29 results on '"Marie-Ève Lebel"'
Search Results
2. p16INK4a Regulates Cellular Senescence in PD-1-Expressing Human T Cells
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Valérie Janelle, Mathieu Neault, Marie-Ève Lebel, Dave Maurice De Sousa, Salix Boulet, Ludovic Durrieu, Cédric Carli, Chloé Muzac, Sébastien Lemieux, Nathalie Labrecque, Heather J. Melichar, Frédérick A. Mallette, and Jean-Sébastien Delisle
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T cells ,exhaustion and activation markers ,cellular senescence ,p38MAPK ,p16INK4a ,adoptive immunotherapy ,Immunologic diseases. Allergy ,RC581-607 - Abstract
T-cell dysfunction arising upon repeated antigen exposure prevents effective immunity and immunotherapy. Using various clinically and physiologically relevant systems, we show that a prominent feature of PD-1-expressing exhausted T cells is the development of cellular senescence features both in vivo and ex vivo. This is associated with p16INK4a expression and an impaired cell cycle G1 to S-phase transition in repeatedly stimulated T cells. We show that these T cells accumulate DNA damage and activate the p38MAPK signaling pathway, which preferentially leads to p16INK4a upregulation. However, in highly dysfunctional T cells, p38MAPK inhibition does not restore functionality despite attenuating senescence features. In contrast, p16INK4a targeting can improve T-cell functionality in exhausted CAR T cells. Collectively, this work provides insights into the development of T-cell dysfunction and identifies T-cell senescence as a potential target in immunotherapy.
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- 2021
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3. Strength and Numbers: The Role of Affinity and Avidity in the ‘Quality’ of T Cell Tolerance
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Sébastien This, Stefanie F. Valbon, Marie-Ève Lebel, and Heather J. Melichar
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T cells ,tolerance ,T cell receptor signaling ,affinity ,avidity ,anergy ,Cytology ,QH573-671 - Abstract
The ability of T cells to identify foreign antigens and mount an efficient immune response while limiting activation upon recognition of self and self-associated peptides is critical. Multiple tolerance mechanisms work in concert to prevent the generation and activation of self-reactive T cells. T cell tolerance is tightly regulated, as defects in these processes can lead to devastating disease; a wide variety of autoimmune diseases and, more recently, adverse immune-related events associated with checkpoint blockade immunotherapy have been linked to a breakdown in T cell tolerance. The quantity and quality of antigen receptor signaling depend on a variety of parameters that include T cell receptor affinity and avidity for peptide. Autoreactive T cell fate choices (e.g., deletion, anergy, regulatory T cell development) are highly dependent on the strength of T cell receptor interactions with self-peptide. However, less is known about how differences in the strength of T cell receptor signaling during differentiation influences the ‘function’ and persistence of anergic and regulatory T cell populations. Here, we review the literature on this subject and discuss the clinical implications of how T cell receptor signal strength influences the ‘quality’ of anergic and regulatory T cell populations.
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- 2021
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4. Plant Viruses as Nanoparticle-Based Vaccines and Adjuvants
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Marie-Ève Lebel, Karine Chartrand, Denis Leclerc, and Alain Lamarre
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recombinant plant virus ,vaccine ,adjuvant ,immune response ,production methods ,Medicine - Abstract
Vaccines are considered one of the greatest medical achievements in the battle against infectious diseases. However, the intractability of various diseases such as hepatitis C, HIV/AIDS, malaria, tuberculosis, and cancer poses persistent hurdles given that traditional vaccine-development methods have proven to be ineffective; as such, these challenges have driven the emergence of novel vaccine design approaches. In this regard, much effort has been put into the development of new safe adjuvants and vaccine platforms. Of particular interest, the utilization of plant virus-like nanoparticles and recombinant plant viruses has gained increasing significance as an effective tool in the development of novel vaccines against infectious diseases and cancer. The present review summarizes recent advances in the use of plant viruses as nanoparticle-based vaccines and adjuvants and their mechanism of action. Harnessing plant-virus immunogenic properties will enable the design of novel, safe, and efficacious prophylactic and therapeutic vaccines against disease.
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- 2015
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5. Efficacy of a Virus-Like Nanoparticle As Treatment for a Chronic Viral Infection Is Hindered by IRAK1 Regulation and Antibody Interference
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Karine Chartrand, Marie-Ève Lebel, Esther Tarrab, Pierre Savard, Denis Leclerc, and Alain Lamarre
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plasmacytoid dendritic cells ,PapMV ,interferon-α ,IRAK1 ,Sca-1 ,antibodies ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Although vaccination has been an effective way of preventing infections ever since the eighteenth century, the generation of therapeutic vaccines and immunotherapies is still a work in progress. A number of challenges impede the development of these therapeutic approaches such as safety issues related to the administration of whole pathogens whether attenuated or inactivated. One safe alternative to classical vaccination methods gaining recognition is the use of nanoparticles, whether synthetic or naturally derived. We have recently demonstrated that the papaya mosaic virus (PapMV)-like nanoparticle can be used as a prophylactic vaccine against various viral and bacterial infections through the induction of protective humoral and cellular immune responses. Moreover, PapMV is also very efficient when used as an immune adjuvant in an immunotherapeutic setting at slowing down the growth of aggressive mouse melanoma tumors in a type I interferon (IFN-I)-dependent manner. In the present study, we were interested in exploiting the capacity of PapMV of inducing robust IFN-I production as treatment for the chronic viral infection model lymphocytic choriomeningitis virus (LCMV) clone 13 (Cl13). Treatment of LCMV Cl13-infected mice with two systemic administrations of PapMV was ineffective, as shown by the lack of changes in viral titers and immune response to LCMV following treatment. Moreover, IFN-α production following PapMV administration was almost completely abolished in LCMV-infected mice. To better isolate the mechanisms at play, we determined the influence of a pretreatment with PapMV on secondary PapMV administration, therefore eliminating potential variables emanating from the infection. Pretreatment with PapMV led to the same outcome as an LCMV infection in that IFN-α production following secondary PapMV immunization was abrogated for up to 50 days while immune activation was also dramatically impaired. We showed that two distinct and overlapping mechanisms were responsible for this outcome. While short-term inhibition was partially the result of interleukin-1 receptor-associated kinase 1 degradation, a crucial component of the toll-like receptor 7 signaling pathway, long-term inhibition was mainly due to interference by PapMV-specific antibodies. Thus, we identified a possible pitfall in the use of virus-like particles for the systemic treatment of chronic viral infections and discuss mitigating alternatives to circumvent these potential problems.
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- 2018
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6. CD5 levels define functionally heterogeneous populations of naïve human CD4 + T cells
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Jean-Sébastien Delisle, Mengqi Dong, Nienke Vrisekoop, Heather J. Melichar, Judith N. Mandl, Marie-Ève Lebel, Suzanne J Vobecky, Marilaine Fournier, Elie Haddad, and Aditi Sood
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CD4-Positive T-Lymphocytes ,0301 basic medicine ,Immunological Synapses ,medicine.medical_treatment ,T cell ,Adaptive immunity ,Immunology ,Cell ,Receptors, Antigen, T-Cell ,Biology ,CD5 Antigens ,Autoantigens ,Immunotherapy, Adoptive ,Mice ,03 medical and health sciences ,0302 clinical medicine ,T-Lymphocyte Subsets ,Gene expression ,medicine ,Animals ,Humans ,Immunology and Allergy ,Compartment (development) ,Human T cells ,Basic ,Clonal Selection, Antigen-Mediated ,Research Articles ,Cells, Cultured ,Effector ,T-cell receptor ,CD4+ T cells ,CD5 ,Thymus ,Cell biology ,Mice, Inbred C57BL ,030104 developmental biology ,medicine.anatomical_structure ,Cytokine ,Cytokines ,Research Article|Basic ,Immunologic Memory ,Biomarkers ,Protein Binding ,Signal Transduction ,030215 immunology - Abstract
Studies in murine models show that subthreshold TCR interactions with self‐peptide are required for thymic development and peripheral survival of naïve T cells. Recently, differences in the strength of tonic TCR interactions with self‐peptide, as read‐out by cell surface levels of CD5, were associated with distinct effector potentials among sorted populations of T cells in mice. However, whether CD5 can also be used to parse functional heterogeneity among human T cells is less clear. Our study demonstrates that CD5 levels correlate with TCR signal strength in human naïve CD4+ T cells. Further, we describe a relationship between CD5 levels on naïve human CD4+ T cells and binding affinity to foreign peptide, in addition to a predominance of CD5hi T cells in the memory compartment. Differences in gene expression and biases in cytokine production potential between CD5lo and CD5hi naïve human CD4+ T cells are consistent with observations in mice. Together, these data validate the use of CD5 surface levels as a marker of heterogeneity among human naïve CD4+ T cells with important implications for the identification of functionally biased T‐ cell populations that can be exploited to improve the efficacy of adoptive cell therapies., CD5lo and CD5hi naïve human CD4+ T cells differ in their gene expression profiles, affinity for foreign antigen, cytokine production after activation, and accumulation in the memory compartment. These findings have important implications in the identification of functionally biased T‐cell populations that can be exploited to improve cell therapies.
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- 2021
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7. MHC-Independent Thymic Selection of CD4 and CD8 Coreceptor Negative αβ T Cells
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Erin E. Hillhouse, Heather J. Melichar, Félix Lombard-Vadnais, Marie-Ève Lebel, Sylvie Lesage, Geneviève Chabot-Roy, and Roxanne Collin
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Male ,Cell type ,Receptors, Antigen, T-Cell, alpha-beta ,T-Lymphocytes ,T cell ,Immunology ,Thymus Gland ,Major histocompatibility complex ,Secondary lymphoid organs ,Major Histocompatibility Complex ,Mice ,Immune system ,T-Lymphocyte Subsets ,medicine ,Animals ,Immunology and Allergy ,Cell Proliferation ,Mice, Knockout ,Thymocytes ,biology ,Cell Differentiation ,Flow Cytometry ,Cell biology ,Thymocyte ,medicine.anatomical_structure ,Models, Animal ,T cell subset ,biology.protein ,Female ,CD8 - Abstract
It is becoming increasingly clear that unconventional T cell subsets, such as NKT, γδ T, mucosal-associated invariant T, and CD8αα T cells, each play distinct roles in the immune response. Subsets of these cell types can lack both CD4 and CD8 coreceptor expression. Beyond these known subsets, we identify CD4−CD8−TCRαβ+, double-negative (DN) T cells, in mouse secondary lymphoid organs. DN T cells are a unique unconventional thymic-derived T cell subset. In contrast to CD5high DN thymocytes that preferentially yield TCRαβ+ CD8αα intestinal lymphocytes, we find that mature CD5low DN thymocytes are precursors to peripheral DN T cells. Using reporter mouse strains, we show that DN T cells transit through the immature CD4+CD8+ (double-positive) thymocyte stage. Moreover, we provide evidence that DN T cells can differentiate in MHC-deficient mice. Our study demonstrates that MHC-independent thymic selection can yield DN T cells that are distinct from NKT, γδ T, mucosal-associated invariant T, and CD8αα T cells.
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- 2020
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8. Differential expression of tissue-restricted antigens among mTEC is associated with distinct autoreactive T cell fates
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Maria Galipeau, Heather J. Melichar, Marie Coutelier, Claudia L. Kleinman, James J. Moon, and Marie-Ève Lebel
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Male ,0301 basic medicine ,Central tolerance ,T-Lymphocytes ,Transgene ,T cell ,Science ,Antigen-presenting cells ,T cells ,General Physics and Astronomy ,Mice, Transgenic ,Thymus Gland ,Biology ,Article ,General Biochemistry, Genetics and Molecular Biology ,Immune tolerance ,Mice ,03 medical and health sciences ,Negative selection ,0302 clinical medicine ,Antigen ,Bone Marrow ,Cell Line, Tumor ,Immune Tolerance ,medicine ,Animals ,Antigens ,lcsh:Science ,Mice, Knockout ,Thymocytes ,Multidisciplinary ,Cell Differentiation ,Epithelial Cells ,Bacterial Infections ,General Chemistry ,Thymus ,Cell biology ,Mice, Inbred C57BL ,030104 developmental biology ,medicine.anatomical_structure ,Cell culture ,Intraepithelial lymphocyte ,Female ,lcsh:Q ,Lymph Nodes ,Bone marrow ,Transcription Factors ,030215 immunology - Abstract
Medullary thymic epithelial cells (mTEC) contribute to the development of T cell tolerance by expressing and presenting tissue-restricted antigens (TRA), so that developing T cells can assess the self-reactivity of their antigen receptors prior to leaving the thymus. mTEC are a heterogeneous population of cells that differentially express TRA. Whether mTEC subsets induce distinct autoreactive T cell fates remains unclear. Here, we establish bacterial artificial chromosome (BAC)-transgenic mouse lines with biased mTEClo or mTEChi expression of model antigens. The transgenic lines support negative selection of antigen-specific thymocytes depending on antigen dose. However, model antigen expression predominantly by mTEClo supports TCRαβ+ CD8αα intraepithelial lymphocyte development; meanwhile, mTEChi-restricted expression preferentially induces Treg differentiation of antigen-specific cells in these models to impact control of infectious agents and tumor growth. In summary, our data suggest that mTEC subsets may have a function in directing distinct mechanisms of T cell tolerance., T cell tolerance is established in the thymus via interactions with medullary thymic epithelial cells (mTEC) expressing tissue-restricted self antigens. Here, the authors suggest, using new transgenic mouse lines and single cell transcriptome analyses, that specific mTEC subsets are associated with distinct T cell fates.
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- 2020
9. The ICOS-ICOSL pathway tunes thymic selection
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Mengqi Dong, Jinsam Chang, Marie‐Ève Lebel, Noémie Gervais, Marilaine Fournier, Ève Mallet Gauthier, Woong‐Kyung Suh, and Heather J Melichar
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B-Lymphocytes ,Inducible T-Cell Co-Stimulator Ligand ,CD28 Antigens ,T-Lymphocytes ,Immunology ,Immunology and Allergy ,Antigen-Presenting Cells ,Cell Biology - Abstract
Negative selection of developing T cells plays a significant role in T-cell tolerance to self-antigen. This process relies on thymic antigen-presenting cells which express both self-antigens and cosignaling molecules. Inducible T-cell costimulator (ICOS) belongs to the CD28 family of cosignaling molecules and binds to ICOS ligand (ICOSL). The ICOS signaling pathway plays important roles in shaping the immune response to infections, but its role in central tolerance is less well understood. Here we show that ICOSL is expressed by subsets of thymic dendritic cells and medullary thymic epithelial cells as well as thymic B cells. ICOS expression is upregulated as T cells mature in the thymus and correlates with T-cell receptor signal strength during thymic selection. We also provide evidence of a role for ICOS signaling in mediating negative selection. Our findings suggest that ICOS may fine-tune T-cell receptor signals during thymic selection contributing to the generation of a tolerant T-cell population.
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- 2021
10. Pre-existing chromatin accessibility and gene expression differences among naive CD4
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Dakota, Rogers, Aditi, Sood, HanChen, Wang, Jasper J P, van Beek, Thomas J, Rademaker, Patricio, Artusa, Caitlin, Schneider, Connie, Shen, Dylan C, Wong, Aanya, Bhagrath, Marie-Ève, Lebel, Stephanie A, Condotta, Martin J, Richer, Andrew J, Martins, John S, Tsang, Luis B, Barreiro, Paul, François, David, Langlais, Heather J, Melichar, Johannes, Textor, and Judith N, Mandl
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CD4-Positive T-Lymphocytes ,Male ,Mice, Inbred C57BL ,Gene Expression Profiling ,Receptors, Antigen, T-Cell ,Animals ,Lymphocytic choriomeningitis virus ,Cell Differentiation ,Female ,T-Lymphocytes, Helper-Inducer ,Lymphocytic Choriomeningitis ,Lymphocyte Activation ,Chromatin - Abstract
CD4
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- 2021
11. Multicentre randomised controlled trial comparing Bankart repair with remplissage and Latarjet procedure in shoulder instability with subcritical bone loss (STABLE): study protocol
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Asheesh Bedi, Patrick Henry, Mohit Bhandari, Jaydeep Moro, John Carroll, Sarah Kerslake, Rachel M Frank, Jon Warner, Katrine Milner, Timothy Leroux, Michaela Kopka, Julie-Anne Fritz, Marie-Eve Lebel, Moin Khan, Stéphane Pelet, Kim Madden, Stacey Wanlin, Robert Litchfield, Peter MacDonald, Fatima Nadeem, Paul Dunn, Han Yang, Heather Grant, Nicole Bryant, Ashley Ambrose, Ryan Degen, Miriam Garrido Clua, Danielle Dagher, Asma Mirza, Matthew Denkers, Peter Lapner, Katie McIlquham, Himani Anand, Stephanie Lewaniak, Atqiya Fariha, Alessandra Rodriguez, Priethika Suthakaran, Nithila Sivakumar, Montserrat García Portabella, Josep Massons Albareda, Lledó Batalla Gurrea, Luken Zubizarreta Barrutia, Denisse Guadalupe Loya De la Cerda, Bashar Alolabi, Caralee Bolton, Davide Bardana, Ryan Bicknell, Fiona Howells, Xinning “Tiger” Li, Jayson Saleet, Daniel J Stokes, Rodrigo Ignacio de Marinis Acle, Catalina Victoria Vidal Olate, Abdul-ilah Hachem, Pablo Marcet, Katelyn Inch, Jill Neufeld, Jason Old, Jarret Woodmass, Sheila McRae, Rahne Magnusson, Brenna Cyr, Christine Johnston Heise, Sara Telles-Langdon, Heather Normand, Dan Ogborn, Jeff Leiter, Cristina Ventura-Parellada, Jose M Mora-Guix, Ferran Gamez-Baños, Mar Muñoz Valverde, Carlos Torrens Canovas, Fernando Santana, Tamara Wagner, Lakshmi Ambika, Rania Khalil, Oma Persaud, Amelia Cardoso, Mary Nasim, Ydo V Kleinlugtenbelt, I F Kodde, Ellie B M Landman, Hannie Elskamp-Meijerman, Monique V M Voskamp, Jordi Salvador Carreño, Pablo Castillón Bernal, Pilar Gomez Haccart, Jorge H Nuñez Camarena, Judit López Catena, Laurie A Hiemstra, S Mark Heard, Gregory M Buchko, Katrina Munro, Emilio Calvo Crespo, Cristina Delgado del Caño, Amir Sohail, Sylvie Turmel, Mahdi Alsaffar, Naser Alnusif, and Najla Alsiri
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Medicine - Abstract
Introduction Recurrent shoulder dislocations often cause attrition of the labrum and progressive loss of the anterior bony contour of the glenoid. Treatment options for this pathology involve either soft tissue repair or bony augmentation procedure. The optimal management for patients with shoulder instability with subcritical bone loss remains unknown and current clinical practice is highly varied.Methods and analysis The Shoulder instability Trial comparing Arthroscopic stabilisation Benefits compared with Latarjet procedure Evaluation (STABLE) is an ongoing multicentre, randomised controlled trial of 114 patients diagnosed with recurrent anterior shoulder instability and subcritical glenoid bone loss (10%–20%, measured on 3D CT using circle of best fit technique). Patients are randomised either arthroscopic capsuloligamentous repair (Bankart repair+remplissage) or open or arthroscopic coracoid transfer (Latarjet procedure). The primary outcome of this trial will be the between-group difference in the change from baseline to 24 months postintervention in Western Ontario Shoulder Instability Index scores. Secondary outcomes include: (1) rates of recurrent shoulder dislocations and symptoms of instability up to 24 months’ postsurgery; (2) clinical outcomes measured by American Shoulder and Elbow Society score, Shoulder Activity Scale, EQ-5D and Patient Satisfaction Scale; (3) physical examination (range of motion, stability); (4) return to previous level of activity/sport; (5) rate of shoulder-related complications and serious adverse events.Ethics and dissemination This protocol has been reviewed and approved by the Hamilton Integrated Research Ethics Board (HiREB; project number 15998) prior to commencement of the trial. Results from the study will be submitted for publication in a peer-reviewed journal regardless of whether there are statistically significant findings.Trial registration number NCT05705479; this study was prospectively registered on clinicaltrials.gov.
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- 2024
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12. Pre-existing chromatin accessibility and gene expression differences among naïve CD4+T cells influence effector potential
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Aditi Sood, Dylan C. Wong, Judith N. Mandl, Thomas J. Rademaker, Patricio Artusa, John S. Tsang, David Langlais, Heather J. Melichar, Andrew J. Martins, Connie Shen, Paul François, Martin J. Richer, Stephanie A. Condotta, Marie-Ève Lebel, Johannes Textor, HanChen Wang, Luis B. Barreiro, Caitlin Schneider, Jasper J. P. van Beek, and Dakota Rogers
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Antigen ,Effector ,Gene expression ,T-cell receptor ,biology.protein ,Epigenetics ,CD5 ,Biology ,Major histocompatibility complex ,Chromatin ,Cell biology - Abstract
SummaryCD4+T cells have a remarkable potential to differentiate into diverse effector lineages following activation. Here, we probed the heterogeneity present among naïve CD4+T cells before encountering their cognate antigen to ask whether their effector potential is modulated by pre-existing transcriptional and epigenetic differences. Using single-cell RNA sequencing, we showed that key drivers of variability are genes involved in T cell receptor (TCR) signaling. Using CD5 expression as a read-out of the strength of tonic TCR interactions with self-peptide MHC, and sorting on the ends of this self-reactivity spectrum, we find that pre-existing transcriptional differences among naïve CD4+T cells impact follicular helper cell (TFH) versus non-TFHeffector lineage choice. Moreover, our data implicate TCR signal strength during thymic development in establishing differences in naïve CD4 T cell chromatin landscapes that ultimately shape their effector potential.
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- 2021
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13. CD5 levels reveal distinct basal T-cell receptor signals in T cells from non-obese diabetic mice
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Cindy Audiger, Mengqi Dong, Adeolu Adegoke, Sylvie Lesage, Heather J. Melichar, Stefanie F Valbon, Marie-Ève Lebel, Colin C. Anderson, and Université de Montréal. Faculté de médecine. Département de microbiologie, infectiologie et immunologie
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0301 basic medicine ,Genetically modified mouse ,TCR signals ,Immunology ,Receptors, Antigen, T-Cell ,chemical and pharmacologic phenomena ,Mice, Transgenic ,Nod ,Thymus Gland ,Biology ,CD8-Positive T-Lymphocytes ,CD5 Antigens ,Diabetes Mellitus, Experimental ,03 medical and health sciences ,Mice ,0302 clinical medicine ,Mice, Inbred NOD ,Immunology and Allergy ,Animals ,Receptor ,NOD ,Thymic selection ,NOD mice ,T-cell receptor ,Cell Biology ,CD5 ,Cell biology ,030104 developmental biology ,Diabetes Mellitus, Type 1 ,B6. H2g7 ,CD8 ,Homeostasis ,030215 immunology ,Signal Transduction - Abstract
Type 1 diabetes in non-obese diabetic (NOD) mice occurs when autoreactive T cells eliminate insulin producing pancreatic β cells. While extensively studied in T-cell receptor (TCR) transgenic mice, the contribution of alterations in thymic selection to the polyclonal T-cell pool in NOD mice is not yet resolved. The magnitude of signals downstream of TCR engagement with self-peptide directs the development of a functional T-cell pool, in part by ensuring tolerance to self. TCR interactions with self-peptide are also necessary for T-cell homeostasis in the peripheral lymphoid organs. To identify differences in TCR signal strength that accompany thymic selection and peripheral T-cell maintenance, we compared CD5 levels, a marker of basal TCR signal strength, on immature and mature T cells from autoimmune diabetes-prone NOD and -resistant B6 mice. The data suggest that there is no preferential selection of NOD thymocytes that perceive stronger TCR signals from self-peptide engagement. Instead, NOD mice have an MHC-dependent increase in CD4+ thymocytes and mature T cells that express lower levels of CD5. In contrast, T cell-intrinsic mechanisms lead to higher levels of CD5 on peripheral CD8+ T cells from NOD relative to B6 mice, suggesting that peripheral CD8+ T cells with higher basal TCR signals may have survival advantages in NOD mice. These differences in the T-cell pool in NOD mice may contribute to the development or progression of autoimmune diabetes.
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- 2021
14. 516 Caspase-8 regulated senescence as an immune checkpoint in T lymphocytes for adoptive cell therapy
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Nathalie Labrecque, Mathieu Neault, Dave Maurice De Sousa, Ludovic Durrieu, Salix Boulet, Frédérick A. Mallette, Jean-Sébastien Delisle, Sébastien Lemieux, Cedric Carli, Heather J. Melichar, Valérie Janelle, and Marie-Ève Lebel
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Senescence ,Adoptive cell transfer ,biology ,business.industry ,CD3 ,Lymphocytic choriomeningitis ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,lcsh:RC254-282 ,Immune checkpoint ,Cell therapy ,Immune system ,Antigen ,Immunology ,biology.protein ,Medicine ,business - Abstract
Background The development of immunotherapies holds great promise for the treatment of refractory infections and cancer. Current approaches, although effective in many settings, have limitations that prevent their widespread use. Hence, several aspects require improvements, including the re-wiring of T-cell fates and function. T-cell dysfunction is central to the persistence of several chronic viral infections and the progression of malignancies. Upon activation, T cells can follow several paths of differentiation, leading to terminal effector differentiation and/or exhaustion which are widely recognized as dysfunctional features limiting human immune competence. Furthermore, dysfunctional features induced during laboratory-based manipulations of T-cell products prior to adoptive cell transfer has a determining effect on outcomes. Similarly, repeated antigen encounters after transfer in vivo favors the development of T-cell dysfunction. However, the nature and underlying mechanisms of T-cell dysfunction are still incompletely understood. Methods Combining genomics, phenotypic and functional analyses in various physiologically and clinically relevant settings, we investigated the key factors leading to T-cell dysfunction. Specifically, we evaluated the impact of repeated stimulations using CD3/CD28-coated beads or antigen-loaded dendritic cells in human T-cell long term cultures, and BCMA-expressing cells for anti-BCMA CAR T cells. We also examined mouse antigen-specific T cells during chronic lymphocytic choriomeningitis virus (LCMV) infection as well as datasets obtained from circulating T cells from acute myeloid leukemia (AML) patients. Results We identified telomere-independent cellular senescence as a central aspect of exhausted PD-1-expressing T cells following repeated stimulations. Mechanistically, it is associated the induction of p16INK4a. Additionally, we found that cellular senescence features are partly regulated by the activation of caspase-8, through a non-apoptotic function of this molecule not previously described in T cells. Conclusions We thus conclude that caspase-8 may regulate the balance between apoptosis and proliferation by protecting T cells from cellular senescence. Senescence-associated mechanisms may be seen as key players in T-cell dysfunction occurring following repeated stimulations and as such should be considered as novel immune checkpoints impeding the success of T-cell adoptive immunotherapy in humans. Ethics Approval This study was approved by the local Maisonneuve-Rosemont Hospital research ethics authorities and participants’ informed consent was obtained (CER2020-2141 and CER13030).
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- 2020
15. Pre-existing chromatin accessibility and gene expression differences among naive CD4+ T cells influence effector potential
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Aditi Sood, Dylan C. Wong, Connie Shen, HanChen Wang, Jasper J. P. van Beek, Luis B. Barreiro, Martin J. Richer, Judith N. Mandl, Paul François, Johannes Textor, Heather J. Melichar, Dakota Rogers, Aanya Bhagrath, Andrew J. Martins, John S. Tsang, Marie-Ève Lebel, David Langlais, Thomas J. Rademaker, Stephanie A. Condotta, Caitlin Schneider, and Patricio Artusa
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biology ,Effector ,Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2] ,T-cell receptor ,Major histocompatibility complex ,General Biochemistry, Genetics and Molecular Biology ,Chromatin ,Cell biology ,Transcriptome ,All institutes and research themes of the Radboud University Medical Center ,Antigen ,Gene expression ,biology.protein ,Gene - Abstract
Summary CD4+ T cells have a remarkable potential to differentiate into diverse effector lineages following activation. Here, we probe the heterogeneity present among naive CD4+ T cells before encountering their cognate antigen to ask whether their effector potential is modulated by pre-existing transcriptional and chromatin landscape differences. Single-cell RNA sequencing shows that key drivers of variability are genes involved in T cell receptor (TCR) signaling. Using CD5 expression as a readout of the strength of tonic TCR interactions with self-peptide MHC, and sorting on the ends of this self-reactivity spectrum, we find that pre-existing transcriptional differences among naive CD4+ T cells impact follicular helper T (TFH) cell versus non-TFH effector lineage choice. Moreover, our data implicate TCR signal strength during thymic development in establishing differences in naive CD4+ T cell chromatin landscapes that ultimately shape their effector potential.
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- 2021
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16. NR4A3 Mediates Thymic Negative Selection
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Heather J. Melichar, Mengqi Dong, Marie-Ève Lebel, Salix Boulet, Nathalie Labrecque, Jean-François Daudelin, and Livia Odagiu
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Receptors, Steroid ,Receptors, Thyroid Hormone ,Thymocytes ,biology ,T cell ,Immunology ,T-cell receptor ,Mice, Transgenic ,Nerve Tissue Proteins ,Major histocompatibility complex ,Cell biology ,DNA-Binding Proteins ,Negative selection ,Mice ,medicine.anatomical_structure ,Diabetes Mellitus, Type 1 ,Downregulation and upregulation ,medicine ,biology.protein ,Immunology and Allergy ,Animals ,Central tolerance ,Receptor ,CD8 ,Transcription Factors - Abstract
Central tolerance aims to limit the production of T lymphocytes bearing TCR with high affinity for self-peptide presented by MHC molecules. The accumulation of thymocytes with such receptors is limited by negative selection or by diversion into alternative differentiation, including T regulatory cell commitment. A role for the orphan nuclear receptor NR4A3 in negative selection has been suggested, but its function in this process has never been investigated. We find that Nr4a3 transcription is upregulated in postselection double-positive thymocytes, particularly those that have received a strong selecting signal and are destined for negative selection. Indeed, we found an accumulation of cells bearing a negative selection phenotype in NR4A3-deficient mice as compared with wild-type controls, suggesting that Nr4a3 transcriptional induction is necessary to limit accumulation of self-reactive thymocytes. This is consistent with a decrease of cleaved caspase-3+–signaled thymocytes and more T regulatory and CD4+Foxp3−HELIOS+ cells in the NR4A3-deficient thymus. We further tested the role for NR4A3 in negative selection by reconstituting transgenic mice expressing the OVA Ag under the control of the insulin promoter with bone marrow cells from OT-I Nr4a3+/+ or OT-I Nr4a3−/− mice. Accumulation of autoreactive CD8 thymocytes and autoimmune diabetes developed only in the absence of NR4A3. Overall, our results demonstrate an important role for NR4A3 in T cell development.
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- 2019
17. Differential interferon-gamma production potential among naïve CD4
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Aditi, Sood, Marie-Ève, Lebel, Marilaine, Fournier, Dakota, Rogers, Judith N, Mandl, and Heather J, Melichar
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CD4-Positive T-Lymphocytes ,Male ,Mice, Inbred C57BL ,Interferon-gamma ,Antigens, CD ,Receptors, Antigen, T-Cell ,Animals ,Antigens ,Lymphocyte Activation ,Cell Line - Abstract
Individual CD4
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- 2019
18. Complement Component 3 Regulates IFN-α Production by Plasmacytoid Dendritic Cells following TLR7 Activation by a Plant Virus–like Nanoparticle
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Denis Leclerc, Jean-François Daudelin, Marie-Pierre Langlois, Pierre Savard, Marie-Ève Lebel, Esther Tarrab, Alain Lamarre, Institut Armand Frappier (INRS-IAF), Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), Maisonneuve-Rosemont Hospital Research Center, Université Laval [Québec] (ULaval), and Department of Microbiology, Infectiology, and Immunology, Infectious Disease Research Centre
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0301 basic medicine ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Immunology ,Enzyme-Linked Immunosorbent Assay ,Biology ,Polymerase Chain Reaction ,Interferon-gamma ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Phagocytosis ,Mosaic Viruses ,medicine ,Animals ,Immunology and Allergy ,Membrane Glycoproteins ,Complement component 3 ,Innate immune system ,Complement C3 ,Dendritic Cells ,Immunotherapy ,TLR7 ,Flow Cytometry ,biology.organism_classification ,Complement system ,Cell biology ,Mice, Inbred C57BL ,Antibody opsonization ,030104 developmental biology ,Toll-Like Receptor 7 ,Nanoparticles ,Female ,030215 immunology ,Papaya mosaic virus - Abstract
The increasing use of plant viruses for the development of new vaccines and immunotherapy approaches poses questions regarding the mechanism by which the mammalian immune system recognizes these viruses. For example, although natural Abs (NA) and complement are key components of the innate immune system involved in the opsonization, phagocytosis, and destruction of microorganisms infecting mammals, their implication in plant virus recognition and immunogenicity is not well defined. In this study, we address the involvement of NA and the complement system in the activation of innate immunity through engagement of TLR7 with papaya mosaic virus (PapMV)-like nanoparticles. We demonstrate that NA, although binding to PapMV, are not involved in its recognition by the immune system. On the other hand, C3 strongly binds to PapMV nanoparticles and its depletion significantly reduces PapMV’s interaction with immune cells. Unexpectedly, however, we observed increased immune cell activation following administration of PapMV to complement-depleted mice. TLR7 activation by PapMV in the absence of C3 induced higher IFN-α production, resulting in superior immune cell activation and increased immunotherapeutic properties. In conclusion, in this study we established the involvement of the complement system in the recognition and the phagocytosis of PapMV nanoparticles and identified an unsuspected role for C3 in regulating the production of IFN-α following TLR7 activation.
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- 2017
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19. Use of an anterolateral distal tibia Locking Compression Plate for the management of acromion pseudoarthrosis in an osteogenesis imperfecta patient: a case report
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Kajeandra Ravichandiran, HBSc, MSc, MD, FRCSC and Marie-Eve LeBel, MD, MHPE, FRCSC
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Osteogenesis imperfecta ,Acromion ,Scapular spine ,Pseudoarthrosis ,Fracture ,Plating ,Surgery ,RD1-811 - Published
- 2023
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20. Potentiating Cancer Immunotherapy Using Papaya Mosaic Virus-Derived Nanoparticles
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Esther Tarrab, Karine Chartrand, Alain Lamarre, Denis Leclerc, Marie-Ève Lebel, Pierre Savard, Institut Armand Frappier (INRS-IAF), Réseau International des Instituts Pasteur (RIIP)-Institut National de la Recherche Scientifique [Québec] (INRS), Department of Neurosciences, Université Laval [Québec] (ULaval), and Department of Microbiology, Infectiology, and Immunology, Infectious Disease Research Centre
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0301 basic medicine ,Chemokine ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Cancer immunotherapy ,Bioengineering ,02 engineering and technology ,CD8-Positive T-Lymphocytes ,immunomodulation ,Cancer Vaccines ,03 medical and health sciences ,Adjuvants, Immunologic ,Mosaic Viruses ,Cell Line, Tumor ,medicine ,Animals ,General Materials Science ,Melanoma ,Innate immune system ,biology ,Carica ,Mechanical Engineering ,therapeutic vaccination ,plant virus-derived nanoparticle ,General Chemistry ,immune checkpoint blockade ,021001 nanoscience & nanotechnology ,Condensed Matter Physics ,medicine.disease ,biology.organism_classification ,Immune checkpoint ,Mice, Inbred C57BL ,030104 developmental biology ,biology.protein ,Cancer research ,Cytokines ,Nanoparticles ,Female ,Immunotherapy ,0210 nano-technology ,Adjuvant ,CD8 ,Papaya mosaic virus - Abstract
International audience; The recent development of novel immunotherapies is revolutionizing cancer treatment. These include, for example, immune checkpoint blockade, immunomodulation, or therapeutic vaccination. Although effective on their own, combining multiple approaches will most likely be required in order to achieve the maximal therapeutic benefit. In this regard, the papaya mosaic virus nanoparticle (PapMV) has shown tremendous potential as (i) an immunostimulatory molecule, (ii) an adjuvant, and (iii) a vaccine platform through its intrinsic capacity to activate the innate immune response in an IFN-α-dependent manner. Here, we demonstrate that intratumor administration of PapMV significantly slows down melanoma progression and prolongs survival. This correlates with enhanced chemokine and pro-inflammatory-cytokine production in the tumor and increased immune-cell infiltration. Proportions of total and tumor-specific CD8(+) T cells dramatically increase following PapMV treatment whereas those of myeloid-derived suppressor cells (MDSC) concomitantly decrease. Moreover, systemic PapMV administration prevents metastatic tumor-implantation in the lungs. Importantly, PapMV also synergistically improves the therapeutic benefit of dendritic cell (DC)-based vaccination and PD-1 blockade by potentiating antitumor immune responses. This study illustrates the immunostimulatory potential of a plant virus-derived nanoparticle for cancer therapy either alone or in conjunction with other promising immunotherapies in clinical development.
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- 2016
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21. 'Can You Feel It': An Early Experience with Simulated Vibration to Recreate Glenoid Reaming
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Jason A. Strelzow, MD, AOA, Jonathan R. Kusins, PhD, Louis M. Ferreira, PhD, and Marie-Eve LeBel, MD
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Orthopedic surgery ,RD701-811 - Abstract
Background:. When developing educational simulators, meaningful haptic feedback is important. To our knowledge, no shoulder arthroplasty surgical simulator exists. This study focuses on simulating vibration haptics of glenoid reaming for shoulder arthroplasty using a novel glenoid reaming simulator. Methods:. We validated a novel custom simulator constructed using a vibration transducer transmitting simulated reaming vibrations to a powered nonwearing reamer tip through a 3D-printed glenoid. Validation and system fidelity were evaluated by 9 fellowship-trained shoulder surgeon experts performing a series of simulated reamings. We then completed the validation process through a questionnaire focused on experts' experience with the simulator. Results:. Experts correctly identified 52% ± 8% of surface profiles and 69% ± 21% of cartilage layers. Experts identified the vibration interface between simulated cartilage and subchondral bone (77% ± 23% of the time), indicating high fidelity for the system. An interclass correlation coefficient for experts' reaming to the subchondral plate was 0.682 (confidence interval 0.262-0.908). On a general questionnaire, the perceived utility of the simulator as a teaching tool was highly ranked (4/5), and experts scored “ease of instrument manipulation” (4.19/5) and “realism of the simulator” (4.11/5) the highest. The mean global evaluation score was 6.8/10 (range 5-10). Conclusions:. We examined a simulated glenoid reamer and feasibility of haptic vibrational feedback for training. Experts validated simulated vibration feedback for glenoid simulation reaming, and the results suggested that this may be a useful additional training adjuvant. Level of Evidence:. Level II, prospective study.
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- 2023
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22. Nanoparticle adjuvant sensing by TLR7 enhances CD8+ T cell-mediated protection from Listeria monocytogenes infection
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Karine Chartrand, Pierre Savard, Jean-François Daudelin, Denis Leclerc, Marie-Ève Lebel, Esther Tarrab, Alain Lamarre, Ulrich Kalinke, Nathalie Labrecque, Institut Armand Frappier (INRS-IAF), Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), Maisonneuve-Rosemont Hospital Research Center, Institute for Experimental Infection Research, Centre for Experimental and Clinical Infection Research [Hanover] (TWINCORE), Department of Neurosciences, Université Laval [Québec] (ULaval), Department of Medicine, Department of Microbiology and Immunology, Department of Microbiology, Infectiology, and Immunology, Infectious Disease Research Centre, and This work was supported by Canadian Institutes of Health Research Grants MOP-89833(to A.L. and D.L.) and MOP-115139 (to N.L.). A.L. holds the Jeanne and J.-LouisLe´vesque Chair in Immunovirology from the J.-Louis Le´vesque Foundation.
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Ovalbumin ,medicine.medical_treatment ,T cell ,[SDV]Life Sciences [q-bio] ,Immunology ,Drug Evaluation, Preclinical ,Receptor, Interferon alpha-beta ,Adaptive Immunity ,CD8-Positive T-Lymphocytes ,Mice ,Immune system ,Adjuvants, Immunologic ,T-Lymphocyte Subsets ,medicine ,Animals ,Immunology and Allergy ,Cytotoxic T cell ,Listeriosis ,Tymovirus ,Membrane Glycoproteins ,biology ,Vaccination ,Dendritic Cells ,biology.organism_classification ,Acquired immune system ,Listeria monocytogenes ,Virology ,Mice, Inbred C57BL ,medicine.anatomical_structure ,Toll-Like Receptor 7 ,Immunization ,Immunoglobulin G ,Interferon Type I ,Myeloid Differentiation Factor 88 ,Nanoparticles ,RNA, Viral ,Female ,Immunologic Memory ,Adjuvant ,Papaya mosaic virus - Abstract
Developing new adjuvants and vaccination strategies is of paramount importance to successfully fight against many life-threatening infectious diseases and cancer. Very few adjuvants are currently authorized for human use, and these mainly stimulate a humoral response. However, specific Abs are not sufficient to confer protection against persisting infections or cancer. Therefore, development of adjuvants and immunomodulators able to enhance cell-mediated immune responses represents a major medical need. We recently showed that papaya mosaic virus nanoparticles (PapMV), self-assembled from the coat protein of a plant virus and a noncoding ssRNA molecule, are highly immunogenic in mice. PapMV can be used either as a vaccine delivery platform, through fusion of various epitopes to the coat protein or as adjuvant to enhance humoral immune responses against coadministered Ags or vaccines. However, the mechanisms that confer these immunomodulatory properties to PapMV and its ability to enhance T cell vaccines remain unknown. Using immunization studies in mice, we demonstrate in this paper that PapMV represents a novel TLR7 agonist with strong immunostimulatory properties. More importantly, pretreatment with PapMV significantly improves effector and memory CD8+ T cell responses generated through dendritic cell vaccination increasing protection against a Listeria monocytogenes challenge.
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- 2014
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23. Identification of a new cell line permissive to porcine reproductive and respiratory syndrome virus infection and replication which is phenotypically distinct from MARC-145 cell line
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Mario Jacques, Nedzad Music, Carl A. Gagnon, Chantale Provost, Cynthia Lévesque, Marie-Ève Lebel, Jian Jun Jia, Jérôme R. E. del Castillo, and Université de Montréal. Faculté de médecine vétérinaire
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Virus replication ,Swine ,040301 veterinary sciences ,SJPL cells ,viruses ,animal diseases ,Type 1 IFN ,Gene Expression ,Apoptosis ,Virus ,Cell Line ,lcsh:Infectious and parasitic diseases ,0403 veterinary science ,Viral Proteins ,03 medical and health sciences ,Virology ,Sialoadhesin ,Animals ,Porcine respiratory and reproductive syndrome virus ,lcsh:RC109-216 ,RNA, Messenger ,Virus Release ,Cell permissivity ,030304 developmental biology ,Cytopathic effect ,Caspase 7 ,0303 health sciences ,biology ,Caspase 3 ,Cell growth ,Research ,Interferon-alpha ,virus diseases ,04 agricultural and veterinary sciences ,respiratory system ,Porcine reproductive and respiratory syndrome virus ,biology.organism_classification ,Viral Tropism ,Infectious Diseases ,Viral replication ,Cell culture ,TNF-α ,PRRSV ,Tissue tropism ,Receptors, Virus ,Cytokines ,IFNγ - Abstract
Background Airborne transmitted pathogens, such as porcine reproductive and respiratory syndrome virus (PRRSV), need to interact with host cells of the respiratory tract in order to be able to enter and disseminate in the host organism. Pulmonary alveolar macrophages (PAM) and MA104 derived monkey kidney MARC-145 cells are known to be permissive to PRRSV infection and replication and are the most studied cells in the literature. More recently, new cell lines developed to study PRRSV have been genetically modified to make them permissive to the virus. The SJPL cell line origin was initially reported to be epithelial cells of the respiratory tract of swine. Thus, the goal of this study was to determine if SJPL cells could support PRRSV infection and replication in vitro. Results The SJPL cell growth was significantly slower than MARC-145 cell growth. The SJPL cells were found to express the CD151 protein but not the CD163 and neither the sialoadhesin PRRSV receptors. During the course of the present study, the SJPL cells have been reported to be of monkey origin. Nevertheless, SJPL cells were found to be permissive to PRRSV infection and replication even if the development of the cytopathic effect was delayed compared to PRRSV-infected MARC-145 cells. Following PRRSV replication, the amount of infectious viral particles produced in SJPL and MARC-145 infected cells was similar. The SJPL cells allowed the replication of several PRRSV North American strains and were almost efficient as MARC-145 cells for virus isolation. Interestingly, PRRSV is 8 to 16 times more sensitive to IFNα antiviral effect in SJPL cell in comparison to that in MARC-145 cells. PRRSV induced an increase in IFNβ mRNA and no up regulation of IFNα mRNA in both infected cell types. In addition, PRRSV induced an up regulation of IFNγ and TNF-α mRNAs only in infected MARC-145 cells. Conclusions In conclusion, the SJPL cells are permissive to PRRSV. In addition, they are phenotypically different from MARC-145 cells and are an additional tool that could be used to study PRRSV pathogenesis mechanisms in vitro.
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- 2012
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24. 516 Caspase-8 regulated senescence as an immune checkpoint in T lymphocytes for adoptive cell therapy
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Valérie Janelle, Mathieu Neault, Marie-Eve Lebel, Dave De Sousa, Salix Boulet, Ludovic Durrieu, Cedric Carli, Sebastien Lemieux, Nathalie Labrecque, Heather Melichar, Frederick Mallette, and Jean-Sebastien Delisle
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2020
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25. Clinical Assessment of Physical Examination Maneuvers for Superior Labral Anterior to Posterior Lesions
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Lyndsay E. Somerville, Kevin Willits, Andrew M. Johnson, Robert Litchfield, Marie-Eve LeBel, Jaydeep Moro, and Dianne Bryant
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shoulder ,slap ,diagnosis ,physical examination ,Surgery ,RD1-811 - Abstract
Abstract Purpose Shoulder pain and disability pose a diagnostic challenge owing to the numerous etiologies and the potential for multiple disorders to exist simultaneously. The evidence to support the use of clinical tests for superior labral anterior to posterior complex (SLAP) is weak or absent. The purpose of this study is to determine the diagnostic validity of physical examination maneuvers for SLAP lesions by performing a methodologically rigorous, clinically applicable study. Methods We recruited consecutive new shoulder patients reporting pain and/or disability. The physician took a history and indicated their certainty about each possible diagnosis (“certain the diagnosis is absent/present,” or “uncertain requires further testing”). The clinician performed the physical tests for diagnoses where uncertainty remained. Magnetic resonance imaging arthrogram and arthroscopic examination were the gold standards. We calculated sensitivity, specificity, and likelihood ratios (LRs) and investigated whether combinations of the top tests provided stronger predictions. Results Ninety-three patients underwent physical examination for SLAP lesions. When using the presence of a SLAP lesion (Types I–V) as disease positive, none of the tests was sensitive (10.3–33.3) although they were moderately specific (61.3–92.6). When disease positive was defined as repaired SLAP lesion (including biceps tenodesis or tenotomy), the sensitivity (10.5–38.7) and specificity (70.6–93.8) of tests improved although not by a substantial amount. None of the tests was found to be clinically useful for predicting repairable SLAP lesions with all LRs close to one. The compression rotation test had the best LR for both definitions of disease (SLAP tear present = 1.8 and SLAP repaired = 1.67). There was no optimal combination of tests for diagnosing repairable SLAP lesions, with at least two tests positive providing the best combination of measurement properties (sensitivity 46.1% and specificity 64.7%). Conclusion Our study demonstrates that the physical examination tests for SLAP lesions are poor diagnostic indicators of disease. Performing a combination of tests will likely help, although the magnitude of the improvement is minimal. These authors caution clinicians placing confidence in the physical examination tests for SLAP lesions rather we suggest that clinicians rely on diagnostic imaging to confirm this diagnosis.
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- 2017
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26. Diagnostic Validity of Patient-Reported History for Shoulder Pathology
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Lyndsay E. Somerville, Kevin Willits, Andrew M. Johnson, Robert Litchfield, Marie-Eve LeBel, Jaydeep Moro, and Dianne Bryant
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shoulder ,diagnosis ,history ,Surgery ,RD1-811 - Abstract
Abstract Objective The purpose of this article is to determine whether patient-reported history items are predictive of shoulder pathology and have the potential for use in triaging patients with shoulder pathology to orthopaedic outpatient clinics. Setting It is set at two tertiary orthopaedic clinics. Patients All new patients reporting pain and/or disability of the shoulder joint were prospectively recruited. A total of 193 patients were enrolled, 15 of whom withdrew, leaving 178 patients composing the study sample. Design Patients completed a questionnaire on the history of their pathology, then the surgeon took a thorough history indicating the most likely diagnosis. The clinician then performed appropriate physical examination. Arthroscopy was the reference standard for those undergoing surgery and magnetic resonance imaging (MRI) with arthrogram for all others. We calculated the sensitivity, specificity, and likelihood ratios (LRs) of history items alone and in combination. We used the LRs to generate a clinical decision algorithm. Main Outcome Measures Diagnosis was determined through arthroscopy or MRI arthrogram. Reporting was standardized to ensure review of all structures. Results The physical examination and history agreed in 75% of cases. Of those that did not agree, the physical examination misdirected the diagnosis in 47% of our cases. In particular, history items were strong predictors of anterior and posterior instability and subscapularis tears and were combined in a tool to be utilized for screening patients. Conclusion The patient-reported history items were effective for diagnosing shoulder pathology and should be considered for use in a triaging instrument.
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- 2017
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27. The effect of observing novice and expert performance on acquisition of surgical skills on a robotic platform.
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David J Harris, Samuel J Vine, Mark R Wilson, John S McGrath, Marie-Eve LeBel, and Gavin Buckingham
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Medicine ,Science - Abstract
Observational learning plays an important role in surgical skills training, following the traditional model of learning from expertise. Recent findings have, however, highlighted the benefit of observing not only expert performance but also error-strewn performance. The aim of this study was to determine which model (novice vs. expert) would lead to the greatest benefits when learning robotically assisted surgical skills.120 medical students with no prior experience of robotically-assisted surgery completed a ring-carrying training task on three occasions; baseline, post-intervention and at one-week follow-up. The observation intervention consisted of a video model performing the ring-carrying task, with participants randomly assigned to view an expert model, a novice model, a mixed expert/novice model or no observation (control group). Participants were assessed for task performance and surgical instrument control.There were significant group differences post-intervention, with expert and novice observation groups outperforming the control group, but there were no clear group differences at a retention test one week later. There was no difference in performance between the expert-observing and error-observing groups.Similar benefits were found when observing the traditional expert model or the error-strewn model, suggesting that viewing poor performance may be as beneficial as viewing expertise in the early acquisition of robotic surgical skills. Further work is required to understand, then inform, the optimal curriculum design when utilising observational learning in surgical training.
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- 2017
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28. Energy-Based Metrics for Arthroscopic Skills Assessment
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Behnaz Poursartip, Marie-Eve LeBel, Laura C. McCracken, Abelardo Escoto, Rajni V. Patel, Michael D. Naish, and Ana Luisa Trejos
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energy-based metrics ,surgical skills assessment ,arthroscopy ,machine learning algorithms ,sensorized instruments ,Chemical technology ,TP1-1185 - Abstract
Minimally invasive skills assessment methods are essential in developing efficient surgical simulators and implementing consistent skills evaluation. Although numerous methods have been investigated in the literature, there is still a need to further improve the accuracy of surgical skills assessment. Energy expenditure can be an indication of motor skills proficiency. The goals of this study are to develop objective metrics based on energy expenditure, normalize these metrics, and investigate classifying trainees using these metrics. To this end, different forms of energy consisting of mechanical energy and work were considered and their values were divided by the related value of an ideal performance to develop normalized metrics. These metrics were used as inputs for various machine learning algorithms including support vector machines (SVM) and neural networks (NNs) for classification. The accuracy of the combination of the normalized energy-based metrics with these classifiers was evaluated through a leave-one-subject-out cross-validation. The proposed method was validated using 26 subjects at two experience levels (novices and experts) in three arthroscopic tasks. The results showed that there are statistically significant differences between novices and experts for almost all of the normalized energy-based metrics. The accuracy of classification using SVM and NN methods was between 70% and 95% for the various tasks. The results show that the normalized energy-based metrics and their combination with SVM and NN classifiers are capable of providing accurate classification of trainees. The assessment method proposed in this study can enhance surgical training by providing appropriate feedback to trainees about their level of expertise and can be used in the evaluation of proficiency.
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- 2017
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29. Use of a Hip Arthroscopy Flexible Radiofrequency Device for Capsular Release in Frozen Shoulder
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Stephen R. Thompson, M.D., M.Ed., F.R.C.S.C. and Marie-Eve LeBel, M.D., F.R.C.S.C.
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Orthopedic surgery ,RD701-811 - Abstract
Adhesive capsulitis is a common and challenging condition to treat. Arthroscopic capsular release is usually contemplated when conservative treatment fails or when there is severe and/or chronic loss of range of motion. This procedure can be difficult to perform because of difficult access to the joint, poor visualization, and loss of working space from retraction of the joint capsule. The articular surfaces and the axillary nerve are also at higher risk of injury. Arthroscopic scissors, shavers, and electrocautery are typically used to perform the capsular release. To perform a safer and more precise arthroscopic shoulder capsular release, a creative and innovative use of a flexible hip arthroscopy radiofrequency ablator is described.
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- 2012
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