Abstract
The beneficial effects of brown adipose tissue (BAT) on obesity and associated metabolic diseases are mediated through its capacity to dissipate energy as heat. While immune cells, such as ...tissue-resident macrophages, are known to influence adipose tissue homeostasis, relatively little is known about their contribution to BAT function. Here we report that neuropilin-1 (NRP1), a multiligand single-pass transmembrane receptor, is highly expressed in BAT-resident macrophages. During diet-induced obesity (DIO), myeloid-resident NRP1 influences interscapular BAT mass, and consequently vascular morphology, innervation density and ultimately core body temperature during cold exposure. Thus, NRP1-expressing myeloid cells contribute to the BAT homeostasis and potentially its thermogenic function in DIO.
Age‐related macular degeneration (AMD) in its various forms is a leading cause of blindness in industrialized countries. Here, we provide evidence that ligands for neuropilin‐1 (NRP1), such as ...Semaphorin 3A and VEGF‐A, are elevated in the vitreous of patients with AMD at times of active choroidal neovascularization (CNV). We further demonstrate that NRP1‐expressing myeloid cells promote and maintain CNV. Expression of NRP1 on cells of myeloid lineage is critical for mitigating production of inflammatory factors such as IL6 and IL1β. Therapeutically trapping ligands of NRP1 with an NRP1‐derived trap reduces CNV. Collectively, our findings identify a role for NRP1‐expressing myeloid cells in promoting pathological angiogenesis during CNV and introduce a therapeutic approach to counter neovascular AMD.
Synopsis
A population of innate immune myeloid cells expressing NRP1 receptor invades the retina where it drives and maintains pathological neovascularization during age‐related macular degeneration (AMD). A recombinant NRP1‐derived trap prevents choroidal neovascularization‐associated pathological angiogenesis.
NRP1 ligands were elevated in patients with neovascular AMD and in a mouse model of choroidal neovascularization (CNV).
NRP1‐expressing mononuclear phagocytes rose in the retina upon injury and promoted CNV.
CNV was reduced in mice by therapeutic intravitreal administration of soluble NRP1.
A population of innate immune myeloid cells expressing NRP1 receptor invades the retina where it drives and maintains pathological neovascularization during age‐related macular degeneration (AMD). A recombinant NRP1‐derived trap prevents choroidal neovascularization‐associated pathological angiogenesis.
Age-related macular degeneration is a prevalent neuroinflammatory condition and a major cause of blindness driven by genetic and environmental factors such as obesity. In diseases of aging, ...modifiable factors can be compounded over the life span. We report that diet-induced obesity earlier in life triggers persistent reprogramming of the innate immune system, lasting long after normalization of metabolic abnormalities. Stearic acid, acting through Toll-like receptor 4 (TLR4), is sufficient to remodel chromatin landscapes and selectively enhance accessibility at binding sites for activator protein-1 (AP-1). Myeloid cells show less oxidative phosphorylation and shift to glycolysis, ultimately leading to proinflammatory cytokine transcription, aggravation of pathological retinal angiogenesis, and neuronal degeneration associated with loss of visual function. Thus, a past history of obesity reprograms mononuclear phagocytes and predisposes to neuroinflammation.
Pathological neovascularization in age-related macular degeneration (nvAMD) drives the principal cause of blindness in the elderly. While there is a robust genetic association between genes of innate ...immunity and AMD, genome-to-phenome relationships are low, suggesting a critical contribution of environmental triggers of disease. Possible insight comes from the observation that a past history of infection with pathogens such as Chlamydia pneumoniae, or other systemic inflammation, can predispose to nvAMD in later life. Using a mouse model of nvAMD with prior C. pneumoniae infection, endotoxin exposure, and genetic ablation of distinct immune cell populations, we demonstrated that peripheral infections elicited epigenetic reprogramming that led to a persistent memory state in retinal CX3CR1+ mononuclear phagocytes (MNPs). The immune imprinting persisted long after the initial inflammation had subsided and ultimately exacerbated choroidal neovascularization in a model of nvAMD. Single-cell assay for transposase-accessible chromatin sequencing (scATAC-seq) identified activating transcription factor 3 (ATF3) as a central mediator of retina-resident MNP reprogramming following peripheral inflammation. ATF3 polarized MNPs toward a reparative phenotype biased toward production of proangiogenic factors in response to subsequent injury. Therefore, a past history of bacterial endotoxin-induced inflammation can lead to immunological reprograming within CNS-resident MNPs and aggravate pathological angiogenesis in the aging retina.
Obesity is a major risk factor for cancer. Conventional thought suggests that elevated adiposity predisposes to heightened inflammatory stress and potentiates tumor growth, yet underlying mechanisms ...remain ill-defined. Here, we show that tumors from patients with a body mass index >35 carry a high burden of senescent cells. In mouse syngeneic tumor models, we correlated a pronounced accretion of senescent cancer cells with poorly immunogenic tumors when mice were subjected to diet-induced obesity (DIO). Highly immunogenic tumors showed lesser senescence burden suggesting immune-mediated elimination of senescent cancer cells, likely targeted as a consequence of their senescence-associated secretory phenotype. Treatment with the senolytic BH3 mimetic small molecule inhibitor ABT-263 selectively stalled tumor growth in mice with DIO to rates comparable to regular diet-fed mice. Thus, consideration of body adiposity in the selection of cancer therapy may be a critical determinant for disease outcome in poorly immunogenic malignancies.
Attenuating pathological angiogenesis in diseases characterized by neovascularization such as diabetic retinopathy has transformed standards of care. Yet little is known about the molecular ...signatures discriminating physiological blood vessels from their diseased counterparts, leading to off-target effects of therapy. We demonstrate that in contrast to healthy blood vessels, pathological vessels engage pathways of cellular senescence. Senescent (p16INK4A-expressing) cells accumulate in retinas of patients with diabetic retinopathy and during peak destructive neovascularization in a mouse model of retinopathy. Using either genetic approaches that clear p16INK4A-expressing cells or small molecule inhibitors of the anti-apoptotic protein BCL-xL, we show that senolysis suppresses pathological angiogenesis. Single-cell analysis revealed that subsets of endothelial cells with senescence signatures and expressing Col1a1 are no longer detected in BCL-xL-inhibitor-treated retinas, yielding a retina conducive to physiological vascular repair. These findings provide mechanistic evidence supporting the development of BCL-xL inhibitors as potential treatments for neovascular retinal disease.
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•Senescent cells accumulate during diabetic retinopathy•Pathological vasculature engages p16INK4A and BCL-xL•Clearance of p16INK4A-expressing cells suppresses pathological angiogenesis•BCL-xL inhibitor UBX1967 eliminates senescent cells and suppresses neovascularization
Pathological angiogenesis is a cardinal feature of retinopathies and cancer. Crespo-Garcia, Tsuruda, Dejda et al. demonstrate that diseased blood vessels can be discriminated by their propensity to engage pathways of cellular senescence. They show that targeting senescence effector/anti-apoptotic protein BCL-xL suppresses pathological angiogenesis, providing a target for elimination of deregulated neovascularization.
Compromised vascular endothelial barrier function is a salient feature of diabetic complications such as sight-threatening diabetic macular edema (DME). Current standards of care for DME manage ...aspects of the disease, but require frequent intravitreal administration and are poorly effective in large subsets of patients. Here we provide evidence that an elevated burden of senescent cells in the retina triggers cardinal features of DME pathology and conduct an initial test of senolytic therapy in patients with DME. In cell culture models, sustained hyperglycemia provoked cellular senescence in subsets of vascular endothelial cells displaying perturbed transendothelial junctions associated with poor barrier function and leading to micro-inflammation. Pharmacological elimination of senescent cells in a mouse model of DME reduces diabetes-induced retinal vascular leakage and preserves retinal function. We then conducted a phase 1 single ascending dose safety study of UBX1325 (foselutoclax), a senolytic small-molecule inhibitor of BCL-xL, in patients with advanced DME for whom anti-vascular endothelial growth factor therapy was no longer considered beneficial. The primary objective of assessment of safety and tolerability of UBX1325 was achieved. Collectively, our data suggest that therapeutic targeting of senescent cells in the diabetic retina with a BCL-xL inhibitor may provide a long-lasting, disease-modifying intervention for DME. This hypothesis will need to be verified in larger clinical trials. ClinicalTrials.gov identifier: NCT04537884 .
L'obésité est un facteur de risque majeur de cancer. Il est connu qu’une adiposité élevée prédispose à un stress inflammatoire accru et potentialise la croissance tumorale. Néanmoins, les mécanismes ...restent mal définis. De façon intéressante, la sénescence cellulaire, ou le programme moléculaire causant l’arrêt du cycle cellulaire suite à un stress insurmontable, favorise l'inflammation chronique et délétère pendant l'obésité. Nous avons donc émis l’hypothèse que l'obésité puisse être un inducteur de sénescence protumoral qu’il est possible d’exploiter, via une stratégie sénolytique, pour ralentir ou même bloquer le développement de tumeurs. Grâce à des marquages de coupes histologiques de tumeurs métastatiques, nous avons montré que les masses malignes de patients ayant un indice de masse corporelle (IMC)>35 sont associées à des marqueurs de sénescence. Cette découverte suggère une charge élevée de cellules sénescentes chez ses patients. Alors que la sénolyse, ou l’élimination thérapeutique des cellules sénescentes, s'est révélée très prometteuse dans le traitement de plusieurs maladies liées à l'âge, son efficacité en tant que traitement du cancer est souvent mitigé et dépend des antécédents du patient. Dans notre étude, nous avons utilisé un modèle murin d'obésité induit par la diète combinée avec un modèle d’injections syngéniques de différentes lignées cancéreuses occasionnant des réponses immunogéniques faibles, légères ou hautes. Chez les souris sur une diète riche en gras, nous avons identifié des cellules cancéreuses sénescentes spécifiquement dans les tumeurs faiblement immunogènes, soit faiblement reconnue par le système immunitaire et donc difficile à traiter. Un traitement sénolytique avec l'inhibiteur de la famille BCL-2 ABT-263 abolit la réponse protumorale observée via l'ablation des cellules cancéreuses sénescentes. Ainsi, nous proposons que les thérapies combinatoires avec des agents sénolytiques devraient être envisagées pour traiter les patients cancéreux présentant une adiposité accrue. De plus, dans la même cohorte de patients où nous avons rapporté des marqueurs de sénescence dans les tissus malins, les patients obèses ont aussi montré une expression importante de Toll-like receptor 4 (TLR4). Nous avons donc émis l’hypothèse que le récepteur TLR4 joue un rôle important dans l’établissement d’un microenvironnement tumoral qui favorise la sénescence cellulaire et la croissance tumorale de souris en surplus de poids. Dans notre étude, nous rapportons que l'expression systémique de TLR4 est importante pour la croissance tumorale induite par l'obésité. Nous montrons également que l’induction d’un stress du réticulum endoplasmique médié par Inositol requiring enzyme 1a (IRE1ɑ) dans les cellules myéloïdes associées à une tumeur, favorise la sénescence des cellules cancéreuses, dans un contexte de faible immunogénicité, via TLR4. Ce travail établit les fondements d’une compréhension moléculaire du lien entre les régimes à forte teneur calorique et l'immunité protumorale.
Obesity is a major risk factor for cancer. High adiposity predisposes to increased inflammatory stress, which potentiates tumor growth. However, the mechanisms remain poorly defined. Interestingly, cellular senescence, or the molecular program causing cell cycle arrest following insurmountable stress, is known to promote chronic and deleterious inflammation during obesity. We therefore hypothesized that obesity could be an inducer of a protumoral senescence that can be exploited, via a senolytic strategy, to slow down or even block tumor development. Through histological sections of metastatic tumor, we show that malignant masses from patients with a body mass index (BMI)>35 are associated with markers of senescence, suggesting a high burden of senescent cells in these patients. While senolysis, or the therapeutic elimination of senescent cells, has shown great promises in the treatment of several age-related diseases, its efficacy as a treatment for cancer is often elusive and depends on patients’ history. In our study, we used a mouse model of diet-induced obesity (DIO) combined with a model of syngeneic injections of different cancer cell lines causing low, mild, or high immunogenic responses. In mice under a DIO, we have identified senescent cancer cells specifically in weakly immunogenic tumors, or tumors poorly recognized by the immune system, and therefore difficult to treat. Moreover, a senolytic treatment with the BCL-2 family inhibitor ABT-263 abolishes the protumor response seen in these mice via the ablation of senescent cancer cells. Thus, combination therapies using senolytic agents should fall into consideration to treat cancer patients with increased adiposity. In addition, in the same cohort of patients where we reported markers of senescence in malignant tissues, obese patients also showed significant expression of TLR4. We therefore hypothesized that the TLR4 receptor plays an important role in establishing a tumor microenvironment that promotes cellular senescence and tumor growth in mice subjected to experimental obesity. In our second study, we report that systemic expression of TLR4 is important for obesity-induced tumor growth. Moreover, we show that the induction of an IRE1ɑ-mediated endoplasmic reticulum stress, in tumor-associated myeloid cells, promotes the senescence of cancer cells, in a context of low immunogenicity, via TLR4. This work lays the foundation for a molecular understanding of the link between high-calorie diets and protumoral immunity.
In this study, a fast and rugged method is presented for the analysis of PCBs, PAHs, PBDEs and PCDD/Fs in biological tissues using a simple Quick, Easy, Cheap, Efficient, Rugged and Safe (QuEChERS) ...extraction and a clean-up by Gel Permeation Chromatography (GPC) and silica Solid Phase Extraction (SPE). Development was performed on blue mussels (Mytilus edulis) and Atlantic salmon (Salmo salar) for evaluation of two ranges of lipid and water content of biological tissues. Statistical validation was performed with Atlantic salmon samples. Forty-five PAHs were analyzed including the priority list of the US EPA and the European Union with 41 PCBs, 24 PBDEs and 17 PCDD/Fs. Instrumental analyses were performed on Gas Chromatography – High Resolution Mass Spectrometry (GC-HRMS). Accuracy was evaluated for PCBs and PCDD/Fs with a certified reference material furnished by the National Research Council Canada (NRCC) and also compared with results obtained by the conventional Soxhlet extraction. Statistical validation showed recoveries for PCBs, PAHs, PBDEs and PCDD/Fs close to 100% with average Relative Standard Deviation (RSD) lower than 10% and internal standard recoveries in the range of 70% with average RSD ranging from 5–15%. Average calculated Method Detection Limits (MDLs) were lower than 0.05μg/Kg for PCBs, 0.2μg/Kg for PAHs and PBDEs and 1ng/Kg for PCDD/Fs. The method is a faster and cheaper alternative to the time-consuming conventional method that has been used in most environmental laboratories.
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•Simultaneous sample treatment for the analytes POPs and PAHs to analysis by GC-HRMS.•Validity confirmed by statistical validation spiked-salmon and CRM.•Non-destructive sample treatment proposed allows easily extension to similar compounds.
Abstract
Aims
To assess the effect of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) with contemporary drug-eluting stents on the composite of cardiac death or ...myocardial infarction (MI) vs. medical therapy in patients with stable coronary lesions.
Methods and results
We performed a systematic review and meta-analysis of individual patient data (IPD) of the three available randomized trials of contemporary FFR-guided PCI vs. medical therapy for patients with stable coronary lesions: FAME 2 (NCT01132495), DANAMI-3-PRIMULTI (NCT01960933), and Compare-Acute (NCT01399736). FAME 2 enrolled patients with stable coronary artery disease (CAD), while the other two focused on non-culprit lesions in stabilized patients after acute coronary syndrome. A total of 2400 subjects were recruited from 54 sites world-wide with 1056 randomly assigned to FFR-guided PCI and 1344 to medical therapy. The pre-specified primary outcome was a composite of cardiac death or MI. We included data from extended follow-ups for FAME 2 (up to 5.5 years follow-up) and DANAMI-3-PRIMULTI (up to 4.7 years follow-up). After a median follow-up of 35 months (interquartile range 12–60 months), a reduction in the composite of cardiac death or MI was observed with FFR-guided PCI as compared with medical therapy (hazard ratio 0.72, 95% confidence interval 0.54–0.96; P = 0.02). The difference between groups was driven by MI.
Conclusion
In this IPD meta-analysis of the three available randomized controlled trials to date, FFR-guided PCI resulted in a reduction of the composite of cardiac death or MI compared with medical therapy, which was driven by a decreased risk of MI.
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