Stanford Advisors


All Publications


  • The immunometabolic topography of tuberculosis granulomas governs cellular organization and bacterial control. bioRxiv : the preprint server for biology McCaffrey, E. F., Delmastro, A. C., Fitzhugh, I., Ranek, J. S., Douglas, S., Peters, J. M., Fullaway, C. C., Bosse, M., Liu, C. C., Gillen, C., Greenwald, N. F., Anzick, S., Martens, C., Winfree, S., Bai, Y., Sowers, C., Goldston, M., Kong, A., Boonrat, P., Bigbee, C. L., Venugopalan, R., Maiello, P., Klein, E., Rodgers, M. A., Scanga, C. A., Lin, P. L., Kirschner, D., Fortune, S., Bryson, B. D., Butler, J. R., Mattila, J. T., Flynn, J. L., Angelo, M. 2025

    Abstract

    Despite being heavily infiltrated by immune cells, tuberculosis (TB) granulomas often subvert the host response to Mycobacterium tuberculosis (Mtb) infection and support bacterial persistence. We previously discovered that human TB granulomas are enriched for immunosuppressive factors typically associated with tumor-immune evasion, raising the intriguing possibility that they promote tolerance to infection. In this study, our goal was to identify the prime drivers for establishing this tolerogenic niche and to determine if the magnitude of this response correlates with bacterial persistence. To do this, we conducted a multimodal spatial analysis of 52 granulomas from 16 non-human primates (NHP) who were infected with low dose Mtb for 9-12 weeks. Notably, each granuloma's bacterial burden was individually quantified allowing us to directly ask how granuloma spatial structure and function relate to infection control. We found that a universal feature of TB granulomas was partitioning of the myeloid core into two distinct metabolic environments, one of which is hypoxic. This hypoxic environment associated with pathologic immune cell states, dysfunctional cellular organization of the granuloma, and a near-complete blockade of lymphocyte infiltration that would be required for a successful host response. The extent of these hypoxia-associated features correlated with worsened bacterial burden. We conclude that hypoxia governs immune cell state and organization within granulomas and is a potent driver of subverted immunity during TB.

    View details for DOI 10.1101/2025.02.18.638923

    View details for PubMedID 40027668

    View details for PubMedCentralID PMC11870603

  • Temporal and spatial composition of the tumor microenvironment predicts response to immune checkpoint inhibition. bioRxiv : the preprint server for biology Greenwald, N. F., Nederlof, I., Sowers, C., Ding, D. Y., Park, S., Kong, A., Houlahan, K. E., Varra, S. R., de Graaf, M., Geurts, V., Liu, C. C., Ranek, J. S., Voorwerk, L., de Maaker, M., Kagel, A., McCaffrey, E., Khan, A., Yeh, C. Y., Fullaway, C. C., Khair, Z., Bai, Y., Piyadasa, H., Risom, T., Delmastro, A., Hartmann, F. J., Mangiante, L., Sotomayor-Vivas, C., Schumacher, T. N., Ma, Z., Bosse, M., van de Vijver, M. J., Tibshirani, R., Horlings, H. M., Curtis, C., Kok, M., Angelo, M. 2025

    Abstract

    Immune checkpoint inhibition (ICI) has fundamentally changed cancer treatment. However, only a minority of patients with metastatic triple negative breast cancer (TNBC) benefit from ICI, and the determinants of response remain largely unknown. To better understand the factors influencing patient outcome, we assembled a longitudinal cohort with tissue from multiple timepoints, including primary tumor, pre-treatment metastatic tumor, and on-treatment metastatic tumor from 117 patients treated with ICI (nivolumab) in the phase II TONIC trial. We used highly multiplexed imaging to quantify the subcellular localization of 37 proteins in each tumor. To extract meaningful information from the imaging data, we developed SpaceCat, a computational pipeline that quantifies features from imaging data such as cell density, cell diversity, spatial structure, and functional marker expression. We applied SpaceCat to 678 images from 294 tumors, generating more than 800 distinct features per tumor. Spatial features were more predictive of patient outcome, including features like the degree of mixing between cancer and immune cells, the diversity of the neighboring immune cells surrounding cancer cells, and the degree of T cell infiltration at the tumor border. Non-spatial features, including the ratio between T cell subsets and cancer cells and PD-L1 levels on myeloid cells, were also associated with patient outcome. Surprisingly, we did not identify robust predictors of response in the primary tumors. In contrast, the metastatic tumors had numerous features which predicted response. Some of these features, such as the cellular diversity at the tumor border, were shared across timepoints, but many of the features, such as T cell infiltration at the tumor border, were predictive of response at only a single timepoint. We trained multivariate models on all of the features in the dataset, finding that we could accurately predict patient outcome from the pre-treatment metastatic tumors, with improved performance using the on-treatment tumors. We validated our findings in matched bulk RNA-seq data, finding the most informative features from the on-treatment samples. Our study highlights the importance of profiling sequential tumor biopsies to understand the evolution of the tumor microenvironment, elucidating the temporal and spatial dynamics underlying patient responses and underscoring the need for further research on the prognostic role of metastatic tissue and its utility in stratifying patients for ICI.

    View details for DOI 10.1101/2025.01.26.634557

    View details for PubMedID 39975273

    View details for PubMedCentralID PMC11838242

  • Automated classification of cellular expression in multiplexed imaging data with Nimbus. bioRxiv : the preprint server for biology Rumberger, J. L., Greenwald, N. F., Ranek, J. S., Boonrat, P., Walker, C., Franzen, J., Varra, S. R., Kong, A., Sowers, C., Liu, C. C., Averbukh, I., Piyadasa, H., Vanguri, R., Nederlof, I., Wang, X. J., Van Valen, D., Kok, M., Hollmann, T. J., Kainmueller, D., Angelo, M. 2024

    Abstract

    Multiplexed imaging offers a powerful approach to characterize the spatial topography of tissues in both health and disease. To analyze such data, the specific combination of markers that are present in each cell must be enumerated to enable accurate phenotyping, a process that often relies on unsupervised clustering. We constructed the Pan-Multiplex (Pan-M) dataset containing 197 million distinct annotations of marker expression across 15 different cell types. We used Pan-M to create Nimbus, a deep learning model to predict marker positivity from multiplexed image data. Nimbus is a pre-trained model that uses the underlying images to classify marker expression across distinct cell types, from different tissues, acquired using different microscope platforms, without requiring any retraining. We demonstrate that Nimbus predictions capture the underlying staining patterns of the full diversity of markers present in Pan-M. We then show how Nimbus predictions can be integrated with downstream clustering algorithms to robustly identify cell subtypes in image data. We have open-sourced Nimbus and Pan-M to enable community use at https://github.com/angelolab/Nimbus-Inference.

    View details for DOI 10.1101/2024.06.02.597062

    View details for PubMedID 38895405

    View details for PubMedCentralID PMC11185540