Medical Specialties Commons^™

The Deadly Hoover: A Curiouser And Curiouser Case Of Disappearing Platelets, Rachael Starcher

Providence Portland Medical Center Internal Medicine 2021

No abstract provided.

Double The Battle: Two Cases Of Irreversible Endocrinopathies In Patients Already Fighting Metastatic Cancer., Olesya Petrenko, Nicholas L Stucky

Providence Portland Medical Center Internal Medicine 2021

INTRODUCTION: Emergence of cancer immunotherapy has instigated a new era in field of oncology and revolutionized treatment of cancer. In 2011, Immune Checkpoint Inhibitors (ICI) gained approval for treatment of advanced solid and hematological malignancies and have had remarkable results. Since being released, new cases of irreversible endocrine adverse events are increasingly becoming reported and leave patients with a new life-long diagnosis after battling metastatic cancer.

Discussion • 6 Immune Checkpoint Inhibitors (ICIs) approved: •CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) inhibitor Ipilimumab •PD-1 (programmed cell death protein 1) inhibitors nivolumab, pembrolizumab •PD-L1 (programmed cell death ligand 1) inhibitors atezolizumab, avelumab, durvalumab …

Hormone Wars: The Thyroid Strikes Back! A Case Of Hashimoto Encephalopathy Manifesting As Diffuse Extremity Weakness And Confusion, Cody Paiva, Brinton Clark

Providence Portland Medical Center Internal Medicine 2021

Case Presentation

A 42-year-old female with a past medical history of schizoaffective disorder recently discontinued on multiple psychiatric medications, stable HIV, and hypothyroidism presented with a chief complaint of diffuse extremity weakness and Parkinsonism-like symptoms. History of Present Illness •4-month history of jerking leg movements bilaterally •2-week history of ”feeling paralyzed” with difficulty ambulating •Recent long-term hospitalization at a psychiatric facility as a ward of the state •Multiple changes to psychiatric medication regimen, including abrupt discontinuation of clozapine and risperidone •Abrupt onset confusion at facility and decreased level of interaction at facility prior to admission Exam •T 98.8F, BP 114/66, …

Esophageal Necrosis As An Unexpected Complication Of Diabetic Ketoacidosis, Hayden Smith, Tricia James

Providence Portland Medical Center Internal Medicine 2021

No abstract provided.

Cryptococcoma From Disseminated Cryptococcus Neoformans Infection In An Immunocompetent Patient, Megan Block, David Hotchkin, Amy Dechet

Providence Portland Medical Center Internal Medicine 2021

Background Cryptococcal infection is an infection caused by encapsulated yeasts of the Cryptococcusfungi that primarily manifests in the CNS or lungs in immunocompromised hosts. Our case describes disseminated Cryptococcus neoformansinfection and cerebral cryptococcomain an immunocompetent individual.

Case History •A 64 year-oldmale with no pertinent medical history presented to his PCP for worsening headaches for the past 2 months. •MRI: new ring enhancing lesion of the left thalamus •CT chest: bilateral upper lobe tree-in-bud nodules and a right upper lobe nodule with stippled calcification. •Lung biopsy, complicated by pneumothorax, was unremarkable. •2 days later developed headaches and nausea, became non-verbal, and …

Critical Conversations: Improving Goals Of Care Conversations At Southeast Family Medicine, Elizabeth Deyo, Michael Dirks, Tyler Nelson, Katherine Cobb, Nicholas Wolfgang, Hannah Kadavy, Ben Pederson

Milwaukie Family Medicine 2021

Quality Improvement Project - Background

Introduction Goals of care (GOC) conversations are an essential element of high quality patient care across care contexts. At our residency clinic site, Southeast Family Medicine, there currently is not a standardized workflow that encourages and reminds providers to complete and document GOC discussions with their patients. Currently, end of life planning is tracked and monitored primarily through two tools: patient completion of advanced directives and POLST forms. Although these two documents are important, their use and application is at times to general or specific to truly reflect a patient’s perspective on their goals of …

Pharmacist Pilot Project To Reduce Hypoglycemic Events On Internal Medicine Unit, Carly Barnes, Pamela Levine

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2021

No abstract provided.

Adding Incapacity To Injury: A Case Of Trauma And Central Cord Syndrome, Christopher Bender, Jesse Powell

Providence Portland Medical Center Internal Medicine 2021

Introduction Central cord syndrome occurs with a lesion or soft tissue injury affecting the central anatomy of the spinal cord, causing weakness more prominent in the arms than legs, and sensory abnormalities at the level of the lesion. Here I present a case of central cord syndrome caused by a traumatic fall.

Case Patient A 71 year oldman with history of ESRD, CAD, CHF, and atrial fibrillation HPI Admitted to the hospital after a syncopalevent at home with traumatic falland subsequent development of weakness Exam Weakness was greater in the upper extremities than lower extremitiesand had a left sided predominance. …

Cxcl11 And Smica As Predictive Biomarkers For Efficacy Of Anti-Ctla4 Immunotherapy, Keith Sadoon Bahjat, Helena Maria Hoen, Yoshinobu Koguchi, Alan J. Korman

Technology Transfer - Patents

Provided herein are methods for selecting a cancer patient for anti-CTLA-4 immunotherapy, or predicting whether a cancer patient will respond to anti-CTLA4 immunotherapy, based on measured levels of CXCL1 1 and/or sMICA. Such methods are useful for determining whether an anti-CTLA-4 immunotherapy is likely to improve overall survival of a cancer patient. Also provided herein are methods of treating a cancer patient with an anti-CTLA-4 immunotherapy, wherein the patient is first tested for levels of CXCL1 1 and/or sMICA. Also provided are methods for treating a cancer patient with a CXCL1 1 antagonist or sMICA ant agonist alone, or in …

Sars-Cov-2 Antibodies Detected In Human Breast Milk Postvaccination, Jill K. Baird, Shawn M. Jensen, Walter Urba, Bernard A Fox, Jason R Baird

Articles, Abstracts, and Reports

Importance The SARS-CoV-2 pandemic has infected over a hundred million people worldwide, with almost 2.5 million deaths at the date of this publication. In the United States, Pfizer-BioNTech and Moderna vaccines were first administered to the public starting in December 2020, and no lactating women were included in the initial trials of safety/efficacy. Research on SARS-CoV-2 vaccination in lactating women and the potential transmission of passive immunity to the infant through breast milk is needed to guide patients, clinicians and policy makers during the worldwide effort to curb the spread of this virus.

Objective To determine whether SARS-CoV-2 specific immunoglobins …

Race Differences In Predictors Of Weight Gain Among A Community Sample Of Smokers Enrolled In A Randomized Controlled Trial Of A Multiple Behavior Change Intervention., Marcia M Tan, Terry Bush, Jennifer C Lovejoy, Harold Javitz, Alula Jimenez Torres, Ken Wassum, Bonnie Spring

Articles, Abstracts, and Reports

African Americans have disproportionate rates of post-cessation weight gain compared to non-Hispanic whites, but few studies have examined this weight gain in a multiracial sample of smokers receiving evidence-based treatment in a community setting. We examined race differences in short-term weight gain during an intervention to foster smoking cessation plus weight management. Data were drawn from the Best Quit Study, a randomized controlled trial conducted via telephone quitlines across the U.S. from 2013 to 2017. The trial tested the effects on cessation and weight gain prevention of adding a weight control intervention either simultaneously with or sequentially after smoking cessation …

Very Low Prevalence And Incidence Of Atrial Fibrillation Among Bolivian Forager-Farmers., Christopher J Rowan, Michael A Eskander, Edmond Seabright, Daniel Eid Rodriguez, Edhitt Cortez Linares, Raul Quispe Gutierrez, Juan Copajira Adrian, Daniel Cummings, Bret Beheim, Kirsten Tolstrup, Abinash Achrekar, Thomas Kraft, David E Michalik, Michael Miyamoto, Adel H Allam, L Samuel Wann, Jagat Narula, Benjamin C Trumble, Jonathan Stieglitz, Randall C Thompson, Gregory S Thomas, Hillard S Kaplan, Michael D Gurven

Articles, Abstracts, and Reports

Background: Atrial fibrillation is the most common arrhythmia in post-industrialized populations. Older age, hypertension, obesity, chronic inflammation, and diabetes are significant atrial fibrillation risk factors, suggesting that modern urban environments may promote atrial fibrillation.

Objective: Here we assess atrial fibrillation prevalence and incidence among tropical horticulturalists of the Bolivian Amazon with high levels of physical activity, a lean diet, and minimal coronary atherosclerosis, but also high infectious disease burden and associated inflammation.

Methods: Between 2005-2019, 1314 Tsimane aged 40-94 years (52% female) and 534 Moseten Amerindians aged 40-89 years (50% female) underwent resting 12-lead electrocardiograms to assess atrial fibrillation prevalence. …

Neoadjuvant Anti-Ox40 (Medi6469) Therapy In Patients With Head And Neck Squamous Cell Carcinoma Activates And Expands Antigen-Specific Tumor-Infiltrating T Cells., Rebekka Duhen, Carmen Ballesteros-Merino, Alexandra K Frye, Eric Tran, Venkatesh Rajamanickam, Shu-Ching Chang, Yoshinobu Koguchi, Carlo Bifulco, Brady Bernard, Rom Leidner, Brendan Curti, Bernard A Fox, Walter Urba, Richard Bryan Bell, Andrew D Weinberg

Articles, Abstracts, and Reports

Despite the success of checkpoint blockade in some cancer patients, there is an unmet need to improve outcomes. Targeting alternative pathways, such as costimulatory molecules (e.g. OX40, GITR, and 4-1BB), can enhance T cell immunity in tumor-bearing hosts. Here we describe the results from a phase Ib clinical trial (NCT02274155) in which 17 patients with locally advanced head and neck squamous cell carcinoma (HNSCC) received a murine anti-human OX40 agonist antibody (MEDI6469) prior to definitive surgical resection. The primary endpoint was to determine safety and feasibility of the anti-OX40 neoadjuvant treatment. The secondary objective was to assess the effect of …

Immune Checkpoint Inhibitor Therapy In Hiv-Associated Merkel Cell Carcinoma: A Case Series Of 3 Patients., Song Y Park, Candice Church, Nora A Alexander, Michi M Shinohara, Kelly G Paulson, Karl D Lewis, Nancy S Lee, Paul Nghiem

Articles, Abstracts, and Reports

No abstract provided.

Rapid, Successful Adoption Of Virtual Outpatient Cardiology Care During The Covid-19 Pandemic, Lesley Jones Larson, D Christensen, S Long, Lian Wang, Kateri Spinelli, Xiaoyan Huang

Articles, Abstracts, and Reports

No abstract provided.

Heparin-Induced Thrombocytopenia Presenting As Splenic Hemorrhage Following Cardiac Surgery: A Case Report., Joseph Ferry, Samuel J Youssef, Pierce Wu, Livia Hegerova

Articles, Abstracts, and Reports

BACKGROUND: Heparin-induced thrombocytopenia with thrombosis (HITT) is a paradoxical prothrombotic complication of anticoagulant therapy. As many as 3% of patients undergoing cardiac surgery develop clinical HIT presenting as thrombocytopenia with or without thrombosis within 5-10 days of heparin exposure. Thrombotic complications associated with HIT carry a mortality rate of 5-10%.

CASE PRESENTATION: We report a case of atraumatic splenic hemorrhage due to splenic vein thrombosis as the main indicator of HIT following cardiac surgery in a 62-year-old woman. She presented to the emergency department on day nine following coronary artery bypass graft surgery with acute weakness, dizziness, and malaise. Her …

Self-Administered Behavioral Skills-Based At-Home Virtual Reality Therapy For Chronic Low Back Pain: Protocol For A Randomized Controlled Trial., Laura Garcia, Beth Darnall, Parthasarathy Krishnamurthy, Ian Mackey, Josh Sackman, Robert Louis, Todd Maddox, Brandon Birckhead

Articles, Abstracts, and Reports

BACKGROUND: Chronic pain is one of the most common and debilitating health conditions. Treatments for chronic low back pain typically focus on biomedical treatment approaches. While psychosocial treatments exist, multiple barriers prevent broad access. There is a significant unmet need for integrative, easily accessible, non-opioid solutions for chronic pain. Virtual reality (VR) is an immersive technology allowing innovation in the delivery of behavioral pain treatments. Behavioral skills-based VR is effective at facilitating pain management and reducing pain-related concerns. Continued research on these emerging approaches is needed.

OBJECTIVE: In this randomized controlled trial, we seek to test the efficacy of a …

Improved Image Reconstruction Of, Julian Kirchner, Joseph A O'Donoghue, Anton S Becker, Gary A Ulaner

Articles, Abstracts, and Reports

Purpose: The aim of this study was to evaluate the use of a Bayesian penalized likelihood reconstruction algorithm (Q.Clear) for 89Zr-immunoPET image reconstruction and its potential to improve image quality and reduce the administered activity of 89Zr-immunoPET tracers.

Methods: Eight 89Zr-immunoPET whole-body PET/CT scans from three 89Zr-immunoPET clinical trials were selected for analysis. On average, patients were imaged 6.3 days (range 5.0-8.0 days) after administration of 69 MBq (range 65-76 MBq) of [89Zr]Zr-DFO-daratumumab, [89Zr]Zr-DFO-pertuzumab, or [89Zr]Zr-DFO-trastuzumab. List-mode PET data was retrospectively reconstructed using Q.Clear with incremental β-values from 150 to 7200, as well as standard ordered-subset expectation maximization (OSEM) reconstruction …

Immune-Based Mutation Classification Enables Neoantigen Prioritization And Immune Feature Discovery In Cancer Immunotherapy., Peng Bai, Yongzheng Li, Qiuping Zhou, Jiaqi Xia, Peng-Cheng Wei, Hexiang Deng, Min Wu, Sanny K Chan, John W Kappler, Yu Zhou, Eric Tran, Philippa Marrack, Lei Yin

Articles, Abstracts, and Reports

Genetic mutations lead to the production of mutated proteins from which peptides are presented to T cells as cancer neoantigens. Evidence suggests that T cells that target neoantigens are the main mediators of effective cancer immunotherapies. Although algorithms have been used to predict neoantigens, only a minority are immunogenic. The factors that influence neoantigen immunogenicity are not completely understood. Here, we classified human neoantigen/neopeptide data into three categories based on their TCR-pMHC binding events. We observed a conservative mutant orientation of the anchor residue from immunogenic neoantigens which we termed the "NP" rule. By integrating this rule with an existing …

Integrated Genetic And Metabolic Landscapes Predict Vulnerabilities Of Temozolomide Resistant Glioblastoma Cells., Selva Rupa Christinal Immanuel, Avinash D Ghanate, Dharmeshkumar S Parmar, Ritu Yadav, Riya Uthup, Venkateswarlu Panchagnula, Anu Raghunathan

Articles, Abstracts, and Reports

Metabolic reprogramming and its molecular underpinnings are critical to unravel the duality of cancer cell function and chemo-resistance. Here, we use a constraints-based integrated approach to delineate the interplay between metabolism and epigenetics, hardwired in the genome, to shape temozolomide (TMZ) resistance. Differential metabolism was identified in response to TMZ at varying concentrations in both the resistant neurospheroidal (NSP) and the susceptible (U87MG) glioblastoma cell-lines. The genetic basis of this metabolic adaptation was characterized by whole exome sequencing that identified mutations in signaling pathway regulators of growth and energy metabolism. Remarkably, our integrated approach identified rewiring in glycolysis, TCA cycle, …

Partial Inhibition Of Mitochondrial Complex I Ameliorates Alzheimer's Disease Pathology And Cognition In App/Ps1 Female Mice., Andrea Stojakovic, Sergey Trushin, Anthony Sheu, Layla Khalili, Su-Youne Chang, Xing Li, Trace Christensen, Jeffrey L Salisbury, Rachel E Geroux, Benjamin Gateno, Padraig J Flannery, Mrunal Dehankar, Cory C Funk, Jordan Wilkins, Anna Stepanova, Tara O'Hagan, Alexander Galkin, Jarred Nesbitt, Xiujuan Zhu, Utkarsh Tripathi, Slobodan Macura, Tamar Tchkonia, Tamar Pirtskhalava, James L Kirkland, Rachel A Kudgus, Renee A Schoon, Joel M Reid, Yu Yamazaki, Takahisa Kanekiyo, Song Zhang, Emirhan Nemutlu, Petras Dzeja, Adam Jaspersen, Ye In Christopher Kwon, Michael K Lee, Eugenia Trushina

Articles, Abstracts, and Reports

Alzheimer's Disease (AD) is a devastating neurodegenerative disorder without a cure. Here we show that mitochondrial respiratory chain complex I is an important small molecule druggable target in AD. Partial inhibition of complex I triggers the AMP-activated protein kinase-dependent signaling network leading to neuroprotection in symptomatic APP/PS1 female mice, a translational model of AD. Treatment of symptomatic APP/PS1 mice with complex I inhibitor improved energy homeostasis, synaptic activity, long-term potentiation, dendritic spine maturation, cognitive function and proteostasis, and reduced oxidative stress and inflammation in brain and periphery, ultimately blocking the ongoing neurodegeneration. Therapeutic efficacy in vivo was monitored using translational …

Prognostic Gene Expression Signatures Of Breast Cancer Are Lacking A Sensible Biological Meaning., Kalifa Manjang, Shailesh Tripathi, Olli Yli-Harja, Matthias Dehmer, Galina Glazko, Frank Emmert-Streib

Articles, Abstracts, and Reports

The identification of prognostic biomarkers for predicting cancer progression is an important problem for two reasons. First, such biomarkers find practical application in a clinical context for the treatment of patients. Second, interrogation of the biomarkers themselves is assumed to lead to novel insights of disease mechanisms and the underlying molecular processes that cause the pathological behavior. For breast cancer, many signatures based on gene expression values have been reported to be associated with overall survival. Consequently, such signatures have been used for suggesting biological explanations of breast cancer and drug mechanisms. In this paper, we demonstrate for a large …

Multiplex Immunofluorescence To Measure Dynamic Changes In Tumor-Infiltrating Lymphocytes And Pd-L1 In Early-Stage Breast Cancer., Katherine Sanchez, Isaac Kim, Brie Chun, Joanna Pucilowska, William L. Redmond, Walter Urba, Maritza Martel, Yaping Wu, Mary Campbell, Zhaoyu Sun, Gary Grunkemeier, Shu-Ching Chang, Brady Bernard, David B Page

Articles, Abstracts, and Reports

BACKGROUND: The H&E stromal tumor-infiltrating lymphocyte (sTIL) score and programmed death ligand 1 (PD-L1) SP142 immunohistochemistry assay are prognostic and predictive in early-stage breast cancer, but are operator-dependent and may have insufficient precision to characterize dynamic changes in sTILs/PD-L1 in the context of clinical research. We illustrate how multiplex immunofluorescence (mIF) combined with statistical modeling can be used to precisely estimate dynamic changes in sTIL score, PD-L1 expression, and other immune variables from a single paraffin-embedded slide, thus enabling comprehensive characterization of activity of novel immunotherapy agents.

METHODS: Serial tissue was obtained from a recent clinical trial evaluating loco-regional cytokine …

Identifying The Mirna Signature Association With Aging-Related Senescence In Glioblastoma., Mutharasu Gnanavel, Akshaya Murugesan, Saravanan Konda Mani, Olli Yli-Harja, Meenakshisundaram Kandhavelu

Articles, Abstracts, and Reports

Glioblastoma (GBM) is the most common malignant brain tumor and its malignant phenotypic characteristics are classified as grade IV tumors. Molecular interactions, such as protein-protein, protein-ncRNA, and protein-peptide interactions are crucial to transfer the signaling communications in cellular signaling pathways. Evidences suggest that signaling pathways of stem cells are also activated, which helps the propagation of GBM. Hence, it is important to identify a common signaling pathway that could be visible from multiple GBM gene expression data. microRNA signaling is considered important in GBM signaling, which needs further validation. We performed a high-throughput analysis using micro array expression profiles from …

Circulating Exosomal Microrna Expression Patterns Distinguish Cardiac Sarcoidosis From Myocardial Ischemia., Elliott D Crouser, Mark W Julian, Sabahattin Bicer, Vikas Ghai, Taek-Kyun Kim, Lisa A Maier, May Gillespie, Nabeel Y Hamzeh, Kai Wang

Articles, Abstracts, and Reports

OBJECTIVE: Cardiac sarcoidosis is difficult to diagnose, often requiring expensive and inconvenient advanced imaging techniques. Circulating exosomes contain genetic material, such as microRNA (miRNA), that are derived from diseased tissues and may serve as potential disease-specific biomarkers. We thus sought to determine whether circulating exosome-derived miRNA expression patterns would distinguish cardiac sarcoidosis (CS) from acute myocardial infarction (AMI).

METHODS: Plasma and serum samples conforming to CS, AMI or disease-free controls were procured from the Biologic Specimen and Data Repository Information Coordinating Center repository and National Jewish Health. Next generation sequencing (NGS) was performed on exosome-derived total RNA (n = 10 …

Patient-Reported Outcomes Data In Patients With Psoriatic Arthritis From A Randomised Trial Of Etanercept And Methotrexate As Monotherapy Or In Combination., Vibeke Strand, Philip Mease, Ervant J Maksabedian Hernandez, Bradley S Stolshek, Lyrica X H Liu, David H Collier, Gregory Kricorian, Joseph F Merola

Articles, Abstracts, and Reports

OBJECTIVES: We examined patient-reported outcomes (PROs) in The Study of Etanercept And Methotrexate in Patients with Psoriatic Arthritis (PsA); a 48-week, phase 3, randomised controlled trial that compared outcomes with methotrexate (MTX) monotherapy, etanercept monotherapy, and MTX+ etanercept in patients with PsA.

METHODS: Efficacy endpoints included: mean changes from baseline and proportion of patients who reported improvements≥minimal clinically important difference (MCID) at week 24 in treatment groups for Health Assessment Questionnaire-Disability Index, Patient Global Assessment (PtGA), Patient Global Assessment of Joint Pain (PtGAJP) and Medical Outcomes Study Short Form-36 Questionnaire (SF-36) Physical Component Summary (PCS), and Mental Component Summary, and …

Pregnancy Outcomes In Women With Epilepsy And Mthfr Mutations Supplemented With Methylated Folate And Methylcobalamin (Methylated B12)., Emma M Lascar, Nicole M Warner, Michael J Doherty

Articles, Abstracts, and Reports

Antiseizure medications (ASM) may contribute to adverse fetal outcomes in pregnant women with epilepsy (WWE). Folate processing (Methylenetetrahydrofolate reductase, MTHFR) gene abnormalities are common in women with epilepsy and depression. L-methylfolate supplements may bypass MTHFR deficiencies, yet their use in WWE during gestation or on fetal development is not well studied. We examine pregnancy histories of three WWE who supplemented with either folate or L-methylfolate and methylcobalamin (methylated B12) during pregnancies. Their pregnancy outcomes improved with L-methylfolate and methylcobalamin supplementation. L-methylfolate and methylcobalamin supplementation merits further study in WWE who have MTHFR mutations, fertility, recurrent miscarriage and or depression histories.

Successful Bilateral Electroconvulsive Therapy In A Patient With A Seizure Disorder Taking Levetiracetam, Lorazepam, And Zonisamide: A Case Report., Ian R Mcgrane, Rachel E Tenison, Dana M Bimler, Robert C Munjal, Jason R Molinaro

Articles, Abstracts, and Reports

Electroconvulsive therapy (ECT) may be considered for treatment of severe, treatment-resistant, and emergent depression associated with MDD or bipolar disorder. Patients with epilepsy usually take medications that raise the seizure threshold, which poses challenges during ECT. We report a 66-year-old male with epilepsy taking levetiracetam extended-release (XR), lorazepam, and zonisamide requiring ECT for severe MDD. After literature review, the XR form of levetiracetam was changed to higher doses of the immediate-release (IR) formulation, and zonisamide was discontinued 2 days prior to ECT in the hospital and was resumed when the patient underwent outpatient continuation ECT. The patient was treated to …

Partnership Between Islam And Palliative Care At Swedish Health Services (First Hill And Cherry Hill), Hodo Mohamud

Articles, Abstracts, and Reports

INTRODUCTION  The spiritual practice of Islam is considered one of the three major monotheistic religions. There is minimal research about Palliative care and Muslim patients in both Muslim majority and Muslim minority countries. Engaging in internal assessment of palliative care provision to Muslim patients is important for quality care. This project aimed to examine gaps in Palliative needs assessment of Muslims in one institution.

OBJECTIVES Assess Swedish palliative care team’s barriers to spiritual care (SC) and baseline knowledge of Islamic influences on healthcare. Interview Muslim patients and insights from a Muslim Imam trained in chaplaincy about PC experience. Develop …

Developing An Enhanced 7-Color Multiplex Ihc Protocol To Dissect Immune Infiltration In Human Cancers., Zhaoyu Sun, Richard Nyberg, Yaping Wu, Brady Bernard, William L. Redmond

Articles, Abstracts, and Reports

The TSA Opal multiplex immunohistochemistry (mIHC) protocol (PerkinElmer) has been used to characterize immune infiltration in human cancers. This technique allows multiple biomarkers to be simultaneously stained in a single tissue section, which helps to elucidate the spatial relationship among individual cell types. We developed and optimized two improved mIHC protocols for a 7-color panel containing 6 biomarkers (CD3, CD8, CD163, PD-L1, FoxP3, and cytokeratin (CK)) and DAPI. The only difference between these two protocols was the staining sequence of those 6 biomarkers as the first sequence is PD-L1/CD163/CD8/CK/CD3/FoxP3/DAPI and the second sequence is FoxP3/CD163/CD8/CK/CD3/PD-L1/DAPI. By comparing PD-L1/FoxP3 staining in …