infection

Regulation of neutrophil endoplasmic reticulum stress response by IRE1a

Project Summary/Abstract: The lungs are exposed to pathogens and environmental toxins that trigger stress and cause numerous respiratory diseases. Effective host defenses against lung infection by bacterial pathogens, including methicillin- resistant Staphylococcus aureus (MRSA), rely on innate immune cells including neutrophils, prominent early responders to sites of infection. If host defenses are ineffective, MRSA causes serious lung infection, resulting in severe morbidity and a significant economic burden on healthcare facilities, where it is endemic. MRSA infections have a mortality rate of up to 14% and an estimated $500 million in healthcare costs in the US alone. Increasing resistance to vancomycin, the last resort antibiotic for MRSA infections, underscore the urgent need for innovative treatment approaches. Although directly targeting pathogens with antibiotics has been a successful approach for treating infections, many pathogens, including MRSA, eventually will become resistant to these drugs. As an alternative, immunomodulatory strategies to enhance host defenses, such as those shown to be effective against cancer cells, have the potential for treating drug-resistant pathogen infections. Recently, we showed that the inositol-requiring enzyme 1-α (IRE1α), an endoplasmic reticulum (ER) stress sensor, is required for clearance of MRSA in a murine skin abscess model, where neutrophils are robustly recruited to the site of infection. Further, IRE1α coordinates signaling events upstream of calcium (Ca2+) mobilization, histone citrullination, and production of mitochondrial reactive oxygen species (mitoROS), all of which are important for neutrophil inflammatory responses including the formation of antimicrobial neutrophil extracellular traps (NETs). Because excessive neutrophil activation and NET release can be detrimental to vital organs, it is not clear whether neutrophil IRE1α-mediated stress responses aid or impede the resolution of infection in the lungs. While IRE1α activation has been linked to the development of lung fibrosis through the regulation of alveolar epithelial- to-mesenchymal transition in the context of chronic inflammatory diseases, its role in pulmonary neutrophil defenses is unknown. Thus, there is a gap in our knowledge of how cellular stress responses modulate pulmonary neutrophil defenses and infection outcomes in the lungs. The overarching goal of this proposal is to elucidate the mechanisms by which neutrophil IRE1α signaling influences production of mitoROS and Ca2+ mobilization to drive NET release, injure lungs, and regulate pulmonary host defense against MRSA. We will accomplish the following Aims: (1) Define the molecular mechanisms underlying IRE1α-mediated mitoROS hyperactivation of human and mouse primary neutrophils and excessive NET release, and (2) Elucidate the role of neutrophil IRE1α signaling in excessive NET release, lung injury, and immunity in vivo using a MRSA pneumonia infection mouse model. These studies will yield mechanistic insight into how IRE1α-driven ER stress responses impact pulmonary neutrophil defenses and lung injury revealing potential targets for anti-microbial immunotherapies.

Modulating the Action of Cylindrical Proteases to Eliminate Neisseria Gonorrhea and Chlamydia Trachomatis Infections

Project Summary/Abstract Sexually transmitted bacteria diseases caused by Chlamydia trachomatis (Ctr) and Neisseria gonorrhoeae (NG) are the two most common sexually transmitted bacterial diseases. The infections caused by these pathogens may result in infertility, ectopic pregnancy, blindness, and perinatal mortality. Over 1.70 M cases of chlamydia and 0.65 M cases of drug-resistant gonorrhea are reported yearly in the US. Women with gonorrhea are co- infected with chlamydia in 17.6%–57.9% of cases, while women with chlamydia are co-infected with gonorrhea in 2.1%–17.2% of cases. These infections are treated with broad spectrum antibiotics, which can favor the development of resistance on NG/CTr but also in other bacteria, or damage the microbiota, diminishing its protective function and allowing bacteria and viruses to infect the patient. The Caseinolytic protease (ClpP) proteolytic machinery regulates protein turnover and homeostasis and is key in bacterial growth and development The machinery consists of the proteolytic unit (the ClpP) and its chaperone (ClpX), which transports proteins to be degraded, and it is termed the ClpXP. Our theory is that molecules that inhibit the action of the ClpX chaperone can become efficient antibacterial agents against both pathogens. We have found that the dihydrothiazepines can erradicate both pathogens and prevent the action of the ClpXP complex. Our goal is to advance the dihydrothiazepines as selective agents against Ctr and NG infections. To develop these therapeutic agents, we have envisioned four specific aims. Specific Aim 1. Synthesis and Optimization of the Pharmacophore. Our goal is to use computational models to design dihydrothiazepines molecule that will be synthesized, purified, and characterized using chemical techniques. The molecules will be tested against Ctr and NG and their toxicity against human cells evaluated. Also, we will determine their effect in other bacterial, including those from the microbiota. Specific Aim 2. Assessment of Stability and In Vivo Activity. We will study the stability of the most active molecules under various conditions. Then, we will study the pharmacokinetics, biodistribution , and antibacterial activity against Ctr and NG in mice. Specific Aim 3. Target Validation and Effect. We will study the ability of the compounds to inhibit the activity of ClpX using a luciferase assay and to block protein degradation. We will try grow crystal of the protein and the molecule and will study if the molecules prevent the assembly of the ClpXP system. Finally, we will assess the ability of the bacteria to develop resistance to the molecules.

Defining Microbial and Host Pathways Driving Asymptomatic C. difficile Colonization Associated with Aging and High-Sugar Diets

SUMMARY Clostridioides difficile infection (CDI) is a leading cause of healthcare-associated diarrhea, with rising incidence in community settings and a growing burden of asymptomatic colonization. Asymptomatic car- riers, particularly among the elderly and individuals consuming high-sugar diets, represent a critical but underexplored reservoir for transmission and disease progression. This proposal introduces novel, anti- biotic-independent mouse models demonstrating that both dietary sugar and aging independently pro- mote asymptomatic C. difficile colonization. We hypothesize that these factors disrupt colonization re- sistance (CR) through distinct but overlapping microbial, metabolic, and immune pathways. In Aim 1, we will define how traditional and emerging dietary sugars alter the gut environment to permit C. difficile colonization using in vitro bioreactors and in vivo models. Aim 2 will identify age-associated changes in microbiota and mucosal immunity that impair CR, using longitudinal studies and fecal micro- biota transfer. Aim 3 will functionally validate C. difficile genes upregulated during asymptomatic carriage using CRISPR-Cas9 mutants in both sugar- and age-induced models. This integrative, multi-omics approach will uncover the mechanisms enabling asymptomatic colonization and identify microbial and host targets for intervention. The findings will inform microbiome-based strat- egies to prevent CDI in vulnerable populations and shift current paradigms in CDI risk assessment and prevention.

The role of endogenous chimeric mRNA encoded GasderminD fusion proteins in immunity

Project Summary: Programmed inflammatory cell death, or pyroptosis, is a crucial innate defense mechanism that protects hosts against infection and orchestrates subsequent immune responses. Central to this process is Gasdermin D (GSDMD), a protein that forms plasma membrane pores upon activation, enabling the release of pro- inflammatory cytokines such as IL-1β and driving cell lysis. Although GSDMD-mediated pyroptosis has been conventionally understood to be controlled mainly at the post-translational level, through proteolytic cleavage by inflammatory caspases, we have discovered compelling evidence that alternative RNA processing may introduce additional, previously unappreciated complexity in GSDMD regulation. Our laboratories have developed and optimized a highly innovative long-read direct RNA sequencing pipeline, which bypasses conventional cDNA synthesis to avoid artifacts and enables unbiased discovery of native chimeric mRNA (chRNA) in mammalian cells. Using this approach, we have uncovered a remarkably diverse repertoire of chRNA species, including over a thousand unique fusions in murine macrophages and more than two thousand in human inflamed tissues. Among the chRNA found in mice, we identified a chRNA joining the effector domain of GSDMD with a novel C-terminal region encoded by Tmem106a, giving rise to the GSDMD:TMEM106A fusion protein. Functional studies demonstrate that GSDMD:TMEM106A is not only produced in response to inflammatory signals in macrophages but is critical for GSDMD-dependent cytokine release and optimal pyroptosis. Genetic loss of GSDMD:TMEM106A in mice results in reduced cytokine secretion and increased susceptibility to bacterial infection, while in vivo delivery of Gsdmd:Tmem106a mRNA is sufficient for protective immunity. Intriguingly, we have also identified a putative human counterpart, GSDMD:S100A6, which is highly inducible in colon biopsies from patients with inflammatory bowel disease. In this application, we propose a comprehensive exploration of this newly defined class of naturally occurring GSDMD fusion proteins. The specific aims are: (1) to elucidate the subcellular localization, protein-protein interactions, and pore-forming function of GSDMD:TMEM106A during canonical and non-canonical inflammasome activation; (2) to determine the transcriptomic, proteomic, and physiological consequences of GSDMD chRNA expression in vivo during infection, sepsis, and inflammatory disease, and to validate and functionally characterize GSDMD:S100A6 in relevant immune and barrier cell populations. Collectively, this work will establish chimeric splicing as a fundamental source of immunoregulatory protein diversity, redefining the landscape of cell death control in the immune system. By revealing new layers of gasdermin regulation and function, our studies have the potential to identify novel therapeutic strategies for infectious, auto-inflammatory, and immune-mediated diseases.

Linear diribonucleotides regulation of bacterial physiology and infections

RNA degradation was thought to proceed through endonucleolytic fragmentation, followed by exo- ribonuclease trimming which generate short RNA fragments that are turned over into mononucleotides by oligoribonuclease (Orn). In the last funding period, we published data supporting that only specific enzymes (Orn, NrnA, NrnB, and NrnC) cleave diribonucleotides into monoribonucleotides, and that prokaryotic organisms need to encode at least one diribonuclease to fulfill this specific function. These results support a new perspective on RNA degradation in which the short oligoribonucleotides are processed through a sequence of discrete steps involving distinct enzymes. In addition, linear diribonucleotides appear to be biologically active molecules since we reported that mutants lacking these enzymes accumulate diribonucleotides and have altered cell growth, biofilm formation, motility, and sporulation. Here we present additional preliminary data supporting diribonucleotides as active signaling molecules in the cell including: 1. Specific enzymes act trinucleases to generate diribonucleotides, 2. RNase AM of Pseudomonas aeruginosa ∆orn is a cryptic diribonuclease, 3. Two enzymes in central metabolism are diribonucleotide- binding proteins, and 4. P. aeruginosa ∆orn has virulence defects in an animal model of catheter-associated urinary tract infection. Our past publications and preliminary data provide the scientific premise for our hypothesis that cells generate linear dinucleotides from RNA degradation and linearization of cyclic dinucleotides, which can bind target proteins to alter cell physiology and pathogenesis. To test these aims, we will perform the following specific aims: In Aim 1, we will characterize the generation and degradation of diribonucleotides by characterizing how diribonucleases and triribonucleases bind their respective substrates through molecular biology, biochemistry, and computational docking. In Aim 2, we will identify effects of dinucleotides on bacterial metabolism and physiology by characterizing the binding proteins that specifically interact with linear diribonucleotides. Building on our success of identifying cellular diribonucleotide receptors, we will screen for additional proteins from open reading libraries of P. aeruginosa and Bacillus anthracis. We will exploit the strains available to us that lack all diguanylate cyclases to reveal whether the effect of linear diribonucleotides is independent of c-di-GMP signaling. In Aim 3, we will characterize the effect of expression levels of dinucleases and the effect of dinucleotide accumulation on bacterial physiology and pathogenesis. We will develop mass spectrometry methods to detect di- and triribonucleotides. We will employ existing mutants lacking diribonucleases, including P. aeruginosa ∆orn to study the defects in chronic infection in a murine model of catheter-associated urinary tract infection. Results from these studies will advance our understanding of RNA degradation and open a new area of signaling by linear diribonucleotides with the potential to be applied to novel antibacterial strategies.

The Role of the Intestinal Microbiota in Sepsis Mortality

Project Summary/Abstract Sepsis is a life-threatening condition characterized by a dysregulated host response to infection that can cause multi-organ damage and death. As the leading cause of in-hospital mortality, sepsis mortality rates reach up to 50%, and account for approximately 270,000 deaths and $38 billion annually in health care costs in the United States. Notably, patients with similar medical backgrounds can have vastly different sepsis outcomes— some survive with medical treatment while others die. The reasons for this dichotomy are unknown but is seen across all forms of bacterial bloodstream infections, is not specific to any strain-level differences in the infecting pathogen and cannot be explained by human genetic differences. Human microbiota studies suggest that gut microbial dysbiosis is associated with sepsis mortality and that these alterations influence gut barrier breakdown, leading to gram-negative bacteremia—one of the most common causes of sepsis and mortality. However, there are a lack of studies that investigate the causal role of the intestinal microbiota in sepsis mortality. This K08 proposal will elucidate the role of the intestinal microbiota in sepsis mortality. Utilizing the well- established murine model of sepsis by intraperitoneal injection of lipopolysaccharide (LPS), we combine microbiota taxonomic sequencing and metagenomics, advanced bioinformatic techniques and prediction modeling, with knowledge of mucosal immunity and germ-free mouse systems to characterize the microbiota features and members that correlate with, predict, and cause sepsis mortality. This proposal is organized into two specific aims: (1) identify baseline stool microbial features associated with and predictive of sepsis outcomes and (2) determine how colonization with immunostimulatory microbes heightens sepsis mortality. In this work, I will holistically characterize the host immunologic and microbiota features that are associated with and predictive of mortality and experimentally identify microbes and microbial pathways that cause death in our model. These findings will reveal new microbial and host biomarkers of sepsis mortality and identify novel targets for sepsis prevention and treatment to reduce the overall mortality rate of this deadly disease. My long-term goal is to become an independent physician-scientist who integrates cutting-edge computational methods with experimental biology to identify predictive biomarkers of disease onset and outcomes, investigate how they influence disease processes, and develop novel therapeutic and preventive strategies to improve patient care. This proposal details specific research aims and a structured career development and training plan that will allow me to acquire focused, in-depth and multidisciplinary training under the guidance of an internationally recognized team of experts in clinical infectious diseases, host-microbiota interactions, immunology, immunometabolism, and computational biology. The knowledge generated will address the fundamental role of the microbiota in sepsis outcomes and inform future preventative and therapeutic strategies that will lower the sepsis mortality rate worldwide.

Mentoring investigators in patient-oriented research on HIV and public health

PROJECT SUMMARY/ABSTRACT Despite marked progress in treatment and prevention, HIV remains a significant public health threat in the US and globally. Innovative strategies are needed to effectively deploy interventions and reduce HIV incidence, which requires a sustained and committed workforce. Dr. Dennis is an infectious disease physician and researcher at the University of North Carolina (UNC) at Chapel Hill, Division of Infectious Diseases. She seeks the protected time of the K24 award to ensure adequate time and effort to provide mentorship in patient- oriented HIV research focused on applied public health strategies. Dr. Dennis has a track record of performing high-quality patient-oriented research supported by independent funding. Her research bridges basic, clinical, and epidemiologic science by using HIV-1 molecular epidemiology and phylogenetics to understand HIV transmission at the population level and to use this information to direct prevention. She has expanded this work to optimize strategies to detect and respond to HIV networks using mixed-methods approaches. The overall goal of this work is to uncover the links between these sub-epidemics - which are overlapping sub- epidemics defined by risk groups, geography, social interaction - to facilitate the design of timely, effective interventions. The research specific aims are 1) Investigate HIV transmission networks using molecular epidemiology and phylodynamics (R01AI135970), 2) Evaluate uptake of HIV treatment and prevention services in public health with social network approaches (supported by R01AI169602), and 3) Pilot a network-based characterization of early syphilis infections to inform strategies to increase the uptake of injectable antiretrovirals for HIV treatment and prevention (supported by K24). With the support of the K24, she will leverage resources at UNC to support mentorship and professional development to strengthen new directions (implementation science, community-engaged research). Dr. Dennis is deeply committed to expanding her mentorship and dedicated to fostering diverse mentees with lived experiences that are critical for sustaining the HIV workforce. Dr. Dennis is Co-Director of the UNC Center for AIDS Research (CFAR) Scientific Working Group which focuses on Ending the HIV Epidemic efforts in North and South Carolina. She has strong institutional support and a multidisciplinary team of advisors, including the UNC CFAR, and is an advisor on the UNC T32 HIV/STI institutional training program. She has collaborated for the past 10 years with NC Division of Public Health and with multiple investigators and trainees at the UNC Gillings School of Public Health. She is active in the UNC Infectious Diseases Fellowship program, providing clinical and research mentorship to numerous ID fellows. Her clinical activity provides practical grounding and relevance in patient-oriented research. The K24 will provide 50% of Dr. Dennis’ salary and additional funds to support mentees’ research. The proposed research is timely and aligned with the National HIV/AIDS Strategy and will support the protected time needed to mentor the next-generation of investigators in HIV patient-oriented research.

TACTIC: Tuberculosis Active Case Tracking via Interpersonal Connections

PROJECT SUMMARY/ABSTRACT Tuberculosis (TB) remains the leading infectious cause of death worldwide. Interruption of transmission is the most effective strategy to reduce incident infections, yet current approaches often fail to reach individuals for timely testing and treatment. This study addresses that gap by leveraging social networks to identify individuals at highest risk of transmitting TB, specifically, people who use drugs (PWUD). We will evaluate respondent-driven sampling (RDS), a peer7 based community recruitment strategy, to identify TB cases among PWUD and the household contacts (HHCs) of those with TB disease (RDS-TB) in Kampala, Uganda. Conducting this work in a high-prevalence setting such as Kampala where our team has established expertise allows us to overcome recruitment challenges common in settings in the United States while generating findings that are directly translatable. This is particularly relevant given that higher TB prevalence and larger outbreaks in the United States have been associated with the use of methamphetamine, heroin, and crack/cocaine, drugs that we will study. In Aim 1, we will compare the effectiveness and reach of RDS-TB with a traditional clinic-based index case HHC approach for TB case finding. We will screen 2,000 PWUD and their HHCs, estimate the number needed to screen to identify one case of TB disease, and compare the demographic and network characteristics of RDS-TB recruits with clinic-based HHCs. Whole genome sequencing will be used to characterize transmission dynamics. In Aim 2, we will compare the yield of individual and combined TB diagnostic strategies for community-based active case finding. Participants will undergo chest radiography with computer-aided detection, tongue swab testing for TB nucleic acid amplification tests (NAAT), and sputum testing for NAAT and mycobacterial culture. We will identify the minimal combination of tests needed to meet World Health Organization target product profile thresholds for screening. In Aim 3, we will define the conditions under which RDS-based screening can effectively interrupt TB transmission. We will develop an agent-based model informed by social network data from individuals with and without TB, incorporating drug use patterns and demographic characteristics. This project will generate a practical, scalable roadmap for social network–based TB active case finding in high28 risk communities. The approach will be readily adaptable to settings in the United States and will inform strategies to interrupt transmission and advance progress toward TB elimination, in alignment with the NIH Strategic Plan for TB Research.

Mechanisms of Commensal- Specific CD8+ T Cell Differentiation, Restraint and Dysregulation in Intestinal Inflammation

PROJECT SUMMARY Our understanding of immunity largely stems from models of infection with pathogenic microbes. However, the vast majority of microbial-immune encounters occur as a symbiotic relationship with the commensal microbiota. Recently, the contribution of commensal-specific T cells to host physiology has received significant attention. These commensal-specific responses not only control microbiota containment but also promote immune tolerance within the gastrointestinal tract. While commensal-specific CD4+ T cell responses in the lamina propria have dominated models of mucosal immune regulation, these are vastly outnumbered by CD8+ intraepithelial lymphocytes within the epithelium. How CD8+ T cell responses to gut microbiota are primed, differentiate and function under homeostasis has not been addressed. Conversely, aberrant immunity to commensal microbes has been proposed to underlie pathologies of barrier tissues, including inflammatory bowel disease (IBD), where commensal-specific T cells accumulate in blood and intestinal tissues of afflicted patients. A better understanding of the properties and functions of commensal-specific T cell responses is therefore fundamental to studies of tissue immunity in health and disease. Our long term goal is to better understand how commensal-specific T cell responses contribute to barrier tissue homeostasis, and the objective in this application is to investigate the mechanisms regulating induction of commensal-specific CD8+ T cells in homeostasis and how they become dysregulated in IBD. Our rationale for the proposed work is that uncovering these mechanisms has the potential to translate into new therapeutic approaches. Our central hypothesis is that commensal-specific CD8+ T cells develop as functionally restrained intraepithelial lymphocytes (IEL) under homeostasis, but that perturbation of local immune regulation within the intestinal epithelium, in the case of patients with ulcerative colitis, by autoantibody-mediated blockade of integrin avb6 results in aberrant CD8+ effector T cell responses in IBD. Based on strong preliminary data, we will test three specific aims: (1) Determine key antigen-presenting cells (APC) priming SFB-specific CD8⍺β+ IEL. (2) Identify how cell-intrinsic pathways drive differentiation, maintenance and restraint of SFB-specific CD8⍺β+ pIEL. (3) Determine how pathogenic KLRG1+Eomes+ CD8+ T cells arise and contribute to inflammation in murine models of ulcerative colitis Our approach is innovative as it investigates new mechanisms of immunity unique to commensal-specific CD8+ T cell responses. The proposed work is significant because it will establish new insights into the interaction and communication between commensal microbes and immune cells in the gut environment and identify potential targets for therapeutic intervention in conditions of chronic intestinal inflammation.

Optimization of a novel and effective antiviral agent targeting Zika NS4B

This project focuses on developing novel anti-Zika virus (ZIKV) compounds targeting the NS4B protein, which is crucial for viral replication. ZIKV poses a significant medical challenge due to its potential for severe pathogenic outcomes, such as congenital Zika syndrome and Guillain-Barré Syndrome. Furthermore, its pandemic potential has been increasing with the expansion of carrier mosquito habitats. The project aims to address the urgent need for anti-ZIKV therapeutics that could greatly reduce severity of symptoms and minimize vertical and community transmissions. We have identified a novel small-molecule series with a benzamide scaffold through a cell-based, antiviral ultra-high-throughput screen. This series demonstrates strong potency against ZIKV without measurable cytotoxicity or non-specific antiviral effects, justifying this scaffold as a lead series for further development. Preliminary mechanism-of-action studies, utilizing genetic, biochemical, and virological assays, suggest that this series may inhibit the formation of the ZIKV viral replicase complex by interfering with NS4B. Our goal for this project is to develop a preclinical therapeutic candidate for ZIKV that demonstrates promising therapeutic activity following oral administration in ZIKV-infected mice, at a dosage that shows no clinical toxicity. The project has the following significant and novel objectives: 1) Optimize the benzamide lead for potency and drug-likeness; 2) Develop a lead candidate and a backup compound with optimized pharmacokinetic, pharmacodynamic, and toxicity profiles; 3) Determine the molecular mechanisms of action of the benzamide series using novel structural approaches to assist medicinal chemistry studies; 4) Evaluate the in vivo therapeutic efficacy and safety in mouse models and develop the best therapeutic regime. This project seeks to develop effective antivirals for ZIKV with high retention in the blood and central nervous system (CNS) and high oral bioavailability. The expected successful outcomes will provide significant advancements in ZIKV therapeutics and open new avenues for treating other flavivirus infections

Borrelia burgdorferi genotypic diversity, pathogenesis, and host cellular responses

PROJECT SUMMARY Lyme disease is the most common tick-borne illness in the United States, with an estimated 476,000 cases annually, and Pennsylvania (PA) consistently reports one of the highest case numbers nationwide. Borrelia burgdorferi sensu stricto (Bb) is a causative agent of Lyme disease in the US and is transmitted by Ixodes spp. ticks. Bb produces various outer surface proteins (Osp) and other mechanisms to survive in vectors, evade host immune systems, and to propagate infection within a host. Over 35 OspC genotypes have been characterized, which fluctuate in abundance in natural vector and host populations, suggesting host adaptation. While many Lyme-infected patients recover following antibiotic treatment, some may experience neurological symptoms, Lyme neuroborreliosis (LNB), which may be associated with specific genotypes. While previous studies focused on clinical manifestations, pathogenicity, genetic variations, and host immune responses using mouse models or patient samples, the genotype-specific immune responses that contribute to disease progression in humans remain poorly understood. Our central hypothesis is that certain Bb OspC genotypes, maintained in natural populations, are associated with distinct host immune responses that influence disease severity, progression, and persistence. Aim 1 will define the dynamics of OspC genotypes in tick and small mammal populations over time in Western PA to establish a 16-year longitudinal tick study and an 8-year longitudinal small mammal study. Using deep amplicon sequencing, we will quantify genotype diversity, detect low-abundance genotypes, and identify potential host-adapted genotypes. These empirical data will inform a compartmental mathematical model to evaluate OspC genotype prevalence, distribution, and public health risks, including LNB, across space and time. Aim 2 will assess how distinct Bb OspC genotypes affect the host immune landscape and cellular responses using human samples. To determine how Bb genotype contributes to disease phenotype, we will perform immune profiling studies which will include microscopy-based assessment of infected cell cultures, flow cytometric analysis of immune cell phenotypes, and measurement of genotype-specific cytokine, chemokine, and antigen production (sub-Aim2a). We will also employ multi-omics approaches that integrate single cell RNA sequencing with antibody-based protein profiling (scRNA-seq/Ab-seq) to characterize transcriptional and functional changes in immune cell populations exposed to different Bb genotypes (sub-Aim2b). This work is innovative in its integration of long-term ecological data with advanced immune profiling and single cell multi- omics to uncover genotype-specific mechanisms of Bb pathogenicity and human immune response—an approach not previously applied in Lyme disease research. These studies will clarify how specific genotypes influence immune responses and disease severity. Together, the proposed aims will identify critical genetic and immunological mechanisms that drive Bb pathogenicity and human susceptibility, informing the development of improved diagnostics, targeted therapies, and public health interventions to reduce the burden of Lyme disease.

Perturbation of mammary immunoglobulins during maternal antibiotic administration

Project Summary Prescribed in up to 40% of pregnancies, antibiotics represent the most commonly used class of medication during pregnancy. Although this practice is often necessary for maternal health, accumulating evidence suggests that antibiotic exposure may have unintended consequences for the mother-infant dyad. Epidemiologic studies associate maternal antibiotic exposure, especially in the absence of infection, with increased risk of neonatal complications including late-onset sepsis (LOS) and necrotizing enterocolitis (NEC), yet the mechanisms driving these associations remain poorly understood. Secretory IgA (sIgA) in milk is an essential component of neonatal mucosal immunity, shaping early gut microbial colonization and providing protection against enteric pathogens. The mechanisms by which maternal physiology regulates the abundance and microbial specificity of these antibodies in milk remain poorly understood. In animal models, the maternal gut–mammary axis governs the generation of milk IgA: IgA-committed lymphocytes from the maternal intestine migrate to the mammary gland during advancing pregnancy via CCL- 28/CCR10 signaling. Our preliminary data suggest that maternal antibiotic exposure disrupts this process leading to a decrease in milk IgA. However, the timing and extent of antibody dysbiosis are undefined; the downstream effects on neonatal intestinal health are unknown; and the underlying mechanisms—whether due to altered microbial stimulation, impaired recruitment of IgA⁺ cells to the mammary gland, or both—remain to be elucidated. Our central hypothesis is that maternal antibiotic exposure reduces pathogen-reactive IgA in milk by impairing gut-to-mammary immune cell trafficking thereby compromising neonatal mucosal immunity and increasing infection susceptibility. We will address this hypothesis through three integrated aims: (1) Determine the magnitude and duration of antibiotic-mediated mammary antibody dysbiosis in women who deliver preterm and at term; (2) Identify microbial targets of mammary antibodies diminished by maternal antibiotic exposure and (3 Determine the role of maternal antibiotics in the disruption of mammary resident IgA+ plasma cells in animal models. This integrative human and animal study will uncover critical mechanisms by which maternal antibiotic use alters the maternal-infant immune axis. The results will provide mechanistic insight into the risks associated with perinatal antibiotic exposure and inform clinical strategies to mitigate risk to neonatal health.

Th17 plasticity in rheumatoid arthritis

ABSTRACT The objective of this grant application is to explore the plasticity of Th17 in arthritis. Interleukin-17A (IL-17A) producing Th17 are present in the blood and synovium of patients with rheumatoid arthritis (RA). However, targeting of IL17A has been insufficient to control joint inflammation of RA patients. One potential scenario is that in the context of worsening RA joint inflammation, Th17 undergo conversion into pathogenic IL17A- negative cell populations, collectively called exTh17. The conversion of Th17 into exTh17 has been documented in the context of neuroinflammation, colitis, and infection. However, the occurrence of Th17 plasticity in autoimmune arthritis and its potential role in perpetuating synovial inflammation has remained mostly unexplored. We generated a novel fate-mapping mouse model of autoimmune arthritis, which allows to follow the conversion of Th17 into exTh17, and collected preliminary data suggesting that Th17 undergo significant loss of IL17A expression and conversion into exTh17 in the context of synovial inflammation. We also identified exTh17 signatures which might help exTh17 perpetuate joint inflammation despite their loss of IL17A expression. Here our objective is to further elucidate intrinsic (Aim 1) and extrinsic (Aim 2) mechanism of Th17-exTh17 conversion and exTh17-mediated joint inflammation, and explore the potential role of exTh17 in RA interstitial lung disease (ILD, Aim 3) a feared and often untreatable complication of established RA. Our long-term goal is to leverage the knowledge of local immune cell phenotypes and how they change at various stages of disease to enable stage-specific and personalized therapies of RA which minimize non- specific immunosuppression.

The role of GPR132 in regulating T cell responses in infection and cancer

PROJECT SUMMARY. CD8 T cells play a critical role in protection from a variety of infectious microorganisms, and pathogen-specific CD8 T cells undergo robust expansion, with an individual T cell clones expanding up to 10,000-fold in a matter of days. After infection is resolved, the majority of these T cells die, leaving a small population of memory cells to provide protective immunity from secondary challenge. T cell expansion and contraction are tightly orchestrated processes that involve a delicate balance between stimulatory and inhibitory signals to ensure proper immune function. Dysregulation of the T cell response can have detrimental effects; too little proliferation and the host fails to mount a successful immune response, while excessive proliferation and persistence of effector T cell populations can lead to tissue damage. This proposal aims to determine the role of the G protein coupled receptor GPR132 in the regulation of CD8 T cell responses during infection and tumorigenesis. GPR132 detects oxidized endogenous and microbial lipids, and this can lead to cell cycle arrest; however, the role of GPR132 in CD8 T cells remains unexplored. Here we identify GPR132 as a critical regulator of CD8 T cell expansion and memory differentiation. Completion of the proposed aims will: 1) uncover the temporal role of GPR132 in regulating T cell accumulation and function during infection and tumorigenesis, 2) examine the abundance of GPR132-activating ligands within the tissue during health and disease, and 3) determine how altering GPR132 ligand availability could be used to enhance/inhibit T cell responses. Overall, these studies will provide fundamental insights into the regulatory mechanisms that dictate the magnitude of T cell responses and how they can be modulated therapeutically, which would allow us to boost responses to pathogens/tumors or inhibit pathogenic responses in the context of autoimmune disease.

Eosinophils promote persistence and transmission during Bordetella spp. infections

ABSTRACT Despite widespread vaccination, Bordetella spp., the causative agents of whooping cough, continue to circulate globally. Resurgent outbreaks contribute to significant healthcare burdens and costs estimated up to $79 million annually. This persistence and reemergence highlight a critical need for new therapies and prevention methods. Our laboratory investigates bacterial and host drivers that enable Bordetella success, defined as enhanced persistence, reinfection, and transmission. We have identified the Bordetella sigma factor BtrS as a regulator of immunosuppressive pathways that modulate eosinophil function. Leveraging genetically tractable Bordetella strains, advanced murine models, and immunological tools, we are uniquely positioned to dissect how eosinophils contribute to respiratory bacterial infections. Our preliminary data reveal that eosinophils promote Bordetella persistence. Our results also show that the anti-inflammatory cytokine IL1 receptor antagonist (IL1Ra) also contribute to persistence. However, the contribution of eosinophil-derived immunosuppressors remains unclear and will be investigated in Specific Aim 1. Moreover, we have evidence that eosinophils are required for nasal shedding, through mucus enhancement, and paroxysmal coughing, via exacerbation of bronchoconstriction, during Bordetella spp. infection, two key metrics of transmission. The eosinophil-effectors that promote shedding, coughing, and transmission, will be investigated in Specific Aim 2. Based on our data, we hypothesize that eosinophils contribute to Bordetella pathogenesis by (1) promoting persistent infection and (2) enhancing transmission through mucus-driven shedding and cough reflex induction. This proposal will test this hypothesis through two specific aims: Aim 1: Delineate the immunosuppressive role of eosinophils in modulating host responses and enabling Bordetella persistence. Aim 2: Define the mechanisms by which eosinophils facilitate Bordetella spp. transmission. By reframing eosinophils as active modulators of bacterial pathogenesis, this research challenges traditional views of eosinophils as terminal effector cells and positions them as novel targets for therapeutic intervention, that might be applicable to other mucosal pathogens. The outcomes will contribute to our understanding of eosinophil biology in infection and may lead to innovative strategies to halt bacterial persistence and transmission.

Integrins α4β7 in Leukocyte Rolling in Shear Flow, Firm Adhesion, and Therapy

Abstract. Integrin α4β7 facilitates leukocyte migration to sites of infection and autoimmune disease, making it an important therapeutic target for ulcerative colitis and Crohns disease. However, the currently approved antibody drug vedolizumab targeting α4β7 has limited efficacy. This proposal seeks mechanistic understanding of how α4β7 mediates rolling and firm adhesion of leukocytes during extravasation as well as how therapeutically relevant antibodies modulate α4β7 function to improve drug design. Unlike most integrins, α4β7 mediates rolling adhesion on its ligand MAdCAM. α4β7 can also mediate firm adhesion like α5β1. Integrins typically equilibrate between two low-affinity closed conformations and a high-affinity open conformation. Ligand binding is intimately coordinated with conformational change. During rolling adhesion, receptor-ligand bonds must rapidly form beneath rolling cells as cells are torqued by shear flow onto the substrate. Bonds must also rapidly dissociate at the upstream tethers to the substrate due to hydrodynamic force applied to the cell. To enable their function in rolling adhesion, we hypothesize that α4β7 ligand binding and dissociation and conformational change kinetics are faster than those of other integrins like α5β1 and that α4β7's pathways for conformational change may also differ. We propose that activation of the actin cytoskeleton in the transition from rolling to firm adhesion stabilizes α4β7 in a high-affinity state. Aim 1 will determine high-resolution structures of unliganded α4β7 and its complexes with MAdCAM or medically relevant antibodies using cryo- EM. These structures will reveal how these integrins recognize their ligands, the conformational changes due to ligand binding, and potential structural specializations that enable α4β7 to mediate rolling adhesion. The binding epitopes and conformational specificities of activating antibodies to the β7 subunit will also be defined. The structure of α4β7 bound to vedolizumab will resolve the contention around how it blocks MAdCAM binding. Aim 2 will quantitatively define the mechanisms by which α4β7 mediates both rolling and firm adhesion to improve therapies for inflammatory bowel diseases. Ligand affinity and binding kinetics of α4β7 stabilized in different conformations will be measured as well as single-molecule conformational change rates when bound and unbound to ligand. The effect of mutations that stabilize rolling or firm adhesion will be used to identify parameters important for each adhesion type. The tensile force and bond lifetimes during rolling and firm adhesion will be quantified at the single-molecule level. Together, our studies will enhance our structural, biochemical, and mechanical understanding of α4β7-mediated rolling and firm adhesion and will provide structural and functional information that can be utilized in the development of more effective therapies for inflammatory bowel diseases and multiple myeloma.

Antibody-guided design of a human astrovirus vaccine

PROJECT SUMMARY Viral diarrheal diseases cause substantial global morbidity and mortality. Diarrheal disease is the second leading cause of childhood mortality in the world, accounting for over 10% of all deaths of children under 5 years old. Gobally, over 1 billion cases of diarrheal diseases occur every year, making prevention of these diseases a public health concern of the highest priority. Human astrovirus (HAstV) infection is a leading cause of viral diarrhea in children and has been shown to cause chronic gastrointestinal disease and fatal neurological disease in immunocompromised patients. There are nearly 4 million cases of HAstV infection each year in the United States alone, and there are no clinically approved HAstV-specific vaccines or therapeutics. Antibody-guided vaccine development leverages a deep understanding of productive antiviral antibody responses in order to design vaccine immunogens that deliberately focus the induced response toward highly conserved epitopes with the goal of reliably inducing broad, durable immunity. Using a cutting-edge monoclonal antibody (mAb) discovery approach based on next-generation antigen barcoding, single cell multi-omics, and sophisticated bioinformatics, we will exhaustively screen the HAstV- specific antibody repertoires of geographically distinct donor cohorts to uncover the structural and immunogenetic features that differentiate broad and potently neutralizing HAstV mAbs. A more complete understanding of these exceptional – and potentially very rare – mAbs will accelerate the development of HAstV vaccines and therapeutics. We have assembled a collaborative, multidisciplinary group of investigators with a long history of productive collaboration and with highly complementary areas of expertise. We expect our work will result in the discovery of thousands of novel anti-HAstV mAbs from cohorts of healthy adult and pediatric participants. Detailed genetic, functional, and structural characterization of these mAbs will reveal conserved sites of viral vulnerability, uncover the precise molecular mechanisms of viral neutralization, and inform our development of a broadly protective HAstV vaccine.

Calcium signaling in MR1-dependent presentation of Mycobacterium tuberculosis antigens

Project Summary The fundamental role of the immune system is to detect self from non-self. The detection and elimination of microbial infection is critical for human survival. One challenge to the immune system is infection from an intracellular microbe because the microbe masks its presence in a host cell. One strategy of the immune system to detect microbes is the sampling of different kinds of antigens, such as peptides, lipids and glycolipids, by antigen presenting molecules. A fundamentally unique arm of the immune system is MR1, which is an antigen presenting molecule that is intracellular, ubiquitously expressed across tissues, and detects small molecules derived from microbial metabolism. These features suggest that MR1 is poised to detect intracellular microbes. MR1 presents antigens to MR1-restricted T cells. These T cells are highly prevalent in the lungs and can kill infected cells. Because MR1 presents small molecule antigens and adopts an intracellular distribution, the mechanisms governing MR1 sampling of the intracellular environment are distinct from other antigen presenting molecules. These mechanisms remain unknown. Our over-arching hypothesis is that intracellular calcium signaling is important for MR1 antigen presentation. We use Mycobacterium tuberculosis (Mtb) as a model for intracellular infection and have identified calcium-sensitive trafficking proteins and calcium channels important for MR1 antigen presentation. Aim 1 of this study will determine the mechanism of two-pore channel 1 in MR1- dependent antigen presentation, with a focus on endoplasmic reticulum-endosome contact sites. Aim 2 will determine the role of specific calcium-sensitive Synaptotagmins and their binding partners. Aim 3 will determine the mechanism behind augmented MR1 antigen presentation following modulation of the of the cystic fibrosis transmembrane conductance regulator. Successful completion of these Aims has the potential to lead to new MR1-based immunotherapies.

Staphylococcus aureus metabolic requirements during skin colonization

Project Summary Staphylococcus aureus causes 76% of all skin infections, and yet simultaneously this pathogen asymptomatically colonizes the skin of 8-22% of healthy adults. Since the majority of S. aureus disease is the result of autoinfection from the colonizing strain, and invasive infections often originate from the skin, there is an urgent need to understand colonization mechanisms. In colonizing the skin, S. aureus encounters abundant levels of amino acid derivatives like urocanic acid and 5-oxoproline (OP) that contribute to the skin’s “acid mantle” and have reported anti-Staphylococcal properties. The central hypothesis of this project is that amino acid transport and catabolism is a critical feature of S. aureus skin colonization. To model this environment, we developed a skin-like media (SLM) to assess S. aureus physiology on the human skin surface. We determined the S. aureus transcriptional response using RNAseq and performed metabolomics in SLM, both of which demonstrated that amino acid catabolism genes are upregulated and that amino acids are rapidly consumed. These findings indicate that S. aureus has a skin expression program that enables survival and growth in this harsh environment. In Specific Aim 1, we are investigating S. aureus metabolism of serine, the second most abundant amino acid on human skin. We hypothesize that serine transport and catabolism is critical for S. aureus skin colonization. We will assess growth of mutant strains disrupted in serine pathways in the SLM and during mouse skin colonization. With 13C-tracing experiments we will investigate serine flux in S. aureus using metabolomics. We will determine serine transport mechanisms using bioinformatic guided targets and serine analogues. In Specific Aim 2, we will assess S. aureus resistance to toxic skin metabolites. OP is abundant on human skin and is known to be deleterious to bacteria. Our preliminary metabolomics studies indicate that S. aureus metabolizes OP in SLM, and we have identified a putative oxoprolinase (genes SAUSA300_1566-1561) that is upregulated on skin. We hypothesize that the detoxification of OP contributes to S. aureus survival on the skin. We will construct mutants in the 1566-1561 locus and test their contributions to OP metabolism in SLM with growth and metabolomics experiments. We will also investigate OP transport and test mutant strains in our mouse skin colonization model. In Specific Aim 3, we will identify new determinants of S. aureus skin colonization using TnSeq. We have developed an improved TnSeq library preparation and analysis protocol, and in our preliminary studies we performed TnSeq in SLM and in our mouse skin colonization model. We will evaluate pathway hits, such as respiration and fermentation, and aspartate metabolism targets by testing constructed mutants during SLM growth and in the mouse model. Novel hits will be validated with follow-up genetic experiments and 13C-tracing experiments. Collectively, the proposed studies will advance our knowledge of S. aureus colonization and adaptation to the skin environment.

Investigating the nonlinear complex dynamics of the tuft cell-microbiome cross-talk: the impact of feedback loops on immune regulation, microbial modulation and response to tissue insults

Project Abstract Tuft cells (TCs) are specialized chemosensory epithelial cells that are emerging as critical regulators of intestinal homeostasis. Named over 70 years ago based on their distinct morphology, a defined function for TCs was only elucidated in the last decade. TCs in the small intestine sense succinate from helminths to initiate type 2 immune responses that mediate parasite expulsion. Recently, we discovered a novel physiologic function for TCs in the colon, where their role had been considered minimal. Succinate, a key microbial metabolite, is produced by colonic microbiota as both a precursor to other metabolites and a cross-feeding fuel source for pathogens. TCs respond to succinate by secreting interleukin-25 (IL-25), which activates type 2 cytokine- producing lymphocytes (T2Ls), amplifying TC expansion and reinforcing barrier function. We recently demonstrated that this SPB–TC–IL-25–T2L feedback loop is essential for protection against pathogen-induced colitis. Our preliminary data further suggest that TCs actively promote colonization by succinate-producing bacteria (SPBs), establishing positive feedback on TC-supporting microbes, while other epithelial cells such as goblet cells (GCs) and Paneth cells (PCs) may exert complementary or counterbalancing influences. Supported by new modeling insights, we hypothesize that these epithelial–immune–microbiome interactions form coordinated feedback loops that collectively optimize intestinal resilience. These loops may create a dynamic, multi-stable system that flexibly transitions between homeostatic and hyperplastic states, buffering against microbial fluctuations and pathogenic insults while preventing uncontrolled type 2 inflammation. Using a combination of mathematical modeling and experimental validation, we will develop a multi- layered systems framework to explore how epithelial–immune–microbial feedbacks shape resilience or breakdown in clinically relevant models of colonic infection and inflammation. Our three Aims will (1) develop, calibrate, and validate a mathematical model that integrates TCs, GCs, PCs, SPBs, and SCBs; (2) define the immunological circuits governing epithelial–microbiome equilibrium; and (3) determine how epithelial feedbacks regulate microbial community structure and resilience. In line with NIH’s new initiative to prioritize human-based research, our proposal combines computational modeling, human colonic organoids, and complementary mouse models. Organoid experiments will provide human-relevant data for model calibration, while in vivo studies validate systemic predictions, ensuring both rigor and translational relevance while minimizing reliance on animal models. This work will generate interoperable models that integrate epithelial, microbial, and immune networks, providing predictive insight into intestinal outcomes under homeostatic, infectious, and inflammatory conditions and informing therapeutic strategies for microbiome-targeted interventions.

Transcriptional control of activation induced deaminase (AID) function

SUMMARY Somatic hypermutation (SHM) and class switch recombination (CSR) are vital for the generation of high affinity antibodies with appropriate effector function, protection against infection, and vaccine efficiency. They are initiated when the activation induced deaminase (AID) deaminates cytidines in single-stranded DNA in the context of transcription by RNA polymerase 2 (Pol2). Aberrant DNA deamination by AID is an important driver of genetic instability and the development of B cell malignancies. Understanding the factors and mechanisms that coordinate AID-mediated deamination with Pol2 transcription is an important objective in the study of humoral immunity and the central goal of research under this grant. Our preliminary data demonstrate that Pol2 pause factor NELF, Super Elongation Complex (SEC) components MLLT1/3, and the phosphatase module of the Integrator-protein phosphatase complex (INT-PP2A) are required for SHM, with MLLT1/3 but not NELF being required for AID binding to its chromatin targets. Our findings yield a new conceptual framework and model for AID-Pol2 collaboration in which NELF and a balance between kinase and phosphatase activities of SEC and INT-PP2A regulate Pol2 pausing/elongation to generate the critical stalled Pol2 complex on which AID acts. Further, our work has yielded major methodological advances that allow us to overcome obstacles that have stymied progress in the field. In this proposal, we take advantage of these conceptual and technical advances to pursue our central goal through the following two aims: Aim 1: Determine the molecular mechanisms by which NELF and other Pol2 regulatory factors enable AID-Pol2 collaboration and SHM/CSR. It has previously been very difficult to assess the role of cell-essential factors in SHM. By combining our new Rapid Assay for SHM (RASH) cells with degron technology, we will determine the mechanism of action of our newly discovered regulators of SHM using genomic, transcriptomic, and interaction assays that assess Pol2 distribution, phosphorylation, and activity, and the chromatin binding profiles of and interactions between AID and components of NELF, SEC, and INT-PP2A. AID and MLLT1 appear to co-associate in a complex and we will test for a direct interaction between AID and MLLT1/3. Factors will be tested for roles in CSR and validated in human cell line and germinal center B cell models and in mice. Aim 2: Hypothesis testing and deep mechanistic analysis through perturbation of the balance between Pol2 pause/arrest and elongation. We will rigorously test our new model for AID-Pol2 collaboration using degron, reconstitution, mutagenesis, and small molecular inhibitor approaches to perturb the balance between Pol2 pausing and elongation, revealing how altering NELF-Pol2 interactions and the balance between SEC kinase and INT-PP2A phosphatase activities influences SHM efficiencies and AID binding. Together, our proposed studies are significant for the development of new technologies and for understanding mechanisms of antibody gene diversification and causes of genome instability and cancer.

Dissecting the role for astrocytes in mediating adverse outcomes of maternal immune activation.

Prenatal infections cause maternal immune activation (MIA), a major risk factor for several neurodevelopmental disorders, including schizophrenia, autism spectrum disorders (ASD), and attention deficit hyperactivity disorder (ADHD). Consequently, elucidating the mechanisms by which MIA alters brain function is critical for understanding the pathophysiology of these disorders and developing effective treatments. While the effects of MIA on neurons and microglia have been extensively studied, the impact of MIA on astrocytes, key regulators of brain physiology and homeostasis, remain unknown that significantly impedes our understanding the mechanisms of MIA-induced neurobehavioral abnormalities. To address this major knowledge gap, we conducted pilot studies that suggest that MIA increases impulsivity-like behaviors and amphetamine-induced hyperactivity and enhances extracellular levels of glutamate (GLU) and dopamine (DA) in the dorsal striatum (DS). MIA also increased pro-inflammatory signatures of astrocytes, including up- regulation of the Nuclear Factor kappa B (NF-κB) pathway and increased GFAP immunoreactivity in DS astrocytes. Collectively, these novel findings support our overarching hypothesis that MIA increases astrocyte reactivity, leading to increased gliotransmission (e.g., GLU), which in turn enhances DS DA release and DA- dependent behaviors. To test this hypothesis, we will leverage the expertise of the research team in molecular, physiological and neurobehavioral approaches and conduct the following Specific Aims: In Aim 1, we will identify the MIA-induced cellular and physiological changes characteristic of astrocyte reactivity. In Aim 2, we will determine the circuit mechanisms by which MIA increases DA signaling. In Aim 3, we will identify the molecular mechanisms whereby reactive astrocytes contribute to MIA-induced cellular and behavioral abnormalities. These studies will enhance the current understanding of the effects of MIA on brain functions and generate new insight into potential treatment strategies for MIA-associated neurodevelopmental disorders.

Protective efficacy and immunogenicity of a live attenuated Chlamydia strain

PROJECT SUMMARY The main goal of this project is to rigorously evaluate the immunogenicity and protective efficacy of a mutant, live attenuated Chlamydia trachomatis (CT) vaccine strain in an established nonhuman primate (NHP) model that accurately mimics many aspects of human CT infection. This work is highly significant, as CT is the leading cause of bacterial sexually transmitted infection and an important causative agent of morbidity in women. Although the development of an effective CT vaccine is an urgent medical priority, no approved vaccines exist and it is imperative to pursue new candidates. Historical evidence supports the vaccine efficacy of whole Chlamydia organisms in protecting the reproductive tract from reinfection, primarily using C. muridarum infections in a mouse model. Recent advances in Chlamydia genetic engineering now allow for the development of genetically attenuated strains which can be evaluated as live vaccines in preclinical models. We recently characterized a human-tropic CT mutant with a disruption in garD (CT∆garD); this mutant is sensitive to an intracellular, IFNγ activated defense mechanism and we demonstrated that this strain was attenuated in the female NHP genital tract. In a pilot vaccine efficacy study, we further demonstrated that immunization of macaques with CT∆garD was safe and elicited protection against subsequent challenge with wildtype CT. A unique feature of this strain is that it arrests at an intracellular stage and thus presents a broad array of desirable T and B cell antigens that are broadly conserved across circulating CT strains. We will first generate an improved genetically attenuated CT strain that harbors a clean deletion of garD, and we will subsequently genetically and phenotypically validate its attenuation phenotype. We will then conduct an immunogenicity and efficacy study in female macaques to determine the optimal dosing regimen of live attenuated CT for eliciting protective cellular and humoral immune responses, and also protective efficacy, against challenge with a wild type circulating clinical CT strain. These studies will investigate the potential for a live attenuated human tropic vaccine candidate in a macaque preclinical model and pave the way for greater understanding of immune correlates of protection against CT.

Airway Epithelial Defense Mechanisms in Combating STAT3-Deficiency-Related Lung Infections

Airway Epithelial Defense Mechanisms in Combating STAT3-Deficiency-Related Lung Infections Signal transducer and activator of transcription 3 (STAT3) regulates the expression of genes essential for various cellular processes, including survival, proliferation, differentiation, self-renewal, angiogenesis, and immune response. Abnormal and persistent STAT3 activation is detected in diverse human cancers, driving multiple pro- oncogenic functions. Multiple antitumor drug development targets the inhibition of STAT3 to treat various types of cancer. Unfortunately, downregulated STAT3 significantly increases host susceptibility to recurrent infections, especially pneumonia. Additionally, individuals with genetic polymorphisms associated with lower STAT3 expression are more susceptible to severe tuberculosis. Furthermore, patients with autosomal dominant hyper- IgE syndrome (AD-HIES), also known as Job Syndrome, which is caused by de novo STAT3 mutations and substantially decreased STAT3 expression, have a significantly increased susceptibility to bacterial and fungal infections, with high mortality rates and a shortened life span often associated with Pseudomonas aeruginosa infections. Gram-negative bacteria, particularly P. aeruginosa, are opportunistic pathogens that frequently cause hospital-acquired infections. The problems are worsened by the emerging P. aeruginosa with multidrug resistance (MDR), especially in patients with repeated antibiotic treatments, such as Job Syndrome sufferers. Notably, airway epithelial cell-derived proteins play a significant role in the antimicrobial milieu, promoting effective host defense against invading pathogens. One of the most critical STAT3-regulated antimicrobial molecules is bactericidal permeability-increasing protein fold A1 (BPIFA1, also known as SPLUNC1), a multifunctional innate immunity molecule and indispensable host defense protein that is abundantly secreted in the lungs. This application aims to elucidate how STAT3 deficiency impairs host epithelial defense against microbial infections and whether BPIFA1-mediated innate immune responses can sufficiently restore effective antimicrobial protection to prevent pneumonia. The long-term objective is to advance our understanding of the respiratory innate immune response, particularly in relation to epithelial cell-specific antimicrobial defense. We characterized BPIFA1 as an airway lining fluid protein secreted apically in the airway lumen and in primary human airway epithelial cultures. In this study, we hypothesize that mucosal BPIFA1 is an essential antimicrobial protein that plays a critical role in host defense against microbial infections in STAT3-deficiency- associated pneumonia. Our proposed studies will assess innate immunity mechanisms regulating the antimicrobial activity of the airway epithelium in STAT3 deficiency-associated lung infections. By focusing on the crucial epithelial-derived protein product, BPIFA1, our study will provide an alternative treatment for respiratory infections by augmenting native host defense mechanisms in high-risk individuals, including AD-HIES, cancer, and immunocompromised patients.

Bridging Local and System-Wide Autoreactive, Extrafollicular B Cell Signatures in a TLR7-Driven Model

Project Summary A substantial body of literature has described the development of autoreactive humoral responses in the context of autoimmune disease and recently discerned an exciting new avenue for investigation. While early work focused on canonical mechanisms of activation through the germinal center (GC) response, recent studies have found GC infrastructure to be dispensable for the onset of chronic autoimmunity. It has become clear that an alternative pathway of B cell activation, the extrafollicular (EF) pathway, can drive the onset of new autoreactivity in multiple human disorders including rheumatoid arthritis and systemic lupus erythematosus (SLE). In comparison to the GC pathway, the EF pathway represents a less stringent method for B cell activation, leads to accelerated antibody-secreting cell (ASC) formation, and thus has a higher propensity for the production of autoreactive B cell effectors and ASCs. Recently, our group has identified a similar skew toward the EF response in the context of severe viral infection, tied to acute tolerance loss, increased disease severity, and complicated recovery from infection. These findings highlight how further study of the EF response is crucial to our understanding of autoimmune induction across multiple areas of disease. Toll-like receptor 7 (TLR7) stimulation has been identified as a key contributor to EF B cell development in SLE, and several studies have now linked TLR7 overstimulation to chronic autoimmune disease. While EF effector B cell populations have now been identified in both murine models and humans, substantial gaps in our knowledge remain to be answered concerning i) the origins of these cells and ii) the system-wide and microenvironmental signaling and organization that drive this differentiation pathway. We propose to address these gaps, here, by utilizing a TLR7 agonist (R848) in a murine model to characterize the autoreactive response within the blood and draining lymph node through innovative high-throughput analytical techniques. Systemic shifts in proteomic signatures and immune cell phenotype will be monitored in the blood throughout the induction of autoreactivity, using novel applications of machine-learning based classification. These signatures will then be connected to developing inflammatory microenvironments identified within the draining lymph node by applying a customized set of software tools to spatial transcriptomic data. This work will deepen our understanding of the immunologic mechanisms by which the EF pathway can lead to “run-away” autoreactive B cell development, with the added potential for identification of early blood-based biomarkers for this developing autoreactivity. The above proposed work will provide an ideal training opportunity for the candidate to develop experience with advanced immunologic laboratory techniques, rigorous bioinformatic analysis, a systems-level view of immunology, and scientific communication. The Woodruff and Sanz Labs are highly experienced within the autoimmune disease space with extensive experience with the required techniques and established routes for clinical collaboration to act on these findings.

Response and defense mechanisms of extraintestinal Escherichia coli to reactive oxygen and chlorine species

Members of the Escherichia coli species are remarkably diverse and comprise commensal, probiotic and pathogenic strains. While some pathogenic E. coli cause intestinal diseases, extraintestinal E. coli (ExPEC) can colonize and infect environments outside the gut. For instance, members of this pathotype can inhabit the urinary tract where they are confronted with a multitude of bactericidal host defense strategies, which requires specialized genetic adaption for survival. ExPEC must defend highly toxic antimicrobials such as hypochlorous acid (HOCl), a potent reactive oxygen and chlorine species (RO/CS) generated during neutrophil-mediated phagocytosis and by enzymes in uroepithelial cells to control bacterial colonization. The increasing rate of ExPEC infections in humans due to changing infection dynamics demonstrate the critical need for a better understanding of ExPEC pathogenesis, which is desperately needed to improve approaches for infection prevention and treatment given the rise in antibiotic resistance spreading among E. coli. Our lab has reported that members of the ExPEC pathotype are more resistant to RCS in vitro and to neutrophil-mediated phagocytosis when compared to non-pathogenic and enteropathogenic E. coli. We identified the defense system responsible for these phenotypes and characterized its regulation during RCS stress: the RcrR regulon consisting of the rcrARB genes is controlled by the RCS-sensing transcriptional repressor RcrR, which reversibly loses its repressor activity upon oxidation by RCS, resulting in de-repression of its downstream targets. Induced expression of rcrB contributes significantly to ExPEC’s increased RCS resistance, however, the precise mechanism of RcrB and the role of RcrA (and potentially other defense players) during RCS stress remain enigmatic. Our long-term goal is to increase the efficacy of existing antimicrobial therapies by purposefully and selectively sensitizing ExPEC to clearance by innate immune cells. The overall objective of this application is a comprehensive analysis of ExPEC’s RCS defense with particular focus on the mechanism of the RcrR regulon. We hypothesize that RcrB directly protects cells from HOCl, while RcrA, another member of the RcrR regulon, mediates evasion from HOCl and invasion into host cells. In Aim 1, we will use phenotypic, biochemical, and imaging approaches to investigate the mechanism by which RcrB contributes to ExPEC’s increased RCS resistance. In Aim 2, we will study the role of RcrA for ExPEC motility, biofilm formation, and host cell invasion. In Aim 3, we will use independent unbiased and targeted approaches, including phenotypic characterization of transposon mutants, to fully comprehend ExPEC-specific responses to and defenses against RCS. Identifying, characterizing and targeting ExPEC-specific defense systems has the potential to increase the body’s own capacity to fight UTIs. Overall, we will involve at least four undergraduate students in our research projects, which we believe will provide an excellent training opportunity for the next generation of scientists.

SUPPORT SERVICES FOR THE PREVENTION AND TREATMENT THROUGH A COMPREHENSIVE CARE CONTINUUM FOR HIV-AFFECTED ADOLESCENTS IN RESOURCE CONSTRAINED SETTINGS IMPLEMENTATION SCIENCE NETWORK

Support Services for the Prevention and Treatment through a Comprehensive Care Continuum for HIV-affected Adolescents in Resource Constrained Settings Implementation Science Network (PATC3H-IN) (UG1/UM2) Program The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) requires support for logistical and operational coordination, website and communication management, analytic and data management, infrastructure for emerging research, regulatory, and monitoring of research activities for the Prevention and Treatment through a Comprehensive Care Continuum for HIV-affected Adolescents in Resource Constrained Settings Implementation Science Network (PATC3H-IN) (UG1/UM2) Program. The NICHD and partner NIH Institutes anticipate funding 8 PATC3H-IN UG1 awards in Asia and throughout sub-Saharan Africa in 2023 through a cooperative agreement mechanism for interventions of high public health significance: The prevention of new HIV infections among adolescents at risk, and the identification of, linkage to and retention in care of, and long-term viral suppression among youth living with HIV in low-to-middle income countries with high HIV burden. The PATC3H-IN network will expand and/or improve on successes achieved by its predecessor, PATC3H, to new geographic settings and/or risk populations and stimulate much needed implementation science (IS) research in the prevention of new HIV infections among adolescents at risk and the identification of, and linkage and retention to care of and long-term viral suppression among youth living with HIV in low-to-middle income countries (LMICs). PATC3H-IN will establish a network of investigators with multidisciplinary expertise on the youth-specific PHCC and in IS research, whose mission will be to evaluate promising prevention innovations contextually and developmentally tailored for HIV uninfected at-risk youth, and treatment and care interventions for youth living with HIV which have demonstrated efficacy and/or effectiveness in adolescent or adult populations and to translate them into public health practices. The structure of PATC3H-IN will consist of multiple interdependent functional components: (1) Five Clinical Research Centers (CRC) awarded through the UG1 grant mechanism; (2) one Implementation Science Coordinating Center (ISCC) to be awarded through a UM2 grant mechanism in 2024; and (3) a Scientific Leadership Committee (SLC). The CRCs will conduct clinical research and clinical trials, including implementation, effectiveness, and hybrid implementation-effectiveness studies at their 8-or more participating Clinical Research Performance Sites (CRPS). The ISCC will establish infrastructure to support research education and capacity building across PATC3H-IN, as well as infrastructure for stakeholder engagement in and dissemination of findings from PATC3H-IN and advanced statistical modeling support across PATC3H-IN. The ISCC will also provide infrastructure for conducting foundational research to support the work of clinical sites, including possible modeling studies and translation projects, as well as national surveys, and/or systematic collection and analysis of relevant policies and laws. Lastly, the SLC will be responsible for PATC3H-IN governance, oversight, and coordination, and will develop and implement the network research agenda, convening working groups as needed, prioritizing emerging research projects, efficiently managing the development of clinical protocols, implementing and completing clinical trials, and ensuring timely publication and communication of results.

Enteric virus-induced innate immune responses in oral tolerance

Project Summary The human gut must constantly balance between defending against harmful microbe, including virus infections, and tolerating harmless substances, like food. One important immune process called oral tolerance helps prevent the immune system from overreacting to dietary proteins such as gluten. When this tolerance breaks down, known as loss of oral tolerance (LOT), it can lead to celiac disease, where the body mounts an immune attack against gluten. Viruses that infect the gut, known as enteric viruses, can disturb the intestinal immune homeostasis and contribute to gastrointestinal diseases. Our research has found that one such virus, the Type 1 Lang (T1L) strain of reovirus, capable of infecting human and mice, can induce LOT to gluten. We discovered that T1L triggers a type of inflammatory cell death called necroptosis in intestinal epithelial cells. This cell death sends danger signals to dendritic cells (DCs) presenting dietary antigens, including gluten to T cells. These signals appear to shift DCs from a tolerance-promoting mode to one that drives inflammation and gluten-specific TH1 responses, a hallmark of celiac disease. We believe this process begins when the virus produces a specific form of RNA called Z-RNA, which is sensed by a host protein called ZBP1, triggering necroptosis and inflammation. Our research aims to understand this pathway in detail. Aim 1 will investigate how ZBP1 detects viral Z-RNA and induces necroptosis in intestinal epithelial cells. Aim 2 will examine how this necroptosis leads to LOT and will test whether blocking or engaging the pathway can prevent or induce inflammatory dietary antigen-specific TH1 immune responses. By revealing how a common virus can break oral tolerance and trigger inflammation, this study could lead to new ways to prevent or treat autoimmune and food-related disease such as celiac disease.

Implementing a New Paradigm for Antifungal Drug Development

About 30% of the drugs currently in clinical use function through covalent modification of their target. Yet, until recently, none of these covalent drugs were specifically designed to utilize this irreversible mode of action. It is our hypothesis that the production of a new class of covalent inactivators, designed to selectively modify new drug targets, will lead to novel agents with efficacy against both native and drug-resistant pathogenic fungal species. Because of their novelty these agents will also offer a greater opportunity to bypass the existing mechanisms of drug resistance. Pathogenic fungal infections remain among the leading causes of human mortality, and this threat is rising due to the increasing prevalence of drug- resistance strains and the paucity of effective antifungal drugs against the more virulent fungal species. Our proposed new drug target is an enzyme that plays a critical role in a uniquely microbial pathway that is essential for the survival of fungal organisms. To test our hypothesis and achieve the goals of this project we plan to complete the following specific aims during the initial R21 phase of this project: (1) Optimization of the potency of novel enzyme inactivators. Our goals here are to use our strong preliminary results to address critical barriers that must be overcome to convert potent enzyme inactivators into advanced drug candidates, thereby achieving higher target selectivity and increasing compound reactivity once bound to the target; (2) Enhance the antifungal capability of these enzyme inactivators. Our strategy for this aim is focused on the incorporation of conjugate partners into this new class of covalent inactivators, enabling them to potentially utilize the existing nutrient uptake systems to achieve toxic levels in Candida species; (3) Examine the target selectivity of our new antifungal agents. Results from fungal growth inhibition and fungal killing assays will be used to evaluate and rank the efficacy of our compounds against both wild-type and drug-resistant Candida strains. Specific milestones are presented to evaluate our achievement of these initial aims. Once accomplished we will immediately proceed to the R33 phase of this project, with the aims of: (4) Pharmacological evaluation of lead candidates, though ranking the drug candidates based on their ADME, pharmacokinetic and toxicity properties; and then (5) Evaluate the efficacy of our candidates against pathogenic fungal infections. A systematic infection animal model will be utilized for candidate screening to identify the best agents against disseminated fungal infections, followed by further efficacy screening in an oral infection model. Completion of these aims will produce, refine and evaluate a new class of antifungal agents with a novel mode of action against an unexplored but essential fungal target. The agents with the most promising drug profiles will then be moved into advanced preclinical trials used to select the most effective new antifungal agents.

Directing the Evolution of Common Human Precursors into HIV-1 Broadly Neutralizing Antibodies

Project Summary An effective HIV vaccine will likely elicit broadly neutralizing antibodies (bnAbs). Doing so, however, remains a major challenge because bnAbs usually require multiple rare and unusual changes that emerge after years of active infection. It is not clear that a practical number of immunizations can consistently recapitulate this process. Although investigators have successfully expanded defined precursors of known bnAbs, they have not moved these diversified precursors to a specific target in humans. Importantly here, the severity of this problem increases rapidly with the number changes needed. The problem further deepens if the required changes are in slow-to-mutate antibody framework regions or require specific indels. The need to move from precursor to bnAb in the fewest steps motivates our focus on the V2 apex epitope of the HIV-1 envelope glycoprotein (Env). Apex bnAbs are qualitatively different from other bnAb classes. They require far fewer mutations, located in their rapidly evolving heavy-chain CDR3 (HCDR3) regions. These HCDR3s are unusually important to their ability to neutralize virus. For example, we have shown that a diverse repertoire of mouse B cell receptors can be modified with apex bnAb HCDR3s, and the resulting mouse B cells generated potent neutralizing sera. Thus, apex precursors can largely be defined by their HCDR3s alone and are far more common than other defined bnAb precursors. Interestingly, these HCDR3 are very similar to those of another class of antibodies that recognize the CD4-induced co-receptor-binding site (CoRBS). Both antibody classes have unusually long HCDR3s with sulfated tyrosines at their tips. Unlike apex bnAbs, these non-neutralizing CoRBS antibodies are readily elicited through vaccination. We have recently shown that apex precursors also bind the CoRBS, suggesting that some apex bnAbs emerge from CoRBS antibodies. Thus, the first step of sequential vaccine strategies, expanding and diversifying a defined precursor pool, is straightforward. Here we divide the remaining goals into two: moving from a precursor that does not bind Env to one that does so and then broaden it to recognize the majority of circulating isolates. We have already made significant progress in the first step: we have shown in our original mouse vaccine model that we can generate potent apex- specific neutralizing antisera. However the breadth of this sera remains limited. Building on these studies, we will pursue three goals: (1) Define the essential mutations that transform a CoRBS antibody into one that binds the Env apex and then generate antigens that select for these mutations. (2) Define mutations and generate antigens that expand the breadth of these antibodies, transforming them to bnAbs, and (3) Evaluate these antigens in a novel system that models key features of the human apex response in mice, and iteratively refine this process using antibodies and HCDR3s drawn from a wide panel of HIV-naïve persons. In short, these studies develop original concepts and tools that can accelerate development of an HIV-1 vaccine and deepen our understanding of the antibody response to vaccines and pathogens.

Investigating the role of noncoding RNAs in malaria parasites through targeted Cas13-mediated degradation

Project Summary/Abstract One of the most significant sources of morbidity and mortality throughout large regions of the developing world continues to be malaria caused by infection with mosquito-borne parasites of the genus Plasmodium. The parasite species responsible for the most severe form of the disease is P. falciparum. To avoid antibodies produced by their host and thereby maintain lengthy infections, these parasites undergo a process called antigenic variation by which they can extend an infection for over a year. This results from changes in expression of a protein called PfEMP1, the primary antigenic and virulence determinant expressed on the surface of infected red blood cells. A large, multicopy gene family called var encodes different forms of PfEMP1, and switching expression between var genes enables parasites to evade antibody recognition and destruction by the immune system. The process requires precise and coordinated regulation of transcription of each var gene, however how this is accomplished is unknown. It was recently hypothesized that a family of noncoding RNAs (ncRNAs) plays a key role in controlling the expression of each var gene and in determining the likelihood of activation of any given gene. If correct, this would represent a significant advance in our understanding of how P. falciparum controls antigenic variation and avoids immune clearance. To test this hypothesis, we propose to adapt the CRISPR/Cas13 system of targeted RNA degradation for use in P. falciparum. Similar to the extensively used CRISPR/Cas9 system, CRISPR/Cas13 employes guide RNAs to target a nuclease to a sequence-specific target, however Cas13 targets single stranded RNA rather than DNA. By applying this system to the study of var-related ncRNAs, we will degrade specific ncRNAs and determine the effect on var gene expression. Two classes of ncRNAs previously proposed to regulate var gene expression will be targeted, one called ruf6 and a second encoded by the second exon of all var genes. This will enable us to alter ncRNA expression while leaving the underlying genomic DNA untouched, thereby allowing the unambiguous attribution of any resulting phenotypes to the ncRNAs. Aim 1 will optimize the Cas13 system for P. falciparum by testing different variants of the Cas13 endonuclease for their ability to degrade mRNAs encoding fluorescent reporter proteins. We will determine both the efficiency and sequence specificity of the system. Aim 2 will apply the system to var-associated ncRNAs and quantitatively measure changes in var gene expression and transcriptional switching. If successful, the adaptation of the Cas13 system to P. falciparum will provide the malaria research community with a powerful new tool for manipulating gene expression. In addition, we will gain valuable new insights into how malaria parasites regulate var gene expression, antigenic variation and immune evasion.

Understanding antiretroviral phosphorylation and dephosphorylation using mass spectrometry imaging-based enzyme histochemistry

PROJECT SUMMARY Our overall goal is to understand the mechanistic differences in the activation and deactivation of two widely used first-line antiretroviral drugs: tenofovir (TFV) and emtricitabine (FTC) in colonic tissues. HIV is a global health problem and roughly 1.3 million people became newly infected with HIV globally in 2022. Pre-exposure prophylaxis (PrEP) is an HIV prevention strategy where HIV-negative individuals use antiretrovirals to reduce the risk of HIV infection. Specifically, oral fixed-dose combinations of two antiretrovirals, namely, TFV (TFV; prescribed as TFV disoproxil fumarate or TFV alafenamide prodrugs) and FTC are FDA-approved for HIV PrEP. The pharmacologically active forms of TFV and FTC are TFV-diphosphate (TFV-DP) and FTC-triphosphate (FTC-TP), respectively, and these phosphorylated metabolites are found in cells. Unfortunately, high variability in the responses of TFV and FTC can lead to poor clinical outcomes, including therapeutic failure. However, the molecular mechanisms responsible for the observed variability in TFV and FTC responses are poorly understood. Although the observed variability in TFV and FTC drug responses is likely to be multifactorial, alterations in drug activation and deactivation can contribute to the observed variability in drug responses. Phosphorylation of TFV is known and recent studies suggest that nucleotidases may involve in the dephosphorylation of TFV metabolites. Although the kinases that phosphorylate FTC in peripheral blood mononuclear cells are known, the kinases that are responsible for the phosphorylation of FTC in putative sites of HIV infection such as colonic tissues are yet to be determined. Notably, unprotected receptive anal intercourse has a 20-fold higher risk of HIV transmission than vaginal intercourse. Thus, understanding the biotransformation of TFV and FTC in colonic tissue is important since it is a susceptible tissue to HIV infection. Recently, we have reported the enzymatic activities of nucleotidases toward the pharmacologically active metabolites of TFV and FTC in vitro. However, the mechanistic details of the biotransformation of the above drugs in HIV susceptible tissues such as colonic tissues are yet to be elucidated. Gaining a mechanistic understanding of the biotransformation of TFV and FTC in putative sites of HIV infection is important to improve their therapeutic efficacy. As such, in this application, we propose an innovative mass spectrometry imaging-based interdisciplinary approach to understand the biotransformation of TFV and FTC in the colon. Aim 1 will establish the role of nucleotide kinases and nucleotidases in regulating TFV and FTC metabolites in colonic cells mechanistically. Aim 2 will characterize the region- and cell-type-specific expression patterns, as well as enzymatic activities of nucleotide kinases and nucleotidases in situ. The proposed project will provide novel understandings of TFV and FTC activating and deactivating mechanisms that can be leveraged to optimize the therapeutic efficacy of the above drugs.

Engineering inducible morphotype switching control in Mycobacterium abscessus for investigating infection outcomes and discovering pathophysiological-targeted treatments

PROJECT SUMMARY Antibiotic-resistant nontuberculous mycobacteria (NTM) infections are rising at a rate of 8% each year and account for ~$1.7 billion in annual U.S. healthcare costs. Mycobacterium abscessus (Mabs), the most common rapidly growing NTM infection, is notoriously nicknamed the “antibiotic nightmare” for its extensive intrinsic and inducible broad-range multidrug resistance to antibiotic countermeasures. As part of its natural infection cycle, Mabs undergoes a morphotypical conversion from smooth to rough, characterized by irreversible genetic changes resulting in the loss of cell envelope glycopeptidolipids (GPLs). This morphotypic conversion is intimately associated with disease progression, ultimately leading to debilitating, refractory Mabs pulmonary disease. Specific stimuli triggering Mabs morphotypical conversion are unknown, thus preventing directed investigations into morphotype-specific immunological responses and the discovery of morphotype-specific therapeutic targets. This project leverages cutting-edge molecular genetic tools, including CRISPR (clustered regularly interspersed short palindromic repeats) interference (CRISPRi) and inducible knockdown control of CRISPRi via the anhydrotetracycline-inducible TetR-regulated promoter-operator system, to create six unique, reversible Mabs smooth to conditional rough morphotype strains. These molecular morphoswitchable strains allow precise investigator-mediated on-off control of Mabs surface GPLs, enabling investigations into Mabs morphological plasticity, unique pathophysiology traits associated with each morphotype, and the complex interplay between Mabs and morphotype-specific immunological responses. In Aim 1, we implement CRISPRi inducible knockdown tunable control of Mabs morphotype switching by targeting six, independent genetic targets directly involved in GPL biosynthesis (mps1, mps2) or transport (mmpS4, mmpL4a, mmpL4b, gap) and validate in vitro morphoswitching. In Aim 2, we establish and confirm Mabs morphoswitching and intracellular growth in infected THP-1 macrophages. Subsequently, we evaluate differential and distinct innate cellular immune responses elicited by Mabs smooth and Mabs conditional rough morphotypes during intracellular infection in human primary monocyte-derived macrophages. Collectively, these studies create a suite of characterized and reversible Mabs smooth and conditional rough morphoswitchable strains with controlled, regulated, and on- demand expression of Mabs surface GPLs. By enabling precisely timed and controlled induction of the Mabs conditional rough morphotype during intracellular growth, we can molecularly dissect and investigate fundamental Mabs host-pathogen interactions and immunological responses that so substantially influence negative clinical outcomes.

Magnetic resonance true temperature imaging with high spatial and temporal resolution

ABSTRACT The knowledge of temperature and temperature distribution within the brain can be critical to understanding the healthy and diseased brain, its response to acute injury, and in monitoring critically important thermal interventions. There are several temperature sensitive properties such relaxation rates and the proton resonance frequency shift (PRFS) that can be measured with magnetic resonance imaging (MRI) methods but these methods can only measure temperature change. The PRFS method, which provides the most accurate measurement of temperature change can only measure true tissue temperature if the starting true temperature distribution is known. Fortunately, MR spectroscopy (MRS) methods have been developed that show great promise in the measurement of true temperature. These methods rely on the detection of a temperature independent spectral peak of protons bound to carbon atoms in high concentration metabolites, such as N- acetylaspartate (NAA), creatine (Cr) and choline (Cho) which can be used as a reference for the temperature dependent spectral peak of water protons. Both single voxel spectroscopy (SVS) methods and MRS imaging (MRSI) methods have been described but are slow because of the long readout time needed to achieve adequate spectral resolution and the need to perform multiple averages due to the low signal being measured. Echo-planar spectroscopic imaging (EPSI) speeds up MRSI by interleaving an oscillating imaging gradient to spatially encode one of the imaging dimensions simultaneously with spectral readout. Unfortunately, SVS, MRSI, and even EPSI are unsuitable for clinical applications because of the low spatial resolution (voxel size 1 cm3) and temporal resolution (multiple minutes). The goal of this project is to develop an MRI technique that can measure true temperature in the whole brain at spatial and temporal resolutions that enable clinical utility for acutely assessing and longitudinally monitoring healthy and diseased brain tissue, and real time monitoring of thermal interventional therapies. This innovative true temperature measurement technique combines EPSI, for low resolution background field measurements, with PRFS for high spatial and temporal resolution water proton measurements. While conventional EPSI methods interleave volumetric acquisitions with and without water suppression, we propose an innovative modification to take advantage of the very strong water signal to obtain a very high resolution, dynamic method for true temperature measurements. The MRI pulse sequence will be refined, validated (Aim 1), applied to healthy subjects and post-surgery patients at risk for infections (Aim 2), and applied to essential tremor (ET) patients during the required delay between repeated focused ultrasound sonications (Aim 3). Successful completion of the aims of this study will result in a clinically practical method to obtain true temperature measurements in the brain with a spatial and temporal resolution sufficiently high to meet the needs of monitoring focal thermal therapy treatments as well as to provide true temperature measurements over the entire brain for assessment of the state of the brain with disease, infection, and injury.

Engineering of a temperate Burkholderia cepacia complex phage to improve efficacy as a potential therapeutic

Project Summary Bacteria in the Burkholderia cepacia complex (Bcc) cause difficult to treat infections in patients with compromised respiratory systems, such as those with cystic fibrosis (CF). Alternative treatment options are needed, since antibiotics often fail these patients. Bacteriophage (phage) therapy is a promising strategy, yet therapeutically ideal phages are difficult to find and narrow in their range of use due to host specificity. In the proposed study, we continue development of a potential phage therapeutic sourced from Burkholderia itself. We have isolated a phage, called BCC02, that was present within the genome of a Burkholderia bacteria (a prophage) and have shown that it can kill other bacteria within the same genus. However, this phage still has the potential to integrate into other bacterial genomes, which is an undesirable trait for phage therapy. By engineering changes to the BCC02 genome using synthetic biology techniques, we hypothesize that we can increase its range of therapeutic potential by disabling its ability to integrate into the bacterial genome, and that this change will increase the number of bacteria that it can lyse. The specific aims of this project are to (1) engineer this phage to lose the ability to lysogenize (integrate into bacterial genomes) then test the effects of these modifications on bacterial host range and (2) test activity of our originally isolated phage, BCC02 as well as our engineered variant on a clinically relevant panel of patho-adapted isolates from patients with CF. We propose to use transformation-associated recombination (TAR) cloning methods to target the lysogeny control region of the BCC02 genome for removal. We hypothesize that loss of integration ability will force this phage into an obligately lytic lifestyle, where it will lyse all bacteria it is able to infect. Successful completion of this project will determine the feasibility of engineering obligately lytic Burkholderia-targeting phages from Burkholderia spp. prophages, shed light on the effects of lytic lifestyle on host range, and establish the utility of these phages for tackling particularly problematic clinical infections. In addition, this study may produce a Bcc- targeting phage that is primed for development to be used for phage therapy.

Identifying host-interacting proteins of Sneathia vaginalis

PROJECT SUMMARY AND ABSTRACT Sneathia vaginalis is a member of the human normal flora of the vagina. It is also a human pathogen that is associated with preterm birth and amniotic fluid infections as well as the most common bacterial species associated with HPV infection and cervical cancer. The identification of S. vaginalis as a human pathogen is recent and little is known about how this bacterium interacts with the host in either its commensal or pathogenic lifestyles. With the exception of a single toxin, no additional virulence factors have been identified. Our preliminary data demonstrates that S. vaginalis grows to high cell density in rich media; however, it fails to grow planktonically in other media unless host cells are present indicating that S. vaginalis relies on host cells for nutrients. This is consistent with its reduced genome. In addition, bacterial proliferation requires close proximity with the host cells and previous studies demonstrate that S. vaginalis can bind a variety of host cells. The proteins that mediate contact are unknown. We hypothesize that proteins on the surface of S. vaginalis are critical for host cell adhesion. We will use two Aims to examine this. Aim 1 will use mass spectrometry to identify S. vaginalis surface proteins. Aim 2 generates deletion strains of potential adhesins identified in Aim 1 as well as predicted host-interacting proteins that have already been identified bioinformatically based on those in other bacteria. The mutant bacteria are then tested in host-cell adhesion assays. Together, these aims will identify for the first time the proteins found on the surface of S. vaginalis while identifying proteins that interact with host cells that would be expected to contribute to either its commensal or pathogenic lifestyles or both. Moreover, these studies would be used to inform clinical lab practice as surface-expressed proteins could be used to identify identifying markers of S. vaginalis detection.

Host-pathogen-microbiome interactions in Mycoplasma genitalium pathology and treatment: experiments in a 3D organotypic cervical epithelium model to strengthen clinical guidelines

ABSTRACT Mycoplasma genitalium (MG) is an emerging sexually transmitted pathogen whose clinical outcomes in women are poorly understood. Unlike other bacterial sexually transmitted infections (STI), the CDC does not recommend MG screening for asymptomatic women because it is unclear how often asymptomatic MG leads to adverse reproductive outcomes like cervicitis, which can lead to further adverse outcomes, including pelvic inflammatory disease, infertility, and ectopic pregnancy. Epidemiologic data on MG and cervicitis are mixed, and mechanistic data primarily come from models that did not faithfully recapitulate in vivo cervical microphysiological conditions. Key elements they lacked are cervical mucus, which mediates host-pathogen interactions, and the cervicovaginal microbiota. The microbiota appears to contribute to MG outcomes, and our preliminary epidemiologic data indicate that MG and bacterial vaginosis (BV) may synergize to promote cervicitis. MG care is further complicated by its ongoing rise in antibiotic resistance. Resistance-guided therapy and novel antibiotics improve treatment outcomes, but these are not available in the US. Recent clinical and in vitro data indicate that metronidazole and tinidazole, two antibiotics that are available in the US and used to treat BV, may hold promise for improving MG treatment outcomes. The overall objective of this R21 is to generate robust experimental data to clarify MG pathology, evaluate potential therapies, and inform more thorough and actionable clinical recommendations. We developed an innovative in vitro 3D organotypic model of the cervical epithelium that is ideally suited for investigating MG pathology, host-MG-microbiota interactions, and potential therapies. The model uses primary human cervical cells and better recapitulates cervical epithelial structure and physiology (including cervical mucus production) than prior 2D models. It also allows for simultaneous STI infection and co- culture of live cervicovaginal microbiota. Using the 3D organotypic cervical epithelium model, we will determine if MG causes microbiota-dependent cervical epithelial damage, a hallmark of cervicitis (Aim 1), and we will test if metronidazole and tinidazole arrest MG infection (Aim 2). In both Aims, we will interrogate the potential mediating role of the microbiota by inoculating models with live representative cervicovaginal microbiota, and we will assess host-MG-microbiota interactions via transcriptomics. We hypothesize that a polymicrobial BV-like microbiota will exacerbate MG-induced cervical epithelial damage, and removal of a polymicrobial BV microbiota will partially mediate metronidazole’s and tinidazole’s anti-MG activity. The proposed Aims have high translational potential and will provide crucial pre-clinical evidence to inform more thorough and actionable MG testing and treatment guidelines and improve reproductive health outcomes. This R21 will generate some of the first experimental data on MG-host and MG-microbiota interactions, which we will use to support an R01 to validate these interactions during in vivo MG infection and identify novel therapeutic targets for MG.

Spatial Mapping to Detail the Role of Biomolecules in Governing Biofilm Organization and Resiliency to Stress in Pseudomonas aeruginosa Biofilms

PROJECT SUMMARY The bacterium Pseudomonas aeruginosa is a leading cause of hospital acquired infections, exhibiting substantial antibiotic tolerance due to growth in biofilms. Our previous work shows how biofilm fitness is increased by alkyl quinolones (AQs), a class of molecules produced by the Pseudomonas Quinolone Signal (PQS) pathway of Pseudomonas aeruginosa. AQs form aggregates that spatially limit regions of cell death and reduce overall cell death in biofilms. Spatial studies build on ”what” molecules are doing by revealing when, where, and with whom they are found. Others have shown that AQs transiently bind amyloids and our preliminary results find that amyloid localization is shifted in the absence of AQs. However, the spatial relationships of these molecules have not been investigated. Our research combines multiple spatial analytical techniques, such as fluorescence microscopy, polarized light microscopy, confocal Raman microscopy to assemble detailed maps of AQ and amyloid localization during biofilm development. Using transgenic strains we will also determine amyloid distribution as a function of AQ abundance. This work will build on previous findings that AQ concentrations are able to shift locally in response to stress. We hypothesize that this can impact the localization of amyloids and allow biofilms to respond locally to stress, shielding the greater biofilm from damage. We will map biomolecular distribution of entire colony biofilms in response to stress to determine if local responses have the ability to shield more distal regions of the biofilm. The capacity of spatial biomolecular organization to increase bacterial resilience and infection virulence is an understudied area that has the potential to bring to light to novel targets for therapeutics to fight biofilm infections.

A dynamic regulatory mechanism controlling bacterial persister formation and resuscitation within biofilms

PROJECT SUMMARY Persisters present a major challenge in clinical infection treatment and recurrent infection management. A continued effort towards a better understanding of the molecular mechanisms of persister formation and resuscitation is needed to provide novel treatment strategies for the control of chronic infections and problems related to persisters. Unlike resistant bacteria, persisters are genetically identical to their susceptible counterparts, and this phenotypic state is inherently transient and shifts in response to environmental conditions. Therefore, it is essential to use an approach tailored to the transient and rare nature of this phenomenon. Pseudomonas aeruginosa (Pa) is an important human pathogen frequently implicated in both acute and chronic infections. Persisters have been identified in both Pa planktonic and biofilm modes of growth, with higher frequencies of persister formation being observed in biofilm, especially in the interior of the mature biofilm structure. In this study, we obtained the first high-resolution single-cell transcriptomes of persister and resuscitated cells isolated directly from the interior of mature biofilms. The results led to the identification of a previously uncharacterized transcriptional regulator that controls persister formation and resuscitation. This regulator, named PriR here, is conserved in Pseudomonas species and has homologs in two critical bacterial pathogens, Acinetobacter baumannii and Enterobacter cloacae. We showed that PriR has a dynamic spatiotemporal gene expression profile, and its expression directly correlates with and causes persister resuscitation. In this application, we propose two specific aims to investigate this novel regulation mechanism of persister formation and resuscitation. Aim 1 will identify the physiological effects of this novel regulatory system on antibiotic tolerance in vitro and in hosts using the Drosophila melanogaster biofilm infection model. Aim 2 will determine its molecular regulatory mechanism via ChIP-seq and RNA-seq, and analyze the putative PriR- controlled genes on persister formation and resuscitation in additional clinically-relevant Pa strains. The insights gained from this proposal will provide crucial new information about the dynamic regulatory mechanism of persister formation and resuscitation. The PriR-controlled resuscitation mechanism could be a promising target for persister eradication approaches by re-sensitizing persister cells to conventional antimicrobials or preventing persister formation. Understanding this novel regulatory system that controls bacterial persister formation and resuscitation could provide new drug targets and/or treatment strategies for persistent infections.

Neutralizing persistent IFN-I to improve HIV-specific CAR T cell therapy

PROJECT SUMMARY A critical hurdle to further improving the quality of life for people living with HIV (PLWH) is the need to resolve the residual immune activation and inflammation that persists even in those taking effective antiretroviral therapy (ART), which suppresses HIV replication. This unresolved and persistent immune activation is associated with increased type-I interferon (IFN-I) signaling, and increased incidence of comorbidities. Encouragingly, reports demonstrate that blocking IFN-I signaling in animal models of HIV infection can reduce HIV reservoirs and restore T cell immune function. We hypothesize that blocking IFN-I would likewise augment engineered T cell-based therapies against HIV, such as chimeric antigen receptor (CAR) T cells. Our prior work has demonstrated that when engineered to express both the 4-1BB and CD28 costimulatory domains and protected from HIV infection, HIV-specific CD4 ectodomain CAR T cells can reduce acute viremia, prevent CD4+ T cell loss, and reduce viral burden in the tissues of HIV-infected humanized mice. However, the reduction of plasma viral loads was ultimately transient, suggesting that the potency of HIV-specific CAR T cells should be further optimized for clinical translation. Our preliminary data highlights interferon-beta (IFNb) as a key immunosuppressive IFN-I negatively regulating CAR T cell proliferation, and we demonstrate that neutralizing IFNb in vivo enhanced the engraftment and persistence of HIV-specific CAR T cells adoptively transferred into HIV-infected ART- suppressed humanized mice. This proposal will interrogate whether IFNb neutralization augments CAR T cell therapy through 1) identifying the mechanism(s) by which chronic IFNb exposure mediates HIV-specific CAR T cell dysfunction, and 2) determining the effect of neutralizing IFNb on CAR T cell function and persistence in HIV infection in vivo. The proposed aims seek to develop the neutralization of IFNb as a novel immunotherapy approach to maximize the potency of HIV-specific CAR T cells aimed at achieving a functional HIV cure.

CNS Control of Peripheral Mitochondrial Form and Function: Mitokines

My laboratory has made an intriguing discovery that mitochondrial stress in one tissue can be communicated to distal tissues. We find that mitochondrial stress in the nervous system triggers the production of entities known as mitokines. These mitokines are discharged from the nervous system, orchestrating a response in peripheral tissues that extends the lifespan of C. elegans. The revelation came as a surprise, given the prevalent belief that cell autonomous mechanisms would underlie the relationship between mitochondrial function and aging. It was also surprising given the prevailing dogma that mitochondrial function must be increased, not decreased, to improve health and longevity. Our work also underscores the fact that mitochondria, which originated as a microbial entity and later evolved into an intracellular symbiont, have retained their capacity for intercommunication, now facilitated by signals from the nervous system. We hypothesize that this communication has evolved as a mechanism to reduce infection from pathogens.

Meningeal macrophages protect against viral neuroinfection

https://doi.org/10.1016/j.immuni.2022.10.005

Social immunity in ants: disease defense of the colony

Social insects fight disease as a collective. Their colonies are protected against disease by the combination of the individual immune defenses of all colony members and their jointly performed nest- and colony-hygiene. This social immunity is achieved by cooperative behaviors to reduce pathogen load of the colony and to prevent transmission along the social interaction networks of colony members. Individual and social immunity interact: performance of sanitary care can affect future disease susceptibility, yet also vice versa, individuals differing in susceptibility adjust their sanitary care performance to their individual risk of infection. I present the integrated approach we use to understand how colony protection arises from the individual and collective actions of colony members and how it affects pathogen communities and hence disease ecology.

Gestational exposure to environmental toxins, infections, and stressors are epidemiologically linked to neurodevelopmental disorders

Gestational exposure to environmental toxins, infections, and stressors are epidemiologically linked to neurodevelopmental disorders with strong male-bias, such as autism spectrum disorder. We modeled some of these prenatal risk factors in mice, by co-exposing pregnant dams to an environmental pollutant and limited-resource stress, which robustly dysregulated the maternal immune system. Male but not female offspring displayed long-lasting behavioral abnormalities and alterations in the activity of brain networks encoding social interactions, along with disruptions of gut structure and microbiome composition. Cellularly, prenatal stressors impaired microglial synaptic pruning in males during early postnatal development. Precise inhibition of microglial phagocytosis during the same critical period mimicked the impact of prenatal stressors on the male-specific social deficits. Conversely, modifying the gut microbiome rescued the social and cellular deficits, indicating that environmental stressors alter neural circuit formation in males via impairing microglia function during development, perhaps via a gut-brain disruption.

Tapeworm larvae in the brain: cellular mechanisms of epilepsy in neurocysticercosis

Cerebral infection by the larvae of the cestode, Taenia solium (neurocysticercosis), is thought to be the leading cause of adult-acquired epilepsy worldwide. Despite this, little is known about the cellular mechanisms that underlie seizure development in this condition. In this talk I will present our recent data exploring multiple interactions between cestode larvae, neuroinflammatory processes and network excitability. We find that viable cestode larvae are able to strongly suppress microglial activation and inflammatory cytokine release with consequences for the modulation host neuroinflammatory responses and seizure development in vivo. At the same time, larvae produce and release glutamate, with acute excitatory effects on neuronal circuits. We hope that an improved understanding of epileptogenic mechanisms in neurocysticercosis will one day improve the management of this condition as well as other inflammatory causes of epilepsy.

Toxic effect of pathogenic tau on the nucleus

The nuclear envelope is a lipid bilayer that encases the genome and provides a physical boundary between the cytoplasm and the nucleoplasm. While the nucleus is typically depicted as a sphere encircled by a smooth surface of nuclear envelope, the smooth exterior can be interrupted by tubular invaginations of the nuclear envelope into the deep nuclear interior. Such structures are termed the "nucleoplasmic reticulum." Increased frequency of nuclear envelope invagination occurs in disease states including various cancers, viral infections, and laminopathies, a group of heterogeneous disorders that arise due to mutations in the gene encoding lamin A. A significant increase in the frequency of nuclear envelope invaginations in the human Alzheimer's disease brain has recently been reported. Nuclear envelope invaginations are caused by pathogenic tau, one of the two major pathological hallmarks of Alzheimer's disease. Pathogenic tau-induced dysfunction of the lamin nucleoskeleton drives nuclear envelope invagination and consequent accumulation of polyadenylated RNA within invaginations, both of which drive neuronal death. Our ongoing studies suggest that maintaining proper cytoskeletal, nucleoskeletal, and genomic architecture are critical for survival and function of adult neurons.

Covid And Cognition

ONS figures suggest that at least 10% of individuals suffering COVID -19 Infection continue to experience several weeks after testing positive, and other studies report the proportions as even higher (e.g. Logue et al., 2021). One of the most prevalent reported symptoms among these “Long Covid” sufferers is cognitive dysfunction (Davis et al., 2020). However, to date the cognitive sequelae of COVID -19 are little understood. There are a number of reasons why COVID -19 infection might be associated with cognitive impairment and mental illness (e.g. Bougakov et al., 2020). In particular, increasing evidence indicates inflammation (e.g. Huang et al., 2020) and dysfunctional clotting (e.g. Taquet et al., 2021) as issues of major concern, both of which have been previously linked to a range of cognitive deficits (e.g. Vintimilla et al., 2019; Cumming et al., 2013). Indeed, evidence is beginning to emerge that cognitive issues may be widespread in the post-infection period, particularly among hospitalised and ventilated patients (e.g. Hampshire et al., 2020; Alemanno et al,. 2020). Here I shall present “Hot off the [SPSS]Press” results from a study on memory and cognition following COVID infection in a non-hospitalized cohort.

Brief Sensory Deprivation Triggers Cell Type-Specific Structural and Functional Plasticity in Olfactory Bulb Neurons

Can alterations in experience trigger different plastic modifications in neuronal structure and function, and if so, how do they integrate at the cellular level? To address this question, we interrogated circuitry in the mouse olfactory bulb responsible for the earliest steps in odor processing. We induced experience-dependent plasticity in mice of either sex by blocking one nostril for one day, a minimally invasive manipulation that leaves the sensory organ undamaged and is akin to the natural transient blockage suffered during common mild rhinal infections. We found that such brief sensory deprivation produced structural and functional plasticity in one highly specialized bulbar cell type: axon-bearing dopaminergic neurons in the glomerular layer. After 24 h naris occlusion, the axon initial segment (AIS) in bulbar dopaminergic neurons became significantly shorter, a structural modification that was also associated with a decrease in intrinsic excitability. These effects were specific to the AIS-positive dopaminergic subpopulation because no experience-dependent alterations in intrinsic excitability were observed in AIS-negative dopaminergic cells. Moreover, 24 h naris occlusion produced no structural changes at the AIS of bulbar excitatory neurons, mitral/tufted and external tufted cells, nor did it alter their intrinsic excitability. By targeting excitability in one specialized dopaminergic subpopulation, experience-dependent plasticity in early olfactory networks might act to fine-tune sensory processing in the face of continually fluctuating inputs. (https://www.jneurosci.org/content/41/10/2135)

Gut Feelings: The Microbiota-Gut-Brain Axis Across the Lifespan

The microbiota-gut-brain axis is emerging as a research area of increasing interest for those investigating the biological and physiological basis of brain development and behaviour during early life, adolescence & ageing. The routes of communication between the gut and brain include the vagus nerve, the immune system, tryptophan metabolism, via the enteric nervous system or by way of microbial metabolites such as short chain fatty acids. Studies in animal models have shown that the development of an appropriate stress response is dependent on the microbiota. Developmentally, a variety of factors can impact the microbiota in early life including mode of birth delivery, antibiotic exposure, mode of nutritional provision, infection, stress as well as host genetics. Recently, the gut microbiota has been implicated in regulating the stress response, and social behaviour. Moreover, fundamental brain processes from adult hippocampal neurogenesis to myelination to microglia activation have been shown to be regulated by the microbiome. Further studies will focus on understanding the mechanisms underlying such brain effects and how they can be exploited by microbiota-targeted interventions including ‘psychobiotics’ and diet

Role of Tunneling Nanotubes (TNTs) in the spreading of amyloid proteins in neurodegenerative diseases

Targeting the Endocannabinoid System for Management of Chemotherapy, HIV and Antiretroviral-Induced Neuropathic Pain

Chemotherapeutic drugs (used for treating cancer), HIV infection and antiretroviral therapy (ART) can independently cause difficult-to-manage painful neuropathy. Paclitaxel, a chemotherapeutic drug, for example is associated with high incidence of peripheral neuropathy, around 71% of the patients of which 27% of these develop neuropathic pain. Use of cannabis or phytocannabinoids has been reported to improve pain measures in patients with neuropathic pain, including painful HIV-associated sensory neuropathy and cancer pain. Phytocannabinoids and endocannabinoids, such as anandamide and 2-arachidonoylglycerol (2-AG), produce their effects via cannabinoid (CB) receptors, which are present both in the periphery and central nervous system. Endocannabinoids are synthesized in an “on demand” fashion and are degraded by various enzymes such as fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MGL). Various studies, including those from our group, suggest that there are changes in gene and protein expression of endocannabinoid molecules during chemotherapy-induced neuropathic pain (CINP), HIV and antiretroviral-induced neuropathic pain. Analysis of endocannabinoid molecule expression in the brain, spinal cord and paw skin using LC-MS/MS show that there is a specific deficiency of the endocannabinoids 2-AG and/or anandamide in the periphery during CINP. Various drugs including endocannabinoids, cannabidiol, inhibitors of FAAH and MGL, CB receptor agonists, desipramine and coadministered indomethacin plus minocycline have been found to either prevent the development and/or attenuate established CINP, HIV and antiretroviral-induced neuropathic pain in a CB receptor-dependent manner. The results available suggest that targeting the endocannabinoid system for prevention and treatment of CINP, HIV-associated neuropathic pain and antiretroviral-induced neuropathic pain is a plausible therapeutic option.

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