Oncolytic viruses (OV) are an emerging class of anticancer bio-therapeutics that induce antitumor immunity through selective replication in cancer cells. However, the efficacy of OVs as single agents remains limited. We postulate that resistance to oncolytic virotherapy results in part from the failure of tumor cells to be sufficiently infected. In this study, we provide evidence that in the context of sarcoma, a highly heterogeneous malignancy, the infection of tumors by different oncolytic viruses varies greatly. Similarly, for a given oncolytic virus, productive infection of tumors across patient samples varies by many orders of magnitude. To overcome this issue, we hypothesize that the infection of resistant tumors can be achieved through the use of selected small molecules. Here, we have identified two novel drug classes with the ability to improve the efficacy of OV therapy: fumaric and maleic acid esters (FMAEs) and vanadium compounds. FMAEs are enhancing infection of cancer cells by several oncolytic viruses in cancer cell lines and human tumor biopsies. The ability of FMAEs to enhance viral spread is due to their ability to inhibit type I IFN production and response, which is associated with their ability to block nuclear translocation of transcription factor NF-κB. Vanadium-based phosphatase inhibitors enhance OV infection of RNA viruses in vitro and ex vivo, in resistant cancer cell lines. Mechanistically, this involves subverting the antiviral type I IFN response towards a death-inducing and proinflammatory type II IFN response, leading to improved OV spread, increased bystander killing of cancer cells, and enhanced anti-tumor immune-stimulation. Both FMAEs and vanadium compounds improve therapeutic outcomes of OV treatment in syngeneic tumor models, leading to durable responses, even in models otherwise refractory to OV and drug alone. Overall, we showcased novel avenues for the development of improved immunotherapy strategies.

Multiple Sclerosis (MS) is a chronic and potentially disabling disease of the central nervous system (CNS) in which the immune system attacks the protective myelin layer that surrounds nerve cells. While the majority of individuals diagnosed with MS initially present with a non-progressive relapsing form of the disease, there is significant risk of eventually transitioning to a more progressive form for which there are few effective treatments. Consequently, early intervention with disease-modifying therapies (DMTs) is essential for effective disease management. Newly diagnosed patients are typically started on one of four first-line therapies (beta interferon, glatiramer acetate, teriflunomide, or dimethyl fumarate). Though there are distinct differences between these treatments in regard to efficacy and safety, there is no uniform standard for making decisions about which to initiate treatment with. This review gives an overview of current first-line MS therapies, and seeks to highlight the lack of comparison data and the gaps in the current understanding of disease management, as well as the need for more comprehensive research in these areas.

Systemic sclerosis (SSc) is a rare connective tissue disease affecting skin and internal organs. The pathogenesis of SSc is multifactorial and includes autoimmunity, inflammation and vasculopathy. Pulmonary arterial hypertension (PAH) is among the most serious of SSc complications and is characterized by augmented vasoconstriction, neointimal remodeling and occlusion of small arteries in lung. Elevated pulmonary arterial blood pressure and volume overload in the right heart eventually lead to death from heart failure. Pre-existing elevated pro-fibrotic signaling, systemic vasculopathy and chronic inflammation are additional factors that likely contribute to the more severe PAH manifestation in SSc patients, whose response to existing therapies is suboptimal. The aim of my thesis research was to investigate the pathological role of altered transcriptional regulation of endothelium in pulmonary vasculature, as well as testing potential novel therapies for SSc-PAH in vivo. I found that endothelial downregulation of GATA6 promotes increased production of reactive oxygen species (ROS) by suppressing enzymatic machinery responsible for ROS clearance. Increased ROS production triggered ER stress and inflammation, exacerbating endothelial dysfunction and vascular injury both in vitro and in vivo. Another discovery is that simultaneous depletion of two ETS-family factors, ERG and FLI1 synergistically activates interferon signaling in pulmonary endothelial cells and promotes inflammation in lung in vivo. Based on observed pathological contribution of oxidative stress and inflammation to vasculopathy and fibrosis I tested an anti-oxidative and anti-inflammatory agent- dimethyl fumarate (DMF) in mouse models of PAH, as well as lung and skin fibrosis. DMF efficiently ameliorated increased pulmonary artery pressure and vascular remodeling, as well as fibrotic changes in lung and skin. Mechanistically, I found that DMF promotes a proteasomal, βTRCP-dependent degradation of pro-fibrotic mediators TAZ/YAP, β-catenin and Sp1. In conclusion, I characterized new elements of pathological mechanism that promote vasculopathy and fibrosis, as well as provided an insight into anti-inflammatory and anti-fibrotic DMF therapy. Importantly, elucidating the novel mechanism of DMF action and recognizing the pathological role of Hippo and Wnt signaling in fibrosis might help to design more specific and effective pharmacological intervention in SSc-PAH patients.

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