and imipenem/cilastatin (P-I-M), in the 4 weeks before therapy was associated with worse survival and increased neurotoxicity. In stool samples from a prospective cohort of CAR T cell recipients (n = 48), the fecal microbiome was altered at baseline compared to healthy controls. Stool sample profiling by 16S ribosomal RNA and metagenomic shotgun sequencing revealed that clinical outcomes were associated with differences in specific bacterial taxa and metabolic pathways. Through both untargeted and hypothesis-driven analysis of 16S sequencing data, we identified species within the class Clostridia that were associated with day 100 complete response. We concluded that changes in the intestinal microbiome are associated with clinical outcomes after anti-CD19 CAR T cell therapy in patients with B cell malignancies.

Knowledge, attitude and practice towards hepatitis B infection among high school students in Asante Mampong, Ghana.

BACKGROUND: Hepatitis B virus (HBV) infection is a serious global public health problem, with significant morbidity and mortality from acute and chronic complications. Increasing awareness and improving knowledge of HBV helps reduce the risk of the disease. Although many studies have been conducted on HBV in Ghana, few have focused on examining knowledge, attitude and preventive practices among adolescents towards the disease. OBJECTIVE: The objective of this study was to assess HBV knowledge, attitude and practice (KAP) among adolescents in high schools in the Asante Mampong Municipality in the Ashanti Region of Ghana. METHODS: A descriptive cross-sectional study was conducted among 398 adolescents from six senior high schools within the Asante Mampong Municipality. Data was collected using a 30-item structured questionnaire. Each item had two response options: "Yes" and "No". A scoring system was generated and respondents were given a score on each item answered. A positive response to an item was scored 1 point and a negative response was scored 0. Scores were then summed up and averaged to give the mean knowledge, attitude and practice scores. RESULTS: The majority of the respondents were male (60%), between 15 and 17 years (45%), Christian (93%) and in their first year of study. The adolescents had basic knowledge, positive attitude, and poor practices towards HBV. There was no significant relationship between the demographic variables of the respondents and KAP mean scores. CONCLUSION: There is the need to introduce health education and awareness programs in schools within the Asante Mampong Municipality to improve students' level of knowledge of HBV. Countrywide studies examining KAP towards HBV infection among adolescents are also warranted.

Alloreactive T cells deficient of the short-chain fatty acid receptor GPR109A induce less graft-versus-host disease.

The intestinal microbiota is essential for the fermentation of dietary fiber into short-chain fatty acids (SCFA) such as butyrate, acetate, and propionate. SCFAs can bind to the G-protein-coupled receptors GPR43 and GPR109A (HCAR2), with varying affinities to promote cellular effects in metabolism or changes in immune function. We explored the role of GPR109A as the main receptor for butyrate in mouse models of allogeneic hematopoietic cell transplantation (allo-HCT) and graft-versus-host disease (GVHD). Deletion of GPR109A in allo-HCT recipients did not affect GVHD, but transplantation of T cells from GPR109A knockout (KO) (Gpr109a-/-) mice into allo-HCT recipient mice significantly reduced GVHD morbidity and mortality compared with recipients of wild-type (WT) T cells. Recipients of Gpr109a-/- T cells exhibited less GVHD-associated target organ pathology and decreased proliferation and homing of alloreactive T cells to target tissues. Although Gpr109a-/- T cells did not exhibit immune deficits at a steady state, following allo-activation, Gpr109a-/- T cells underwent increased apoptosis and were impaired mitochondrial oxidative phosphorylation, which was reversible through antioxidant treatment with N-acetylcysteine (NAC). In conclusion, we found that GPR109A expression by allo-activated T cells is essential for metabolic homeostasis and expansion, which are necessary features to induce GVHD after allo-HCT.

Dietary Heterocyclic Amine Intake and Risk of Esophageal Squamous Cell Carcinoma in Rural Uganda.

Dietary exposure to 2-amino-1-methyl-6-phenylimidazo [4,5-b] pyridine (PhIP) in cooked meats maybe responsible for the high burden of Esophageal squamous cell carcinoma (ESCC) in southwestern Uganda. We conducted a pilot case-control study among 31 histologically confirmed ESCC cases and 54 age, gender, and residence matched healthy community controls sampled from the general population at the time of accrual of each case in southwestern Uganda. We collected data including smoking, alcohol consumption, diet, and scalp hair samples analyzed for normalized PhlP (adjusted per gram of melanin). We used logistic regression to determine the association of PhlP and ESCC. Overall, the mean normalized PhIP (ng/g melanin) was 44.79 (SD 148.08), higher among women compared to men (130.68 vs. 9.00, p = 0.03), lowest among healthy men [8.31 (SD 8.52) ng/g melanin] and highest among healthy women 158.39 (SD 288.75) ng/g melanin. In fully adjusted models, covariates associated with greater odds of ESCC included ever smoking 2 to 3 pack years of cigarettes (aOR 7.75 (95% CI 1.90, 31.50) and those 3 or more pack years (aOR5.82, 95%CI 1.25, 27.11), drinking 3 to 4 alcoholic drinks daily (aOR8.00, 95%CI 2.31, 27.74), and normalized PhIP above 75th percentile (8.65 ng/g of melanin) (aOR4.27, 95%CI 1.12, 16.24). In conclusion, high PhIP levels maybe associated with ESCC in a rural Uganda, a high ESCC burden setting. Further study with larger sample with a wider geographical representation is needed to validate scalp hair PhIP for assessment of ESCC risk.

Biomass fuel as a risk factor for esophageal squamous cell carcinoma: a systematic review and meta-analysis.

BACKGROUND: The link between use of solid biomass fuel (wood, charcoal, coal, dung, and crop residues) for cooking and/or heating and esophageal squamous cell carcinoma (ESCC) is inconclusive. OBJECTIVE: We systematically reviewed the literature and performed a meta-analysis to determine whether cooking fuel type influences esophageal squamous cell carcinoma. METHODS: We searched MEDLINE, EMBASE, Web of Knowledge and Cochrane Database of Systematic Reviews for studies investigating cooking fuel and ESCC from 2000 until March 2019. We performed random effects meta-analysis stratified by the continent, World Bank's country income classifications and fuel type and calculated pooled odds ratios and 95% CIs for the risk of esophageal squamous cell carcinoma in biomass fuel users compared with non-users. RESULTS: Our analysis included 16 studies (all case-control) with 16,189 participants (5233 cases and 10,956 controls) that compared risk of ESCC among those using nonsolid fuels and biomass fuels. We found use of biomass fuel was associated with Esophageal squamous cell carcinoma with a pooled odds ratio (OR) 3.02 (95% CI 2.22, 4.11, heterogeneity (I2) = 79%). In sub-group analyses by continent, Africa (OR 3.35, 95%CI 2.34, 4.80, I2 = 73.4%) and Asia (OR 3.08, 95%CI 1.27, 7.43, I2 = 81.7%) had the highest odds of ESCC. Use of wood as fuel had the highest odds of 3.90, 95% CI 2.25, 6.77, I2 = 63.5%). No significant publication bias was detected. CONCLUSIONS: Biomass fuel is associated with increased risk of Esophageal squamous cell carcinoma. Biomass fuel status should be considered in the risk assessment for Esophageal squamous cell carcinoma.

Fabrication and Evaluation of Polycaprolactone Beads-on-String Membranes for Applications in Bone Tissue Regeneration.

Tissue engineering leads to the development of biomaterial scaffolds where its biocompatibility and bioactivity are often improved after performing physical or chemical surface modification treatments. Micropatterning, soft lithography, and biofabrication are also approaches that provide a biomimetic microenvironment but have proven very costly and time consuming. In this concern, an appropriate substrate with suitable sites for cell attachment represents a major factor in cell behavior and biological functions. For this reason, our strategy was to fabricate a standard fibrous biomaterial with reproducible surface topography, incorporating microbeads and nanofeatures, and show the positive outcomes of the new substrate reflected on cell functions of bone cells. The electrospun polycaprolactone (PCL) beads-on-string membranes were obtained by adjusting the spinning solution at different concentrations until continuous beads were formed. Cell adhesion and proliferation, on the PCL scaffold, were analyzed the subsequent 2 days after initial culture. Complementary studies of cytoskeleton spreading and differentiation were analyzed after 7 and 14 days of the initial incubation. The scanning electron microscopy (SEM) images showed evidence of the formation of beads-on-string nanofibers and suggested that as-formed microstructures worked as attachment sites for osteoblasts. We investigated cell proliferation using anti-BrdU fluorescence assay, and results show a similar proliferation rate of cells cultured between PCL scaffolds and control. Finally, Phalloidin TRITC and antisialoprotein antibody were used to analyze cell spreading and differentiation after 7 and 14 days, respectively. This work shows a low-cost fabrication method to produce a biodegradable scaffold with micro/nanostructured characteristics that favor cell adhesion, proliferation, maturation, and subsequent differentiation of osteoblasts. According to the results, the biocompatibility of PCL beads-on-string could be comparable to other complex biomaterials, and we conclude that our scaffold is optimal for applications in bone tissue regeneration.

Investigations on Oecophylla longinoda (Latreille) (Hymenoptera: Formicidae) as a biocontrol agent in the protection of cashew plantations.

BACKGROUND: Cashew (Anacardium occidentale L.) has become a very important non-traditional tree crop in Ghana. The crop is, however, attacked by sap-sucking insects, particularly the mosquito bug, Helopeltis schoutedeni Reuter, the leaf-footed bug, Pseudotheraptus devastans (Dist.), and the coreid bug, Anoplocnemis curvipes (F.), which feed on shoots, panicles and fruits. Their damage is characterised by withering of the latter. In Ghana, Oecophylla longinoda Latr. occurs in large numbers on cashew and other native plants, but little is known about its relationship with insect pests. The relationship between O. longinoda and shoot and panicle damage by sap-sucking bugs and the effectiveness of O. longinoda as a biocontrol agent in the protection of cashew as compared with two chemical insecticides, lambda-cyhalothrin (Karate) and cypermethrin + dimethoate (Cyperdim), were therefore investigated at Bole in the northern region of Ghana. RESULTS: There was a negative correlation between numbers of O. longinoda nests and pest damage. Trees treated with cypermethrin + dimethoate (969 mg AI mL(-1) tree(-1)) and lambda-cyhalothrin (100 mg AI mL(-1) tree(-1)) recorded the smallest bug numbers, followed by O. longinoda. Trees infested by Oecophylla longinoda and trees treated with cypermethrin + dimethoate and with lambda-cyhalothrin had less than 6% pest damage to shoots, panicles and fruits, while water-sprayed trees recorded damage as high as 36.8% (shoots) in February, 32.9% (panicles) in February and 37.8% (fruits) in March. Cypermethrin + dimethoate again recorded the highest (485.0 kg ha(-1)) nut yield, followed by O. longinoda (431.0 kg ha(-1)), with water recording the lowest (93.0 kg ha(-1)) nut yield. CONCLUSION: The results indicate that O. longinoda can be used to control some sucking bugs as effectively as some insecticides.