Effect of Itolizumab on gene expression profiles of patients enrolled in phase 2 psoriasis clinical trial study (Study number: T1hAb‐CT1‐001‐07).
Ontology highlight
ABSTRACT: Punch biopsies of patients enrolled in phase II clinical trial study was obtained at various time points. Skin biopsies from 16 responders and 8 non responders and partial responders, chosen after the completion of clinical trial, was evaluated before Itolizumab treatment (Day 1) and at Day 57. Responders had a PASI improvement >75% while non responders had a PASI improvement <60%. The gene expression values at Day 57 were normalised with values obtained at Day 1 of the respective patient sample. The genes with a minimum fold change of 1.8 spontaneously clustered into predominantly responders and non responders.
Project description:Punch biopsies of patients enrolled in phase II clinical trial study was obtained at various time points. Skin biopsies from 16 responders and 8 non responders and partial responders, chosen after the completion of clinical trial, was evaluated before Itolizumab treatment (Day 1) and at Day 57. Responders had a PASI improvement >75% while non responders had a PASI improvement <60%. The gene expression values at Day 57 were normalised with values obtained at Day 1 of the respective patient sample. The genes with a minimum fold change of 1.8 spontaneously clustered into predominantly responders and non responders. Agilent Custom Human Gene Expression 8X15k (AMADID: 16332) designed by Genotypic Technology Private Limited .
Project description:TNF antagonists are routinely used in severe rheumatoid arthritis (RA) patients who failed conventional DMARD therapy. According to large clinical trials, the three available drugs (adalimumab, infliximab and etanercept) display similar effects in terms of efficacy, tolerability and side effects. These studies also indicate that about 25% of RA patients treated with TNF-antagonists do not display any significant clinical improvement. The aim of this study was to investigate global molecular patterns in synovial biopsies from RA patients obtained 12 weeks after initiation of adalimumab therapy. All patients had rheumatoid arthritis (RA), according to the American College of rheumatology criteria for the diagnosis of RA. They had active disease at the time of initiation of adalimumab therapy and were resistant to conventional therapy. They all had erosive changes imaged on conventional x-rays of the hands and/or feet. All patients were treated with disease-modifying antirheumatic drugs (DMARD’s), 23 with methotrexate (median dose 15 mg/week, range 7.5 – 20 mg/week), and 2 with leflunomide (20 mg/day); 18 of them were treated with low-dose steroids (prednisolone ≤ 7.5 mg/day). Six patients had been included in double-blind clinical trials before inclusion in the present study (1 in a Golimumab versus placebo trial, 3 in a MapKinase inhibitor versus placebo trial and 2 in a TACE-inhibitor versus placebo trial). These trials were stopped at least 3 months prior to initiation of TNF-blocking therapy. All drug dosages were stable from at least 3 months prior to initiation of TNF blocking therapy until completion of the study. No steroid injections were allowed during the duration of the study. Adalimumab therapy was initiated at a dosage of 40 mg subcutaneously every other week. Disease activity at baseline and 12 weeks after initiation of therapy (T12) was evaluated using DAS(28)-CRP (3- and 4-variables) scores, and response to therapy was assessed according to the EULAR response criteria that categorize patients in responders (good- or moderate-) and non- (or poor-) responders based on changes in DAS activity between T0 and T12 and absolute DAS values at T12. Synovial biopsies were obtained by needle-arthroscopy of knee of the patients at T12. The aim of the study was to compare gene expression profiles in synovial tissue of RA patients who responded versus not responded to adalimumab therapy.
Project description:Immunoadsorption with subsequent immunoglobulin substitution (IA/IgG) represents a therapeutic approach for patients with dilated cardiomyopathy (DCM). Here, we studied which molecular cardiac alterations are initiated after this treatment. Transcription profiling of endomyocardial biopsies with Affymetrix whole genome arrays was performed on 33 paired samples of DCM patients collected before and six months after IA/IgG. Therapy-related effects on myocardial protein levels were analysed by label free proteome profiling for a subset of 23 DCM patients. Data were analysed regarding therapy-associated differences in gene expression and protein levels by comparing responders (defined by improvement of left ventricular ejection fraction ≥ 20% relative and ≥5% absolute) and non-responders. Responders to IA/IgG showed a decrease in serum N-terminal proBNP levels in comparison to baseline which was accompanied by a decreased expression of heart failure markers such as angiotensin converting enzyme 2 or periostin. However, despite clinical improvement even in responders IA/IgG did not trigger general inversion of DCM associated molecular alterations in myocardial tissue. Transcriptome profiling revealed reduced gene expression for connective tissue growth factor, fibronectin, and collagen type I in responders. In contrast, in non-responders after IA/IgG, for fibrosis associated genes and proteins showed elevated levels whereas values were reduced or maintained in responders. Thus, improvement of LV function after IA/IgG seems to be related to a reduced gene expression of heart failure markers and pro-fibrotic molecules as well as reduced fibrosis progression.
Project description:In this study we aimed to identify a baseline intrahepatic transcriptional signature associated with response in chronic hepatitis B patients treated with peginterferon-alfa-2a (peg-IFN) and adefovir. Liver gene expression values of patients with combined response (responders; n=9) and non-response (n=6) were compared for 21,462 annotated gene transcripts. We identified 182 genes which differed on average more than 1.5-fold, of which 53 were relatively upregulated in non-responders and 129 in responders. 15 liver biopsies of chronic hepatitis B patients were selected for RNA extraction and hybridization on Affymetrix microarrays. Expression values in 9 biopsies of patients with a combined response to therapy were compared with 6 biopsies of non-responders. Differentially expressed genes between responders and non-responders were determined using filtering on minimal average expression, fold change (1.5 fold) and p-values from 2-sided t-tests (0 permutations) in GenePattern. This dataset is part of the TransQST collection.
Project description:Background: The pathogenesis of pityriasis rubra pilaris (PRP) is not completely understood, but interleukin (IL)-17 has been shown to play a critical role. There are no reliable immunomodulatory agents to treat PRP. We conducted an open-label, single-arm clinical trial of secukinumab, a monoclonal antibody that inhibits IL-17A, for the treatment of PRP. Objectives: To evaluate the clinical efficacy of secukinumab and define the transcriptomic landscape of PRP and its response to IL-17A blockade. Methods: Twelve patients with PRP were recruited for an open-label trial of secukinumab. Patients received a 24-week course of secukinumab. The primary endpoint was a ≥ 75% reduction in Psoriasis Area and Severity Index (PASI 75) from baseline to week 28. Secondary endpoints included PASI 90, change in Physician's Global Assessment (PGA), and change in Dermatology Life Quality Index (DLQI). RNA sequencing was performed on lesional and nonlesional skin biopsies obtained at baseline and week 2. Sample groups were compared to identify differential gene expression and pathway enrichment. This trial was registered with ClinicalTrials.gov: 'Cosentyx (secukinumab) for the treatment of adult onset pityriasis rubra pilaris' - NCT03342573. Results: At week 28, six of 11 patients (55%) achieved PASI 75, and three patients (27%) achieved PASI 90. PGA (P = 0.008) and DLQI scores (P = 0.010) showed significant improvement with treatment. No serious treatment-related adverse events were encountered. Treatment with secukinumab normalized transcriptional differences between lesional and nonlesional skin. Transcriptomic data from nonresponsive patients suggest that overactivity of innate immune pathways may be driving resistance to secukinumab. Conclusions: Secukinumab appears to be an effective treatment for PRP and warrants further investigation. PRP is a transcriptionally heterogeneous disease, reflecting its variable response to therapy. Agents targeting other IL-17 isoforms and innate immune mediators should be considered for future clinical trials. What is already known about this topic? The pathogenesis of pityriasis rubra pilaris is incompletely understood. Successful treatment has been reported with a variety of immunomodulatory agents, but disease is often refractory to therapy. Interleukin (IL)-17 is thought to drive keratinocyte proliferation and vascular dysfunction in this disease. A previous trial demonstrated efficacy of the anti-IL-17A drug ixekizumab for pityriasis rubra pilaris. What does this study add? Herein we describe the findings of a clinical trial of secukinumab, an anti-IL-17A monoclonal antibody, for the treatment of pityriasis rubra pilaris. Secukinumab was effective in treating pityriasis rubra pilaris. Our transcriptomic data give new insight into the expressional changes that occur in response to secukinumab and suggest mechanisms of treatment resistance.
Project description:Afatinib is a pan-HER inhibitor that improved progression-free-survival (PFS) in recurrent HNSCC versus methotrexate: median PFS 2.6 versus 1.7 months (LUX H&N 1 trial). This study is a translational research linked to EORTC 90111 afatinib trial, an open-label, randomized, multicenter, phase II window of opportunity trial. Treatment-naïve HNSCC patients selected for primary curative surgery were randomized (5:1 ratio) to receive Afatinib during 14 days (day -15 until day -1) before surgery (day 0) or no treatment. Tumour biopsies, FDG/PET, and MRI were performed at diagnosis and at surgery. The primary end point was metabolic FDG-PET/CT response, defined according to EORTC guidelines.
Project description:Importance: There is no FDA-approved treatment for pityriasis rubra pilaris and it is common for patients to fail several systemic options. Involvement of IL-23 pathway suggests a potential therapeutic target. Objective: To determine whether guselkumab, an IL-23p19 inhibitor, provides clinical improvement for subjects with PRP. Design: Single-arm, investigator-initiated trial from October, 2019 to August, 2022. Primary outcome was observed at 24 weeks, and additional patient follow-up occurred at 36 weeks. Participants: 14 adult subjects with moderate-to-severe pityriasis rubra pilaris were enrolled; 12 completed the trial. Age- and sex-matched healthy controls provided skin and blood for proteomic and transcriptomic studies. Intervention: Guselkumab is a humanized IgG1 lambda antibody that selectively binds and inhibits the p19 subunit of interleukin-23. Subcutaneous injections were performed at the FDA-approved dosing schedule for psoriasis over a 24-week period. Main Outcomes and Measures: The primary outcome was mean change in psoriasis area and severity index (PASI) at week 24. Secondary outcomes included improvement in body surface area, quality of life, time to improvement, sustained remission at 36 weeks, and correlation to germline mutations and cytokine expression. Results: An intention-to-treat analysis was performed for our cohort of ten males and six females, with a median age of 59.5 years. The mean improvement in psoriasis area and severity index, body surface area, and dermatology life quality index (DLQI) were 18.9 ± 12.5 (p<0.001), 40.5 ± 36.5 (p=0.003), and 12.2 ± 7.8 (p<0.001), respectively. 11 subjects showed sustained remission off therapy, evidenced by decreased PASI scores between week-24 and week-36. No subjects had CARD14 gene variations. There was one serious adverse event, unrelated to study drug. Proteomics and gene expression profiles improved with clinical improvement. Conclusion and Relevance: Guselkumab appears to be efficacious in the treatment of refractory PRP.
Project description:In the EORTC 90111, open-label, randomised, multicentre, phase II trial, patients were treated with afatinib for 14 days (day 15 until day 1) before surgery (day 0). Tumour biopsies, 2-[fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography (18-FDG PET) and magnetic resonance imaging (MRI) were performed at diagnosis and just before surgery. The main aim of the study was to identify predictive biomarkers among treatment-naive patients in this curative setting.
Project description:Purpose: muscle transcriptomics of subjects supplemented with Urolithin A at different doses or placebo for 4 month. Method: RNA-seq was performed using Illumina HiSeq 4000 sequencing; single read 1 x 50 bp . The quantification of mRNA from the RNA-seq FASTQ files was performed using Salmon. Sample-wise quant.sf files containing raw transcript-level read estimates were read into R, v. 4.0.3 and were combined into a data matrix. Transcripts with very low total counts (< 10) across all samples were filtered out. The data was transformed using the variance stabilizing transformation (VST) method of R package DESeq2, v. 1.30.0. Top 10,000 transcripts with the highest variance across all samples were used for principal component analysis (PCA) using DESeq2. Data transformation and PCA was also done separately for each treatment group. Based on the PCAs, probable outlier samples were excluded and new PCAs were plotted without these samples. The raw transcript-level read count estimates were read in R and summarized to gene-level counts based on the provided transcript and gene ID annotations using summarizeToGene function of R package tximport, v. 1.18.0. DESeqDataSetFromTximport function of DESeq2 was then used for constructing a DESeqDataSet object for DE analysis. Pre-filtering was applied before the DE analysis by excluding genes with < 10 total counts across samples. Subset DE analysis was performed, contrasting Visit time D120 with baseline (BL) and by adjusting for the subject effect. The normalization and DE analysis was done separately for the three different treatment groups. Independent filtering option of DESeq2 was enabled (default), filtering out genes with very low counts and thus unlikely to show significant evidence. R package biomaRt. v. 2.46.0 was used for annotating the results with HGNC gene symbols, gene descriptions and gene biotypes. DESeq2-normalised expression values of all the samples in the given comparison were added to the result tables. Non-adjusted p-value 0.05 was used to filter the results by statistical significance. Results were also generated using DESeq2 function lfcShrink that allows for the shrinkage of the log2 fold change (LFC) estimates toward zero when the information for a gene is low (such as in those cases with low counts or high dispersion values) but has little effect on genes with high counts. The shrinked log2FC values were subsequently used for visualisation and ranking the genes.
Project description:Genome wide DNA methylation profiling of peripheral blood samples of moderate-to-severe psoriasis patients treated with anti-TNF drugs. Patients were distributed on Excellent Responders (ER) if they achieved PASI90 (a 90% reduction with respect to baseline PASI) at 3 and 6 months of treatment with anti-TNF drugs and Partial responders if they did not achieve a PASI75 (a 75% reduction with respect to baseline PASI) at 3 and 6 months of treatment. The Illumina Infinium 450k Human DNA methylation Beadchip v1.2 was used to obtain DNA methylation profiles across approximately 485,000 CpGs in 49 ER and 21 PR which were obtained from peripheral blood samples of anti-TNF drug treated patients. We have searched for pharmaoepigenetic biomarkers of anti-TNF response in moderate-to-severe psoriasis patients.