Podcasts about TLR9

From the American Association of Immunologists 2024 conference in Chicago, Cindy and Steph meet up with Mark Shlomchik to talk about his career and the research of his laboratory on systemic autoimmune diseases, long-lived B cell immunity, and immunopathogenesis. Hosts: Cindy Leifer and Steph Langel Guest: Mark Shlomchik Subscribe (free): Apple Podcasts, RSS, email Become a patron of Immune! Music by Tatami. Logo image by Blausen Medical Send your immunology questions and comments to immune@microbe.tv Content in this podcast should not be construed as medical advice.

References Nature Immunology 2018. volume 19, pages:871–884 Jon Anderson, Chris Squire, and Bill Bruford 1971. "Heart of the Sunrise". Yes. https://youtu.be/0vNcgL9Fi4w?si=DkXqwHwIEuQcTiMt --- Send in a voice message: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/message Support this podcast: https://podcasters.spotify.com/pod/show/dr-daniel-j-guerra/support

Learn about whether you lose more heat through your head; red blood cells in immunity; and Venus' non-existent oceans. You Don't Lose The Most Heat Through Your Head by Ashley Hamer Noreen. (2011, June). You Don't Lose Heat Faster Through Your Head than Other Parts of Your Body. Today I Found Out. http://www.todayifoundout.com/index.php/2011/06/you-dont-lose-heat-faster-through-your-head-than-other-parts-of-your-body/  ‌Sample, I. (2008, December 18). Scientists debunk the myth that you lose most heat through your head. The Guardian; The Guardian. https://www.theguardian.com/science/2008/dec/17/medicalresearch-humanbehaviour  Red blood cells might play a big role in immunity by Cameron Duke Lam, L. K. M., Murphy, S., Kokkinaki, D., Venosa, A., Sherrill-Mix, S., Casu, C., Rivella, S., Weiner, A., Park, J., Shin, S., Vaughan, A. E., Hahn, B. H., Odom John, A. R., Meyer, N. J., Hunter, C. A., Worthen, G. S., & Mangalmurti, N. S. (2021). DNA binding to TLR9 expressed by red blood cells promotes innate immune activation and anemia. Science Translational Medicine, 13(616). https://doi.org/10.1126/scitranslmed.abj1008 Perelman School of Medicine. (2021, October 20). Study finds red blood cells play significant role in immune system through discovery of DNA-binding capability. Medicalxpress.com; Medical Xpress. https://medicalxpress.com/news/2021-10-red-blood-cells-significant-role.html Contrary to popular belief, Venus probably never had oceans by Briana Brownell Did Venus ever have oceans? (2021, October 13). EurekAlert! https://www.eurekalert.org/news-releases/931214  ‌Turbet, M., Bolmont, E., Chaverot, G., Ehrenreich, D., Leconte, J., & Marcq, E. (2021). Day–night cloud asymmetry prevents early oceans on Venus but not on Earth. Nature, 598(7880), 276–280. https://doi.org/10.1038/s41586-021-03873-w  Follow Curiosity Daily on your favorite podcast app to learn something new every day withCody Gough andAshley Hamer. Still curious? Get exclusive science shows, nature documentaries, and more real-life entertainment on discovery+! Go to https://discoveryplus.com/curiosity to start your 7-day free trial. discovery+ is currently only available for US subscribers. See omnystudio.com/listener for privacy information.

Immune reviews evidence that toll-like receptor 9 on the surface of red blood cells binds DNA, leading to uptake by macrophages and innate immune activation. Hosts: Vincent Racaniello, Stephanie Langel, Cynthia Leifer, and Brianne Barker Subscribe (free): iTunes, Google Podcasts. RSS, email Become a patron of Immune! Links for this episode DNA binding to TLR9 on red blood cells (Sci Transl Med) Time stamps by Jolene. Thanks! Music by Steve Neal. Immune logo image by Blausen Medical Send your immunology questions and comments to immune@microbe.tv

Dr. Patel discusses the significance of the new collaboration between The University of Texas MD Anderson Cancer Center and TriSalus™ Life Sciences and the resulting research evaluating the administration of an investigational toll-like receptor 9 (TLR9) agonist in combination with immunotherapy across a range of liver and pancreatic solid tumors.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.11.11.377713v1?rss=1 Authors: Choudhury, A., Das, N. C., Patra, R., Bhattacharya, M., Mukherjee, S. Abstract: The worldwide outbreak of COVID-19 pandemic caused by SARS-CoV-2 leads to loss of mankind and global economic stability. The continuous spreading of the disease and its pathogenesis takes millions of lives of peoples and the unavailability of appropriate therapeutic strategy makes it much more severe. Toll-like receptors (TLRs) are the crucial mediators and regulators of host immunity. The role of several TLRs in immunomodulation of host by SARS-CoV-2 is recently demonstrated. However, the functionality of human intracellular TLRs including TLR3,7,8 and 9 is still being untested for sensing of viral RNA. This study is hoped to rationalize the comparative binding and sensing of SARS-CoV-2 mRNA towards the intracellular TLRs, considering the solvent-based force-fields operational in the cytosolic aqueous microenvironment that predominantly drive these reactions. Our in-silico study on the binding of all mRNAs with the intracellular TLRs shown that the mRNA of NSP10, S2, and E proteins of SARS-CoV-2 are potent enough to bind with TLR3, TLR9, and TLR7 and trigger downstream cascade reactions, and may be used as an option for validation of therapeutic option and immunomodulation against COVID-19. Copy rights belong to original authors. Visit the link for more info

At Aarhus University in Denmark, Vincent speaks with Trine Mogensen, Søren Paludan, Ole Søgaard, and Madalina Carter-Timofte about their careers and their work on sensing herpesviral DNA, immunodeficiencies that predispose to severe viral infections, and the path to a cure for HIV/AIDS. Hosts: Vincent Racaniello Guests: Trine Mogensen, Søren Paludan, Ole Søgaard, and Madalina Carter-Timofte Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Aarhus University Findaphd.com Sensing incoming HSV-1 (J Int Cyto Res) Be careful of canons (TWiV 456) Polio and host genetics (Front Micro) TLR9 treatment of AIDS (AIDS) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees. Send your virology questions and comments to twiv@microbe.tv

At Aarhus University in Denmark, Vincent speaks with Trine Mogensen, Søren Paludan, Ole Søgaard, and Madalina Carter-Timofte about their careers and their work on sensing herpesviral DNA, immunodeficiencies that predispose to severe viral infections, and the path to a cure for HIV/AIDS. Hosts: Vincent Racaniello Guests: Trine Mogensen, Søren Paludan, Ole Søgaard, and Madalina Carter-Timofte Subscribe (free): iTunes, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Aarhus University Findaphd.com Sensing incoming HSV-1 (J Int Cyto Res) Be careful of canons (TWiV 456) Polio and host genetics (Front Micro) TLR9 treatment of AIDS (AIDS) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees. Send your virology questions and comments to twiv@microbe.tv

ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so the data described here may change as research progresses. The 2019 ASCO Annual Meeting, held May 31 to June 4, brought together physicians, researchers, patient advocates, and other health care professionals from around the world to present and discuss the latest research in cancer treatment and patient care. In the annual Research Round Up podcast series, Cancer.Net Associate Editors share their thoughts on the most exciting scientific research to come out of this year’s ASCO Annual Meeting and what it means for patients. First, Dr. Lynn Henry will discuss 3 studies that explored new treatment options for women with breast cancer, including a study on immunotherapy for triple-negative breast cancer and 2 studies on treatment for hormone receptor positive, HER2-negative breast cancer. She also discusses research on the effects of a low-fat diet in women diagnosed with breast cancer, and a study on whether pregnancy after breast cancer increased the risk of recurrence.   Dr. Henry is an Associate Professor and Interim Division Chief of Oncology in the Department of Medicine at the University of Utah and Director of Breast Medical Oncology at the Huntsman Cancer Institute. She is also the Cancer.Net Associate Editor for Breast Cancer. Dr. Henry: Hi. My name is Dr. Lynn Henry. I'm a medical oncologist who specializes in treating breast cancer at the University of Utah. Today, I'm going to discuss research on breast cancer that was presented at the 2019 ASCO Annual Meeting in Chicago. In particular, I'm going to focus on the results of some clinical trials that directly impact how oncologists treat patients with breast cancer. First, I'm going to give just a very brief overview of the types of breast cancer and then talk about some research that was presented on triple-negative and hormone-receptor-positive breast cancer. Then I'm going to briefly review findings related to diet and breast cancer as well as pregnancy after breast cancer in women with BRCA mutations. As a quick reminder, there are multiple kinds of breast cancer. Some breast cancers are called hormone-receptor positive or estrogen-receptor positive, and those are stimulated to grow by estrogen. We treat those cancers with anti-estrogen treatments or anti-hormone treatments to block estrogen or lower the estrogen level in the body. Other breast cancers are called HER2-positive. These are often more aggressive cancers. But because they have extra copies of HER2, they often respond to treatments that block HER2. And finally, there are breast cancers that don't have hormone receptors or HER2, and these are called triple-negative breast cancer. So first, I'm going to focus on this type, triple-negative breast cancer. Until recently, most of the time, we treated triple-negative breast cancer with chemotherapy because we hadn't found other drugs that worked very well. There's a new type of drug, however, called immunotherapy that tries to use a patient's immune system to help fight the breast cancer. Early in 2019, the FDA approved a new treatment for triple-negative breast cancer that is a combination of a chemotherapy called Abraxane and a new immune drug called atezolizumab or Tecentriq. The combination increased the length of time until cancer progressed or grew. Overall, the treatment was fairly well tolerated. But we did learn that in order for the treatment to work, the cells surrounding the cancer have to have at least a small amount of a very specific protein called PD-L1. So at this recent ASCO meeting, we heard an update about this treatment. In the trial, the patients whose cancers had the PD-L1 protein and who got the combination treatment lived 7 months longer than those who got just the chemotherapy, which was an increase from 18 months to just over 2 years. This is an important first step towards finding a better treatment for this difficult type of triple-negative breast cancer. And this treatment is currently available to patients. Additional clinical trials are going on now to try to find even better combinations of chemotherapy and immune therapies to treat this type of cancer. So next, I'm going to talk about hormone-receptor-positive breast cancer. There were two trials of this type of cancer that had important results presented at the ASCO meeting. First, I'll focus on the treatment of early-stage node-negative breast cancer that is hormone-receptor positive and HER2 negative. The Oncotype DX test is a test we commonly run on tumors of this type to help determine whether treatment with chemotherapy is likely to be helpful. For this test, if your tumor has a score over 25, then chemotherapy is generally recommended in addition to anti-hormone therapy. If you have a score under 11, then chemotherapy is not recommended and a patient should receive only anti-hormone therapy. But for those with scores between 11 and 25, it was unclear how beneficial it was to receive chemotherapy. Last year, the results of the TAILORx trial were reported. And that showed that for women over the age of 50, if their tumor had a score between 11 and 25, they were not likely to get benefit from chemotherapy. However, it turned out it was a bit more complicated for women aged 50 and under. For those with scores between 11 and 15, chemotherapy was not likely to be beneficial. However, for those who score 16 to 25, chemotherapy might be beneficial. So we got some answers but not everything. At this recent ASCO meeting, additional information was reported to help guide treatment decision making for this middle group of women aged 50 and under. So for women whose scores were at the higher end, 21 to 25, chemotherapy was found to be likely to be beneficial. However, in that middle group, the 16 to 20 group, chemotherapy might be beneficial but generally only for women with higher risk cancers, meaning larger cancers or higher grade. This information is helpful because it provides more information for oncologists and for patients when they are discussing whether or not chemotherapy should be included as part of their treatment. So switching gears a little, still staying with premenopausal women and hormone-receptor-positive HER2-negative cancer, but now thinking about metastatic breast cancer, so cancer that has spread. We now have additional information about treatment with an anti-hormone therapy plus an additional drug called the CDK4/6 inhibitor. We've routinely been recommending this treatment combination because it leads to a longer time before the cancer progresses. But until now, we didn't know if it actually allows women with this type of cancer to live longer. The results of the MONALEESA-7 trial, which looked at the combination of an anti-hormone therapy plus the drug called ribociclib, showed that women who received the combination instead of anti-hormone therapy alone live almost 30% longer. So looking at women 3 and a half years after they started treatment, just over 70% of the women who were treated with ribociclib plus anti-hormone therapy were alive compared to just under half of women treated with anti-hormone therapy alone. So these results reinforce that this is an excellent first approach to treatment of premenopausal women who have newly diagnosed, hormone-receptor-positive HER2-negative metastatic breast cancer. So in addition to studies looking at these specific types of breast cancer, there were 2 other interesting studies that were applicable to breast cancer more generally. So there was a large study that was reported that looked at whether having a low-fat diet reduced the likelihood of developing triple-negative breast cancer. So in this study, postmenopausal without cancer were randomized to either a low-fat diet or their usual diet and followed for many, many years. Over time, some of these women developed breast cancer with no difference between those who followed the low-fat diet or the regular diet. However, in this new report, they looked specifically at the women who developed breast cancer who were enrolled in this trial. Fewer women died from their breast cancer if they ate the low-fat diet, especially if they had preexisting high cholesterol, diabetes, and obesity. These findings suggest that having a low-fat diet may actually reduce the risk of dying overall and also specifically from breast cancer. Now, these need to be validated, and we don't quite understand why this would be the case. But in general, it seems like having a low-fat diet, avoiding high cholesterol, diabetes, and obesity is a good thing. And then finally, 1 question that comes up often is whether it is safe to have a baby after the diagnosis of breast cancer. This is especially concerning for patients who have a mutation in genes called BRCA1 or BRCA2 since those mutations greatly increase their risk of developing both breast and ovarian cancer and also leads to the diagnosis of breast cancer at an early age. In addition, patients with these mutations are often recommended to have their ovaries removed at a young age. So in this study, patients who became pregnant did so about 4 and a half years after they were diagnosed with breast cancer. There was no apparent increase in miscarriage, preterm birth, or birth defects compared to what would be expected in women without cancer. And in the patients, there was no increase in the risk of breast cancer recurrence compared to those who did not become pregnant. And in fact, those who became pregnant were slightly less likely to have their cancer return, especially those who had mutations in BRCA1. So while there are some limitations to the study, the findings are reassuring that there does not appear to be an increase in risk of breast cancer returning in these patients with BRCA mutations who become pregnant after breast cancer diagnosis. So overall, as you can see, there's a lot of exciting research going on across all the different subsets of breast cancer. The results of many important clinical trials were reported at the recent ASCO meeting, and there are many more trials ongoing that will hopefully result in the approval of multiple new effective treatments for breast cancer. In addition, there's research going on examining the impact of treatment on patients with breast cancer and trying to improve the lives of those living with breast cancer. Clinical trials are critical for the development of these new treatments. Well, that's it for this quick summary of this important research from ASCO 2019. Overall, we continue on a fast track in breast cancer, with many new and exciting therapies being actively studied and research helping support our patients do better than ever before. Stay tuned to Cancer.Net for future updates from upcoming breast cancer conferences. Thank you very much. ASCO: Thank you, Dr. Henry. Next, Dr. Ezra Cohen will discuss several studies that looked at using immunotherapy and targeted therapy to treat different types of head and neck cancer. Dr. Cohen is Associate Director of Translational Science and leads the Solid Tumor Therapeutics research program at Moores Cancer Center at UC San Diego Health. He is the Cancer.Net Associate Editor for Head and Neck Cancer. Dr. Cohen: Hi. I'm Dr. Ezra Cohen from UC San Diego Moores Cancer Center. Today, I'm going to talk about research on head and neck cancer that was presented at the 2019 ASCO Annual Meeting. I think the most impactful presentation at the meeting was a follow-up on the KEYNOTE-048 study, which implemented the drug pembrolizumab, an anti-PD-1 antibody in first-line recurrent metastatic head and neck cancer. These were patients who were treated with curative intent or presented with metastatic disease, and either way, either had recurrence or eventually developed metastases. The first-line standard of care for these patients used to be the so-called extreme regimen, which involved platinum, 5-FU, and cetuximab. This was validated in an earlier phase III study that was conducted about 10 years ago and was the approved first-line regimen for these patients. In KEYNOTE-048, this extreme regimen was tested against either pembrolizumab alone or pembrolizumab, platinum, and 5-FU, in other words, substituting cetuximab for pembrolizumab in one of the experimental arms. We'd initially seen the interim analysis data at last year's ESMO meeting, but this year, we have the final analysis presented at ASCO. And what we saw was that both experimental arms actually achieved an improvement in overall survival compared to the extreme regimen. Interestingly, for pembrolizumab alone, this occurred in patients whose tumors expressed some level of PD-L1. That was evaluated by something called the composite score and takes into account both stromal and tumor cell staining of PD-L1. In fact, even at a very low level—that is CPS greater than or equal to 1—pembrolizumab monotherapy was superior to the extreme regimen with respect to overall survival. For all patients, the regimen of pembrolizumab plus chemotherapy was superior to the extreme regimen irrespective of PD-L1 staining. What we saw at this year's ASCO meeting was that, in fact, first, the higher the expression of PD-L1, the greater the benefit one derived from pembrolizumab either as monotherapy or in combination with chemotherapy. And in patients who had higher levels of PD-L1 and received both pembrolizumab and chemotherapy, the overall survival was quite remarkable with a hazard ratio of just higher than 0.6. In fact, we now have FDA approval in the United States for pembrolizumab monotherapy with tumors that have some expression level of PD-L1—that is CPS greater than or equal to one—or for all comers in patients who either the CPS status is unknown or patients whose tumors don't express PD-L1. Beyond KEYNOTE-048, we saw interesting data in first-line recurrent metastatic using a regimen of taxane, platinum, and 5-FU compared to the same extreme regimen that we just mentioned. That regimen turned out to be much better tolerated with fewer adverse events but with no improvement in overall survival, giving us a regimen that we could substitute for the extreme regimen if one wanted to, realizing that it does not involve immunotherapy, and for some patients, this may still be an appropriate treatment. Beyond the first-line recurrent metastatic studies, we saw a few interesting trials looking at targeted therapy in head and neck cancer but specific subsets. The first was in patients whose tumors expressed HER2 at very high levels—that is HER2 amplified—and had salivary ductal carcinoma. We've known that a proportion of salivary ductal carcinoma patients' tumors amplify this gene, HER2, similar to breast cancer and some other malignancies and that trastuzumab may, in fact, be effective. Well, in this study conducted by the Memorial Sloan Kettering Group, an antibody-drug conjugate trastuzumab emtansine was employed as a single agent in these patients whose, again, tumors amplified HER2. And what they saw was a remarkable 90% response rate. Now, this was only in 10 patients, so the study is small, but I think it's safe to say that this drug appears to be quite effective in patients with HER2-amplified salivary ductal carcinoma. Along those lines, in the subset of thyroid cancer patients whose tumors either mutate or have a RET fusion, the gene RET, there appeared to be very high efficacy for a novel agent that targets the RET oncogene. This was in both patients with medullary thyroid cancers that often have a RET mutation or in papillary thyroid cancers whose tumors often have a fusion of the same RET gene. Again, underscoring the idea that if we can target a driver even in a relatively small subset of patients, the benefit may be quite large. Along those lines, we had seen prior data for track inhibitors in patients who have in track fusions. And again, this applies to subsets of head and neck cancer patients that have either salivary gland cancers or thyroid cancers. Lastly, we continue to see emerging promising data of combinations with immunotherapy, and 2 highlights from ASCO were pembrolizumab with cetuximab showing a response rate of over 40% in a small group of patients and pembrolizumab with a TLR9 agonist called SD-101 showing about a 30% response rate. Of course, these data are very early and uncontrolled, and so we have to follow these stories further along to see if, indeed, these early signs of efficacy turn out to validate. But the idea that further combinations of immunotherapies eventually making their way to larger studies and hopefully approval is now well enforced in head and neck cancer. Thank you very much for your attention and hope you enjoyed the ASCO 2019 Annual Meeting. ASCO: Thank you Dr. Cohen. Next, Dr. Charles Loprinzi will discuss new research on ways to prevent or treat nausea and vomiting caused by cancer treatment. Dr. Loprinzi is a medical oncologist and the Regis Professor of Breast Cancer Research at the Mayo Clinic. He is also the Cancer.Net Associate Editor for Psychosocial Oncology. Dr. Loprinzi: Hello, I'm Charles Loprinzi, Regis Professor of Breast Cancer Research at Mayo Clinic. I'm going to be talking today about chemotherapy-induced nausea and vomiting. Now, chemotherapy can cause a lot of nausea and vomiting. That's well known, for years and years, by many people. It's not all types of chemotherapy, but some chemotherapy drugs cause a lot of nausea and vomiting, and others cause little to none. It's not as big a problem now as it was decades ago when we didn't have good drugs to try to prevent nausea and vomiting. Many drugs over the time have been developed for trying to prevent this nausea and vomiting problem. Examples of the drugs that cause a lot of nausea and vomiting are Cisplatinum, and Adriamycin and cyclophosphamide is a combination that is oftentimes used for patients with breast cancer. So in the past, we have developed many, many drugs for this. Three of the drugs that have commonly been used for the last many, many years for treatment or prevention of nausea and vomiting associated with chemotherapy are corticosteroid medications like Dexamethasone. It's quite cheap. It's got some side effects, but relatively cheap. Then there's a group called 5-HT3 receptor antagonists. I didn't make up that name, but that's the long name for it. They're relatively expensive, some more expensive than other ones. And then there's another group called NK1 receptor antagonists, and they can be quite expensive, sometimes being hundreds of dollars for each dose that's given to try to prevent nausea and vomiting related to chemotherapy. So a couple years ago, 2016, there was a report in the New England Journal of Medicine, which is a prominent journal for us in the business, that looked at a drug called olanzapine. It's a relatively cheap drug. It's a drug that was developed for psychosis-type problems, given for long term in those patients. But it had been noted that if it's given for just a few days, it seems to markedly improve or decrease the instance of nausea and vomiting, or if people were having nausea and vomiting, it appears actually to help and reverse that particular problem. So this trial looked at 10 milligrams of this drug for 4 days, given before chemotherapy, and then for 3 more days after that. Patients who were on this study got the 3 drugs that I talked about before with the olanzapine or with the placebo. And it noted that it improved things by quite a bit. The patients who had what we call a complete response, which means no vomiting and no need to take extra medications because of nausea and vomiting, improved from 41% of the patients who were on the placebo, to 64% who were on the olanzapine, a 23% improvement. And if we looked at a different endpoint there, the number of patients who had no nausea during the five days after chemotherapy, it was 22% in the group that got the placebo and improved to 37% in the group that didn't. So it was a good result in that area. One of the problems with this drug is that it can cause some sedation, cause some drowsiness for some patients. Most patients, not much, but some patients, it's a problem. So most trials that have been done in the past use this 10-milligram dose. And what we learned at ASCO in 2019, our main meeting that we have once a year, was that people looked at a 5-milligram dose and had looked at 5 milligrams instead of the 10 milligrams. And what it showed is that the results seemed to be quite similar to what was seen with 10 milligrams. They did the study quite the same as what had been reported in the previous trial and the results looks similar. They didn't compare 5 milligrams versus 10 milligrams, which would've been nice because then we would have better information along that line. They did note that there was drowsiness that some patients had, and it looks similar to what was seen with the 10-milligram dose. But these data support, but don't prove, that giving 5 milligrams does look like it's good in this particular setting. So data from this year also supported that instead of giving the drug during the day when getting the chemotherapy, sometimes, people take it at bedtime, and there, the drowsiness is not as big a problem because you want to be drowsy at bedtime. So it's not proven that it works as well at bedtime, but it suggests that that actually is the case. Data from this year also supported that if you looked at those 3 drugs I mentioned before and just took out that 1 really, really expensive one, the NK1 receptor antagonist, and put the olanzapine in there instead, that very cheap medication, that that looked like that one with the olanzapine did better than the very expensive one. Not a whole lot better; they looked similar, but a little bit better in that setting, and it was a whole lot cheaper. This was also seen in a publication that came out a couple of years ago which showed the same sort of result. Again, not proof that it's beneficial, that it's okay to do that, but it looked better. So the next obvious question that comes up then is when you have these 4 drugs that you give, the 3 drugs I mentioned before and this fourth one, what about if you take away that more expensive one and see how they do there? So there was a trial at the ASCO meeting that suggested that the addition of that expensive medications didn't provide a whole lot more benefit. Right now, there is a trial going on across the United States, with about 800 patients who are scheduled to go on this trial, and it's approving about 30 patients a month, which is a pretty good accrual rate, which is looking at this particular question where people would get the 4-drug regimen versus 3 drugs where they take away the expensive intravenous medication. So, in summary, 35 to 40 years ago, when I started my cancer career, when I was about 10 years old, most patients had a lot a trouble with nausea and vomiting with drugs like Cisplatinum. Now, this a minority of patients who have a lot of problems, and we're continuing to find new things that will make things better along this line. Thank you for your attention. ASCO: Thank you Dr. Loprinzi. Learn more about these topics and other research presented at the 2019 ASCO Annual Meeting at www.cancer.net. If this podcast was useful, please take a minute to subscribe, rate, and review the show on Apple Podcasts or Google Play. And stay tuned for additional Research Round Up podcasts coming later this summer. Cancer.Net is supported by Conquer Cancer, the ASCO Foundation, which funds breakthrough research for every type of cancer, helping patients everywhere. To help fund Cancer.Net and programs like it, donate at conquer.org/support.

The immunophiles explain how metabolic rewiring of macrophages by CpG promotes clearance of cancer cells. Hosts: Vincent Racaniello, Stephanie Langel, and Cynthia Leifer Become a patron of Immune! Links for this episode Darwin Day Metabolic rewiring of macrophages by CpG (Nat Immunol) Letters read on Immune 17 Time stamps by Jolene. Thanks! Weekly Science Picks Steph- Pregnant Scholar Cindy- Anti-vaxxers vaccinating against measles Vincent- Center for Science in the Public Interest Music by Steve Neal. Immune logo image by Blausen Medical. Send your immunology questions and comments to immune@microbe.tv

The pathomechanisms of the progression of chronic kidney diseases involve progressive glomerulosclerosis with renal parenchymal cell loss by proapoptotic factors. Tumor necrosis factor-alpha (TNF-α) is a proapoptotic cytokine that is produced by macrophages as well as by a variety of cell types. TNF-α signaling regulates cell survival and death. Like in other inflammatory renal diseases, the increased intrarenal TNF-α expression contributes to the disease progression of Alport nephropathy, “a non-inflammatory” murine CKD model. I show that TNF-α expressed by podocytes as well as by infiltrating leukocytes progressively activates renal parenchymal cells, inducing apoptotic pathways that can trigger glomerulosclerosis in Alport disease. The blockade of TNF-α by etanercept prolonged mean survival of Col4a3-deficient mice. The beneficial effect on life span was associated with a significant improvement of the glomerulosclerosis, proteinuria, and the glomerular filtration rate (GFR). In particular, etanercept treatment significantly increased the number of glomerular podocytes (WT-1 and nephrin co-staining) and the renal mRNA expression of nephrin and podocin without affecting markers of renal inflammation. The increased number of podocytes was consistent with less TUNEL-positive podocytes that undergo apoptosis. Importantly, exogenous signals, e.g. infections or toxins, have the potential to regulate the influx of immune cells including dendritic cells, macrophages, neutrophils, and T cells. Here I report a large influx of leukocyte subsets that are mostly dendritic cells and macrophages in Col4a3-deficient mice as compared to wildtype mice. While bacterial endotoxin treatment had no effect on the renal disease progression, bacterial cytosine-guanine (CpG)-DNA exacerbated all aspects of Alport nephropathy and reduced the overall life span of Col4a3-deficient mice. This effect of CpG-DNA was associated with a significant increase of renal CD11b+/Ly6Chigh macrophages, intrarenal production of TNF-α, iNOS, IL-12, and CXCL10. CpG-DNA switched intrarenal macrophages from non-activated phenotype (M2) towards the classically activated form (M1). These M1 macrophages increased the secretion of TNF-α, which accelerated the disease progression of Alport nephropathy by inducing podocyte loss. Taken together, I demonstrated that TNF-α is a crucial cytokine which induces podocyte loss in the natural course of the progression of Alport nephropathy. Moreover, the expression of TNF-α is enhanced by selective exogenous factors, e.g. TLR9 activation, which alter the phenotype of renal macrophages towards the M1 phenotype. TNF-α blockade might therefore represent a novel therapeutical option to delay the progression of Alport nephropathy and potentially of other forms of glomerulosclerosis in non-inflammatory and inflammatory conditions.

Im Rahmen der vorliegenden Arbeit wurden 855 Individuen mit Morbus Crohn, 481 Individuen mit Colitis ulcerosa und ein Kontrollkollektiv aus 1029 unverwandten, gesunden Individuen hinsichtlich drei verschiedener Einzelnukleotidpolymorphismen im Gen für den Toll-like Rezeptor 9 (TLR9) untersucht. Ziel war es, zu ermitteln, ob Assoziationen dieser SNPs mit Morbus Crohn oder Colitis ulcerosa oder mit klinischen Subtypen der beiden Erkrankungen vorliegen, und ob Interaktionen mit anderen krankheitsassoziierten Genen stattfinden. Es wurden für die vorliegende Arbeit drei Polymorphismen ausgewählt, mithilfe derer in Kombination mit den SNPs -1237 C/T und 2848 G/A, für die die Studienpopulation bereits typisiert war, zwischen den elf häufigsten beschriebenen 5-Punkt TLR9-Haplotypen differenziert werden kann. Es handelt sich dabei um die beiden Promotorpolymorphismen -1923 A/C und -1486 C/T sowie den Polymorphismus 1174A/G im Intron 1 des TLR9-Gens. Als wichtigstes Ergebnis der vorliegenden Arbeit kann eine hier erstmals beschriebene Assoziation des Polymorphismus 1174 A/G mit Colitis ulcerosa betrachtet werden. Für den SNP 1174 A/G konnte ein signifikant selteneres Auftreten des A-Allels bei Patienten mit Colitis ulcerosa gegenüber der Kontrollgruppe (p=0,035) oder Patienten mit Morbus Crohn (p=0,002) gezeigt werden. Signifikant war auch das seltenere Vorkommen des Genotyps AA bei Patienten mit Colitis ulcerosa (p=0,012 gegenüber Kontrollgruppe bzw. p=0,004 gegenüber Patientengruppe Morbus Crohn) Dies kann im Sinne eines protektiven Effekts des 1174 A/G A-Allels gegenüber Colitis ulcerosa interpretiert werden. Die im Rahmen dieser Arbeit beobachtete Assoziation des TLR9-Polymorphismus 1174 A/G mit Colitis ulcerosa kann als Hinweis darauf verstanden werden, dass TLR9 nicht nur, wie bereits beschrieben eine Rolle in der Pathogenese des Morbus Crohn spielt, sondern auch Bedeutung für die Colitis ulcerosa hat. Der Polymorphismus -1486 C/T scheint mit weiteren Suszeptibilitätsvarianten für Morbus Crohn zu interagieren, und das Krankheitsrisiko zu erhöhen. Es handelt sich hierbei jedoch um sehr schwache Effekte, so dass Aussagen über die Krankheitsrelevanz vor Ausschluss anderer Einflüsse (z.B. Kopplungsungleichgewichte) nicht getroffen werden können. Zusammen mit den Beobachtungen bzgl. Interaktionen zwischen dem Polymorphismus -1237 T/C im TLR9 und Polymorphismen im NOD2 und IL23R {Török, 2009}, unterstützen diese Ergebnisse aus genetischer Sicht jedoch eine Rolle von TLR9 in der Pathogenese Chronisch-entzündlicher Darmerkrankungen. Ein wichtiger Punkt bleibt allerdings die nähere Abgrenzung der funktionellen Relevanz der beschriebenen Assoziationen, was eine große Herausforderung für künftige Untersuchungen darstellt.

Innate immune activation via IL-1R or Toll-like receptors (TLR) contibutes to acute kidney injury but its role in tissue remodeling during chronic kidney disease is unclear. SIGIRR is an inhibitor of TLR-induced cytokine and chemokine expression in intrarenal immune cells, therefore, we hypothesized that Sigirr-deficiency would aggravate postobstructive renal fibrosis. The expression of TLRs as well as endogenous TLR agonists increased within six days after UUO in obstructed compared to unobstructed kidneys while SIGIRR itself was downregulated by day 10. However, lack of SIGIRR did not affect the intrarenal mRNA expression of proinflammatory and profibrotic mediators as well as the numbers of intrarenal macrophages and T cells or morphometric markers of tubular atrophy and interstitial fibrosis. Because SIGIRR is known to block TLR/IL-1R signaling at the level of the intracellular adaptor molecule MyD88 UUO experiments were also performed in mice deficient for either MyD88, TLR2 or TLR9. After UUO there was no significant change of tubular interstitial damage and interstitial fibrosis in neither of these mice compared to wildtype counterparts. Additional in-vitro studies with CD90+ renal fibroblasts revealed that TLR agonists induce the expression of IL-6 and MCP-1/CCL2 but not of TGF-β, collagen-1α or smooth muscle actin. Together, postobstructive renal interstitial fibrosis and tubular atrophy develop independent of SIGIRR, TLR2, TLR9, and MyD88. These data argue against a significant role of these molecules in renal fibrosis.

Thu, 9 Dec 2010 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/12751/ https://edoc.ub.uni-muenchen.de/12751/1/Endres_Ilona.pdf Endres, Ilona

Olá malta... Após um mês de Janeiro cheio de peripécias, consegui gravar uma nova edição do podcast. Desta feita, descrevo-vos um artigo onde se utiliza a estratégia de "prime-boost" amelhorada com CpG e FLT3L para aumentar a sua eficácia objectiva num ensaio pre-clinico em macacos para o virus SIV. O artigo chama-se "Adjuvanting a DNA vaccine with a TLR9 ligand plus Flt3 ligand results in enhanced cellular immunity against the simian immunodeficiency virus" publicado em 2007 no jornal JOURNAL EXPERIMENTAL MEDICINE. Eu achei este artigo muito interessante por ser um artigo relatando um ensaio pré-clinico em primatas (Rhesus macaques), e tratar-se de um modelo de HIV (human immudeficiency virus) - SIDA em português. É claro que neste experimental de primatas tenta-se tratar os animais com a variante símia (SIV). Outro factor interessante no artigo é o uso de uma estratégia de vacinação onde se utilizam dois vectores virais de origens distintas expressando os mesmo antigénios (SIV gag e pol) e HIV (Env e Nef). O uso de dois vectores distintos sequêncialmente chama-se prime-boost. O objectivo é evitar a neutralização do vector viral modificando a sua origem mantendo em comum o antigénio de interesse. Assim sendo o vector inicial é o virus Vaccinia e depois o vector seguinte é o virus Ankara. Os autores testam o ligando de Toll-like receptor9 (Desoxiribonucleotideos CpG) e o uso de Flt3 ligand para potenciar os efeitos da estratégia de prime-boost. Os autores descrevem que a vacina assim utilizada induz uma elevada mobilização de células dendriticas (células apresentadoras de antigénios profissionais do sistema imunológico) e em estado maturo de diferenciação. Como resultados os autores mostram que no grupo de animais tratado com Flt3L e CpG, o número de linfócitos T CD8 especificos do antigénio Gag do SIV é superior a todos os outros grupos animais testados, e que em termos clinicos a vacina tem efeitos profiláticos na protecção dos animais contra um infecção mucosal por via rectal com o virus SIV. Os dados apresentados são extremamente encorajadores para o uso desta estratégia prime-boost com CpG e Flt3L em estudos pré-clinicos em humanos. Dêem uma olhada e deixem os vossos comentários...

Olá, Viva. Décima edição do podcast "Journal Club Imunoterapia tumoral". Apresento-vos o artigo Dendritic cell preactivation impairs MHC class II presentation of vaccines and endogenous viral antigens Young et al 2007 PNAS 104: 17753 Este artigo demonstra que células dendriticas no seu estado maturo in vivo são incapazes de induzir respostas imunológicas específicas de um antigénio, e sobretudo que a razão que justifica este comportamento é a ausência de sintese das moléculas alpha e beta do heterodimero MHC classe II após maturação. Os autores observam que mesmo após maturação, as células continuam a apresentar capacidade de endocitose e capacidade de degradar antigénios solúveis e antigénios endogenos à célula dendritica, tais como antigénios virais. As células dendriticas são células fundamentais no desenvolvimento de respostas imunológicas in vivo sobretudo pela sua capacidade de induzirem a activação de linfócitos T naive. Para induzir a maturação das células dendriticas in vivo, os autores injectam CpG 1668 em ratinhos, o que gera uma maturação generalizada das células dendriticas encontradas no baço destes ratinhos. Semelhante fenómeno pode ser encontrado em condições de choque séptico ou em situações de infecções parasiticas como por exemplo a malária. O CpG são moléculas de ADN lineares ricas em sequências de nucleotideos citosina e guanina e que tem a propriedade de induzir fortes respostas imunológicas. Tal acontece porque existem nas células do sistema imunológico receptores que se ligam a este tipo de moléculas muito comuns em agentes infecciosos: os receptores Toll-like.  Estes receptores Toll-like são vários e reconhecem cada um deles um tipo específico de moléculas, eg TLR9 reconhece CpG, TLR4 reconhece LPS, TLR3 reconhece Poly I:C. Para mais informações deem uma olhada no link seguinte do wikipedia. Embora in vitro existam vários estudos sobre os aspectos funcionais das células dendriticas, estudos in vivo são raros. Este estudo é por isso valioso para reforçar o nosso conhecimento dos processos imunológicos. Um abraço e até breve. Pedro

Die beiden Pathogen-assoziierten molekularen Muster, CpG-Oligonukleotide, als Imitate bakterieller DNA, und LPS, sind in der Lage, das menschliche Immunsystem zu stimulieren. Vor Entdeckung der Toll-like Rezeptoren konnte nicht zwischen direkten und indirekten Effekten von CpG-Oligonukleotiden und LPS auf Zellen des menschlichen Immunsystems unterschieden werden. Durch die Entdeckung der Toll-like Rezeptoren und vor allem die Charakterisierung von TLR9 als Rezeptor für CpG und TLR4 als Rezeptor für LPS entstand die Möglichkeit, die Zielzellen von PAMPs an Hand der Expression der dazugehörigen Rezeptoren zu definieren. Dendritische Zellen sind im Immunsystem des Menschen essenziell für die Auslösung einer Immunantwort. Sie sind in der Lage, eindringende Pathogene an Hand von PAMPs schnell und sicher zu erkennen, und daraufhin eine passende Immunantwort zu initiieren. Zwei Subpopulationen von dendritischen Zellen konnten kürzlich im peripheren Blut identifiziert werden: Plasmazytoide dendritische Zellen (PDC) und myeloide dendritische Zellen (MDC). In der vorliegenden Arbeit wurden die Unterschiede zwischen PDC und MDC in ihren Reaktionen auf CpG-Oligonukleotide, LPS und CD40 Ligand charakterisiert. Funktionelle Untersuchungen zeigten, dass nur PDC und nicht MDC direkte Zielzellen von CpG-ODN im humanen Immunsystem darstellen, während LPS MDC aktiviert, jedoch nicht PDC. Damit konsistent konnte auf molekularbiologischer Ebene nachgewiesen werden, dass PDC TLR9 exprimieren, jedoch nicht TLR4, während MDC den für die Erkennung von LPS notwendigen Rezeptor TLR4 besitzen, aber TLR9 nicht exprimieren. In gemischten Populationen reagierten auch myeloide dendritische Zellen auf CpG-Oligodesoxynukleotide, was auf eine indirekte Aktivierung durch plasmazytoide dendritische Zellen hinweist. PDC reagierten nach Stimulation mit ODN 2006 mit einer Hochregulation von Reifemarkern und kostimulatorischer Moleküle, der Expression von Chemokinrezeptoren, der Produktion proinflammatorischer Chemokine und einer verminderten Apoptoserate. Nach Stimulation mit ODN 2216 sezernierten sie große Mengen IFN-α, während ODN 2006 für die Induktion von IFN-α eine Kostimulation mit CD40 Ligand benötigte. Weder ODN 2006, ODN 2216 oder CD40 Ligand alleine waren in der Lage, IL-12 in PDC zu induzieren, die synergistische Stimulation von PDC mit CpG-ODN und CD40 Ligand führen jedoch zur Produktion großer Mengen an IL-12. Unter optimaler Stimulation mit ODN 2006 und CD40 Ligand können PDC damit gleichzeitig IL-12 und IFN-α produzieren. Das Verhältnis der produzierten Zytokine ist dabei abhängig vom Differenzierungsgrad der PDC. Durch zunehmende Ausreifung der PDC mit IL-3 verschiebt sich nach der Stimulation das Produktionsverhältnis an sezernierten Zytokinen zugunsten von IL-12. Ausreifung mit ODN 2006 ermöglicht PDC, zudem naive allogene CD4 Zellen zu aktivieren, und induziert in Kokulturen IL-12-abhängig ein Th1-gerichtetes Zytokinprofil in den CD4 T-Zellen. IFN-α schien dabei eine geringe Rolle zu spielen. Durch die Charakterisierung der PDC als TLR9-tragende Zielzelle für CpG-DNA, trägt diese Arbeit entscheidend dazu bei, die PDC als Schlüsselzelle für die physiologischen Wirkungen von TLR9-Liganden zu identifizieren und zu verstehen. Dies ist von hoher Relevanz für die Entwicklung therapeutischer Anwendungen von CpG-ODN in der Tumortherapie, Asthmabehandlung, Infektionsprophylaxe und als Adjuvans bei Impfungen.

It has been reported that interferon (IFN-) enhances humoral immunity and that dendritic cells of the myeloid lineage promote B-cell differentiation. Here we studied whether the plasmacytoid dendritic cell (PDC), a subset of dendritic cells specialized for the production of IFN-, is involved in regulating B-cell differentiation and immunoglobulin production. The recently identified class of CpG oligonucleotides (CpG-C) was used to activate both B cells and PDCs via Toll-like receptor 9 (TLR9). The presence of PDCs synergistically enhanced CD86 expression, cytokine production (interleukin 6 [IL-6], tumor necrosis factor , and IL-10) and plasma cell differentiation of isolated human peripheral blood B cells stimulated through CpG-C and B-cell antigen receptor (BCR) ligation. This stimulation protocol was sufficient to drive purified naive B cells into IgM-producing plasma cells and to trigger IgG synthesis in memory B cells. PDCs contributed to B-cell activation via IFN- secretion. Up-regulation of TLR9 on B cells was not involved. These results demonstrate that CpG-stimulated PDCs induce plasma cell differentiation in naive and memory B cells in the absence of T-cell help, providing an explanation for the excellent activity of CpG oligonucleotides as a humoral vaccine adjuvant. (Blood. 2004;103:3058-3064)

Toll-like receptor (TLR)-9 recognizes CpG motifs in microbial DNA. TLR9 signalling stimulates innate antimicrobial immunity and modulates adaptive immune responses including autoimmunity against chromatin, e.g., in systemic lupus erythematosus (SLE). This review summarizes the available data for a role of TLR9 signalling in lupus and discusses the following questions that arise from these observations: 1) Is CpG-DNA/TLR9 interaction involved in infection-induced disease activity of lupus? 2) What are the risks of CpG motifs in vaccine adjuvants for lupus patients? 3) Is TLR9 signalling involved in the pathogenesis of lupus by recognizing self DNA?