Journal of Clinical Investigation (J CLIN INVEST)

Publisher: American Society for Clinical Investigation, American Society for Clinical Investigation

Journal description

The Journal of Clinical Investigation has a respected history as a vital publication for the physician and scientist alike. Since 1924, the JCI has published research that examines the basic science behind clinical presentation. The JCI continues to offer expanded commentary on published articles and series focused on critical topics in emerging areas of biomedicine.

Current impact factor: 13.22

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 13.215
2013 Impact Factor 13.765
2012 Impact Factor 12.812
2011 Impact Factor 13.069
2010 Impact Factor 14.152
2009 Impact Factor 15.387
2008 Impact Factor 16.559
2007 Impact Factor 16.915
2006 Impact Factor 15.754
2005 Impact Factor 15.053
2004 Impact Factor 14.204
2003 Impact Factor 14.307
2002 Impact Factor 14.051
2001 Impact Factor 14.118
2000 Impact Factor 12.015
1999 Impact Factor 10.921
1998 Impact Factor 9.315
1997 Impact Factor 9.667
1996 Impact Factor 9.486
1995 Impact Factor 8.788
1994 Impact Factor 8.467
1993 Impact Factor 8.519
1992 Impact Factor 8.389

Impact factor over time

Impact factor

Additional details

5-year impact 14.05
Cited half-life >10.0
Immediacy index 2.50
Eigenfactor 0.19
Article influence 6.11
Website Journal of Clinical Investigation website
ISSN 0021-9738
OCLC 55055897
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

American Society for Clinical Investigation

  • Pre-print
    • Author cannot archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Authors personal websites, institutional repositories and funding-body repositories
    • Published source must be acknowledged
    • Please use publisher PDF
    • Cannot appear before publication
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Improved recovery from ischemia reperfusion injury (IRI) in females compared to males is apparent experimentally, but human data are less established. To investigate gender effects on IRI, we developed a series of murine renal ischemia and transplant models. We found profoundly increased IRI tolerance in female mice compared to males and describe an intermediate phenotype after neutering of either gender. Adult kidneys of either gender, when transplanted into the opposing gender recipient and subjected to ischemia at a remote time, demonstrated ischemia recovery reflecting the gender of the recipient, revealing that the host environment is determinative. Likewise, female estrogen receptor-alpha knockout mice displayed exacerbated renal IRI, whereas female mice receiving supplemental estrogen pre-ischemia were protected. To investigate similar effects in humans, we examined UNOS national data for any association between gender and delayed graft function in deceased donor renal transplants. A multivariable logistic regression analysis determined that male recipient gender was highly associated with delayed graft function relative to female recipient gender (OR 1.39; 95% CI 1.33-1.46). We conclude that gender significantly affects renal IRI tolerance in mice and humans, and describe therapeutic benefit with estrogen administration in mice, implying a potential for therapeutic intervention to improve ischemia tolerance clinically.
    No preview · Article · Feb 2016 · Journal of Clinical Investigation

  • No preview · Article · Feb 2016 · Journal of Clinical Investigation
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    ABSTRACT: HIV persistence in patients undergoing antiretroviral therapy is a major impediment to the cure of HIV/AIDS. The molecular and cellular mechanisms underlying HIV persistence in vivo have not been fully elucidated. This lack of basic knowledge has hindered progress in this area. The in vivo analysis of HIV persistence and the implementation of curative strategies would benefit from animal models that accurately recapitulate key aspects of the human condition. This Review summarizes the contribution that humanized mouse models of HIV infection have made to the field of HIV cure research. Even though these models have been shown to be highly informative in many specific areas, their great potential to serve as excellent platforms for discovery in HIV pathogenesis and treatment has yet to be fully developed.
    No preview · Article · Feb 2016 · Journal of Clinical Investigation
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    ABSTRACT: This position statement originated from a working group meeting convened on April 15, 2015, by the NHLBI and incorporates follow-up contributions by the participants as well as other thought leaders subsequently consulted, who together represent research fields relevant to all branches of the NIH. The group was deliberately composed not only of individuals with a current research emphasis in the glycosciences, but also of many experts from other fields, who evinced a strong interest in being involved in the discussions. The original goal was to discuss the value of creating centers of excellence for training the next generation of biomedical investigators in the glycosciences. A broader theme that emerged was the urgent need to bring the glycosciences back into the mainstream of biology by integrating relevant education into the curricula of medical, graduate, and postgraduate training programs, thus generating a critical sustainable workforce that can advance the much-needed translation of glycosciences into a more complete understanding of biology and the enhanced practice of medicine.
    No preview · Article · Feb 2016 · Journal of Clinical Investigation
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    ABSTRACT: Combination antiretroviral therapy (ART) can suppress plasma HIV to undetectable levels, allowing HIV-infected individuals who are treated early a nearly normal life span. Despite the clear ability of ART to prevent morbidity and mortality, it is not curative. Even in individuals who have full suppression of viral replication on ART, there are resting memory CD4+ T cells that harbor stably integrated HIV genomes, which are capable of producing infectious virus upon T cell activation. This latent viral reservoir is considered the primary obstacle to the development of an HIV cure, and recent efforts in multiple areas of HIV research have been brought to bear on the development of strategies to eradicate or develop a functional cure for HIV. Reviews in this series detail progress in our understanding of the molecular and cellular mechanisms of viral latency, efforts to accurately assess the size and composition of the latent reservoir, the characterization and development of HIV-targeted broadly neutralizing antibodies and cytolytic T lymphocytes, and animal models for the study HIV latency and therapeutic strategies.
    No preview · Article · Feb 2016 · Journal of Clinical Investigation
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    ABSTRACT: Current efforts toward achieving a cure for HIV are focused on developing strategies to eliminate latently infected CD4+ T cells, which represent the major barrier to virus eradication. Sensitive, precise, and practical assays that can reliably characterize and measure this HIV reservoir and can reliably measure the impact of a candidate treatment strategy are essential. PCR-based procedures for detecting integrated HIV DNA will overestimate the size of the reservoir by detecting replication-incompetent proviruses; however, viral outgrowth assays underestimate the size of the reservoir. Here, we describe the attributes and limitations of current procedures for measuring the HIV reservoir. Characterizing their relative merits will require rigorous evaluation of their performance characteristics (sensitivity, specificity, reproducibility, etc.) and their relationship to the results of clinical studies.
    No preview · Article · Feb 2016 · Journal of Clinical Investigation
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    ABSTRACT: A substantial research effort has been directed to identifying strategies to eradicate or control HIV infection without a requirement for combination antiretroviral therapy (cART). A number of obstacles prevent HIV eradication, including low-level viral persistence during cART, long-term persistence of HIV-infected cells, and latent infection of resting CD4+ T cells. Mechanisms of persistence remain uncertain, but integration of the provirus into the host genome represents a central event in replication and pathogenesis of all retroviruses, including HIV. Analysis of HIV proviruses in CD4+ lymphocytes from individuals after prolonged cART revealed that a substantial proportion of the infected cells that persist have undergone clonal expansion and frequently have proviruses integrated in genes associated with regulation of cell growth. These data suggest that integration may influence persistence and clonal expansion of HIV-infected cells after cART is introduced, and these processes may represent key mechanisms for HIV persistence. Determining the diversity of host genes with integrants in HIV-infected cells that persist for prolonged periods may yield useful information regarding pathways by which infected cells persist for prolonged periods. Moreover, many integrants are defective, and new studies are required to characterize the role of clonal expansion in the persistence of replication-competent HIV.
    No preview · Article · Feb 2016 · Journal of Clinical Investigation
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    ABSTRACT: Abnormal fibroblast function underlies poor wound healing in patients with diabetes; however, the mechanisms that impair wound healing are poorly defined. Here, we evaluated fibroblasts from individuals who had type 1 diabetes (T1D) for 50 years or more (Medalists, n = 26) and from age-matched controls (n = 7). Compared with those from controls, Medalist fibroblasts demonstrated a reduced migration response to insulin, lower VEGF expression, and less phosphorylated AKT (p-AKT), but not p-ERK, activation. Medalist fibroblasts were also functionally less effective at wound closure in nude mice. Activation of the δ isoform of protein kinase C (PKCδ) was increased in postmortem fibroblasts from Medalists, fibroblasts from living T1D subjects, biopsies of active wounds of living T1D subjects, and granulation tissues from mice with streptozotocin-induced diabetes. Diabetes-induced PKCD mRNA expression was related to a 2-fold increase in the mRNA half-life. Pharmacologic inhibition and siRNA-mediated knockdown of PKCδ or expression of a dominant-negative isoform restored insulin signaling of p-AKT and VEGF expression in vitro and improved wound healing in vivo. Additionally, increasing PKCδ expression in control fibroblasts produced the same abnormalities as those seen in Medalist fibroblasts. Our results indicate that persistent PKCδ elevation in fibroblasts from diabetic patients inhibits insulin signaling and function to impair wound healing and suggest PKCδ inhibition as a potential therapy to improve wound healing in diabetic patients.
    No preview · Article · Jan 2016 · Journal of Clinical Investigation
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    ABSTRACT: Nonalcoholic steatohepatitis (NASH) is the most common liver disease in industrialized countries. NASH is a progressive disease that can lead to cirrhosis, cancer, and death, and there are currently no approved therapies. The development of NASH in animal models requires intact TLR9, but how the TLR9 pathway is activated in NASH is not clear. Our objectives in this study were to identify NASH-associated ligands for TLR9, establish the cellular requirement for TLR9, and evaluate the role of obesity-induced changes in TLR9 pathway activation. We demonstrated that plasma from mice and patients with NASH contains high levels of mitochondrial DNA (mtDNA) and intact mitochondria and has the ability to activate TLR9. Most of the plasma mtDNA was contained in microparticles (MPs) of hepatocyte origin, and removal of these MPs from plasma resulted in a substantial decrease in TLR9 activation capacity. In mice, NASH development in response to a high-fat diet required TLR9 on lysozyme-expressing cells, and a clinically applicable TLR9 antagonist blocked the development of NASH when given prophylactically and therapeutically. These data demonstrate that activation of the TLR9 pathway provides a link between the key metabolic and inflammatory phenotypes in NASH.
    No preview · Article · Jan 2016 · Journal of Clinical Investigation
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    ABSTRACT: In successful cancer immunotherapy, T cell responses appear to be directed toward neoantigens created by somatic mutations; however, direct evidence that neoantigen-specific T cells cause regression of established cancer is lacking. Here, we generated T cells expressing a mutation-specific transgenic T cell receptor (TCR) to target different immunogenic mutations in cyclin-dependent kinase 4 (CDK4) that naturally occur in human melanoma. Two mutant CDK4 isoforms (R24C, R24L) similarly stimulated T cell responses in vitro and were analyzed as therapeutic targets for TCR gene therapy. In a syngeneic HLA-A2-transgenic mouse model of large established tumors, we found that both mutations differed dramatically as targets for TCR-modified T cells in vivo. While T cells expanded efficiently and produced IFN-γ in response to R24L, R24C failed to induce an effective antitumor response. Such differences in neoantigen quality might explain why cancer immunotherapy induces tumor regression in some individuals, while others do not respond, despite similar mutational load. We confirmed the validity of the in vivo model by showing that the melan-A-specific (MART-1-specific) TCR DMF5 induces rejection of tumors expressing analog, but not native, MART-1 epitopes. The described model allows identification of those neoantigens in human cancer that serve as suitable T cell targets and may help to predict clinical efficacy.
    No preview · Article · Jan 2016 · Journal of Clinical Investigation
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    ABSTRACT: The transcription factor GATA3 is essential for the genesis and maturation of the T cell lineage, and GATA3 dysregulation has pathological consequences. Previous studies have shown that GATA3 function in T cell development is regulated by multiple signaling pathways and that the Notch nuclear effector, RBP-J, binds specifically to the Gata3 promoter. We previously identified a T cell-specific Gata3 enhancer (Tce1) lying 280 kb downstream from the structural gene and demonstrated in transgenic mice that Tce1 promoted T lymphocyte-specific transcription of reporter genes throughout T cell development; however, it was not clear if Tce1 is required for Gata3 transcription in vivo. Here, we determined that the canonical Gata3 promoter is insufficient for Gata3 transcriptional activation in T cells in vivo, precluding the possibility that promoter binding by a host of previously implicated transcription factors alone is responsible for Gata3 expression in T cells. Instead, we demonstrated that multiple lineage-affiliated transcription factors bind to Tce1 and that this enhancer confers T lymphocyte-specific Gata3 activation in vivo, as targeted deletion of Tce1 in a mouse model abrogated critical functions of this T cell-regulatory element. Together, our data show that Tce1 is both necessary and sufficient for critical aspects of Gata3 T cell-specific transcriptional activity.
    No preview · Article · Jan 2016 · Journal of Clinical Investigation

  • No preview · Article · Jan 2016 · Journal of Clinical Investigation
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    ABSTRACT: Cancer immunotherapy in which cytotoxic T cells (CTLs) target tumor-specific antigens complexed to MHC-I molecules has been used successfully for several types of cancer; however, MHC-I is frequently downregulated in tumors, resulting in CTL evasion. Recently, it has been shown that MHC-Ilo tumors produce a set of T cell epitopes associated with impaired peptide processing (TEIPP) that have potential to be exploited for immunotherapy. TEIPP-specific CTLs recognize tumors defective in antigen presentation machinery (APM) but not those with intact APM. In this issue of the JCI, Doorduljn et al. evaluated thymus selection and peripheral behavior of TEIPP-specific T cells, using a unique T cell receptor (TCR) transgenic mouse model. They demonstrated that TEIPP-specific T cells in TAP-deficient mice have largely been deleted by central tolerance, while the same T cells in WT mice are naive and sustained. The results of this study suggest that TIEPPs have potential to be successful targets for elimination of MHC-Ilo tumors.
    No preview · Article · Jan 2016 · Journal of Clinical Investigation
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    ABSTRACT: Overexpression of FGF23 results in hypophosphatemic rickets, which is characterized by renal phosphate wasting, inappropriately low circulating levels of the active form of vitamin D, and skeletal abnormalities. The precise mechanisms of how excess FGF23 leads to hypophosphatemic rickets are not clear. In this issue of the JCI, Bai and colleagues demonstrate that deletion or inhibition of CYP24A1, which initiates degradation of the active form of vitamin D, ameliorates skeletal abnormalities in two mouse models of hypophosphatemic rickets. While this work supports an important role for excess CYP24A1 activity in the pathogenesis of FGF23-mediated hypophosphatemic rickets, more work will need to be done before CYP24A1 inhibition can be integrated into the management of patients living with these diseases.
    No preview · Article · Jan 2016 · Journal of Clinical Investigation
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    ABSTRACT: CYP24A1 (hereafter referred to as CYP24) enzymatic activity is pivotal in the inactivation of vitamin D metabolites. Basal renal and extrarenal CYP24 is usually low but is highly induced by its substrate 1,25-dihydroxyvitamin D. Unbalanced high and/or long-lasting CYP24 expression has been proposed to underlie diseases like chronic kidney disease, cancers, and psoriasis that otherwise should favorably respond to supplemental vitamin D. Using genetically modified mice, we have shown that renal phosphate wasting hypophosphatemic states arising from high levels of fibroblast growth factor 23 (FGF23) are also associated with increased renal Cyp24 expression, suggesting that elevated CYP24 activity is pivotal to the pathophysiology of these disorders. We therefore crossed 2 mouse strains, each with distinct etiology for high levels of circulating FGF23, onto a Cyp24-null background. Specifically, we evaluated Cyp24 deficiency in Hyp mice, the murine homolog of X-linked dominant hypophosphatemic rickets, and transgenic mice that overexpress a mutant FGF23 (FGF23R176Q) that is associated with the autosomal dominant form of hypophosphatemic rickets. Loss of Cyp24 in these murine models of human disease resulted in near-complete recovery of rachitic/osteomalacic bony abnormalities in the absence of any improvement in the serum biochemical profile. Moreover, treatment of Hyp and FGF23R1760-transgenic mice with the CYP24 inhibitor CTA102 also ameliorated their rachitic bones. Our results link CYP24 activity to the pathophysiology of FGF23-dependent renal phosphate wasting states and implicate pharmacologic CYP24 inhibition as a therapeutic adjunct for their treatment.
    No preview · Article · Jan 2016 · Journal of Clinical Investigation
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    ABSTRACT: Although the cognitive and biological characteristics of Alzheimer's disease (AD) are well known and mouse models of AD are available, current treatments for AD-related cognitive deficits have quite limited efficacy. The development of tasks with cross-species validity may enable better prediction of the efficacy of potential new treatments. In this issue of the JCI, Possin et al. present a virtual version of the Morris water maze (a common test of spatial learning and memory for rodents) that is designed for use with humans. The authors tested a mouse model of AD (transgenic mice expressing human amyloid precursor protein [hAPP]) and patients in the earlier mild cognitive impairment (MCI) stage of AD in their respective versions of the maze. Using novel statistical methods, they detected similar deficits across species, providing support for the hAPP model and use of the virtual water maze. Importantly, this work enabled recommendations for appropriate sample sizes when developing potential therapeutics for AD.
    No preview · Article · Jan 2016 · Journal of Clinical Investigation