Familial adenomatous polyposis (FAP) is an inherited gastrointestinal syndrome associated with duodenal adenoma formation. Even among carriers of the same genetic variant, duodenal phenotypes vary, indicating that additional factors, such as the local immune system, play a role. We observe an increase in duodenal IL-17A(+)NKp44(−) innate lymphoid type 3 cell (ILC3) in FAP, localized near the epithelium and enriched in adenomas and carcinomas. Elevated IL1B , IL23A , and DLL4 transcript levels correlate with IL-17A(+)NKp44(−)ILC3 accumulation, and in vitro studies with duodenal organoids confirmed this relationship. Bulk RNA sequencing reveals upregulated Reactive oxygen species (ROS)-inducing enzymes DUOX2 and DUOXA2 in FAP adenomas. IL-17A-stimulated FAP organoids show increased DUOX2/DUOXA2 expression, Duox2 protein, and ROS production, leading to DNA damage, suggesting a mechanism by which these immune cells promote tumorigenesis. These findings suggest IL-17A(+)NKp44(–)ILC3s may contribute to a local environment that makes the epithelium more submissive for oncogenic transformation in FAP.

Dexamethasone is a life-saving treatment for severe COVID-19, yet its mechanism of action is unknown, and many patients deteriorate or die despite timely treatment initiation. Here, we identify dexamethasone treatment-induced cellular and molecular changes associated with improved survival in COVID-19 patients. We observed a reversal of transcriptional hallmark signatures in monocytes associated with severe COVID-19 and the induction of a monocyte substate characterized by the expression of glucocorticoid-response genes. These molecular responses to dexamethasone were detected in circulating and pulmonary monocytes, and they were directly linked to survival. Monocyte single-cell RNA sequencing (scRNA-seq)-derived signatures were enriched in whole blood transcriptomes of patients with fatal outcome in two independent cohorts, highlighting the potential for identifying non-responders refractory to dexamethasone. Our findings link the effects of dexamethasone to specific immunomodulation and reversal of monocyte dysregulation, and they highlight the potential of single-cell omics for monitoring in vivo target engagement of immunomodulatory drugs and for patient stratification for precision medicine approaches.

Background: Development of cirrhosis and hepatocellular carcinoma (HCC) in patients with high alcohol intake is modulated by genetic predispositions. Genetic variation in angiotensin II type 1 receptor (AGTR1) has been described as a risk factor for non-alcoholic fatty liver disease in Asian patients. Methods: We analysed Caucasian patients with alcohol–associated cirrhosis without (n = 238) and with (n = 339) HCC, healthy controls (n = 200), and HCV–infected cirrhotic patients with and without HCC (n = 263) for association with the polymorphisms rs3772622 and rs2276736 in AGTR1. Results: Rs2276736 in AGTR1 was associated with both low–density lipoprotein (LDL) cholesterol levels and hepatic steatosis in patients with alcohol–associated liver disease. The distribution of genotypes for both rs3772622 and rs2276736 in AGTR1 were comparable between controls, cirrhosis patients, and those with HCC. Minor allele frequencies were 32% (44%) in healthy controls, 35%/34% (46%/45%) in alcohol–associated liver disease without/with HCC and 31%/38% (43%/39%) in HCV cirrhosis and HCV HCC, respectively. The genotype of the most important genetic risk factor for fatty liver disease, PNPLA3 I148M, did not interact with the AGTR1 polymorphisms. Conclusion: Genetic variation in AGTR1, although associated with blood lipid levels and hepatic steatosis, is not a risk factor for alcohol–associated cirrhosis or HCC in Caucasians.

Cyanobacterial harmful algal blooms (CHABs) are increasingly common in freshwater ecosystems and are often associated with climate change. Here, we used two independent high‐resolution surface temperature records (1995–2022) and temperature‐dependent growth rates of Microcystis to evaluate changes in these CHABs in Lake Erie. The potential mean seasonal growth rate of Microcystis and the duration of the Microcystis bloom season have both significantly increased within the western basin of Lake Erie since 1995. Trends were strongest in the far western region of Lake Erie including Maumee Bay which receives the largest point source of nutrients in the Lake and where the Microcystis bloom season has expanded by up to 1 month. In contrast, warming trends in bloom‐free portions of central and eastern Lake Erie have been more muted. We conclude that increasing water temperature is an important factor facilitating the intensification of these, and likely other, CHABs, and is thus promoting an expanding public health threat.

Warmer temperatures can significantly increase the intensity of cyanobacterial harmful algal blooms (CHABs) in eutrophic freshwater ecosystems. However, few studies have examined the effects of CO2 enrichment in tandem with elevated temperature and/or nutrients on cyanobacterial taxa in freshwater ecosystems. Here, we observed changes in the biomass of cyanobacteria, nutrients, pH, and carbonate chemistry over a two-year period in a shallow, eutrophic freshwater lake and performed experiments to examine the effects and co-effects of CO2, temperature, and nutrient enrichment on cyanobacterial and N2-fixing (diazotrophic) communities assessed via high throughput sequencing of the 16S rRNA and nifH genes, respectively. During both years, there were significant CHABs (50-500 μg cyanobacterial chlorophyll-a L-1) and lake CO2 levels were undersaturated (≤300 μatm pCO2). NH4+ significantly increased the net growth rates of cyanobacteria as well as the biomass of the diazotrophic cyanobacterial order Nostocales under elevated and ambient CO2 conditions. In a fall experiment, the N2 fixation rates of Nostocales were significantly higher when populations were enriched with CO2 and P, relative to CO2-enriched populations that were not amended with P. During a summer experiment, N2 fixation rates increased significantly under N and CO2 - enriched conditions relative to N-enriched and ambient CO2 conditions. Nostocales dominated the diazotrophic communities of both experiments, achieving the highest relative abundance under CO2-enriched conditions when N was added in the first experiment and when CO2 and temperature were elevated in the second experiment, when N2 fixation rates also increased significantly. Collectively, this study indicates that N promotes cyanobacterial blooms including those formed by Dolichospermum and that the biomass and N2 fixation rates of diazotrophic cyanobacterial taxa may benefit from enhanced CO2 levels in eutrophic lakes.

Group 1 innate lymphoid cells (ILCs) comprise a heterogeneous family of cytotoxic natural killer (NK) cells and ILC1s. We identify a population of "liver-type" ILC1s with transcriptional, phenotypic, and functional features distinct from those of conventional and liver-resident NK cells as well as from other previously described human ILC1 subsets. LT-ILC1s are CD49a+CD94+CD200R1+, express the transcription factor T-BET, and do not express the activating receptor NKp80 or the transcription factor EOMES. Similar to NK cells, liver-type ILC1s produce IFN-γ, TNF-α, and GM-CSF; however, liver-type ILC1s also produce IL-2 and lack perforin and granzyme-B. Liver-type ILC1s are expanded in cirrhotic liver tissues, and they can be produced from blood-derived ILC precursors in vitro in the presence of TGF-β1 and liver sinusoidal endothelial cells. Cells with similar signature and function can also be found in tonsil and intestinal tissues. Collectively, our study identifies and classifies a population of human cross-tissue ILC1s.

Recently, Weiss et al discovered that a catecholamine metabolite, 4hydroxy3methoxyphenylglycol sulfate (MOPEG sulfate), is associated with death after 28 days in patients with acutely decompensated cirrhosis. The authors hypothesise that systemic inflammation, an important prognostic factor, may be connected to the intensity of the stressinduced alarm reaction in the central nervous system, triggering release of norepinephrine, which is later metabolised to MOPEG sulfate. However, immune cells may also produce catecholamines, offering another link between systemic inflammation and catecholamine metabolites. Additionally, the source of MOPEG sulfate is difficult to determine, because it is not only a metabolite of norepinephrine but also of epinephrine. Epinephrine is important, because it is the main agonist for beta2 adrenoceptors, with unselective betablockers being beneficial in patients with advanced liver disease and portal hypertension. To further assess a potential interplay between autocrine/ paracrine catecholamine production by immune cells and immune activation, we analysed mononuclear immune cells from peripheral blood and ascites from patients with decompensated cirrhosis. Ascites and peripheral blood were collected from 12 patients with decompensated cirrhosis, details of which are given in online supplemental table 1. In short, expression of cell markers and adrenoreceptor beta 2 (ADRB2) was evaluated via flow cytometry. Mononuclear cells from blood and ascites were isolated via density gradient centrifugation and cultured overnight in the presence of lipopolysaccharide (LPS), peptidoglycan (PGN) and propranolol. Epinephrine and cytokine production was measured via ELISA. Details on patients and methods are given in online supplemental material. We found that mononuclear cells both from ascites and blood expressed ADRB2. The highest expression was found in CD8 T cells, and expression was higher on CD4 T cells and CD19 B cells from ascites versus blood (figure 1A). Expression of ADRB2 was dependent on the ADRB2 rs1047213 genotype, as described previously (figure 1B,C). Expression of ADRB2 tended to be higher in patients taking betablockers compared with those without betablockers (figure 1D), potentially reflecting a compensatory upregulation. On overnight culture, mononuclear cells from ascites (figure 2A) and blood (figure 2B) produced epinephrine. The epinephrine production was stimulated by LPS in mononuclear cells from ascites. While interferongamma production increased only after LPS stimulation of ascites mononuclear cells, both LPS and Letter

The intensity and duration of heat waves are expected to increase this century, occurrences considered favorable for harmful, bloom-forming freshwater cyanobacteria. Dinitrogen (N2) fixation is a major component of nitrogen cycling in freshwater systems, yet little is known with respect to how diazotrophic (N2 fixing) cyanobacteria respond to heat waves. Here, we quantified the effects of elevated temperature and fixed N enrichment on the growth and N2 fixation rates of Dolichospermum isolates from differing latitudes and cyanobacterial communities in four lakes across New York state, USA, during the summer and early fall. In culture experiments, temperatures ≥ 26℃ significantly reduced maximum growth rates of the sub-polar Dolichospermum strains from Finland relative to those grown at 20 − 25℃, while a strain of Dolichospermum isolated from subtropical Australia grew significantly faster at 20 − 30℃ compared to cooler temperatures. All strains, however, exhibited significantly lower N2 fixation rates at higher temperatures (29 − 30℃) relative to lower temperatures (13-26℃). During ecosystem-based experiments with cyanobacterial communities comprised of Nostocales and other diazotrophic cyanobacteria, short-term (3–4 day) exposures to elevated temperatures mimicking heat waves (+3-6℃; 27-31℃) and/or N (NH4+) enrichment caused a significant increase in cyanobacterial net growth rates but also caused a significant decline in N2 fixation rates. Collectively, results indicate that while heat waves and fixed N loading can promote cyanobacterial communities, they also suppress diazotrophy, which is generally regarded as a significant component of nitrogen cycling in eutrophic freshwater systems. Such reductions in N2 fixation would promote or intensify N limitation of primary production in lakes during the summer, an outcome that would be exacerbated under future warming scenarios.

Background and Aims: Human innate lymphoid cells (ILCs) are critically involved in the modulation of homeostatic and inflammatory processes in various tissues. However, only little is known about the composition of the intrahepatic ILC pool and its potential role in chronic liver disease. Here, we performed a detailed characterization of intrahepatic ILCs in both healthy and fibrotic livers.Approach and Results: A total of 50 livers (nonfibrotic = 22, and fibrotic = 29) were analyzed and compared with colon and tonsil tissue (each N = 14) and peripheral blood (N = 32). Human intrahepatic ILCs were characterized ex vivo and on stimulation using flow cytometry and single-cell RNA sequencing. ILC differentiation and plasticity were analyzed by both bulk and clonal expansion experiments. Finally, the effects of ILC-derived cytokines on primary human HSteCs were studied. Unexpectedly, we found that an "unconventional" ILC3like cell represented the major IL-13-producing liver ILC subset. IL-13(+) ILC3-like cells were specifically enriched in the human liver, and increased frequencies of this cell type were found in fibrotic livers. ILC3-derived IL-13 production induced upregulation of proinflammatory genes in HSteCs, indicating a potential role in the regulation of hepatic fibrogenesis. Finally, we identified KLRG1expressing ILC precursors as the potential progenitor of hepatic IL-13(+) ILC3like cells.Conclusions: We identified a formerly undescribed subset of IL-13-producing ILC3-like cells that is enriched in the human liver and may be involved in the modulation of chronic liver disease.

Background Progression of alcohol-associated liver disease (ALD) is driven by genetic predisposition. The rs13702 variant in the lipoproteinlipase (LPL) gene is linked to non-alcoholic fatty liver disease, but LPL is not expressed in healthy liver. We aimed at clarifying its role in ALD.

The mechanisms involved in HIV-associated natural killer (NK) cell impairment are still incompletely understood. We observed HIV infection to be associated with increased plasma levels of IFABP, a marker for gut epithelial barrier dysfunction, and LBP, a marker for microbial translocation. Both IFABP and LBP plasma concentrations were inversely correlated with NK cell interferon-γ production, suggesting microbial translocation to modulate NK cell functions. Accordingly, we found lipopolysaccharide to have an indirect inhibitory effect on NK cells via triggering monocytes' transforming growth factor-β production. Taken together, our data suggest increased microbial translocation to be involved in HIV-associated NK cell dysfunction.

INTRODUCTION: Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease with periductal inflammation and fibrosis. Genetic studies suggest inflammatory cytokines and IL-6–dependent activation of transcription factor STAT3 as pivotal steps in PSC pathogenesis. However, details of inflammatory regulation remain unclear. METHODS: We recruited 50 patients with PSC (36 with inflammatory bowel disease, 14 without inflammatory bowel disease), 12 patients with autoimmune hepatitis, and 36 healthy controls to measure cytokines in the serum, bile, and immune cell supernatant using bead-based immunoassays and flow cytometry and immunohistochemistry to analyze phosphorylation of STATs in immune cells. Finally, we analyzed cytokines and STAT3 phosphorylation of T cells in the presence of JAK1/2 inhibitors. RESULTS: In PSC, IL-6 specifically triggered phosphorylation of STAT3 in CD4+ T cells and lead to enhanced production of interferon (IFN) gamma and interleukin (IL)-17A. Phospho-STAT3–positive CD4+ T cells correlated with systemic inflammation (C-reactive protein serum levels). Combination of immunohistology and flow cytometry indicated that phospho-STAT3–positive cells were enriched in the peribiliary liver stroma and represented CD4+ T cells with prominent production of IFN gamma and IL-17A. JAK1/2 inhibitors blocked STAT3 phosphorylation and production of IFN gamma and IL-6, whereas IL-17A was apparently resistant to this inhibition. DISCUSSION: Our results demonstrate systemic and local activation of the IL-6/STAT3 pathway in PSC. Resistance of IL-17A to STAT3-targeted inhibition points to a more complex immune dysregulation beyond STAT3 activation.

Background & Aims:Progression of alcohol-associated liver disease (ALD) is driven by genetic predisposition. The rs13702 variant in the lipoprotein lipase (LPL) gene is linked to non-alcoholic fatty liver disease. We aimed at clarifying its role in ALD. Methods:Patients with alcohol-associated cirrhosis, with (n = 385) and without hepatocellular carcinoma (HCC) (n = 656), with HCC attributable to viral hepatitis C (n = 280), controls with alcohol abuse without liver damage (n = 366), and healthy controls (n = 277) were genotyped regarding the LPL rs13702 polymorphism. Furthermore, the UK Biobank cohort was analysed. LPL expression was investigated in human liver specimens and in liver cell lines. Results:Frequency of the LPL rs13702 CC genotype was lower in ALD with HCC in comparison to ALD without HCC both in the initial (3.9% vs. 9.3%) and the validation cohort (4.7% vs. 9.5%; p <0.05 each) and compared with patients with viral HCC (11.4%), alcohol misuse without cirrhosis (8.7%), or healthy controls (9.0%). This protective effect (odds ratio [OR] = 0.5) was confirmed in multivariate analysis including age (OR = 1.1/year), male sex (OR = 3.0), diabetes (OR = 1.8), and carriage of the PNPLA3 I148M risk variant (OR = 2.0). In the UK Biobank cohort, the LPL rs13702 C allele was replicated as a risk factor for HCC. Liver expression of LPL mRNA was dependent on LPL rs13702 genotype and significantly higher in patients with ALD cirrhosis compared with controls and alcohol-associated HCC. Although hepatocyte cell lines showed negligible LPL protein expression, hepatic stellate cells and liver sinusoidal endothelial cells expressed LPL. Conclusions:LPL is upregulated in the liver of patients with alcohol-associated cirrhosis. The LPL rs13702 high producer variant confers protection against HCC in ALD, which might help to stratify people for HCC risk. Impact and implications:Hepatocellular carcinoma is a severe complication of liver cirrhosis influenced by genetic predisposition. We found that a genetic variant in the gene encoding lipoprotein lipase reduces the risk for hepatocellular carcinoma in alcohol-associated cirrhosis. This genetic variation may directly affect the liver, because, unlike in healthy adult liver, lipoprotein lipase is produced from liver cells in alcohol-associated cirrhosis.

Human immunodeficiency virus (HIV) infection is associated with impaired natural killer (NK) cell activity, which is only incompletely restored under antiretroviral therapy. Analyzing the bioenergetics profiles of oxygen consumption, we observed that several parameters were significantly reduced in HIV+ NK cells, indicating a mitochondrial defect. Accordingly, we found HIV+ CD56bright NK cells to display a decreased mitochondrial membrane potential and mitochondrial mass. Both parameters were positively correlated with interferon gamma (IFN-γ) production of NK cells. Finally, we demonstrated that stimulation of HIV+ NK cells with MitoTEMPO, a mitochondria-targeting antioxidant, significantly improved IFN-γ production. We identified mitochondrial dysfunction as a mechanism that contributes to impaired NK cell function.

We compared the ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike-specific antibodies to induce natural killer cell-mediated antibody-dependent cellular cytotoxicity (ADCC) in patients with natural infection and vaccinated persons. Analyzing plasma samples from 39 coronavirus disease 2019 (COVID-19) patients and 11 vaccinated individuals, significant induction of ADCC could be observed over a period of more than 3 months in both vaccinated and recovered individuals. Although plasma antibody concentrations were lower in recovered patients, we found antibodies elicited by natural infection induced a significantly stronger ADCC response compared to those induced by vaccination, which may affect protection conferred by vaccination.

The effect of rising CO2 levels on cyanobacterial harmful algal blooms (CHABs) is an emerging concern, particularly within eutrophic ecosystems. While elevated pCO2 has been associated with enhanced growth rates of some cyanobacteria, few studies have explored the effect of CO2 and nitrogen availability on diazotrophic (N2-fixing) cyanobacteria that produce cyanotoxins. Here, the effects of elevated CO2 and fixed nitrogen (NO3-) availability on the growth rates, toxin production, and N2 fixation of microcystin, saxitoxin, and anatoxin-a - producing strains of the genus Dolichospermum were quantified. Growth rates of all Dolichospermum spp. were significantly increased by CO2 or both CO2 and NO3- with rates being highest in treatments with the highest levels of CO2 and NO3-for all strains. While NO3- suppressed N2 fixation, diazotrophy significantly increased when NO3--enriched Dolichospermum spp. were supplied with higher CO2 compared to cultures grown under lower CO2 levels. This suggests that diazotrophy will play an increasingly important role in N cycling in CO2-enriched, eutrophic lentic systems. NO3- significantly increased quotas of the N-rich cyanotoxins, microcystin and saxitoxin, at ambient and enriched CO2 levels, respectively. In contrast, elevated CO2 significantly decreased cell quotas of microcystin and saxitoxin, but significantly increased cell quotas of the N-poor cyanotoxin, anatoxin. N2 fixation was significantly negatively and positively correlated with quotas of N-rich and N-poor cyanotoxins, respectively. Findings suggest cellular quotas of N-rich toxins (microcystin and saxitoxin) may be significantly reduced, or cellular quotas of N-poor toxins (anatoxin) may be significantly enhanced, under elevated CO2 conditions during diazotrophic cyanobacterial blooms. Finally, in the future, ecosystems that experience combinations of excessive N loading and CO2 enrichment may become more prone to toxic blooms of Dolichospermum.

Hepatocellular carcinoma (HCC) is a severe complication of advanced alcoholic liver disease, which is modulated by genetic predisposition. Identifying new genetic loci might improve screening. Genetic variation of SAMM50 was linked to HCC. We aimed to validate this finding in a large cohort of patients with advanced alcoholic liver disease (ALD). A large, well-characterised cohort of patients with alcoholic cirrhosis without (n = 674) and with (n = 386) HCC, as well as controls with HCC due to viral hepatitis (n = 134), controls with heavy alcohol abuse without liver disease (n = 266) and healthy subjects (n = 237), were genotyped for SAMM50 rs3827385 and rs3761472 and for PNPLA3 rs738409. Genotype frequencies were compared between patients with alcohol-associated cirrhosis with and without HCC by uni- and multivariate analysis. Minor variants in both SAMM50 rs3827385 and rs3761472 were significantly more frequent in patients with alcoholic HCC versus alcoholic cirrhosis and versus the control cohorts. An even stronger association was noted for PNPLA3 rs738409. The univariate analysis resulted in an odds ratio (OR) of 1.8 for carriers of at least one minor variant of SAMM50 rs3827385 and rs3761472 (each p < 0.001), but this association was lost in multivariate analysis with age (OR 1.1/year), male sex (OR 3.2), diabetes (OR 1.9) and carriage of PNPLA3 148M (OR 2.1) remaining in the final model. Although minor variants of both SAMM50 loci are strongly associated with alcoholic HCC, this association is not independent of carriage of the well-known risk variant PNPLA3 148M.

While freshwater cyanobacteria are traditionally thought to be limited by the availability of phosphorus (P), fixed nitrogen (N) supply can promote the growth and/or toxin production of some genera. This study characterizes how growth on N-2 (control), nitrate (NO3-), ammonium (NH4+), and urea as well as P limitation altered the growth, toxin production, N-2 fixation, and gene expression of an anatoxin-a (ATX-A) - producing strain of Dolichospermum sp. 54. The transcriptomes of fixed N and P-limited cultures differed significantly from those of fixed N-deplete, P-replete (control) cultures, while the transcriptomes of P-replete cultures amended with either NH4+ or NO3- were not significantly different relative to those of the control. Growth rates of Dolichospermum (sp. 54) were significantly higher when grown on fixed N relative to without fixed N; growth on NH4+ was also significantly greater than growth on NO3-. NH4+ and urea significantly lowered N-2 fixation and nifD gene transcript abundance relative to the control while cultures amended with NO3- exhibited N-2 fixation and nifD gene transcript abundance that was not different from the control. Cultures grown on NH4+ exhibited the lowest ATX-A content per cell and lower transcript abundance of genes associated ATX-A synthesis (ana), while the abundance of transcripts of several ana genes were highest under fixed N and P - limited conditions. The significant negative correlation between growth rate and cellular anatoxin quota as well as the significantly higher number of transcripts of ana genes in cultures deprived of fixed N and P relative to P-replete cultures amended with NH4+ suggests ATX-A was being actively synthesized under P limitation. Collectively, these findings indicate that management strategies that do not regulate fixed N loading will leave eutrophic water bodies vulnerable to more intense and toxic (due to increased biomass) blooms of Dolichospermum.