Chlorhexidine for ocular antisepsis before intravitreal injection: A systematic review and meta-analysis

Povidone-iodine (PI) is the gold standard for pre-intravitreal injection ocular antisepsis. Chlorhexidine (CHX) is an emerging alternative with less ocular irritation. This meta-analysis aims to evaluate post-injection endophthalmitis rates with the use of CHX compared to PI. A systematic search of PubMed, Embase, and Scopus was performed for studies published between January 1, 2000 and February 21, 2024. Data on the number of injections and endophthalmitis cases were analyzed. A sample-size weighted mean difference (MD) meta-analysis was performed using RevMan 5.4.1, p < 0.05 was considered statistically significant. Five studies including 230,656 injections were pooled to determine an endophthalmitis rate of 0.0003 [95 % CI, 0.0001-0.0005] with preinjection CHX antisepsis. Three studies included an additional PI branch and thus were used for secondary meta-analysis comparing CHX against PI. The analysis consisted of 185,799 injections in the CHX group and 269,441 injections in the PI group. No significant difference in the weighted relative risk of endophthalmitis with CHX was found (RR = 1.27 [95 %CI 0.50-3.22], p = 0.62). A total of 24 and 31 cases of culture-positivity were recorded in the CHX and PI groups respectively but no significant difference in weighted means was found (RR = 1.42[95 %CI 0.96-2.12], p = 0.08). This meta-analysis disclosed that the rate of post-IVI endophthalmitis while using CHX antisepsis is approximately 1 in 3937 injections, compared to 1 in 3906 with PI. CHX was not associated with a significant difference in the rate of endophthalmitis or culture-positivity compared to PI.

Stable SARS-CoV-2 antibody levels and functionality in serum and COVID-19 convalescent plasma after long-term storage

BACKGROUND AND OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic necessitated various therapeutic approaches, including convalescent plasma (CP) administration. The administration timing of COVID-19 CP (CCP), antibody specificity and quantity were identified as crucial factors for therapeutic success. Currently, antibody durability and storage time are still under debate. The aim of this study was to evaluate the stability and in vitro functionality of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) antibodies in human plasma and serum after long-term storage, to provide a framework for generally applicable rules regarding the long-term storage of CCP.

MATERIALS AND METHODS

Serum and plasma samples of CCP donations were investigated at the time of donation and after 2 and 3 years' storage at less than -30°C using (electro)chemiluminescence immunoassays and enzyme-linked immunosorbent assays, with the plasma undergoing multiple freezing and thawing.

RESULTS

Our data reveal robust levels of SARS-CoV-2 antibodies after long-term storage. Furthermore, our findings also indicate that multiple freezing and thawing cycles do not affect the antibody levels or their neutralizing capability.

CONCLUSION

As antibody stability and in vitro functionality are maintained over extended periods, even after repeated freezing and thawing, our findings support long-term storage of CCP, particularly benefiting vulnerable populations such as immunocompromised individuals. By now, donors have likely encountered various SARS-CoV-2 variants and vaccine-acquired antibodies. This antibody mix present in CCP is suggested to protect even against new variants. Our data indicate that current regulations for the storage of CCP can be extended and that CCPs could be used for therapeutic purposes after long-term storage without significant loss of antibody quantity.

Type I interferon autoantibody footprints reveal neutralizing mechanisms and allow inhibitory decoy design

Autoantibodies neutralizing type I interferons (IFN-Is; IFNα or IFNω) exacerbate severe viral disease, but specific treatments are unavailable. With footprint profiling, we delineate two dominant IFN-I faces commonly recognized by neutralizing IFN-I autoantibody-containing plasmas from aged individuals with HIV-1 and from individuals with severe COVID-19. These faces overlap with IFN-I regions independently essential for engaging the IFNAR1/IFNAR2 heterodimer, and neutralizing plasmas efficiently block the interaction of IFN-I with both receptor subunits in vitro. In contrast, non-neutralizing autoantibody-containing plasmas limit the interaction of IFN-I with only one receptor subunit and display relatively low IFN-I-binding avidities, thus likely hindering neutralizing function. Iterative engineering of signaling-inert mutant IFN-Is (simIFN-Is) retaining dominant autoantibody targets created potent decoys that prevent IFN-I neutralization by autoantibody-containing plasmas and that restore IFN-I-mediated antiviral activity. Additionally, microparticle-coupled simIFN-Is were effective at depleting IFN-I autoantibodies from plasmas, leaving antiviral antibodies unaffected. Our study reveals mechanisms of action for IFN-I autoantibodies and demonstrates a proof-of-concept strategy to alleviate pathogenic effects.

Anti-cytokine autoantibodies in human susceptibility to infectious diseases: insights from Inborn errors of immunity

The study of Inborn Errors of Immunity (IEIs) is critical for understanding the complex mechanisms of the human immune response to infectious diseases. Specific IEIs, characterized by selective susceptibility to certain pathogens, have enhanced our understanding of the key molecular pathways and cellular subsets involved in host defense against pathogens. These insights revealed that patients with anti-cytokine autoantibodies exhibit phenotypes similar to those with pathogenic mutations in genes encoding signaling molecules. This new disease concept is currently categorized as 'Phenocopies of IEI'. This category includes anti-cytokine autoantibodies targeting IL-17/IL-22, IFN-γ, IL-6, GM-CSF, and type I IFNs. Abundant anti-cytokine autoantibodies deplete corresponding cytokines, impair signaling pathways, and increase susceptibility to specific pathogens. We herein demonstrate the clinical and etiological significance of anti-cytokine autoantibodies in human immunity to pathogens. Insights from studies of rare IEIs underscore the pathological importance of cytokine-targeting autoantibodies. Simultaneously, the diverse clinical phenotype of patients with these autoantibodies suggests that the influences of cytokine dysfunction are broader than previously recognized. Furthermore, comprehensive studies prompted by the COVID-19 pandemic highlighted the substantial clinical impact of autoantibodies and their potential role in shaping the outcomes of infectious disease.

Development and Evaluation of a New Gastroenteritis Clinical Severity Score for Children Aged Under 5

AIM

To develop and internally validate a new severity score to more accurately assess the clinical severity forms of acute gastroenteritis (AGE) in children from birth to age 5 years.

METHODS

We included children consulting for AGE in the emergency department of the University Hospital of Nantes (March 2017-June 2019). We developed and evaluated a new predictive score (GASTROVIM score) using the classification and regression trees. We compared its diagnostic performance with the two existing scores: the Vesikari score and clinical dehydration scale (CDS). A clinical expert a posteriori evaluated children's medical records to determine the severity form of AGE as the gold standard.

RESULTS

Of the 200 children included, 129 (64.5%) had severe forms of AGE according to the GASTROVIM score (maximal number of liquid stools and vomiting per day, weight loss and CDS), with sensitivity 90.0% (95% CI: 83.5-94.6) and specificity 82.9% (72.0-90.8). The Vesikari score had similar sensitivity (97.3%) but lower specificity (17.0%) and the CDS had lower sensitivity (28.3%) and higher specificity (100%) than the GASTROVIM score.

CONCLUSION

The GASTROVIM score could discriminate severe forms of AGE with good diagnostic performance. Nevertheless, external validation in other populations and/or other countries is needed.

A review of advancements in antiseptics for wound care in diabetic and non-diabetic patients

Wounds affect many people and require a considerable annual cost to manage. Wound infections significantly delay the healing process, particularly in individuals with diabetes mellitus, due to impaired immunity and microvascular complications. The use of antiseptics is considered a way to reduce this problem. The study aims to assess the different antiseptic categories frequently employed in wound management, focusing on identifying and understanding their unique features. A comprehensive review of PubMed, Scopus, and EMBASE databases identified key antiseptics, including isopropyl alcohol, chlorhexidine, polyhexanide, octenidine, povidone-iodine, hypochlorous acid, silver-based products, hydrogen peroxide, triclosan, and benzalkonium chloride. These antiseptics exhibit varying efficacies and cytotoxicity profiles, necessitating tailored usage to optimize healing while preventing antimicrobial resistance. The primary indication for antiseptics is the prevention of Surgical Site Infections (SSIs), as recommended by guidelines. For diabetic foot ulcers, the strongest evidence supports the use of hypochlorous acid. There are no universal recommendations for antiseptic use; their application depends on specific circumstances. This review highlights the need for evidence-based, condition-specific antiseptic strategies to address unique patient needs effectively.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-025-01607-7.

Broad host range phage LPC-1 reduce the risk of Listeria monocytogenes contamination in different food matrices

Listeria monocytogenes forms biofilms in food and food-processing environments, entering food through cross-contamination. Phages, as antimicrobial agents, have demonstrated efficacy in addressing this issue. This study demonstrated that the LM (Listeria monocytogenes, LM) lytic phage LPC-1 isolated from livestock slaughterhouse effluent effectively lysed LM, Listeria welshimeri, Listeria innocua, and Enterococcus faecium ATCC 35667. Phage LPC-1 is a tailed phage with a non-contractile long tail, has a short incubation period, high cleavage capacity, and can be adsorbed onto the surface of bacteria within a short period. The LPC-1 phage has a genome spanning 43,466 bp with a GC content of 39% and encompasses 67 coding sequences. Notably, LPC-1's genome displayed significant homologies to various non-Listeria phages. Experimental tests under simulated refrigerated conditions revealed that LPC-1 effectively diminished the presence of LM in milk, pork, and both eggshells and egg liquid, indicating its bacteriostatic properties. Moreover, LPC-1 hindered biofilm formation and enhanced biofilm eradication. Consequently, these findings endorse the potential of phage LPC-1 as a prospective antimicrobial agent specifically suited for controlling LM contamination in the food industry, given its proven safety and efficacy.

Prolonged effects of adenoviral vector priming on T-cell cytokine production in heterologous adenoviral vector/mRNA COVID-19 vaccination regimens

mRNA and adenoviral vector vaccine platforms were used for the primary series of COVID-19 vaccines in many countries. However, the distinct immunogenic properties on these platforms remain less understood. We traced neutralizing antibodies, memory B cells, and T cells longitudinally in cohorts that received either mRNA (BNT162b2 or mRNA-1273) or adenoviral vector (ChAdOx1) vaccines with homologous or heterologous regimens (total 9 groups, n = 26-28 for each group) at 4 weeks interval. The priming and boosting effects on various immune parameters were comparably assessed between mRNA and adenoviral vector platforms. We found that initial priming by adenoviral vector vaccine elicited robust T cell responses, but B cell responses, including antibody titers, were relatively lower than those elicited by mRNA priming. The dissociation between T cell and antibody responses were exaggerated at greater extents after the homologous booster with the adenoviral vector vaccine, resulting in 5-19-fold lower antibody titers despite comparable spike-specific T cell numbers at day 28 after the boost. Robust IFN-γ and few IL-2 and IL-5 production characterized T cell functionality primed by adenoviral vector. Boosting with mRNA vaccines restored their IL-2 and IL-5 production at some extents, but the IL-5 T cell responses elicited by adenoviral vector/mRNA heterologous regimen waned faster than those by mRNA homologous regimen. Thus, our data revealed that the cytokine production of helper T cells was skewed by adenoviral vector priming, leading to the attenuated IL-2 and IL-5 responses which were prolonged even after mRNA boosting, suggesting an imprinting of T-cell functionality depending on the vaccine platform used for initial priming. These results highlight the importance of selecting vaccine platforms based on the immunogenic properties.

Effect of perioperative disinfection and isolation measures in infection control after gastrointestinal surgery: A retrospective analysis

BACKGROUND

The application of perioperative disinfection and isolation measures to patients undergoing gastrointestinal surgery with postoperative infection can provide a data reference for reducing the postoperative infection rate, improving postoperative biochemical markers, and enhancing postoperative recovery outcomes.

AIM

To explore the effectiveness of perioperative disinfection and isolation measures in controlling postoperative infection following gastrointestinal surgery. It also sought to compare infection rates and biochemical markers between the observation and control groups and evaluate the impact of disinfection and isolation measures on reducing postoperative complications.

METHODS

A retrospective analysis was conducted. Ninety-six patients who underwent gastrointestinal surgery between January 2022 and December 2023 were selected and divided into an observation group and a control group, with 48 cases in each. The observation group received disinfection and isolation measures during the perioperative period, whereas the control group received standard nursing care. The incidence of infection, white blood cell count, C-reactive protein levels, hemoglobin levels, and liver function markers (alanine aminotransferase, aspartate aminotransferase, creatinine, and blood urea nitrogen) were monitored postoperatively in both groups.

RESULTS

The postoperative infection rate in the observation group was significantly lower than that in the control group (P < 0.05). White blood cell and C-reactive protein levels decreased significantly after surgery in the observation group and were significantly lower than those in the control group (P < 0.05). Alanine aminotransferase, aspartate aminotransferase, creatinine, and blood urea nitrogen levels in the observation group were lower than those in the control group on postoperative days 1 and 3, showing a significant difference (P < 0.05).

CONCLUSION

Perioperative disinfection and isolation measures effectively reduce postoperative infection rates in gastrointestinal surgery patients and improve biochemical markers, thereby enhancing recovery outcomes. This study provides a valuable basis for postoperative infection control and has significant clinical applications.

Infectious and Immunological Links Between Periodontitis and COVID-19: A Review

Emerging evidence suggests a potential association between periodontitis and adverse outcomes in COVID-19. Both conditions share risk factors and exhibit similar immune dysregulation, including elevated pro-inflammatory cytokines, altered myeloid compartments, and T-cell dysfunction. SARS-CoV-2 uses angiotensin-converting enzyme type 2 and transmembrane protease serine 2 membrane proteins, highly expressed in the oral cavity, for cellular entry. Periodontitis may exacerbate COVID-19 through mechanisms such as oral microbe aspiration, increased viral receptor expression, and systemic inflammation. The shared immunopathogenesis, characterized by cytokine storms and perturbed immune profiles, suggests periodontitis can predispose patients to more severe COVID-19 outcomes. This article aims to review the associations between periodontitis and the severity of COVID-19 and the possible immune mechanisms involved.

IgM Antibody Detection as a Diagnostic Marker for Acute Toxoplasmosis: Current Status of Studies and Main Limitations

Accurate dating of Toxoplasma gondii infection is essential for effective clinical management, particularly in pregnant women and immunocompromised individuals, where distinguishing acute from chronic infection informs treatment decisions. Serological detection of IgM antibodies is a key tool in diagnosing recent toxoplasmosis; however, its reliability is compromised by persistent IgM responses, cross-reactivity, and assay variability. While IgM lacks sufficient specificity to serve as a standalone marker of acute infection, it remains an important component of serological panels. This review summarizes current IgM detection methods and explores advancements aimed at improving diagnostic accuracy with a focus on recombinant antigens, which have emerged as promising alternatives to traditional Toxoplasma lysate antigen-based immunoassays. This paper also explores alternative methods of differentiating chronic and acute toxoplasmosis and outlines key areas for future research.

American Society for Transplantation and Cellular Therapy Series #9: Management of HHV-6B After Hematopoietic Cell Transplantation and Chimeric Antigen Receptor (CAR)-T-Cell Therapy

The Practice Guidelines Committee and the Transplant Infectious Disease Special Interest Group of the American Society for Transplantation and Cellular Therapy developed guidelines focusing on human herpes virus 6B (HHV-6B). A compendium-style approach was used to address a series of standalone frequently asked questions (FAQs), supported by tables and figures to spotlight key concepts. Adult and pediatric infectious disease and hematopoietic cell transplantation (HCT) content experts developed these FAQs, and finalized recommendations after consensus was reached. This ninth topic in the series focuses on the relevant risk factors, diagnostic considerations, prophylaxis, and treatment approaches relevant to HHV-6B infections after HCT and Chimeric Antigen Receptor (CAR)-T-Cell Therapy.

Impact of Preoperative Povidone Nasal Swab on the Incidence of Surgical Site Infection: An Observational Study

OBJECTIVES

Surgical site infections (SSIs) are the most common hospital-acquired infections in the United States, of which methicillin-resistant Staphylococcus aureus (MRSA) accounts for 43%. Preoperative povidone-iodine nasal swab (PNS) is considered an effective and cost-saving treatment for Staphylococcus aureus decolonization. We aim to assess the impact of preoperative PNS on SSI incidence.

MATERIALS AND METHODS

This retrospective observational study utilized elective surgical cases between January 1, 2018 and May 31, 2023, at a single academic medical center. The cohort was divided into PNS and no PNS groups. The cohort was propensity-matched, and Pearson χ2/Kruskal-Wallis tests were performed to compare group differences. Multivariable logistic regression was utilized to compare events between cohorts before and after matching. An alpha of <0.05 was considered significant.

RESULTS

A total of 45,998 (22,999 per group) matched participants were evaluated. On multivariate regression, the non-PNS treatment group was associated with an increase in hospital overall SSI occurrence (OR: 1.48, P= 0.02) but not specifically in-hospital methicillin-sensitive Staphylococcus aureus SSI, MRSA-SSI, or any 30-day SSI (P> 0.05). Compared with PNS treatment and prophylactic antibiotics, in-hospital SSI was higher in the absence of PNS treatment (OR: 1.83, P< 0.001), antibiotic (OR: 2.63, P< 0.001), or both (OR: 2.06, P< 0.01). Compared with PNS treatment plus prophylactic antibiotic, in-hospital MRSA-SSI was only higher in the absence of antibiotic (OR: 2.92, P< 0.01) treatment.

CONCLUSIONS

Preoperative treatment with PNS may reduce overall in-hospital SSI but has no independent impact on MRSA SSI.

Severe listeriosis in intensive care units: insights from a retrospective multicentric study

BACKGROUND

Listeriosis is a rare but severe foodborne infection, particularly affecting immunocompromised individuals and older adults. Severe cases may lead to neurolisteriosis and sepsis, necessitating intensive care unit (ICU) admission. This study aims to analyze the demographic characteristics, clinical presentation, microbiological findings, treatments, and outcomes of critically ill patients with Listeria infections in the ICU.

METHODS

A retrospective multicenter study was conducted across 23 French hospitals over a 10-year period, including ICU patients with culture-confirmed Listeria monocytogenes infections. Data on demographics, comorbidities, ICU admission characteristics, biological and microbiological parameters, treatments, and outcomes were collected. The primary outcome was ICU mortality. A multivariable logistic regression model was used to identify factors associated with mortality in patients with neurological manifestations.

RESULTS

A total of 110 patients were included, with a median age of 68 years; 61% were male, and 71% were immunocompromised. Neurological involvement was present in most cases. Invasive mechanical ventilation was required in 58% of patients, and vasopressor support in 44%. ICU and in-hospital mortality rates were 25% and 32%, respectively. Among patients with neurolisteriosis, each 1-point decrease in Glasgow Coma Scale score at admission was associated with increased mortality (OR, 1.22; 95% CI 1.05-1.45; p = 0.009), as were higher cerebrospinal fluid (CSF) protein levels (OR, 1.56; 95% CI 1.15-2.41; p = 0.028). Steroid use was not significantly associated with reduced mortality (OR, 0.30; 95% CI 0.07-1.05; p = 0.076).

CONCLUSION

Listeriosis requiring ICU admission is associated with high morbidity and mortality, particularly in older and immunocompromised patients. The severity of these infections is reflected by the frequent need for organ support. Further research is needed to clarify the potential role of steroids in neurolisteriosis.

The Positive Immunohistochemical Staining of Cytomegalovirus in Colon Biopsy Samples Suggests That the Viral DNA Load in qPCR Is High

Background and AimImmunohistochemistry (IHC) and/or polymerase chain reaction (PCR) are essential for confirming active cytomegalovirus (CMV) infection in patients with inflammatory bowel disease (IBD). A definitive cut-off has not yet been established; however, Roblin et al suggested a viral load threshold of > 250 viral copies/mg of tissue. In this study, we examined the concordance between IHC and quantitative real-time PCR (qPCR) in the detection of CMV in colonic biopsy specimens.MethodsA total of 170 samples that underwent IHC and qPCR were collected. The positive rate and concordance of IHC and qPCR were studied, and the impact of ulcer tissue on both detection methods was observed.ResultsIn a study of 170 hematoxylin-eosin (H&E) sections, 8 samples were found to be infected with cytomegalovirus. The positive rates of CMV detection using IHC and qPCR were 17% (29/170) and 25% (43/170), respectively. Among the IHC-positive samples, the qPCR positive rate was 100% (29/29), with all CMV-DNA loads > 250 copies/mg. The concordance between IHC and qPCR was 94% (kappa = 0.756, P < .001). IHC analysis revealed that positive cells in ulcerated mucosa were more frequent than those in nonulcerated mucosa (P < .001). Additionally, a total of 14 samples tested negative for CMV via IHC but positive through qPCR. Among these, 11 samples did not contain ulcerated tissue.ConclusionThe presence of one or more IHC-positive cells in colon biopsy samples indicates a high CMV-DNA load in qPCR (> 250 copies/mg). IHC-positive cells were more frequently observed in ulcerated mucosa compared to nonulcerated mucosa.

Platelets and diseases: signal transduction and advances in targeted therapy

Platelets are essential anucleate blood cells that play pivotal roles in hemostasis, tissue repair, and immune modulation. Originating from megakaryocytes in the bone marrow, platelets are small in size but possess a highly specialized structure that enables them to execute a wide range of physiological functions. The platelet cytoplasm is enriched with functional proteins, organelles, and granules that facilitate their activation and participation in tissue repair processes. Platelet membranes are densely populated with a variety of receptors, which, upon activation, initiate complex intracellular signaling cascades. These signaling pathways govern platelet activation, aggregation, and the release of bioactive molecules, including growth factors, cytokines, and chemokines. Through these mechanisms, platelets are integral to critical physiological processes such as thrombosis, wound healing, and immune surveillance. However, dysregulated platelet function can contribute to pathological conditions, including cancer metastasis, atherosclerosis, and chronic inflammation. Due to their central involvement in both normal physiology and disease, platelets have become prominent targets for therapeutic intervention. Current treatments primarily aim to modulate platelet signaling to prevent thrombosis in cardiovascular diseases or to reduce excessive platelet aggregation in other pathological conditions. Antiplatelet therapies are widely employed in clinical practice to mitigate clot formation in high-risk patients. As platelet biology continues to evolve, emerging therapeutic strategies focus on refining platelet modulation to enhance clinical outcomes and prevent complications associated with platelet dysfunction. This review explores the structure, signaling pathways, biological functions, and therapeutic potential of platelets, highlighting their roles in both physiological and pathological contexts.

A molecular comparative study of intestinal colonization with Staphylococcus aureus between pediatric inpatients and outpatients of different age groups

Currently, Staphylococcus aureus (S. aureus) is one of the leading causes of death from infectious diseases worldwide. Our aim in this study was to investigate and compare the molecular epidemiology and antibiotic resistance of S. aureus colonizing the intestinal tract of pediatric inpatients and outpatients of different age groups. We analyzed stool samples from 1,300 patients at a children's hospital in Shenzhen, China. After culturing S. aureus, we used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry to identify the strains. In addition, we performed antimicrobial susceptibility testing on isolated S. aureus strains as well as pheno- and genotypic characterization by PCR. S. aureus was detected in 104 out of 1,300 (8.0%) patients, including 20 out of 1,300 (1.5%) patients with methicillin-resistant S. aureus (MRSA). MRSA accounted for 19.2% of the S. aureus isolates. The resistance rates of S. aureus strains to penicillin, erythromycin, clindamycin, levofloxacin, and moxifloxacin were 83.7%, 34.6%, 31.7%, 3.9%, and 3.9%, respectively. None of the strains showed resistance to linezolid, daptomycin, tigecycline, vancomycin, or tetracycline. One hundred fou strains of S. aureus revealed that 49.0% (51/104) harbored enterotoxin genes, and most enterotoxin-positive strains carried only one gene type (90.2%, 46/51), while a minority carried two gene types (9.8%, 5/51). Besides, a total of 29 sequence types (STs) were identified with the three most prevalent STs: ST45, ST188, and ST6, accounting for 12.5%, 12.5%, and 9.6%. We found that the molecular characteristics of S. aureus in intestinal colonization of children have regional differences. To provide a theoretical basis for the prevention and control of S. aureus infections, increased surveillance of local S. aureus resistance and molecular epidemiological characteristics is needed.IMPORTANCEThis study assessed the clinical and molecular epidemiology of Staphylococcus aureus in pediatric patients at a children's hospital in Shenzhen, South China by means of screening stool samples for pheno- and genotypic characterization for carriage of S. aureus. Of 1,300 fecal samples screened, 104 (8.0%) were positive for S. aureus with 19.2% methicillin-resistant S. aureus. The resistance rates of S. aureus to penicillin, erythromycin, clindamycin, levofloxacin, and moxifloxacin were 83.7%, 34.6%, 31.7%, 3.9%, and 3.9%, respectively. None of the strains showed resistance to linezolid, daptomycin, tigecycline, vancomycin, or tetracycline. One hundred four strains of S. aureus revealed that 49.0% (51/104) harbored enterotoxin genes, and most enterotoxin-positive strains carried only one gene type (90.2%, 46/51), while a minority carried two gene types (9.8%, 5/51). Besides, a total of 29 sequence types (STs) were identified with the three most prevalent STs: ST45, ST188, and ST6, accounting for 12.5%, 12.5%, and 9.6%.

Universal administration of nirsevimab in infants: an analysis of hospitalisations and paediatric intensive care unit admissions for RSV-associated lower respiratory tract infections

The aim of this study was to assess the impact of universal nirsevimab administration on hospitalisations and paediatric intensive care unit (PICU) admissions due to lower respiratory tract infection associated with respiratory syncytial virus (RSV-LRTI). An observational study was conducted at a tertiary hospital in Spain to compare the frequency and characteristics of children under five years of age hospitalised for RSV-LRTI between October 2023 and March 2024 (nirsevimab period), with the data from two prepandemic COVID- 19 seasons (2018-2019 and 2019-2020) and one postpandemic season (2022-2023). A total of 311 patients were included in the study. During the nirsevimab period, a decrease in the number of children hospitalised for RSV-LRTI was observed, particularly for children under six months of age. Compared with the prepandemic period, there was an 83.3% decrease in hospitalisations and a 73.3% reduction in PICU admissions in this age group. Similarly, compared with the postpandemic period, there was a 90.8% reduction in hospitalisations and an 87.9% reduction in PICU admissions. Furthermore, the median age was greater (15.6 months; IQR 11.1-27.3) than it was in the prepandemic period (4 months; IQR 1.6-8.9) and postpandemic period (3.4 months; IQR 1.5-10.6) (p < 0.001). Moreover, the length of hospital stay during the nirsevimab period (4 days; IQR 3-6) was shorter than that observed during the prepandemic period (6 days; IQR 4-9) and the postpandemic period (5 days; IQR 3-8) (p = 0.003).Conclusions: Following the introduction of universal immunoprophylaxis with nirsevimab, notable reductions in hospitalisations and PICU admissions due to RSV-LRTI were observed among young infants. This resulted in a shift in the age profile and a shorter length of hospital stay. What Is Known • Nirsevimab is a novel humanised IgG1 monoclonal antibody with a prolonged half-life that has been demonstrated to reduce RSV-associated hospitalisations in controlled clinical trials; however, real-world data are still limited. What Is New: • The findings of the present study corroborate the effectiveness of nirsevimab. Following the implementation of universal immunoprophylaxis with nirsevimab, a notable reduction in hospitalisations and admissions to the paediatric intensive care unit for RSV-associated lower respiratory tract infections was observed, particularly among infants younger than 6 months, who have been the main target of this passive immunisation strategy. In addition, the patients admitted were older and the length of hospital stay was shorter.

Comparison of dried blood spot (DBS) and plasma HIV-1 viral load measurements using Roche COBAS AmpliPrep/COBAS TaqMan assay, Northwest Ethiopia

INTRODUCTION

Quantitative determination of HIV-1 viral load measurements using plasma samples has been widely applicable for prompt monitoring at baseline and following initiation of highly active antiretroviral therapy (HAART). However, improper mixing of whole blood with anticoagulants during plasma sample processing, as well as limited access to specialized health facilities might hinder HIV diagnosis services. Considering its higher stability and increased accessibility in areas with poor laboratory settings, the dried blood spot (DBS) sample might be a suitable alternative approach for periodic monitoring of HIV-1 viral load measurements. Thus, in this study, we aimed to compare the quantitative determination of HIV-1 RNA levels using plasma and DBS samples among people living with HIV in Northwest Ethiopia.

METHODS

An institutional-based analytical cross-sectional study was conducted from March to July 2020 using 48 paired plasma and DBS samples among people living with HIV at the HIV Treatment Center, Northwest Ethiopia. A total of four milliliters of venous blood was collected to harvest plasma and for DBS sample preparation. The HIV-1 RNA extraction, amplification, and quantification were performed using the Roche COBAS AmpliPrep/COBAS TaqMan version 2.0 assay. Data were managed and analyzed using SPSS version 26 software. Mean HIV-1 viral load measurements as well as the associations between plasma and DBS sample measurements were computed using a paired sample t-test and Pearson's correlation statistical tests, respectively. In addition, the level of agreement and the presence of proportional bias between sample measurements were performed using the Bland-Altman plot and linear regression models, respectively. A p-value of ≤ 0.05 with a 95% confidence interval was considered statistically significant.

RESULTS

Among 48 people living with HIV, more than half (64.6%) of them were females. The minimum and maximum age of the study participants was 12 and 58 years, respectively. The mean difference with standard deviation (SD) of sample measurements (DBS minus plasma) HIV-1 viral load was 0.66 ± 0.70 log copies/mL. In the current study, a strong association with a significant linear correlation (r = 0.796) (p < 0.001) was obtained from Pearson's correlation analysis among HIV-1 viral load measurements between DBS and plasma samples. Moreover, the Bland-Altman plot also depicted a high level of agreement between the sample measurements.

CONCLUSIONS

The findings of the current study suggested that DBS samples could be considered as an alternative approach for periodic monitoring of HIV-1 viral loads to scale-up the HIV diagnosis and treatment coverage, particularly in areas with limited laboratory settings due to minimal invasive blood collection, higher stability at room temperature or ease of transportation, and decentralized sample collection approaches.

The use of sialic acids as attachment factors is a common feature of Enterovirus-D species

Among the hundreds of enteroviruses (EVs) infecting humans, the members of the species EV-D (Enterovirus deconjuncti) display original traits. First, only five serotypes are known within this species, while other EV species have tens of serotypes each. Second, EV-Ds display a wide variety of tropisms: EV-D68s are respiratory viruses, EV-D70s have an ocular tropism, while EV-D94s, EV-D111s, and EV-D120s seem to be enteric viruses. Besides, while EV-D68s, EV-D70s, and EV-D94s have been detected in humans, EV-D120s were found exclusively in non-human primates, and the last virus type, EV-D111, was found in both. This and other observations have led to the hypothesis that EV-Ds could have a zoonotic origin. Previous studies have shown that EV-D68, EV-D70, and EV-D94 use sialic acids (Sias) as cellular attachment factors. We investigated the role of Sias in EV-D111 infection using sialidase treatments and loss-of-function experiments in human and simian cells. Assessing viral RNA yield by RT-qPCR analyses and infectious viral particle production by titration assays showed that the absence of Sias at the cell surface significantly slowed down EV-D111 infection kinetics without abolishing it. This suggests that Sia acts as an attachment factor. While EVs generally do not use Sias, EV-Ds seem to rely on them for optimal replication in cultured cells. Sia usage may therefore be an ancestral trait of this species. We also studied EV-B114, a simian enterovirus, and found that it does not use Sias. Our work provides new insight regarding an enterovirus that circulates in humans and exhibits unusual ecological traits.IMPORTANCEExcept for a few epidemics in the 1970s and 1980s, the impact of EV-Ds on human health remained modest until the 2010s. In 2014, EV-D68 was occasionally responsible for severe respiratory distress and fatal cases of muscular paralysis. EV-Ds have thus the ability to become pathogenic in humans, hence the importance of studying them. The recently discovered EV-D111, of which only a few isolates are available, has been detected in both human and simian samples, suggesting a potential zoonotic origin. We characterized the early steps of EV-D111 replication, with a focus on its ability to use Sias as attachment factors. We found that EV-D111, like other members of the EV-D species, but unlike most EVs, relies on Sia for optimal replication. Our work provides a better understanding of EV-D111 biology, which is essential to determine its tropism and its potential to emerge in humans.

Extracellular vesicles from human semen induce unique tolerogenic phenotypes in vaginal dendritic cells and regulatory T lymphocytes

Introduction

The regulation of immune responses to promote tolerance to the fetus is critical for successful pregnancy. An understudied aspect of this process is the initiation of regulation pre-conception via exposure to semen. Our study aimed to understand how semen impacts recipient dendritic cells (DCs) and their subsequent role in shaping CD4 T cell differentiation.

Methods

Monocyte-derived DCs (MoDCs) were exposed to semen extracellular vesicles (SEV) or vesicle-depleted semen plasma (VDSP). Phenotypic and functional markers were analyzed using flow cytometry. We also exposed epithelial sheets from vaginal tissue to SEV and VDSP, and measured the number and marker expression of emigrating cells. Finally, we tested how SEV- or VDSP-exposed DCs altered CD4 T cell differentiation by co-culturing exposed MoDCs or tissue emigrated cells with autologous naïve CD4 T cells.

Results

MoDCs exhibited a significant increase of CD141, CD1a, CD38, and ILT4 expression when exposed to SEV or VDSP. A unique feature of semen-treated MoDCs was expression of indoleamine 2,3-dioxygenase (IDO), a potent contributor to the induction of regulatory T cells (Tregs). SEV but not VDSP significantly increased the emigration of intraepithelial DCs. Additionally, SEV significantly enhanced the expression of multiple immunoregulatory markers in the emigrated DCs. After co-culture, we observed significantly more FOXP3+ Tregs expressing high levels of TIGIT in the groups that were initially exposed to SEV.

Discussion

These findings indicate that exposure to SEV induces a tolerogenic program in DCs that can direct differentiation of a unique memory Treg subset, primed for expansion and presumably destined to support a successful pregnancy.

Cytomegalovirus infection in patients with active ulcerative colitis: a prospective observational study

OBJECTIVES

The role of cytomegalovirus (CMV) infection in the course of inflammatory bowel disease is still controversial. We aimed to prospectively evaluate the course of ulcerative colitis in patients with exacerbation, in whom CMV status was examined using immunohistochemistry of bowel biopsies.

METHODS

In a single centre, we followed-up consecutive patients admitted for moderate or severe ulcerative colitis flare between 2016 and 2019. Colectomies, repeated hospitalisations, major treatment modifications, and quality of life (QoL) were recorded. The relationship between categorical variables was examined with the χ2 statistical test or Fisher's exact test.

RESULTS

Of 84 patients, 16 (19%) were CMV-positive. A Mayo endoscopic score of 3 was more frequent in CMV-positive than CMV-negative patients (81.2 vs. 51.5%; P = 0.048) as was corticosteroid treatment (81.2 vs. 54.4%; P = 0.015). Median follow-up was 2.1 years (range: 0.3-3.6 years). Colectomy was performed in 20 (23.8%) patients, with similar rates in CMV-positive (25%) and CMV-negative patients (23.5%; P = 1.0). Similarly, no differences were found in the frequency of hospitalisation and QoL. The percentage of patients who started biological treatment was higher in the CMV-negative than in the CMV-positive group (58.8 vs. 18.8%; P = 0.005).

CONCLUSION

CMV infection was present in 19% of consecutive patients hospitalised for ulcerative colitis flare. Corticosteroid treatment and severe endoscopic lesions were observed more often in patients with CMV-positive. In the following 2.1 years, the colectomy rate did not differ between patients with CMV-positive and CMV-negative. Routine screening for CMV in ulcerative colitis exacerbation is not advisable.

Herpes Simplex Virus and Drug Resistance - Comprehensive Update on Resistance Mutations and Implications for Clinical Management: A Narrative Review

BACKGROUND

Antiviral drug resistance in herpes simplex virus 1 and 2 (HSV-1 & 2) is a significant clinical challenge, particularly in immunocompromised patients. Drug susceptibility testing (DST) aids clinical management and can be conducted through genotypic (partial genome sequencing) or phenotypic (cell culture) methods. Both have inherent limitations: genotypic DST is limited by outdated datasets lacking information on new helicase-primase inhibitors and corresponding phenotypic data as well as sparse clinical correlations. Phenotypic DST is mainly hampered by a lack of standardization and timely results.

OBJECTIVES

To compile an up-to-date and comprehensive HSV drug resistance dataset encompassing all reported drug resistance-associated mutations (DRMs), polymorphisms, and viral phenotypes. To aggregate clinical conditions with available DST data.

SOURCES

A PubMed search identified studies (January 2016-September 2024) on DRMs associated with resistance to aciclovir, penciclovir, brivudine, foscarnet, cidofovir, amenamevir, and pritelivir. Data from a previous HSV resistance dataset (pre-2016) were also included.

CONTENT

In this review, we summarize novel mutations in the thymidine kinase, polymerase, and helicase-primase gene of HSV conferring resistance to antiviral drugs. Clinical information was available for 513 mutations. In 90% of these (461 cases), viral phenotype and clinical assessment were congruent. However, 10% of cases not responding to antiviral therapy showed phenotypically susceptible virus isolates. We present a framework for clinical and diagnostic management of cases with drug resistant HSV infection.

IMPLICATIONS

This dataset paves the way to harmonize reporting of DRMs for diagnostic labs and to accelerate genotypic DST interpretation through aggregated data. Ongoing large-scale data collection of genotypic, phenotypic, and clinical data is crucial for evidence-based management of HSV antiviral resistance and clinical guidelines.

Reducing Functional Domain of Histatin 5 Improves Antifungal Activity and Prevents Proteolytic Degradation

Histatin 5 (Hst5) is an antifungal peptide (AFP) naturally produced by parotid glands with strong activity against Candida albicans. One of its mechanisms of action is the generation of reactive oxygen species (ROS) inside the C. albicans cells. Despite being an important peptide for the human innate immune response, its activity is reduced or inactivated by proteolytic degradation caused by salivary enzymes. To overcome this barrier, we used solid phase peptide synthesis (SPPS) to modify the Hst5 amino acid sequence improving its antifungal action and minimizing its degradation. We synthesized five peptides, three of which were based on the Hst5 functional domain. We determined that the smallest peptides (8WH5, 7WH5 and 6WH5) demonstrated the greatest antifungal action against C. albicans, including one fluconazole-resistant strain. Besides that, cationic-PAGE and HPLC assays showed that the degradation in saliva was slower for the smaller peptides than for 0WHst5 and WP113. Furthermore, 8WH5, 7WH5 and 6WH5 were found in the samples even after 8 h in whole saliva, while 0WHst5 and WP113 completely disappear after 1.5 h. Finally, we found that the smaller peptides were less fragmented than the 0WHst5 and WP113, so they were the smallest fragments of Hst5 to preserve its antifungal action with reduced degradation in whole saliva. Thus, they can be considered promising molecules for the treatment of C. albicans in the oral cavity.

Climatic factors driving influenza transmission in Sahelian area: A twelve-year retrospective study in Niger (2010-2021)

The relationship between influenza transmission and climate has many public health implications, particularly on the occurrence of epidemics and disease severity. Environmental factors such as temperature, wind and humidity can influence transmission, particularly in this time of climate change. This study aims to use statistical modelling to decipher the impact of climate factors on influenza transmission in Niger. The reference center of respiratory disease (CERMES) collected samples from patients with acute respiratory illness in eight sentinel sites over a period of twelve years. Detection of respiratory virus was conducted on each sample using molecular approaches. Meteorological parameters were recorded on a weekly basis at the National Meteorological Station in Niamey. Climatic and virological data were plotted over the weeks of the years. A multivariate approach was used to identify clusters of weeks with homogeneous climatic conditions, independent of the season. The impact of the predictor variables was determined using generalized additive modelling (GAM). During this study, 9836 suspected influenza cases were PCR tested, of which 982 (9.98%) were confirmed positive for either influenza A or B. 631 (64.25%) of the influenza A/B positive cases were detected during the low temperature periods (December to February). Using clustering analysis, six distinct periods can be identified, with the most favorable conditions for influenza occurring in conjunction with dry, cold and windy weather patterns. Of greater importance, however, are the conditions that predominate in the weeks preceding the detection of clinical cases. The final GAM model accounts for 77% of the variability in the occurrence of influenza cases, indicating that the epidemic can be anticipated weeks before clinical detection in dispensaries using wind and minimum temperature as indicators. Clustering and GAM models can be considered as an efficient and simple approach to analyze the impact of climatic conditions on the transmission of infectious diseases.

Povidone-Iodine and Hydrogen Peroxide Combination Improves the Anti-Biofilm Activity of the Individual Agents on Staphylococcus aureus

Staphylococcus aureus, particularly methicillin-resistant S. aureus (MRSA), poses significant challenges in healthcare settings due to its ability to form biofilms on various surfaces. These biofilms enhance bacterial survival and increase resistance to conventional treatments, complicating infection control efforts. This study evaluated the efficacy of combined povidone-iodine (PVP-I) and hydrogen peroxide (H2O2) to disrupt pre-formed S. aureus biofilms. A series of assays-including crystal violet staining, colony-forming unit (CFU) enumeration, gene expression analysis, and confocal laser scanning microscopy-were performed to assess the effects of each treatment individually and in combination. The combined treatment resulted in significantly greater reductions in biofilm biomass and viable bacteria compared with either agent alone. Gene expression analysis revealed downregulation of key biofilm-associated genes (icaA, icaB, icaD, icaR, and clfA), suggesting interference with biofilm stability and maintenance. While formal synergy quantification was not conducted, the observed effects suggest a potentially synergistic or additive interaction between the two agents. These findings support the use of dual antiseptic strategies as a promising approach to biofilm eradication and highlight the potential clinical utility of dual antiseptic strategies. However, we underscore the need for further optimization and safety evaluation.

Temporal correlations between RBD-ACE2 blocking and binding antibodies to SARS-CoV-2 variants in CoronaVac-vaccinated individuals and their persistence in COVID-19 patients

Antibodies play a crucial role in protection against SARS-CoV-2. Understanding the correlation between binding and functional antibodies is essential to determine whether binding antibody levels can reliably predict neutralizing activity. We assessed antibody responses in 111 individuals vaccinated with the inactivated vaccine CoronaVac and 111 COVID-19 patients in Thailand. Plasma levels of ACE2-blocking antibodies targeting the receptor-binding domain (RBD) of SARS-Co-V2 variants were measured before vaccination and at 14 and 28 days after the second dose using a multiplex surrogate virus neutralization test. Anti-spike and anti-nucleocapsid antibodies were quantified by electrochemiluminescence immunoassay, and anti-RBD IgG by ELISA. After vaccination, blocking, anti-spike, and IgG antibody levels increased but declined rapidly within a month, whereas antibody levels in COVID-19 patients increased and persisted. Blocking and anti-spike antibody correlated at day 14 post-vaccination but not at day 28. In COVID-19 patients, correlations were moderate at day 14, and stronger at day 28. Correlations were weaker for Omicron subvariants than for the ancestral strain and non-Omicron variants. The weak correlation between blocking and anti-RBD IgG suggests binding antibodies might not predict neutralizing activity. These findings highlight the temporal nature of CoronaVac-induced immunity and the need for booster doses and variant-adapted vaccine.

Comparative Effectiveness of Antiviral Agents and Monoclonal Antibodies for Early SARS-CoV-2 Therapy in Immunocompromised Patients: A Multicenter Retrospective Cohort Study (March 2021-March 2022)

Immunocompromised (IC) patients continue to be at risk of severe COVID-19 despite vaccination and anti-SARS-CoV-2 therapies. The comparative effectiveness of antiviral agents (AVAs) and monoclonal antibodies (MoAbs) as early treatment of SARS-CoV-2 in IC patients is described in this work. This retrospective multicenter cohort study included IC outpatients diagnosed with SARS-CoV-2 between March 2021 and March 2022 at the National Institute for Infectious Diseases "Lazzaro Spallanzani" and Santa Maria Goretti University Hospital, Italy. Patients received either AVAs or MoAbs based on national guidelines. The primary outcome was time to negative nasopharyngeal swab (NPS). The secondary outcomes were COVID-19-related hospitalization or death by day 30. Among 1472 IC patients (with a median age of 58 years, 45% male), 688 (46%) were treated with MoAbs, and 783 (54%) were treated with AVAs. The patients treated with MoAbs had a higher duration to negative NPS (17 vs. 11 days, p < 0.05) and a higher risk of sustained SARS-CoV-2 positivity on day 7 (OR: 3.0, 95% CI: 1.72-5.23, p < 0.01) and day 30 (OR: 6.0, 95% CI: 3.7-10.5, p < 0.01) than those treated with AVAs. There were no differences in hospitalization or mortality. AVAs were associated with a more rapid viral clearance than MoAbs, suggesting a potential advantage for reducing infectious duration in IC patients. Additional studies are necessary to further optimize the early treatment of COVID-19 in this high-risk population.

Dysregulated Adaptive Immune Responses to SARS-CoV-2 in Immunocompromised Individuals

The SARS-CoV-2 virus poses a significant risk to immunocompromised patients, who display weakened immunity and reduced seroconversion following infection and vaccination. In this study, we recruited 19 hospitalized patients with immune disorders (ImCo) and 4 immunocompetent controls (ICC) with COVID-19. We evaluated their serological, humoral, and cellular immune responses at <30 days and >90 days post-symptom onset. ICC patients showed robust B and T cell responses against SARS-CoV-2, indicated by detectable antibody levels, memory antibody-secreting cells (mASCs) towards the spike protein and spike-specific CD4+ and CD8+ T cells. ImCo patients showed impaired immune responses, with lower levels of B cell responses. Further subdivision of the ImCo patients demonstrates that solid organ transplant (SOT) patients generated B cell responses similar to ICC patients, whereas the other ImCo patients, including patients with hematological malignancies and anti-CD20 therapy, did not. Absolute T cell numbers and spike-specific CD4+ and CD8+ T cell responses were low in the ImCo patients at <30 days but increased at later time points. Our findings suggest that even when B cell responses were reduced, patients could present a T cell response, suggesting a more successful line of passive immunization for immunocompromised individuals focusing on boosting T cell responses.

Oropharyngeal Manifestations in Patients with HIV from Northeastern Romania

Backgrounds and objective: Disorders in the stomatognathic system and otorhinolaryngologic manifestations are frequently observed in individuals living with HIV. Ear, neck, and throat (ENT) signs and symptoms often serve as critical markers of treatment failure, particularly in the advanced stages of HIV infection. This article aims to evaluate and consolidate recent developments in the treatment and management of otorhinolaryngological manifestations in HIV-positive patients. Materials and methods: We carried out a retrospective clinical investigation of patients admitted with HIV/AIDS in the northeastern region of Romania, hospitalized in the "St. Parascheva" Clinical Hospital of Infectious Diseases in Iasi. We followed the viro-immunological status correlated with patients' otolaryngology and dental symptomatology, aiming to emphasize the comorbidities of HIV/AIDS cases. The study period spanned from 1 January 2020 to 30 November 2024. Results: There were a total of 552 recorded cases of oropharyngeal manifestations in patients with HIV. They were more frequent in men (358 cases, 64.85%) than women (194 cases, 35.15%). The majority of cases were young adults, aged 30 to 39 years, comprising 255 patients (46.19%), and most cases (36.85%) had CD4+ T-lymphocyte values between 200 and 499 cells/μL. The most frequent diagnosis was oral candidiasis, recorded in 335 male and 174 female cases (509, 92.21% total). Other notable conditions included gingivitis/periodontitis, sinusitis/rhinosinusitis, mastoiditis, and dental abscesses, albeit at lower frequencies. Notably, antifungal therapy with fluconazole was the most frequently employed treatment, followed by aminopenicillins and fluoroquinolones. With respect to the antiretroviral treatment, 83.69% of cases were prescribed a single-pill regimen. Conclusions: The key to the management of HIV-positive patients is a multidisciplinary approach, including an ENT specialist and access to antiretroviral therapy.

Cellulose test strips modified with virus-like particles: Advancing viral immunity screening technologies

The COVID-19 pandemic has driven immunity acquisition through infection or vaccination, leading to SARS-CoV-2 antibodies. This study introduces a colorimetric biosensor for COVID-19 immunity screening using Virus-Like Particles (VLPs) with SARS-CoV-2 spike protein motifs on a cellulose carrier. The cellulose was chemically modified with DSS to secure the VLPs, verified via FTIR. Detection utilized the Bradford reagent, with RGB color analysis via ImageJ and smartphone images. The test strips demonstrated high sensitivity (R > 0.998) across a 10-40 µg/mL range in buffer and serum, with 30-minute incubation. They also exhibited selectivity against interferents like albumin, glucose, and urea. Success with undiluted samples highlights clinical potential. This broad-spectrum, REASSURED-compliant method is promising for global testing applications.

Spontaneous Cell Detachment from Temperature Gradients: Getting the Method Ready for Antimicrobial Drug Testing at Cell Culture Level

Spontaneous cell detachment describes an effect in which eukaryotic cells first sediment onto a heated chip and then detach from it spontaneously and collectively after a sharply defined dwell time td. This behavior is triggered by the temperature gradient between the chip and the colder supernatant liquid. Notably, td allows distinguishing between different yeast strains and cancer-cell lines. At the same time, it also varies in the presence of nutrients and cytotoxins, suggesting an added value of this method for pharmacological studies. In the present work, we study the role of fluid convection on the detachment of yeast cells experimentally and by simulations using a sample compartment with a variable aspect ratio. Hereby, we found that the absolute chip temperature, the strength of the temperature gradient and the number of cells inside the sample compartment all affect the dwell time td. To demonstrate the concept, we show that the spontaneous-detachment method can measure the impact of an antibiotic and an antiseptic drug on yeast cultures and corroborate this with reference assays.

Effectiveness of a single COVID-19 mRNA vaccine dose in individuals with prior SARS-CoV-2 infection: a systematic review

BACKGROUND

Based on high population immunity to SARS-CoV-2 from prior infection, vaccination, or both, in fall 2023, regulatory agencies globally authorized/approved a single mRNA XBB.1.5-adapted vaccine dose for individuals aged ≥5 years regardless of prior vaccination.

METHODS

We conducted a systematic review on vaccine effectiveness (VE) of a single COVID-19 mRNA dose in individuals with a history of prior infection compared to individuals who were (i) SARS-CoV-2 naïve, (ii) unvaccinated with prior infection, and (iii) vaccinated with >1 dose with or without prior infection. We searched MEDLINE and Embase for studies published January 2021-October 2023. Data were synthesized following Synthesis Without Meta-Analysis guidelines; bias was assessed using the Newcastle-Ottawa Scale. This study was registered with PROSPERO (CRD42023453257).

RESULTS

Eighteen studies were eligible. None of these studies reported bivalent or XBB.1.5-adapted VE, and none reported VE for immunocompromised populations or children aged <5 years. Among those with prior infection, a single mRNA dose increased protection by 8-71% against infection (during Omicron BA.1, BA.4/5, or XBB predominance), 39-67% against symptomatic infection (BA.1, BA.2, or BA.4/5), and 25-60% against hospitalization or hospitalization or death (BA.1). VE of one dose was comparable to two doses among those with prior infection, and higher than following two doses without prior infection.

CONCLUSIONS

A single dose of original mRNA COVID-19 vaccine provides similar protection to two doses for immunocompetent individuals aged ≥5 years in the current setting of high pre-existing immunity. This supports current recommendations for one dose to be given in advance of the respiratory season, regardless of history of infection or vaccination, with considerations for additional doses for certain populations including young children, older adults, and the immunocompromised.

SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamics

BACKGROUND

Defining the kinetics of SARS-CoV-2 antibody responses is critical for informing the management of reinfections, vaccinations, and therapeutics of Coronavirus disease 2019 (COVID-19).

METHODS

Using four antibody assays, we evaluated antibody titers against SARS-CoV-2 nucleocapsid (N), spike (S), and receptor binding domain (RBD) in 98 convalescent participants with varying COVID-19 disease severities (asymptomatic, mild, moderate or severe) at 1, 3, 6, and 12-months post-SARS-CoV-2-positive PCR and in 17 non-vaccinated, non-infected controls.

RESULTS

Increasing acute COVID-19 disease severity correlates with higher anti-N and anti-RBD titers throughout 12 months post-infection. Anti-N and anti-RBD titers decline over time in all participants, except for increased anti-RBD titers post-vaccination, with hospitalized participants exhibiting faster decay rates. Less than 50% of participants retain anti-N titers above controls at 12 months, with non-hospitalized participants falling below controls sooner. Nearly all participants maintain anti-RBD titers above controls for 12 months, suggesting long-term protection against severe reinfections. Nonetheless, by 6 months, few participants retain >50% of their initial 1-month anti-N or anti-RBD titers. Notably, vaccine-induced anti-RBD titers are higher in non-hospitalized participants. Lastly, early convalescent titers correlate with age but not with Post-Acute Sequelae of SARS-CoV-2 infection (PASC) status or steroid use.

CONCLUSION

Hospitalized participants initially develop higher anti-SARS-CoV-2 antibody titers that decline faster relative to non-hospitalized participants. While anti-N titers fall below control levels in some participants, anti-RBD titers remain above controls over 12 months, demonstrating long-lived antibody responses known to protect against severe disease. These findings advance our understanding of COVID-19 antibody dynamics.

Comparative analysis of virulence in Listeria monocytogenes: Insights from genomic variations and in vitro cell-based studies

Listeria monocytogenes is a significant foodborne pathogen capable of crossing the intestinal barrier and causing invasive listeriosis. This study focused on 37 L. monocytogenes strains isolated from food and clinical samples in the Shanghai region between 2020 and 2023. The in vitro cell models were used to assess the bacteria's ability to cross the intestinal barrier, as well as their adhesion and invasion capabilities in placental cells. Whole-genome analysis of the bacterial strains was also performed. The results showed that strains from lineage I exhibited significantly higher translocation ability across the Caco-2 barrier, as well as higher adhesion and invasion rates in JEG-3 cells, compared to strains from lineage II. Strains from serogroup IIb demonstrated significantly higher adhesion and invasion rates in JEG-3 cells than those from serogroups IIa and IIc. Clinical isolates had significantly higher translocation ability across the Caco-2 barrier, and higher adhesion and invasion rates in JEG-3 cells, compared to food-derived strains. Mutations in the inlA gene were detected in ST9 and ST121 strains, which may be a potential cause of the reduced virulence observed in these ST types. The presence of LIPI-4 in ST87 strains and LIPI-3 in ST3 strains may also explain the high virulence of these ST types strains. The results of this study, by integrating in vitro virulence phenotypes with genomic data, further enhance the understanding of virulence differences among different bacterial strains.

Epidemiological surveillance of astrovirus, norovirus, rotavirus, and enterovirus in sewage (2022-2023) in Giza, Egypt

The majority of people with enterically transmitted viruses excrete significant amounts of the virus in their feces for several days or weeks. Therefore, viruses causing diarrhea could be detected in the feces of infected persons and wastewater. In this study, the presence of human astrovirus (AstV), norovirus (NoV), rotavirus (RV), and enterovirus (EntV) was analyzed by real-time RT-PCR in raw sewage (n = 96), treated sewage (n = 96) and diarrheal stool samples (n = 200). Overall, 92.7% (89/96) of raw sewage samples and 48% (46/96) of treated sewage tested positive for at least one virus. The highest detection rates of the four viruses in raw sewage were observed in the winter season. Overall, the mean concentration of the four viruses was 7.3 log10 in raw and 4.8 log10 in treated wastewater, for a total removal of 34% of viral loads. In clinical samples, the most commonly detected virus was EntV followed by RV, NoV, and AstV. The mean concentrations of the four viruses in clinical samples ranged between 2.5 × 101 and 9.86 × 107 GC/g. The results presented here demonstrated that the environmental surveillance of entric viruses in sewage is a useful tool for the study of their transmission dynamics in humans and their molecular epidemiology.

The potential mechanisms of extracellular vesicles in transfusion-related adverse reactions: Recent advances

Blood transfusion is an irreplaceable clinical treatment. Blood components are differentiated and stored according to specific guidelines. Storage temperatures and times vary depending on the blood component, but they all release extracellular vesicles (EVs) during storage. Although blood transfusions can be life-saving, they can also cause many adverse transfusion reactions, among which the effects of EVs are of increasing interest to researchers. EVs are submicron particles that vary in size, composition, and surface biomarkers, are encapsulated by a lipid bilayer, and are not capable of self-replication. EVs released by blood cells are important contributors to pathophysiologic states through proinflammatory, coagulant, and immunosuppressive effects, which in turn promote or inhibit the associated disease phenotype. Therefore, this review explores the potential mechanisms of hematopoietic-derived EVs in transfusion-associated adverse reactions and discusses the potential of the latest proteomics tools to be applied to the analysis of EVs in the field of transfusion medicine with a view to reducing the risk of blood transfusion.

Heparin-binding protein levels as an emerging key biomarker for accurate diagnosis of bacterial meningitis: A promising yet preliminary evaluation

This systematic review aims to consolidate evidence on the potential of heparin-binding protein (HBP) as an emerging and promising biomarker for diagnosing bacterial meningitis (BM). We conducted a comprehensive search across PubMed, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) databases, with no restrictions on publication date or language. Sixteen studies, encompassing a total of 2,032 participants, were included in the analysis. The results consistently demonstrated that HBP expression levels in both cerebrospinal fluid (CSF) and blood are markedly elevated in cases of BM compared to patients with non-central nervous system (CNS) infections or other types of meningitis, such as viral meningitis. The pooled sensitivity estimate for HBP measured in CSF was 0.94 [95% confidence interval (CI), 0.88-0.97], and the specificity was 0.96 [95%CI, 0.90-0.98]. The diagnostic odds ratio (DOR) was calculated as 327 [95%CI, 96-1,110]. According to Fagan's nomogram, an initial probability of 20% for a positive test result increased to 85% following a positive HBP test, while a negative test reduced the probability to just 2%. The diagnostic performance of CSF HBP surpassed that of procalcitonin in detecting BM. Furthermore, in cases where symptoms of CNS infection are present, HBP levels in blood also demonstrate notable diagnostic accuracy. These findings suggest that HBP holds significant potential as a biomarker for BM. However, further large-scale studies are required to establish optimal HBP thresholds for improved clinical applicability.

Genomic characterization of Listeria monocytogenes isolated from normally sterile human body fluids in Lithuania from 2016 to 2021

Listeria monocytogenes is a saprophytic gram-positive bacterium and opportunistic foodborne pathogen that can cause listeriosis in humans. The incidence of listeriosis has been rising globally and, despite antimicrobial treatment, the mortality rates associated with the most severe forms of listeriosis such as sepsis, meningitis and meningoencephalitis remain high. The notification of listeriosis in humans is mandatory in Lithuania, and up to 20 cases are reported annually. However, no studies have described the detailed virulence and antimicrobial susceptibility profiles of any clinical L. monocytogenes strains in Lithuania. Accordingly, this study aimed to describe the antibiotic susceptibility of invasive L. monocytogenes and perform in-depth characterization of strains isolated from patients with neuroinfections through whole-genome sequencing. A total of 70 isolates were collected, mostly from infected patients aged 65 or older, between 2016 and 2021 : 41 (58.6%) from blood, 19 (27.1%) from cerebrospinal fluid, 5 (7.1%) from wounds, 1 (1.4%) from pleural fluid and 1 (1.4%) from a brain abscess. Two phylogenetic lineages were identified-I (n = 16/70, 22.9%) and II (n = 54/70, 77.1%)-along with three serogroups-IIa (n = 53/70, 75.7%), IVb (n = 16/70, 22.9%), and IIc (n = 1/70, 1.4%). Genomic analysis of 20 isolates showed a high level of diversity with seven genotypes: ST6 (n = 6), ST155 (n = 5), ST8 (n = 4), ST504 (n = 2) and singletons for ST37, ST451 and ST2. Phylogenetic analysis clustered these isolates into two clades defined by serogroups IVb and IIa. Notably, five isolates were clustered tightly together (difference of 6-48 core SNPs from reference and 0, 4 or 44 SNPs from each other) with ST155, previously reported in a European outbreak. Comparison with publicly available L. monocytogenes genomes did not identify unique clusters or genotypes. No acquired antimicrobial resistance genes were identified. Our study highlights the complementary value of whole-genome sequencing in routine PCR-based surveillance in Lithuania. This is the first study to characterize and compare genomes for L. monocytogenes associated with neuroinfections in Lithuania using whole-genome sequencing. The retrospective detection of the ST155 clone underscores the need for a review and strengthening of epidemiological surveillance strategies in clinical and non-clinical settings in Lithuania.

Humoral and Cellular Immune Response to SARS-CoV-2 in Children Undergoing Cardiac Surgery

Evaluating the impact of cardiac surgery on humoral and cellular immunity in pediatric congenital heart disease patients with prior Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection or vaccination is crucial for postoperative care planning. This study enrolled 61 pediatric patients undergoing cardiac surgery with cardiopulmonary bypass at a single institution. Measurements were taken before the operation, immediately postoperation, and during the first follow-up examination at least 1 month later. The evaluations included SARS-CoV-2-specific immunoglobulin G (IgG) and neutralizing antibodies for humoral immunity assessment, as well as specific and nonspecific T-cell immune responses to gauge T-cellular immunity and functionality. The results demonstrated that the serum titers of IgG and neutralizing antibodies remained comparable postsurgery to preoperative levels. Nevertheless, significant decreases in specific and nonspecific T-cell immune responses, along with a decline in CD3+ T-cell numbers, were observed immediately following surgery. This was followed by a gradual recovery of immune response to preoperative levels approximately 1 month later. These findings suggest that in the first month following cardiac surgery in pediatric patients, residual specific antibodies, potentially derived from the original production or plasma transfusion, may provide partial protection against COVID-19 infection. Subsequently, T-cellular immunity gradually recovers and resumes its protective role. The study provides important insights into the dynamics of immune recovery following cardiac surgery in this vulnerable patient population, which may be essential for optimizing postoperative management and reducing the risk of COVID-19 infection.

Reducing rates of endophthalmitis from intravitreal injections - strategies and areas of controversy

PURPOSE OF REVIEW

Post-injection endophthalmitis (PIE) is the most concerning complication that accompanies intravitreal injections. This review discusses the recent literature in endophthalmitis prophylaxis including types of antisepsis, the use of topical antibiotics, methods of anesthesia, masking, and office-based versus operating room-based injections.

RECENT FINDINGS

Povidone iodine (PI) remains the gold standard for PIE prophylaxis. Chlorhexidine gluconate (CHG) is an alternative antiseptic agent utilized in other areas of medicine with similar broad spectrum antibacterial activity. Recent clinical trials have demonstrated that the rate of endophthalmitis is similar with CHG prophylaxis compared to PI prophylaxis while offering improved patient comfort at a similar cost. Routine use of topical antibiotics should be avoided as they do not appear to reduce endophthalmitis risk and may promote bacterial resistance. All methods of anesthesia appear to be acceptable. In-office injections are not associated with an increased rate of endophthalmitis compared to operating room injections.

SUMMARY

The rate of post-injection endophthalmitis is extremely low due to a myriad of measures employed by retina specialists. Topical antisepsis is the most important tool to combat post-injection endophthalmitis. CHG is emerging as an alternative to PI due to its efficacy and enhanced patient comfort.

How we diagnose and manage refractory and resistant herpes simplex virus mucocutaneous infection after haematopoietic cell transplantation

BACKGROUND

Herpes simplex virus (HSV) infection is a clinically significant complication in haematopoietic cell transplant (HCT) recipients. Refractory and resistant (R/R) HSV infections may occur in this patient population, particularly after prolonged exposure to anti-HSV agents.

OBJECTIVES

This study aims to provide a comprehensive review of the diagnostic approach and the treatment options for R/R HSV mucocutaneous infections in HCT recipients and to highlight future treatment strategies.

SOURCES

We searched the PubMed Central Database and Embase to identify published studies on R/R HSV infections in HCT recipients. We used the search terms "herpes simplex virus," "resistant∗," OR "refractory," "immunocompromised," "immunosuppress∗," and "immunodeficien∗," and screened the results for articles reporting R/R HSV infections among HCT recipients. We chose an HCT recipient with a complicated refractory HSV infection as a representative clinical case.

CONTENT

A clear clinical definition of refractory HSV infection is currently not available, which can lead to delays in diagnosis and treatment, negatively impacting patient care. Apart from two small randomized controlled trials in the 1990s that looked at treatment with systemic foscarnet and topical cidofovir in patients living with human immunodeficiency virus, all treatment recommendations for R/R HSV infections are based on observational studies and case reports. The use of alternative treatment options often comes with serious side effects, such as kidney toxicity. This underscores the urgent need for safer and more effective treatment options. Pritelivir, a new oral antiviral medication, is currently being studied in a phase 3 trial for R/R HSV infections in immunocompromised patients. Limited data from the Early Access Program, which allows compassionate use, suggest that pritelivir holds promise as a treatment option for HCT recipients with R/R HSV infections.

IMPLICATIONS

The proposed R/R HSV mucocutaneous infection diagnostic and treatment algorithm guides the appropriate management of these difficult-to-treat infections, potentially improving patient outcomes.

Therapeutic efficacy of Xuebijing injection in treating severe acute pancreatitis and its mechanisms of action: A comprehensive survey

BACKGROUND

Severe acute pancreatitis (SAP) is a life-threatening condition associated with high mortality and limited therapeutic options. Current management strategies focus on infection prevention, immune regulation, and anticoagulation. Xuebijing Injection (XBJ), a widely used traditional Chinese medicine-derived intravenous preparation, has shown promising therapeutic effects in SAP. Herein, we sought to evaluate clinical and preclinical evidence on XBJ to reveal its potential mechanisms of action, and provide insights to guide future research and clinical applications.

METHODS

We conducted a comprehensive survey of studies on XBJ in the treatment of SAP across PubMed, Embase, Cochrane Library, CBM, CNKI, Wanfang and VIP databases from their inception to March 21st, 2024.

RESULTS

A total of 239 studies were included, comprising 12 animal experiments, 7 systematic reviews, 220 clinical trials. Mechanistic studies suggest that XBJ downregulates the expression of inflammatory mediators, improves immune function, and alleviates oxidative stress via multiple signaling pathways, including the TLR4/NF-κB, p38-MAPK, HMGB1/TLR, TLR4/NF-κB, FPR1/NLRP3, and JAK/STAT pathways. These effects contribute to reducing organ damage. Compared to standard treatment, XBJ has more effective at reducing mortality and complications, improving overall clinical outcomes, shortening ventilator use time, and hospital stay in SAP patients.

CONCLUSIONS

Preclinical evidence and clinical trial data indicated that XBJ can simultaneously regulate inflammatory responses, immune function, microcirculatory disorders, oxidative stress, and apoptosis. However, further research is required to elucidate the specific mechanisms of action, clinical characteristics and safety of XBJ.

Pregnancy-related listeriosis in Spain

BACKGROUND

Pregnant women are at high risk of acquiring listeriosis, resulting in severe fetal and neonatal outcomes.

METHODS

All hospitalizations with a listeriosis diagnosis in pregnant women (obstetric listeriosis) and/or newborns (neonatal listeriosis) in Spain from 2000 to 2021 were examined using the National Registry of Hospital Discharges, employing ICD-9 and -10 coding lists.

RESULTS

A total of 540 and 450 hospital admissions for obstetric listeriosis and neonatal listeriosis were identified, respectively, with 146 adverse fetal-neonatal outcomes (miscarriage, fetal loss, stillbirth, and neonatal death). The incidence of obstetric listeriosis, neonatal listeriosis, and adverse fetal-neonatal outcomes (5.7, 4.7, and 1.5 per 100,000 deliveries, respectively) rose significantly from 2000 to 2021. No maternal deaths were recorded among women hospitalized with obstetric listeriosis. However, 9.8 % experienced miscarriage, related to bacteremia (OR=2.46), 6.3 % fetal loss and 5.9 % stillbirths, associated with chorioamnionitis (OR=3.42), which was identified in 77.7 % of 254 deliveries. Overall, 51.1 % of newborns developed sepsis, 58.9 % prematurity, 26.9 % ARDS, and 9.8 % died. ARDS (OR=2.76) and prematurity (OR=5.07) were associated with perinatal death in newborns with listeriosis. Pregnancy-related listeriosis was associated with increased risks of miscarriage (OR=1.75), intrauterine death (OR=17), preterm labor (OR=8.78), fetal distress (OR=2.10), cesarean section (OR=1.68), and stillbirth (OR=23.57).

CONCLUSIONS

Admissions for obstetric listeriosis and neonatal listeriosis in Spain have risen significantly from 2000 to 2021. Pregnancy-related listeriosis has a deleterious impact on fetal and neonatal outcomes, including miscarriages, fetal loss, stillbirth, and neonatal death. Surveillance, prevention, and prompt management of pregnant women with listeriosis and newborns with neonatal infection are warranted.

Effects of Decentralized Sequencing on National Listeria monocytogenes Genomic Surveillance, Australia, 2016-2023

We assessed turnaround times in the national Listeria monocytogenes genomic surveillance system in Australia before and after decentralized sequencing. Using 1,204 samples collected during 2016-2023, we observed statistically significant reductions in median time from sample collection to issuance of national genomic surveillance report to 26 days, despite sample numbers doubling in 2022 and 2023. During 2016-2018, all jurisdictions referred samples to the National Listeria Reference Laboratory for sequencing and analysis, but as jurisdictional sequencing capacity increased, 4 jurisdictions transitioned to sequencing their own samples and referring sequence data to the national laboratory. One jurisdiction had well-established genomics capacity, transitioned without noticeable disruption, and continued to improve. Another 3 jurisdictions initially had increased turnaround times, highlighting the need for defined sequence referral mechanisms. Overall, timeliness and throughput improved, and sequencing decentralization strengthened Australia's genomic surveillance system while maintaining timeliness. The practices described could be beneficial and achievable in other countries.

Targeting the host transcription factor HSF1 prevents human cytomegalovirus replication in vitro and in vivo

FDA-approved antivirals against HCMV have several limitations, including only targeting the later stages of the viral replication cycle, adverse side effects, and the emergence of drug-resistant strains. Antivirals targeting host factors specifically activated within infected cells and necessary for viral replication could address the current drawbacks of anti-HCMV standard-of-care drugs. In this study, we found HCMV infection stimulated the activation of the stress response transcription factor heat shock transcription factor 1 (HSF1). HCMV entry into fibroblasts rapidly increased HSF1 activity and subsequent relocalization from the cytoplasm to the nucleus, which was maintained throughout viral replication and in contrast to the transient burst of activity induced by canonical heat shock. Prophylactic pharmacological inhibition or genetic depletion of HSF1 prior to HCMV infection attenuated the expression of all classes of viral genes, including immediate early (IE) genes, and virus production, suggesting HSF1 promotes the earliest stages of the viral replication cycle. Therapeutic treatment with SISU-102, an HSF1 inhibitor tool compound, after IE expression also reduced the levels of L proteins and progeny production, suggesting HSF1 regulates multiple steps along the HCMV replication cycle. Leveraging a newly developed human skin xenograft transplant murine model, we found prophylactic treatment with SISU-102 significantly attenuated viral replication in transplanted human skin xenografts as well as viral dissemination to distal sites. These data demonstrate HCMV infection rapidly activates and relocalizes HSF1 to the nucleus to promote viral replication, which can be exploited as a host-directed antiviral strategy.

Development of Standard and Rapid Antigen Detection Assays for Human Metapneumovirus

Human metapneumovirus (hMPV), identified as a novel respiratory pathogen in 2001, is responsible for causing acute respiratory illness across various patient demographics. Early detection of hMPV is crucial for administering timely treatment, thereby controlling the virus's propagation. There is a pressing need for the development of a more convenient and expeditious detection strategy for hMPV. The present study focused on the expression and purification of the highly conserved nucleoprotein (N) of hMPV, which served as an antigen in the generation of specific nanobodies and mouse monoclonal antibodies. Subsequently, we evaluated the efficacy of these immunological reagents in detecting the hMPV antigen through the application of double-antibody sandwich enzyme-linked immunosorbent assay and colloidal gold lateral flow chromatography test strips. These detection methods were successfully utilized on the recombinant antigen, cell culture-derived hMPV, and nasopharyngeal swab specimens. The findings offer promising avenues for the development of convenient and rapid detection techniques, which are particularly pertinent during the virus's epidemic seasons.

Paediatric autoimmune uveitis is associated with intraocular antibodies against Epstein-Barr virus Nuclear Antigen 1 (EBNA-1)

BACKGROUND

Non-infectious uveitis is an immune-mediated disease characterized by vision-threatening inflammation within the eye. Increasing evidence indicates that microbial agents promote non-infectious uveitis, but the natural history of immune responses to pathogens in patients remains unexplored. We determined intraocular antibodies against pathogens in paediatric uveitis.

METHODS

We used peptide microarrays containing 3760 linear B-cell epitopes from 196 human pathogens to profile IgG levels in eye fluid biopsies and paired serum samples from 18 Dutch paediatric patients and 6 age-matched controls. We compared intensities of single epitopes and clusters based on overlapping amino acid sequence of peptides. Next-generation sequencing data was obtained to determine the HLA-DRB1∗15:01 genotype.

FINDINGS

Intraocular antibody profiles largely matched serum profiles and were characterized by high IgG against the conserved PALTAVET-motif of enterovirus family members, as well as broad epitope reactivity against Epstein-Barr virus (EBV). The aqueous humour of patients showed elevated levels of antibodies against peptides containing the RRPFFHPV-motif of Epstein-Barr Virus Nuclear Antigen 1 [EBNA-1]. Antibody levels against the RRPFFHPV-motif of EBNA1 were significantly higher in individuals that carry the HLA-DRB1∗15:01 risk allele of paediatric uveitis.

INTERPRETATION

Intraocular antibodies against an immunogenic epitope of EBV showed an association with paediatric uveitis, particularly HLA-DRB1∗15:01 positive uveitis, indicating a potential link between EBV-specific immune responses and autoimmune uveitis.

FUNDING

Funding for this research was received from Fischer Stichting (UZ2022-3), ODAS (2021-02), LSBS and ANVVB.