Medicine and Health Sciences Commons^™

A Human Stem Cell-Derived Neuronal Model Of Morphine Exposure Reflects Brain Dysregulation In Opioid Use Disorder: Transcriptomic And Epigenetic Characterization Of Postmortem-Derived Ipsc Neurons, Emily F Mendez, Sandra L Grimm, Laura Stertz, Damian Gorski, Sai V Movva, Katherine Najera, Karla Moriel, Thomas D Meyer, Gabriel R Fries, Cristian Coarfa, Consuelo Walss-Bass

Faculty, Staff and Student Publications

INTRODUCTION: Human-derived induced pluripotent stem cell (iPSC) models of brain promise to advance our understanding of neurotoxic consequences of drug use. However, how well these models recapitulate the actual genomic landscape and cell function, as well as the drug-induced alterations, remains to be established. New

METHODS: We engineered a novel induced pluripotent stem cell-derived model of neural progenitor cells and neurons from cultured postmortem human skin fibroblasts, and directly compared these to isogenic brain tissue from the donor source. We assessed the maturity of the cell models across differentiation from stem cells to neurons using RNA cell type and maturity …

Changes In Attitudes And Functional Performance After An Educational Intervention And Participation In The Dime In Cadets, Emily Gabriel, Cameron Powden

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Introduction: Cadets frequently suffer from lower extremity injuries, but fail to participate in effective injury prevention programs (IPPs). The purpose of this study was to determine if an intervention focused on benefits and barriers of IPP with participation in an IPP would change attitudes towards participating in IPPs and functional performance. Methods: Thirty-four ROTC cadets (Male: n=28, Age: 19.67±1.45 years, Height: 175.57±8.30cm, Mass: 75.38±14.30kg) volunteered to participate in the study. Participants completed the Health Belief Model Scale (HBMS), Theory of Planned Behavior Scale (TPBS), Y-Balance test, Landing Error Scoring System, 2-mile run, push-up test, and sit-up test. During the Army …

Buford Complex In A High School Softball Player With Glenohumeral Multidirectional Instability And Cubital Tunnel Syndrome With Ulnar Nerve Subluxation, Austin T. Cook

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

A 15-year-old female high school softball player with no prior history of either shoulder or elbow pathologies presented with pain in the elbow of her throwing arm that progressed to her shoulder during her high school softball team’s fall season. The athlete received an MRI showing the presence of a Buford complex, a normal anatomical variation of the glenoid labrum in which the anterosuperior portion of the labrum is undeveloped in conjunction with an overdeveloped cord like middle glenohumeral ligament that originates upon the superior portion of the glenoid at the same location of the base of the biceps tendon. …

The Theory Of Planned Behavior As A Framework To Identify Attitudes And Perceptions Of Athletic Trainers Towards Quality Improvement, Meredith Madden, Dominique M. Ross

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The BOC announced a concept for continuing professional certification for athletic trainers (ATs), including an optional quality improvement (QI) project to examine practice performance. The purpose of this study was to examine current attitudes, perceived control and subjective norms of ATs regarding QI. Method: Data was collected using a qualitative descriptive design. A web-based survey was distributed via email and social media. Open-ended questions were evaluated by two independent coders using a general inductive approach. Results: Three major themes emerged: reservations about QI, benefits of QI, and impacts on the profession. Conclusions: When integrated into the Theory of Planned …

Effect Of Cupping Therapy On Muscle Tenderness In Collegiate Baseball Players Compared To Sham Treatment: A Randomized, Single-Blinded Trial, Andrew Cage, Laurel Trail, Mpa, Lat, Atc, Robert M. Galbraith, Carson Cox, Brandon J. Warner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The purpose of this study was to examine the effects of cupping therapy on muscular tenderness in the triceps surae of collegiate baseball players when compared to a control and sham treatment conditions. Methods: 20 collegiate baseball players (age= 22 ± 2 years, height= 186.8 ± 6.9 cm, weight= 88.6 ± 8.5 kg) participated in this study. Subjects were randomly assigned to either the treatment or sham treatment group. A mark was placed 10-cm superior to the musculotendinous junction of the Achilles tendon and the gastrocnemius on both legs. The treatment or sham treatment was then applied over the …

2023-02-15_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/resources/covid-19-vaccine/covid-19-dashboard.

First-dose tracker above is for entire Michigan Population. Coverage maps below are for age 5+.

Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Primary Series Doses Administered, Primary Series Doses by Vaccine, …

2023-02-15 Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

Relationships Among Health Promotion Behaviors, Patient Engagement, And The Nurse Practitioner-Patient Partnership, Irene Decelie

Seton Hall University Dissertations and Theses (ETDs)

Individuals adopting health promotion behaviors benefit from improved health and reduced risk of chronic diseases. Trends in health care include promoting patient engagement and the development of a partnership between clinicians and patients to improve health and
health outcomes. The purpose of this descriptive, correlational study was to examine the relationships between patient engagement, the nurse practitioner-patient partnership and health promotion behaviors among adults in the primary care setting. Pender’s health promotion model and the recently created interactive care model provided the theoretical framework for this study.
Convenience sampling was used to recruit 85 participants from a nurse practitioner primary …

60 Year Old Male With Autonomic Dysreflexia In C7 Ais A Secondary To A Suprapubic Catheter Inflation In The Membranous Urethra, Brandon Kase, Md, Joshua Levin, Do, Kristin Gustafson, Do

Department of Rehabilitation Medicine Posters

Introduction: Autonomic dysreflexia is a potentially lifethreatening complication in patients with a spinal cord injury above the level of T6. A dangerous symptom is an increase in blood pressure induced by reflex sympathetic hyperactivity secondary to a noxious stimuli which can lead to cerebral hemorrhages, seizures, heart failure or pulmonary edema.¹ The most common causes of autonomic dysreflexia are noxious stimuli to the 1) bladder such as urinary tract infection, distension, or catheterization; 2) bowel, such as constipation or 3) skin such as wounds, or tight clothing. Though Foley catheters and intermittent catheterizations are well known causes of dysreflexia …

Chatgpt & Doctors: The Medical Dream Team, Ishan S. Abdullah, Aditya Loganathan, Randall W. Lee

URGENT Matters

No abstract provided.

A Close-Up Examination Of Racial Disparities In Infant And Maternal Outcomes In Montgomery County, Ohio, Kelsey M. Harman, Keith M. Reisinger-Kindle, Rose Maxwell

Obstetrics and Gynecology Faculty Publications

Background: Infant and maternal outcomes in Montgomery County, Ohio, are among the worst in the state and rival that of many low-income nations. This study compares maternal and infant outcomes across 3 zip codes in Montgomery County to discern factors that are influencing health outcomes for their residents. The zip codes represent 3 distinct communities with unique racial and socioeconomic makeups.  Methods: A cohort of maternal-infant dyads (n=5098) who delivered at Miami Valley Hospital and Good Samaritan Hospital from January 1, 2009, to January 1, 2019, were analyzed via retrospective chart review. Maternal (MCS) and infant (ICS) outcome composite scores …

Steroid Treatment Causes Weakness In Spinal Dural Arteriovenous Fistula, Mina Na, Do, Brandon Kase, Md, Roger Liu, Do, Kristin Gustafson, Do

Department of Rehabilitation Medicine Posters

Introduction: Spinal dural arteriovenous fistula (SDAVF) is an abnormal connection between the arterial and venous system creating an increase in blood flow and pressure into the spinal veins¹ at an estimated frequency of 5-10 cases per million per year.² Activities that increase intrathoracic and venous pressure such as Valsalva, abdominal compression and steroids_² can lead to a venous infarction, subarachnoid hemorrhage, paraplegia or tetraplegia.³ SDAVF is difficult to diagnose as it presents similarly to other neurologic disorders, but if diagnosed early, deficits can be prevented and reversed with intervention.¹

Case Description: A 54-year-old male presented …

Novel Therapeutic Targets For Migraine, Areeba Nisar, Zubair Ahmed, Hsiangkuo Yuan

Department of Jefferson Headache Center Papers and Presentations

Migraine, a primary headache disorder involving a dysfunctional trigeminal vascular system, remains a major debilitating neurological condition impacting many patients’ quality of life. Despite the success of multiple new migraine therapies, not all patients achieve significant clinical benefits. The success of CGRP pathway-targeted therapy highlights the importance of translating the mechanistic understanding toward effective therapy. Ongoing research has identified multiple potential mechanisms in migraine signaling and nociception. In this narrative review, we discuss several potential emerging therapeutic targets, including pituitary adenylate cyclase-activating polypeptide (PACAP), adenosine, δ-opioid receptor (DOR), potassium channels, transient receptor potential ion channels (TRP), and acid-sensing ion channels …

Real-World Maintenance Therapy And Survival Outcomes For Pembrolizumab Plus Pemetrexed And Platinum For Non-Small-Cell Lung Cancer In Usa, Himani Aggarwal, Kayonda Bayo, Yimei Han, Catherine Elizabeth Muehlenbein, Yajun Emily Zhu, Jong Seok Kim

Student Papers, Posters & Projects

Aim: To evaluate treatment patterns and overall survival (OS) in real world metastatic non-squamous non-small-cell lung cancer (NSQ-NSCLC) patients that received pembrolizumab plus pemetrexed-platinum (pembro+pem+plat) aligned with KEYNOTE-189.

Materials & methods: OS was evaluated for the overall cohort and maintenance therapy (MT) subgroups and analyzed using Kaplan-Meier estimates and Cox proportional hazards model.

Results: Of 2488 patients that received first-line treatment, 45.1% received less than four cycles of pembro+pem+plat, 43.9% received four cycles plus MT with pembro and/or pem, and 11.1% received four cycles without continuing on MT. The median OS was 21.0 months and 9.1 months in patients that …

Bacterial Outer Membrane Vesicles Promote Lung Inflammatory Responses And Macrophage Activation Via Multi-Signaling Pathways, Sunhyo Ryu, Kareemah Ni, Chenghao Wang, Ayyanar Sivanantham, Johnathan M. Carnino, Hong-Long Ji, Yang Jin

Cellular and Molecular Biology Faculty Publications and Presentations

Emerging evidence suggests that Gram-negative bacteria release bacterial outer membrane vesicles (OMVs) and that these play an important role in the pathogenesis of bacterial infectionmediated inflammatory responses and organ damage. Despite the fact that scattered reports have shown that OMVs released from Gram-negative bacteria may function via the TLR2/4-signaling pathway or induce pyroptosis in macrophages, our study reveals a more complex role of OMVs in the development of inflammatory lung responses and macrophage pro-inflammatory activation. We first confirmed that various types of Gram-negative bacteria release similar OMVs which prompt proinflammatory activation in both bone marrow-derived macrophages and lung alveolar macrophages. …

Bacterial Outer Membrane Vesicles Promote Lung Inflammatory Responses And Macrophage Activation Via Multi-Signaling Pathways, Sunhyo Ryu, Kareeman Ni, Chenghao Wang, Ayyanar Sivanantham, Jonathon M. Carnino, Hong-Long Ji, Yang Jin

School of Medicine Faculty Publications and Presentations

Emerging evidence suggests that Gram-negative bacteria release bacterial outer membrane vesicles (OMVs) and that these play an important role in the pathogenesis of bacterial infection-mediated inflammatory responses and organ damage. Despite the fact that scattered reports have shown that OMVs released from Gram-negative bacteria may function via the TLR2/4-signaling pathway or induce pyroptosis in macrophages, our study reveals a more complex role of OMVs in the development of inflammatory lung responses and macrophage pro-inflammatory activation. We first confirmed that various types of Gram-negative bacteria release similar OMVs which prompt pro-inflammatory activation in both bone marrow-derived macrophages and lung alveolar macrophages. …

Intestinal Neuropod Cell Gucy2c Regulates Visceral Pain, Joshua R. Barton, Annie K. Londregran, Tyler D. Alexander, Ariana A. Entezari, Shely Bar-Ad, Lan Cheng, Angelo C. Lepore, Adam E. Snook, Manuel Covarrubias, Scott A. Waldman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Visceral pain (VP) is a global problem with complex etiologies and limited therapeutic options. Guanylyl cyclase C (GUCY2C), an intestinal receptor producing cyclic GMP(cGMP), which regulates luminal fluid secretion, has emerged as a therapeutic target for VP. Indeed, FDA-approved GUCY2C agonists ameliorate VP in patients with chronic constipation syndromes, although analgesic mechanisms remain obscure. Here, we revealed that intestinal GUCY2C was selectively enriched in neuropod cells, a type of enteroendocrine cell that synapses with submucosal neurons in mice and humans. GUCY2Chi neuropod cells associated with cocultured dorsal root ganglia neurons and induced hyperexcitability, reducing the rheobase and increasing the resulting …

Cross Cultural Adaptation And Validation Of A Self-Reporting Tool To Assess Health-Related Quality Of Life For Egyptians With Extremity Bone Sarcomas In Childhood Or Adolescence, Nesma Farid

Theses and Dissertations

Validated self-reporting tools are required to evaluate the functional outcome and health-related quality of life (HRQOL) for Egyptians who had extremity bone sarcomas in their childhood or adolescence. Thus, we pursued cross-cultural adaptation and validation of the pediatric Toronto Extremity Salvage Score (pTESS) and Toronto Extremity Salvage Score (TESS) to assess the physical function of children and adult survivors following surgeries of extremity bone sarcomas. Modified versions of pTESS and TESS, which contain additional mental domains, were developed to allow the evaluation of HRQOL using a specific instrument for childhood bone cancer. The internal consistency of the original pTESS and …

Human Gut Microbiota And Parkinson's Disease In An Egyptian Population, Sara Hashish

Theses and Dissertations

Multiple lines of evidence suggest the role of the gut microbiome in the predisposition and progression of Parkinson’s disease. This present cross-sectional study was performed to compare the composition of the gastrointestinal microbiota in patients with Parkinson's disease to their counterparts. Stringent inclusion criteria were followed to reliably identify our target population. Parkinson’s patients (n = 40) along with reference subjects (n = 39) were recruited from November 2021 to August 2022. Detailed demographic and clinical data were obtained at baseline using a set of questionnaires and clinical assessment tools. Fecal specimens were collected from all participants, and gut commensals …

Neuroprotective Effects Of Green Tea (Camellia Sinensis) And Broccoli (Brassica Oleracea) Extracts In An In Vitro Model Of Multiple Sclerosis, Sara Taha Fathallah

Theses and Dissertations

Multiple Sclerosis (MS) is a neurodegenerative autoimmune disease in which the immune system attacks the central nervous system (CNS) resulting in demyelination. Currently, there is no specific treatment for MS. Here, we propose testing the neuroprotective potential of Green tea (Camellia sinensis), and Broccoli (Brassica oleracea) extracts in an in vitro model of multiple sclerosis.

Methods and Results: Green tea and Broccoli plant extracts were analyzed with GC-MS and tested for their neuroprotective effects in an in vitro MS model using Cuprizone (CPZ) on the Human neuroblastoma SH-SY5Y cell line. Cell viability assays proved the safety of the extracts …

Molecular Diagnosis Of Non X-Linked Ectodermal Dysplasias Using Next Generation Sequencing, Eman Abdelalim Rabie

Theses and Dissertations

Ectodermal Dysplasias (EDs) are rare heterogenous monogenic developmental disorders sharing the impairment of at least two surface ectoderm-derived organs. Symptoms characteristically manifest developmental abnormalities of the teeth, and three skin derivatives: hair follicles, nails, and sweat glands. The disease-causing gene was identified for only fewer than half of 160 characterized ED phenotypes. Expectedly, ED-causing genes regulate or function in ectodermal-developmental processes. The most common phenotype is hypohidrotic ED featuring teeth agenesis, and diminished or complete absence of hair and sweat production. Disease-causing variants of EDA, EDAR, EDARADD and WNT10A genes were identified in 60-90% of ED patients in …

Journal Of Shock And Hemodynamics, Vol. I, Iss. 2 (Print Version)

Journal of Shock and Hemodynamics

The print version of Volume I, Issue 2 of the Journal of Shock and Hemodynamics was published in February 2023. The PDF of the print version is downloadable here.

Riluzole And Novel Naphthalenyl Substituted Aminothiazole Derivatives Prevent Acute Neural Excitotoxic Injury In A Rat Model Of Temporal Lobe Epilepsy, Thomas Kyllo, Vikrant Singh, Heesung Shim, Singh Latika, Hai M. Nguyen, Yi Je Chen, Ellen Terry, Heike Wulff, Jeffrey D. Erickson

School of Medicine Faculty Publications

Epileptogenic seizures, or status epilepticus (SE), leads to excitotoxic injury in hippocampal and limbic neurons in the kainic acid (KA) animal model of temporal lobe epilepsy (TLE). Here, we have further characterized neural activity regulated methylaminoisobutryic acid (MeAIB)/glutamine transport activity in mature rat hippocampal neurons in vitro that is inhibited by riluzole (IC50 = 1 μM), an anti-convulsant benzothiazole agent. We screened a library of riluzole derivatives and identified SKA-41 followed by a second screen and synthesized several novel chlorinated aminothiazoles (SKA-377, SKA-378, SKA-379) that are also potent MeAIB transport inhibitors in vitro, and brain penetrant following systemic administration. When …

Effects Of Date Seed (Phoenix Dactylifera) Extract In An Animal Model Of Diabetes Mellitus, Sara Refaat

Theses and Dissertations

Diabetes mellitus is a chronic illness and a global epidemic. The commercial diabetic medicines available are expensive and have several adverse effects. Alternative natural products are still being sought for. Date seeds ( Phoenix dactylifera) are either thrown away as garbage or utilized as animal feed. The use of seed extract as an alternative therapy for diabetes offers a cost-effective and all-natural method for managing the disease. Methods Sprague dawley rats were randomly distributed into groups with a sample size of 4 rats per group. Date seed powder was boiled producing a 10% date seed extract which was administered in …

Sperm Dna Integrity In Absolute Teratozoospermia Patients And Its Impact On Assisted Reproductive Technology Outcome, Dina Faris

Theses and Dissertations

Sperm DNA Fragmentation (SDF) is a common cause of male infertility, although it is underdiagnosed due to lack of routine testing. High levels of SDF are reported in men with abnormal sperm morphology. However, the implications of such findings on live birth following Intracytoplasmic Sperm Injection (ICSI) have not been studied in absolute teratozoospermia men (100% abnormal sperm morphology). In this prospective study, the severity of DNA damage was evaluated in absolute teratozoospermia patients and its impact on ICSI outcomes, particularly live birth rate. My study included 36 men with absolute teratozoospermia and 30 men with normal sperm. Real-time assessment …

A Retrospective Study Of Cladribine And Low-Dose Cytarabine-Based Regimens For The Treatment Of Chronic Myelomonocytic Leukemia And Secondary Acute Myeloid Leukemia, Alexandre Bazinet, Faezeh Darbaniyan, Tapan M Kadia, Sangeetha Venugopal, Rashmi Kanagal-Shamanna, Courtney D Dinardo, Gautam Borthakur, Elias J Jabbour, Naval G Daver, Naveen Pemmaraju, Marina Y Konopleva, Farhad Ravandi, Koji Sasaki, Kelly S Chien, Danielle Hammond, Sherry A Pierce, Hagop M Kantarjian, Guillermo Garcia-Manero, Guillermo Montalban-Bravo

Faculty, Staff and Student Publications

Background: Patients with higher risk chronic myelomonocytic leukemia (CMML) have limited therapeutic options beyond hydroxyurea and hypomethylating agents (HMAs). Regimens based on a backbone of cladribine (CLAD), low-dose cytarabine (LDAC), and an HMA are effective low-intensity therapies for acute myeloid leukemia (AML).

Methods: The authors conducted a retrospective chart review to evaluate the efficacy of CLAD/LDAC/HMA in CMML and secondary acute myeloid leukemia (sAML) arising from CMML. Responses were evaluated according to the 2006 International Working Group criteria for CMML and the 2017 European LeukemiaNet criteria for AML. The overall survival (OS), leukemia-free survival (LFS), and duration of response were …

A Phase 1 Study To Evaluate The Safety, Pharmacology, And Feasibility Of Continuous Infusion Nelarabine In Patients With Relapsed And/Or Refractory Lymphoid Malignancies, Prajwal C Boddu, Jayastu Senapati, Farhad Ravandi-Kashani, Elias J Jabbour, Nitin Jain, Mary Ayres, Yuling Chen, Michael J Keating, Hagop M Kantarjian, Varsha Gandhi, Tapan M Kadia

Faculty, Staff and Student Publications

Background: Nelarabine is a purine nucleoside analogue prodrug approved for the treatment of relapsed and refractory T-cell acute lymphoblastic leukemia (R/R T-ALL) and lymphoblastic lymphoma (T-LBL). Although effective in R/R T-ALL, significant neurotoxicity is dose-limiting and such neurotoxicity associated with nucleoside analogues can be related to dosing schedule.

Methods: The authors conducted a phase 1 study to evaluate the pharmacokinetics and toxicity of nelarabine administered as a continuous infusion (CI) for 5 days (120 hours), rather than the standard, short-infusion approach.

Results: Twenty-nine patients with R/R T-ALL/LBL or T-cell prolymphocytic leukemia (T-PLL) were treated, with escalating doses of nelarabine from …

Triple Combination Targeting Methyltransferase, Bcl-2, And Pd-1 Facilitates Antileukemia Responses In Acute Myeloid Leukemia, Zhihong Zeng, Abhishek Maiti, Shelley Herbrich, Tianyu Cai, Antonio Cavazos, Taylor Manzella, Helen Ma, Kala Hayes, Jairo Matthews, Courtney D Dinardo, Naval G Daver, Marina Y Konopleva

Faculty, Staff and Student Publications

Background: A recent breakthrough therapy combining the BCL-2 inhibitor venetoclax with hypomethylating agents (HMAs) targeting DNA methyltransferase has improved outcomes for patients with acute myeloid leukemia (AML), but the responses and long-term survival in older/unfit patients and in patients with relapsed/refractory AML remain suboptimal. Recent studies showed that inhibition of BCL-2 or DNA methyltransferase modulates AML T-cell immunity.

Methods: By using flow cytometry and time-of-flight mass cytometry, the authors examined the effects of the HMA decitabine combined with the BCL-2 inhibitor venetoclax (DAC/VEN therapy) on leukemia cells and T cells in patients with AML who received DAC/VEN therapy in a …

Waking Immune-Resistant Tumors With Neddylation, Kristin Huntoon, Wen Jiang, Betty Ys Kim

Faculty, Staff and Student Publications

The CD47/signal regulatory protein α (SIRPα) axis, which functions as an inhibitory phagocytosis checkpoint, also serves as a key mediator in cancer immune evasion. Many cancers, including colorectal cancer (CRC), exploit the expression of CD47 to escape phagocytic clearance and activate the innate immune system. Previous work has indicated that distinct paradigms of posttranslational modifications mediate the regulatory mechanisms of the CD47/SIRPα axis. In this issue of the JCI, Li et al. show that neddylation, a ubiquitin-like modification, inactivates Src homology region 2-containing protein tyrosine phosphatase 2 (SHP2), a downstream target of this pathway. They further show that inhibition of …