Recognition of novel proteins encoded by an aquareovirus using mass spectrometry

AQUAREOVIRUS: a genus of within the family Spinareoviridae, order Reovirales, infects aquatic animals. Their genomes comprise 11 segments of double-stranded RNA, which function directly as mRNAs upon release into the cytoplasm of infected cells. Here, liquid chromatography-tandem mass spectrometry was employed to annotate small coding ORFs in the Aquareovirus-C genome. Its plus-strand RNA of segment 8 (S8) contains a novel protein-coding frame (NS15), and S5 seems to has an additional reading frame (NS18) with a putative non-AUG initiation codon. Among them, NS15 polypeptide has been proved by immunoblotting assay. Remarkably, the S4 and S11 minus-strand mRNAs may encode polypeptides, suggesting ambisense polarity of the two segmented RNAs. And the newly discovered NS12 ORF in 2019, from viral tricistronic S7 mRNA, was also confirmed by this mass-spectrometry data. Taken together, these identified new ORFs reveal the genome-coding complexity of Aquareovirus-C.

Apolipoprotein A1-encoding recombinant adenovirus remodels cholesterol metabolism in tumors and the tumor microenvironment to inhibit hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a prevalent malignant tumor requiring effective treatments. Oncolytic viruses induce anti-tumor responses but have limited efficacy. Apolipoprotein A1 (ApoA1) inhibits inflammation, modulates immunity, and promotes anti-oxidation. This study aims to construct an oncolytic adenovirus (Ad5)-ApoA1 for superior anti-tumor effects. We analyzed ApoA1 expression in tumors and its prognostic significance using public databases. Subsequently, we engineered a recombinant oncolytic adenovirus Ad5-ApoA1 and assessed its replication and oncolytic efficacy in vitro and in nude mice. The impact of Ad5-ApoA1 on the tumor microenvironment of HCC was evaluated through flow cytometry, transcriptome sequencing, single-cell sequencing, and other methodologies. Additionally, mechanisms of immune microenvironment modulation by Ad5-ApoA1 were explored. ApoA1 expression was down-regulated with HCC progression and significantly positively correlated with the prognosis of HCC patients. Ad5-ApoA1 exhibited robust oncolytic activity but showed no therapeutic effect on nude mice. However, it significantly inhibited HCC growth and prolonged the survival period of both healthy-immune and humanized immune-reconstituted NCG mice. Furthermore, Ad5-ApoA1 significantly promoted the expression of IFN-γ and GzmB in CD8+ T cells while inhibiting the expression of PD-1 and LAG-3. Notably, the cholesterol content in the CD8+ T cells studied was significantly correlated with the expression of PD-1 and LAG-3, with ApoA1 promoting cholesterol efflux and reducing cholesterol levels. Ad5-ApoA1 activates CD8+ T cells by promoting large-scale viral replication. High levels of ApoA1 protein expression promote cholesterol efflux, inhibit CD8+ T cell depletion, and reduce inflammatory factors, ultimately leading to superior therapeutic effects on hepatocellular carcinoma.

A comparative analysis of Marburg virus-infected bat and human models from public high-throughput sequencing data

Marburg virus (MARV) disease (MVD) is an uncommon yet serious viral hemorrhagic fever that impacts humans and non-human primates. In humans, infection by the MARV is marked by rapid onset, high transmissibility, and elevated mortality rates, presenting considerable obstacles to the development of vaccines and treatments. Bats, particularly Rousettus aegyptiacus, are suspected to be natural hosts of MARV. Previous research reported asymptomatic MARV infection in bats, in stark contrast to the severe responses observed in humans and other primates. Recent MARV outbreaks highlight significant public health concerns, underscoring the need for gene expression studies during MARV progression. To investigate this, we employed two models from the Gene Expression Omnibus, including kidney cells from Rousettus aegyptiacus and primary proximal tubular cells from Homo sapiens. These models were chosen to identify changes in gene expression profiles and to examine co-regulated genes and pathways involved in MARV disease progression. Our analysis of differentially expressed genes (DEGs) revealed that these genes are mainly associated with pathways related to the complement system, innate immune response via interferons (IFNs), Wnt/β-catenin signaling, and Hedgehog signaling, which played crucial roles in MARV infection across both models. Furthermore, we also identified several potential compounds that may be useful against MARV infection. These findings offer valuable insights into the mechanisms underlying MARV's pathophysiology and suggest potential strategies for preventing transmission, managing post-infection effects, and developing future vaccines.

Artificial Intelligence Methods in Infection Biology Research

Despite unprecedented achievements, the domain-specific application of artificial intelligence (AI) in the realm of infection biology was still in its infancy just a couple of years ago. This is largely attributable to the proneness of the infection biology community to shirk quantitative techniques. The so-called "sorting machine" paradigm was prevailing at that time, meaning that AI applications were primarily confined to the automation of tedious laboratory tasks. However, fueled by the severe acute respiratory syndrome coronavirus 2 pandemic, AI-driven applications in infection biology made giant leaps beyond mere automation. Instead, increasingly sophisticated tasks were successfully tackled, thereby ushering in the transition to the "Swiss army knife" paradigm. Incentivized by the urgent need to subdue a raging pandemic, AI achieved maturity in infection biology and became a versatile tool. In this chapter, the maturation of AI in the field of infection biology from the "sorting machine" paradigm to the "Swiss army knife" paradigm is outlined. Successful applications are illustrated for the three data modalities in the domain, that is, images, molecular data, and language data, with a particular emphasis on disentangling host-pathogen interactions. Along the way, fundamental terminology mentioned in the same breath as AI is elaborated on, and relationships between the subfields these terms represent are established. Notably, in order to dispel the fears of infection biologists toward quantitative methodologies and lower the initial hurdle, this chapter features a hands-on guide on software installation, virtual environment setup, data preparation, and utilization of pretrained models at its very end.

Interferon Upregulation Associates with Insulin Resistance in Humans

In humans, insulin resistance is a physiological response to infections developed to supply sufficient energy to the activated immune system. This metabolic adaptation facilitates the immune response but usually persists after the recovery period of the infection and predisposes the hosts to type 2 diabetes and vascular injury. In patients with diabetes, superimposed insulin resistance worsens metabolic control and promotes diabetic ketoacidosis. Pathogenic mechanisms underlying insulin resistance during microbial invasions remain to be fully defined. However, interferons cause insulin resistance in healthy subjects and other population groups, and their production is increased during infections, suggesting that this group of molecules may contribute to reduced insulin sensitivity. In agreement with this notion, gene expression profiles (transcriptomes) from patients with insulin resistance show a robust overexpression of interferon- stimulated genes (interferon signature). In addition, serum levels of interferon and surrogates for interferon activity are elevated in patients with insulin resistance. Circulating levels of interferon- γ-inducible protein-10, neopterin, and apolipoprotein L1 correlate with insulin resistance manifestations, such as hypertriglyceridemia, reduced HDL-c, visceral fat, and homeostasis model assessment-insulin resistance. Furthermore, interferon downregulation improves insulin resistance. Antimalarials such as hydroxychloroquine reduce interferon production and improve insulin resistance, reducing the risk for type 2 diabetes and cardiovascular disease. In addition, diverse clinical conditions that feature interferon upregulation are associated with insulin resistance, suggesting that interferon may be a common factor promoting this adaptive response. Among these conditions are systemic lupus erythematosus, sarcoidosis, and infections with severe acute respiratory syndrome-coronavirus-2, human immunodeficiency virus, hepatitis C virus, and Mycobacterium tuberculosis.

Disinfection effect of ozonated water on SARS-CoV-2 in the presence of salivary proteins

BACKGROUND

Ozonated water is expected to be an effective disinfectant for SARS-CoV-2 present on environmental fomites; however, ozone is consumed by organic substances, resulting in attenuation of its effect. SARS-CoV-2 present in saliva can contaminate environmental surfaces; therefore, it is essential to understand the effect of organic substances in saliva on the disinfectant properties of ozonated water.

AIM

To assess organic factors in saliva and the extent to which they diminish the effect of ozonated water on SARS-CoV-2.

METHODS

Ozonated water was exposed to salivary organic factors and residual ozone concentrations were measured. SARS-CoV-2 was exposed to a salivary factor and virus inactivation by ozonated water was measured.

FINDINGS

Amylase and mucin consumed ozone in a concentration-dependent manner. Urea did not. Ozonated water appeared to inactivate SARS-CoV-2 within 30 s. The amount of inactivated SARS-CoV-2 decreased as the protein concentration increased. Virus inactivation was stronger by 1.5 mg/L ozonated water than by 0.5 mg/L ozonated water.

CONCLUSION

This study suggests that the salivary amylase and mucin decay ozone in a concentration-dependent manner, thereby attenuating the disinfection properties of ozonated water for SARS-CoV-2. An increase of the initial amount of ozone can ameliorate the disinfection effect of ozonated water on SARS-CoV-2. Ozone consumption should be taken into consideration for virus infection control. These results provide fundamental information about the effect of ozonated water when used to decontaminate surfaces harbouring SARS-CoV-2 in saliva.

HIV-TAT dysregulates microglial lipid metabolism through SREBP2/miR-124 axis: Implication of lipid droplet accumulation microglia in NeuroHIV

Chronic HIV infection can dysregulate lipid/cholesterol metabolism in the peripheral system, contributing to the higher incidences of diabetes and atherosclerosis in HIV (+) individuals. Recently, accumulating evidence indicate that HIV proteins can also dysregulate lipid/cholesterol metabolism in the brain and such dysregulation could be linked with the pathogenesis of HIV-associated neurological disorders (HAND)/NeuroHIV. To further characterize the association between lipid/cholesterol metabolism and HAND, we employed HIV-inducible transactivator of transcription (iTAT) and control mice to compare their brain lipid profiles. Our results reveal that HIV-iTAT mice possess dysregulated lipid profiles and have increased numbers of lipid droplets (LDs) accumulation microglia (LDAM) in the brains. HIV protein TAT can upregulate LDs formation through enhancing the lipid/cholesterol synthesis in vitro. Mechanistically, HIV-TAT increases the expression of sterol regulatory element-binding protein 2 (SREBP2) through microRNA-124 downregulation. Cholesterol synthesis inhibition can block HIV-TAT-mediated NLRP3 inflammasome activation and microglial activation in vitro as well as mitigate aging-related behavioral impairment and memory deficiency in HIV-iTAT mice. Taken together, our results indicate an inherent role of lipid metabolism and LDAM in the pathogenesis of NeuroHIV (immunometabolism). These findings suggest that LDAM reversal through modulating lipid/cholesterol metabolism could be a novel therapeutic target for ameliorating NeuroHIV symptoms in chronic HIV (+) individuals.

The Effect of Nirmatrelvir-Ritonavir on Short- and Long-term Adverse Outcomes From COVID-19 Among Patients With Kidney Disease: A Propensity Score-Matched Study

Background

Patients with kidney disease are at high risk for adverse outcomes after coronavirus disease 2019 (COVID-19) despite vaccination. Because patients with advanced chronic kidney disease (CKD) and kidney failure were excluded from registrational trials, the impact of the protease inhibitor nirmatrelvir-ritonavir in patients with kidney disease is unknown.

Methods

This was a cohort study evaluating adverse outcomes in patients with kidney disease who developed COVID-19. Patients prescribed nirmatrelvir-ritonavir for COVID-19 between March 16, 2022, and November 30, 2022, were propensity score-matched to comparators diagnosed with COVID-19 between July 15, 2021, and March 15, 2022 (before the use of nirmatrelvir-ritonavir in our health care network). We determined the association between nirmatrelvir-ritonavir and short- and long-term outcomes using Fine-Gray subdistribution hazard and Cox proportional hazard models, adjusting for potential confounders. Outcomes included 30-day risk of hospitalization and 1-year risk of a major adverse cardiovascular event (MACE), CKD progression, and death.

Results

A total of 1095 nirmatrelvir-ritonavir-treated patients were matched to 584 comparators. Patients who received nirmatrelvir-ritonavir patients were less likely to be hospitalized within 30 days of diagnosis (adjusted subdistribution hazard ratio [sHR], 0.44; 95% CI, 0.26-0.73; P < .01). At 1 year, nirmatrelvir-ritonavir-treated patients had a lower risk of hospitalization for MACE (adjusted sHR, 0.49; 95% CI, 0.36-0.67; P < .01) and death (adjusted hazard ratio, 0.37; 95% CI, 0.21-0.65; P < .01). Use of nirmatrelvir-ritonavir was not associated with decreased risk of CKD progression or attenuation of estimated glomerular filtration rate decline slope in the year following infection.

Conclusions

Nirmatrelvir-ritonavir was associated with decreased risk of hospitalization within 30 days and 1-year risk of MACE and death in patients with CKD and kidney failure.

New Onset Diabetes After COVID 19 (NODAC) is predominantly due to exacerbated Insulin Resistance (IR) rather than beta cell dysfunction: Lessons from tertiary care hospital data during confluence of two epidemics

PURPOSE

To investigate determinants of new onset diabetes after COVID-19 (NODAC) and its recovery at 6 months.

METHODS

This was an observational follow up study conducted from August, 2020 to July, 2023, recruiting patients with preexisting DM and COVID 19 patients with no history of DM. Multivariate regression analysis was used to determine the factors responsible for severity of COVID 19 infection in preexisting DM group. Clinical, laboratory and glycometabolic parameters were estimated at baseline and 6 months in NODAC and euglycemic group to determine the factors responsible for NODAC and its persistence at 6 months.

RESULTS

Of 1310 patients, 855 (65.3%) COVID 19 patients were further divided based on their glycemic status: preexisting DM (19%), NODAC (8.5%) and euglycemia (72.5%). Older age and male gender were independent risk factors for severe COVID 19 disease in patients with preexisting diabetes. Prevalence of NODAC in present study was 8.5%. Patients with NODAC had higher mean fasting blood glucose (FBG), random blood glucose (RBG) and HbA1c at baseline as compared to COVID with euglycemic group with no difference in serum C-peptide levels. Female gender, family history of DM, signs of insulin resistance, higher BMI, WHR, HbA1c, serum insulin levels, FBG and RBG predicted persistence of NODAC at 6 months.

CONCLUSION

Preexisting DM is a risk factor for severe COVID 19 disease. Patients with NODAC have evidence of persistence insulin resistance on follow up, underscoring the need for long term glycemic monitoring.

Epidemiology of Infections in Lung Transplant Recipients Treated With Belatacept

BACKGROUND

Belatacept is a costimulatory blocker that can be used to prevent and treat rejection in lung transplant recipients (LuTRs). The epidemiology of infections in belatacept-treated LuTRs has not been systematically evaluated.

METHODS

We performed a single-center retrospective study of all adult LuTRs who received belatacept as prevention or treatment of antibody-mediated rejection (desensitization) or as part of maintenance immunosuppression from January 1, 2011, to June 30, 2022. We assessed the epidemiology of infections that occurred within 12 months following the first belatacept dose.

RESULTS

Fifty-two LuTRs received at least one dose of belatacept as either desensitization (n = 32) or maintenance immunosuppression (n = 20). Among 45 patients who were cytomegalovirus (CMV) donor and/or recipient seropositive, nine (20%) developed CMV infection. Seven (77%) CMV infections occurred despite valganciclovir prophylaxis and four (44%) were associated with antiviral resistance. Three (6%) LuTRs developed Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disorder (PTLD). Twenty-five (48%) LuTRs developed 43 bacterial infections and five (10%) developed proven or probable invasive fungal disease. Incidence rates of viral, bacterial, and fungal infections were similar between the desensitization and maintenance groups: incidence rate ratios (95% confidence interval) were 0.70 (0.32-1.57), 1.31 (0.70-2.46), and 2.82 (0.31-25.2), respectively. Infection/PTLD prompted belatacept discontinuation in eight (15%) patients.

CONCLUSIONS

In the first year after belatacept initiation, LuTRs commonly developed CMV infections, EBV+ PTLD, and bacterial infections. Multicenter collaborations are needed to better understand infection risks in LuTRs treated with belatacept.

In silico Approach: Design an Optimized shRNA against RUNX1 Gene to Target HIV

INTRODUCTION

Human Immunodeficiency Virus (HIV) is a retrovirus with single-stranded RNA that leads to the challenging disease of acquired immunodeficiency syndrome (AIDS). Combination antiretroviral therapy (cART) can prevent the progression of the disease, but it is not capable of long-term HIV elimination. One of the significant obstacles to treating HIV-1-infected individuals is the creation of latent cell reservoirs early in the infection. Gene-based therapies that utilize RNA interference (RNAi) to silence host or viral gene expression are considered promising therapeutic approaches. It has been demonstrated that RUNX1, a T-cell-specific transcription factor, may significantly affect HIV replication and infection. According to accumulating evidence on the role of interfering RNA techniques in inhibiting gene expression and considering the role of RUNX1 in the replication of HIV-1. In this study, we aim to design shRNAs against RUNX1 that can target the replication of HIV-1.

METHODS

Several computational methods, including target alignment, similarity search, and secondary structure prediction, have been employed in the design of shRNA against RUNX1.

RESULTS

Seven shRNA molecules with the highest efficiency were designed and validated using computational methods to silence the RUNX1 gene.

CONCLUSION

In the present study, we designed shRNA against RUNX1, which can target latent cells infected with HIV. Suppression of RUNX1 by shRNA reactivates HIV in the latent cells and subsequently potentiates the immune response toward identifying accurate virus-infected cells. This process may lead to an effective and efficient reduction of the volume of cell reservoirs infected with HIV.

Oral Immunisation With Non-GMO Surface Displayed SARS-CoV-2 Spike Epitopes on Bacteria-Like Particles Provokes Robust Humoral and Cellular Immune Responses, and Modulated the Gut Microbiome in Mice

The coronavirus disease 2019 (COVID-19) is a fatal disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). To date, several vaccines have been developed to combat the spread of this virus. Mucosal vaccines using food-grade bacteria, such as Lactobacillus spp., are promising strategies for developing safe and effective vaccines against SARS-CoV-2. In this study, we designed a non-GMO surface-displayed SARS-CoV-2 spike S1 epitope on Limosilactobacillus fermentum-derived bacteria-like particles (BLPs). After that, we evaluated its efficacy to induce immune responses in immunocompetent mice. Moreover, we examined the influence of oral immunisation on the gut microbiome and microbiota metabolites. Twenty-eight 6-week-old male C57BL/6 mice were orally immunised with the following: PBS (control), Lm. fermentum-derived BLPs only, BLPs displaying SARS-CoV-2 spike S1-2, or BLPs displaying SARS-CoV-2 spike S1-3 epitopes. Our results showed that mucosal immunisation of mice with surface-displayed SARS-CoV-2 spike epitopes provoked high-level secretory IgA and systemic IgG production. Moreover, the immunisation exhibited a Th1-like immune response, characterised by an elevated IgG2a-to-IgG1 ratio and high antiviral IFN-γ production. In addition, we observed gut microbiome modulation and increased butyrate production in immunised mice. Overall, the use of Lm. fermentum-derived BLPs and the anchor CshA to display SARS-CoV-2 spike S1epitopes is a promising novel strategy in developing a cost-effective, non-GMO mucosal vaccine alternative against SARS-CoV-2.

Safety, Pharmacokinetics and Antiviral Efficacy of Capsid Assembly Modulator Freethiadine in Healthy Volunteers and Chronic Hepatitis B Patients

BACKGROUND AND AIMS

Freethiadine is a novel hepatitis B virus capsid assembly modulator. Herein, we report the safety, tolerability, pharmacokinetics and 28-day antiviral activities of freethiadine.

METHODS

The study consisted of two parts. Part 1 involved a single-ascending-dose, a multiple-ascending-dose and a food effect study. Part 2 was a double-blind, double-dummy, randomised, entecavir-controlled, multi-dose escalation study in chronic hepatitis B (CHB) patients.

RESULTS

A total of 88 healthy subjects and 40 patients with CHB were enrolled in this study. Freethiadine was well tolerated by both healthy subjects and patients. Among freethiadine-treated patients with CHB, the most common drug-related adverse event was alanine aminotransferase elevation (28.1%) (mostly grade 1 or 2). Both HEC160208 and its active metabolite, HEC142106, were rapidly absorbed and eliminated in plasma. Food intake did not significantly influence the exposure of either analyte. Following 28 days of treatment, the mean maximum HBV DNA declines from baseline were -2.76, -3.47, -3.56, -2.89 and -2.55 log10 IU/mL for the 100 mg BID, 200 mg QD, 200 mg BID and 300 mg QD of freethiadine or entecavir control cohorts, respectively; simultaneously, the mean maximum pregenomic RNA (pgRNA) declines from baseline were -1.69, -2.26, -2.07, -1.47 and -0.06 log10 copies/mL, respectively.

CONCLUSIONS

Freethiadine has an acceptable safety profile and favourable antiviral activity in patients with CHB. These results support further investigations of freethiadine for the treatment of chronic HBV infection.

TRIAL REGISTRATION

www.

CLINICALTRIALS

gov identifier NCT05391360; www.chinadrugtrials.org.cn identifier CTR20212114.

Inhibitors of dihydroorotate dehydrogenase synergize with the broad antiviral activity of 4'-fluorouridine

RNA viruses present a constant threat to human health, often with limited options for vaccination or therapy. Notable examples include influenza viruses and coronaviruses, which have pandemic potential. Filo- and henipaviruses cause more limited outbreaks, but with high case fatality rates. All RNA viruses rely on the activity of a virus-encoded RNA-dependent RNA polymerase (RdRp). An antiviral nucleoside analogue, 4'-Fluorouridine (4'-FlU), targets RdRp and diminishes the replication of several RNA viruses, including influenza A virus and SARS-CoV-2, through incorporation into nascent viral RNA and delayed chain termination. However, the effective concentration of 4'-FlU varied among different viruses, raising the need to fortify its efficacy. Here we show that inhibitors of dihydroorotate dehydrogenase (DHODH), an enzyme essential for pyrimidine biosynthesis, can synergistically enhance the antiviral effect of 4'-FlU against influenza A viruses, SARS-CoV-2, henipaviruses, and Ebola virus. Even 4'-FlU-resistant mutant influenza A virus was re-sensitized towards 4'-FlU by DHODH inhibition. The addition of uridine rescued influenza A virus replication, strongly suggesting uridine depletion as a mechanism of this synergy. 4'-FlU was also highly effective against SARS-CoV-2 in a hamster model of COVID. We propose that the impairment of endogenous uridine synthesis by DHODH inhibition enhances the incorporation of 4'-FlU into viral RNAs. This strategy may be broadly applicable to enhance the efficacy of pyrimidine nucleoside analogues for antiviral therapy.

Comparison of the role of vitamin D in normal organs and those affected by COVID-19

The outbreak of COVID-19 has opened up new avenues for exploring the importance of vitamin D in immunity, in addition to its role in calcium absorption. Recently, vitamin D supplementation has been found to enhance T regulatory lymphocytes, which are reduced in individuals with COVID-19. Increased risk of pneumonia and increases in inflammatory cytokines have been reported to be major threats associated with vitamin-D deficiency. Although vaccination reduces the threat of COVID-19 to a certain extent, herd immunity is the long-term solution to overcoming such diseases. Co-administration of vitamin D with certain inactivated vaccines has been reported to enhance the systemic immune response through stimulation of the production of antigen-specific mucosal immunity. COVID-19 was found to induce multiple organ damage, and vitamin D has a beneficial role in various organs, such as the intestines, pancreas, prostate, kidneys, liver, heart, brain, and immune cells. The consequences that occur after COVID-19 infection known as long COVID-19 are also a concern as they accumulate and target multiple organs, leading to immune dysregulation. The present review covers the overall role and impact of vitamin D and its deficiency for various organs in normal conditions and after COVID-19 infection, which is still a serious issue.

Selective and complementary antimicrobial and antiviral activity of silver, copper, and selenium nanoparticle suspensions in deep eutectic solvent

Metallic and nonmetallic nanoparticles are bioactive compounds that exhibit broad resistance to bacteria, fungi, and even viruses. In this paper, a deep eutectic solvent (DES) based on betaine, glucose, and ethylene glycol was used to obtain suspensions of silver, copper, and selenium nanoparticles. Depending on the nanoparticle precursor used, Ag, Cu, and Se nanoparticles (NPs) with an average particle size of 50-100 nm were prepared, and the properties of the products were confirmed by the STEM, XPS, DLS, and UV-VIS methods. The use of a DES, without the need for additional reactants, allowed the production of stable nanoparticles with increased bioactivity against microorganisms. The obtained systems showed high bioactivity against strains of S. aureus, E. coli, and C. albicans. Nanosuspensions, by generating reactive oxygen species (ROSs), caused enzyme inactivation and the inhibition of the metabolic processes of microorganisms. Particle-generated cell degradation processes were investigated through ROS generation assays, API assays, the determination of the MIC/MBC, and cell decomposition rate assays in the early logarithmic growth phase. Copper nanoparticles derived from copper(II) acetate were also highly active against the human influenza A/H1N1 viruses, human coronavirus (HCoV-OC43, Betacoronavirus 1), and vesicular stomatitis virus (VSV, Rhabdoviridae), showing a virus titer reduction of more than 93.7-99.96%.

Human neuroinvasive Toscana virus infections in Italy from 2016 to 2023: Increased incidence in 2022 and 2023

BackgroundToscana virus (TOSV) is transmitted to humans through bites of infected sand flies. Neuroinvasive TOSV infections are leading causes of meningitis/encephalitis in southern Europe and notifiable in Italy since 2016. In 2022-23, Italy experienced extreme climate anomalies and a concomitant increase in mosquito and tick-borne disease transmission.AimTo identify the spatiotemporal distribution and risk groups of neuroinvasive TOSV infections in Italy in 2022-23 vs 2016-21.MethodsWe retrospectively described all autochthonous, laboratory-confirmed neuroinvasive TOSV cases notified to the national surveillance system in 2016-23 using frequencies, proportions, incidences and incidence risk ratios (IRRs) with 95% CIs, stratified by year, sex, age, region/autonomous province (AP) of infection/exposure and infection/exposure municipality by urbanisation level.ResultsIn 2022-23, 276 cases were notified (average annual incidence: 2.34/1,000,000 population) vs 331 cases in 2016-21 (0.92/1,000,000), with increased incidence extending into September. In 2022-23, infections were acquired in 12/21 regions/APs, predominantly in Emilia Romagna (57.6%; 159/276) as in 2016-21, including four regions/APs with no local infections in 2016-21. Similar to 2016-21, during 2022-23 residence in rural municipalities (vs urban), male sex, working age (19-67 years) and age > 67 years (vs ≤ 18 years) were identified as risk factors with IRRs of 2.89 (95% CI: 2.01-4.17), 2.17 (95% CI: 1.66-2.84), 5.31 (95% CI: 2.81-10.0) and 5.06 (95% CI: 2.59-9.86), respectively.ConclusionItaly experienced a nearly 2.6-fold increase in neuroinvasive TOSV incidence in 2022-23 vs 2016-21. Raising public awareness on risk factors and personal protection measures may enhance prevention efforts.

Factors influencing nursing students' willingness to volunteer during wartime emergencies: A cross sectional study in Israel

BACKGROUND

During wartime emergencies, the Ministry of Health in Israel faces workforce shortages, prompting consideration of nursing students as auxiliary support. Understanding the factors influencing nursing students' willingness to volunteer, is essential for effective crisis preparedness.

AIM

The research seeks to identify how self-efficacy, positive attitudes, institutional support, knowledge, age, gender, prior experience, and familial obligations impact nursing students' readiness to volunteer during mass casualty events in wartime.

DESIGN

This study employed a descriptive, cross-sectional research approach.

SETTINGS

Nursing schools in Israel.

PARTICIPANTS

A convenience sample of 300 nursing students who had commenced their studies for at least one month. The study targeted nursing students across Israel, regardless of their specific school affiliation. Recruitment was conducted through various channels, including face-to-face recruitment, emails, and synchronous chat groups.

METHODS

Data were collected using a structured self-report questionnaire based on Bandura's self-efficacy theory and adapted from existing literature. Statistical analyses, included t-tests, Pearson correlation, and linear rand logistic regressions.

RESULTS

The study found high levels of intent (M = 3.33, SD = 0.83), perceived self-efficacy (M = 3.25, SD = 0.54), and positive attitudes towards volunteering during wartime (M = 3.57, SD = 0.54) among nursing students towards volunteering during wartime. Significant correlations were observed between students' willingness to volunteer during wartime and factors such as positive attitudes to volunteer during wartime (r = 0.543, p < 0.01), perceived self-efficacy (r = 0.313, p < 0.01), institutional support (r = 0.313, p < 0.01), knowledge (r = 0.138, p < 0.05), age (r = 0.179, p < 0.01), and previous volunteering experience (r = 0.158, p < 0.01). Regression analyses indicated that positive attitudes towards wartime volunteering, perceived self-efficacy, institutional support, and prior volunteering were significant predictors of the intention to volunteer.

CONCLUSIONS

Nursing students in Israel demonstrate a high willingness to volunteer during wartime, influenced by factors such as perceived self-efficacy, positive attitudes towards volunteering, and institutional support. While these findings suggest potential areas for enhancing volunteerism, further research is needed to assess the effectiveness of targeted training and support interventions. Nonetheless, fostering these key factors could strengthen the healthcare system's capacity to respond to wartime emergencies.

Viral intruders in the heart: A review of RNA viruses and their role in cardiac disorders

Viral cardiac diseases have a significant impact on global health, and RNA viruses play a crucial role in their pathogenesis. This literature review aims to provide a comprehensive understanding of the complex relationship between RNA viruses and cardiac diseases, focusing on the molecular processes and clinical implications of these interactions. The paper begins by discussing the various RNA viruses that have been linked to cardiac infections. Subsequently, the study explores the mechanisms through which RNA viruses can cause cardiac injury, including direct viral invasion, immune-mediated responses, and molecular mimicry. The review extensively examines the intricate interplay between the host immune system and RNA viruses, shedding light on both protective and harmful immune responses. Additionally, it investigates the role of viral persistence and chronic inflammation in the long-term effects on cardiac health. The thorough analysis presented not only enhances our scientific understanding of how RNA viruses contribute to the development of cardiac diseases but also highlights potential avenues for future research and breakthroughs in this field. Given the significant global health threat posed by viral cardiac disorders, unraveling the molecular foundations of these diseases is essential for advancing diagnostic capabilities and therapeutic interventions.

Control of Mycobacterium tuberculosis infection in the elderly: Is there a role for epigenetic reprogramming reversal?

With the increase in the elderly population worldwide, the number of subjects suffering from tuberculosis (TB) has shown an increased prevalence in this group. Immunosenescence is essential in this phenomenon because it may reactivate the lesions and render their adaptive immunity dysfunctional. In addition, inflammation in the lungs of the elderly subjects is also dysfunctional. Although effective drugs are available, they are often tolerated inadequately, reducing adherence to the therapy and leading to therapeutic failure. Comorbidities, poor general health status, and other medications may lead to increased drug adverse reactions and reduced adherence to treatment in the elderly. Hence, older adults require an individualized approach for better outcomes. Trained immunity, which involves epigenetic reprogramming, may contribute to balancing the dysfunction of innate and adaptive immunity in older people. This review analyzes the relationship between inflammation, age, and Mycobacterium tuberculosis. Moreover, we hypothesize that immunomodulation using trained immunity activators will help reduce inflammation while enhancing antimicrobial responses in the elderly. Understanding immunomodulation's molecular and physiological effects will lead to informed decisions about TB prevention and treatment strategies uniquely designed for the elderly.

Computational Analysis of Virus-Host Interactomes

Various high-throughput genetic functional screening and physical protein interaction screening methods have been employed to gain a global understanding of how viruses interact with host cells for replication. In this chapter, we provide an overview of the bioinformatics analysis and computational methods of virus-host interactions and highlight their advantages and disadvantages to provide a technical reference for interactive research on virus-host interactomes and the identification of antiviral factors.

Porcine ISG15 fused IFN-λ3 as a novel antiviral agent for treating porcine reproductive and respiratory syndrome virus infection in vivo

IFN-λs hold promise as therapeutic candidates against mutable respiratory viruses, but their efficacy against porcine reproductive and respiratory syndrome virus (PRRSV) remains unclear. In this study, we expressed a recombinant fusion protein consisting of porcine ISG15 linked porcine IFN-λ3 (ISG15-IFN-λ3) via a rigid protein linker in Escherichia coli (E. coli). In vitro experiments demonstrated that treatment of porcine alveolar macrophage (PAM)-derived CRL-2843 cells with ISG15-IFN-λ3 induced upregulation of several Interferon-stimulated Genes (ISGs) proteins, including ISG15, ISG56, and HERC5. CRL-2843 cells pretreated with ISG15-IFN-λ3 exhibited heightened resistance to Newcastle disease virus infection, while PRRSV-permissive cells treated with ISG15-IFN-λ3 before and during PRRSV exposure showed significantly inhibited PRRSV replication as well. In animal experiments, at 21 days post-infection, ISG15-IFN-λ3-treated piglets displayed milder lung tissue pathology and significantly reduced serum PRRSV-RNA, indicating enhanced viral clearance and faster recovery. Additionally, PAMs collected from ISG15-IFN-λ3-treated piglets showed significantly reduced mRNA expression of representative cytokines, chemokines, suggesting that ISG15-IFN-λ3 treatment may mitigate pneumonia severity by reducing the levels of these inflammatory mediators. These findings indicate that recombinant ISG15-IFN-λ3 expressed in E. coli may serve as a novel, effective, and affordable agent for treating severe PRRSV infection in piglets, potentially benefiting the pork industry.

Development of a recombinant infectious bronchitis virus vaccine expressing infectious laryngotracheitis virus multiple epitopes

Infectious laryngotracheitis (ILT) is a highly contagious disease, usually controlled by vaccination with live attenuated vaccines. However, the latent infection and adverse reactions caused by the live attenuated vaccines against infectious laryngotracheitis virus (ILTV) have limited its use in poultry. Infectious bronchitis virus (IBV) is considered a potential vector for vaccine development, but the issue of poor stability in recombinant IBV expressing foreign genes has not yet been resolved. In this study, we designed a multi-epitope cassette (gD-T/B) containing multiple T and B cell epitopes of ILTV gD protein. The genetic stability of the full-length gD gene and the gD-T/B multi-epitope cassette replacing non-essential genes in IBV was systematically analyzed. We found that, at the same insertion site, the stability of inserting gD-T/B multi-epitope cassette was consistently higher compared to the full-length gD gene. This difference may be related to the presence of more signals affecting virus replication or transcription in larger heterologous genes. In addition, the stability of recombinant IBV varied depending on the genome region being replaced. When the gene 5 was replaced, rH120-Δ5ab-gD-T/B was maintained up to at least passage 20 (P20). Compared with the parental virus H120 strain, rH120-Δ5ab-gD-T/B showed similar growth kinetics. Clinical observations and scoring of clinical signs in the vaccination-challenge experiment showed that rH120-Δ5ab-gD-T/B provided 90% protection against virulent ILTV, effectively alleviating clinical signs caused by infection with a virulent strain of ILTV. Furthermore, rH120-Δ5ab-gD-T/B significantly reduced the replication and shedding of ILTV in the trachea. Overall, this study suggests that rH120-Δ5ab-gD-T/B is a promising candidate vaccine against ILTV.

Use of Machine Learning to Predict the Incidence of Type 2 Diabetes Among Relatively Healthy Adults: A 10-Year Longitudinal Study in Taiwan

Background: The prevalence of diabetes is increasing worldwide, particularly in the Pacific Ocean island nations. Although machine learning (ML) models and data mining approaches have been applied to diabetes research, there was no study utilizing ML models to predict diabetes incidence in Taiwan. We aimed to predict the onset of diabetes in order to raise health awareness, thereby promoting any necessary lifestyle modifications and help mitigate disease burden. Methods: The research dataset used in the study was retrieved from the Clinical Data Center of Taichung Veterans General Hospital. We collected data from the available electronic health records with a total of 33 items being employed for model construction. Individuals with diabetes and those with missing data were excluded. Ultimately, 6687 adults were included in the final analysis, where we implemented three different ML algorithms, including logistic regression (LR), random forest (RF) and extreme gradient boosting (XGBoost) in order to predict diabetes. Results: The top five important factors involved in the prediction model were glycated hemoglobin (HbA1c), fasting blood glucose, weight, free thyroxine (fT4), and triglycerides (TG). Notably, random forest, logistic regression, and XGBoost reached 99%, 99%, and 98% accuracy, respectively. fT4 seems to be one of the significant features in predicting the onset of diabetes. Moreover, this would be the first study using machine learning models to predict diabetes that has demonstrated the importance of thyroid hormone. Conclusions: A total of 33 items were able to be put into the machine learning model in order to predict diabetes with promising accuracy. In comparison to prior studies on machine learning models, this study not only identified similar key factors for predicting diabetes but also highlighted the significance of thyroid hormones, a factor that was previously overlooked. Moreover, it highlighted the relevance of predicting type 2 diabetes using more affordable methods, which would be useful for clinical healthcare professionals and endocrinologists who apply the models to clinical practice.

B and T cell responses to the 3rd and 4th dose of the BNT162b2 vaccine in dialysis patients

Patients on dialysis (PoD) are at high risk of severe morbidity and mortality from COVID-19. Characterizing long-term vaccine immune responses in these patients will help optimize vaccine schedule for PoD. This study aimed to determine whether long-term humoral and B and T cell-responses post 3rd and 4th dose of the BNT162b2 vaccine differed between PoD and controls. Non-infected PoD and controls vaccinated with BNT162b2 were recruited in Ziv Medical Center, Israel, between 2021 and 2022. Specimens were collected 1-2 months pre 3rd dose; 1-3 months post 3rd dose; 4-5 months post 3rd dose and 3-5 months post the 4th dose. Anti-SARS-CoV-2 spike (spike) specific antibodies, spike specific memory B cells, and spike specific CD154+ T cells as well as cytokines producing CD4+/CD8+ T cells were measured using standardized assays and compared between PoD and controls at each time point using Mann Whitney and Fisher's exact tests. We recruited 22 PoD and 20 controls. Antibody levels in PoD were lower compared to controls pre 3rd dose but not post 3rd and 4th doses. Frequencies of spike specific memory B cell populations were similar between PoD and controls overall. Frequencies of spike specific T cells, including those producing IFNγ and TNFα, were not lower in PoD. B and T cell mediated immune response in PoD following a 3rd and a 4th dose of the BNT162b2 vaccine was not inferior to controls up to 5 months post vaccination. Our results suggest that standard BNT162b2 vaccination is suitable for this group.

The protective effect of serum antibodies in preventing SARS-CoV-2 virus entry into cardiac muscle

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with significant cardiovascular complications, including myocardial infection and pulmonary embolism. This study aims to elucidate the relationship between the presence of SARS-CoV-2 RNA in the myocardium of the left ventricle and the levels of IgG and IgM antibodies against the SARS-CoV-2 virus in deceased COVID-19 patients. We conducted a post-mortem examination on 91 individuals who succumbed to COVID-19-related complications. The presence of SARS-CoV-2 RNA in the myocardium of the left ventricle was analyzed reverse transcription real time PCR (RT-qPCR) (EliGene® COVID19 UKV/SAV RT kit, Elisabeth Pharmacon), and antibody levels in serum were analyzed by serological assays (VIDAS SARS-COV-2 IgM and VIDAS SARS-COV-2 IgG II tests, BioMérieux). Of the heart tissue samples, 44 % tested positive for SARS-CoV-2 RNA. Our findings indicate that any detectable level of IgG antibodies against SARS-CoV-2 reduces the risk of viral penetration into the myocardium by more than fourfold. Specifically, individuals with detectable levels of IgG and IgM antibodies exhibited a significantly reduced presence of SARS-CoV-2 RNA in cardiac tissues (p<0.0001 for IgG and p<0.001 for IgM). Notably, all patients who died from pulmonary embolism had elevated levels of IgG antibodies. The study underscores the protective role of IgG and IgM antibodies in preventing SARS-CoV-2 penetration into cardiac tissues. However, high antibody titers were associated with fatal outcomes such as pulmonary embolism, pointing to the intricate balance of immune response in COVID-19 pathology. Key words SARS-CoV-2, Antibody, IgG, IgM, Cardiac damage, qPCR, Pneumonia, Pulmonary embolism, Heart failure.

Virological Aspects of COVID-19 in Patients with Hematological Malignancies: Duration of Viral Shedding and Genetic Analysis

Coronavirus disease 2019 (COVID-19) has been associated with a significant fatality rate and persistent evolution in immunocompromised patients. In this prospective study, we aimed to determine the duration of excretion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 37 Tunisian patients with hematological malignancies (40.5% with lymphoma and 37.8% with leukemia). In order to investigate the accumulation of viral mutations, we carried out genetic investigation on longitudinal nasopharyngeal samples using RT-PCR and whole-genome sequencing. Patients' samples were collected until the RT-PCR results became negative. SARS-CoV-2 infection was symptomatic in 48.6% of cases with fever, and cough was symptomatic in 61% of cases; the mortality rate was estimated to be 13.5%. The duration of viral RNA shedding ranged from 7 to 92 days after onset; it exceeded 18 days in 79.4% of cases. An intermittent PCR positivity was observed in two symptomatic patients. Persistent PCR positivity, defined as the presence of viral RNA for more than 30 days, was found in 51.4% of cases. No significant differences were observed for age, sex, type of hematological malignancy, or COVID-19 evolution between this group and a second one characterized by non-persistent PCR positivity. Lymphopenia was an independent predictor of prolonged SARS-CoV-2 RNA detection (p = 0.04). Three types of variants were detected; the most frequent was the Omicron. Globally, the mean intra-host variability in the SARS-CoV-2 genome was 1.31 × 10-3 mutations per site per year; it was 1.44 × 10-3 in the persistent group and 1.3 × 10-3 in the non-persistent group. Three types of mutations were detected; the most frequent were nucleotide substitutions in the spike (S) gene. No statistically significant difference was observed between the two groups as to the type and mean number of observed mutations in the whole genome and the S region (p = 0.650). Sequence analysis revealed the inclusion of one to eight amino acid-changing events in seventeen cases; it was characterized by genetic stability from the third to the twentieth day of evolution in six cases. For the two patients with intermittent PCR positivity, sequences obtained from samples before and after negative PCR were identical in the whole genome, confirming an intra-host evolution of the same viral strain. This study confirms the risk of persistent viral shedding in patients with hematological malignancies. However, persistence of PCR positivity seems to be correlated only with a continuous elimination of viral RNA debris. Additional studies based on cell culture analysis are needed to confirm these findings.

Clinical Characteristics and Outcomes in Patients with Chronic HBV Infection and Hospitalized for COVID-19 Pneumonia: A Retrospective Cohort Study

The effects of a concomitant infection of hepatitis B virus (HBV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are still debated, with a recognized major risk of HBV reactivation during immune-suppressive treatments. The aim of this study was to determine the prevalence and predictive factors of HBV reactivation in a cohort of hospitalized patients with coronavirus disease 2019 (COVID-19) and a current or past hepatitis B infection. In a monocentric retrospective observational study, we enrolled all consecutive hospital admitted patients with COVID-19 pneumonia and a positive HBV serology (N = 84) in our Infectious Diseases Unit from April 2021 to December 2023. We identified 18 (21%) HBsAg-positive/anti-HBc-positive, 41 (49%) HBsAg-negative/anti-HBc-positive/anti-HBs-positive, and 25 (30%) HBsAg-negative/anti-HBc-positive/anti-HBs-negative subjects. The overall rate of hepatitis flare was 10.7%, without any HBsAg seroreversion, severe HBV reactivation, and/or need for new HBV antiviral therapy introduction. Systemic corticosteroid treatment for COVID-19 and baseline anti-HBsAg status were associated with this risk of HBV reactivation. In conclusion, the overall risk of hepatitis flares in hospitalized COVID-19 was reasonably low, with higher doses of corticosteroids treatment being the major risk factor for HBV reactivation, and anti-HBs-positive serological status as a protective element.

Proposed computed tomography severity index for the evaluation of invasive fungal sinusitis: Preliminary results

BACKGROUND

Invasive fungal sinusitis (IFS) can present as a mild disease to life-threatening infection. A recent surge in cases was seen due to the coronavirus disease 2019 (COVID-19) pandemic. Many patients require surgical debridement and hence imaging [contrast-enhanced computed tomography (CECT) of the paranasal sinuses (PNS)] to document the extent of the disease. However, there was no scoring system using CECT to describe the severity of IFS. This study proposes a computed tomography (CT) severity index (CTSI) to describe the severity of rhino-orbital-cerebral involvement in symptomatic COVID-19 patients and hypothesizes that higher CTSI correlates with disease severity and thus slow response/non-response to treatment.

AIM

To propose a scoring system using CECT to describe the severity of IFS and correlate it with clinical outcomes.

METHODS

A prospective study on 66 COVID-19 positive patients with CECT PNS done for IFS was performed. Split-bolus single-phase CT technique was used. Based on the extent of involvement, a CTSI was designed. Disease in four major subsite areas was assessed. Each subsite involvement was given points according to this model and then summated. Based on the final summated CTSI, the disease was classified as mild, moderate, or severe. Two subsets were subsequently analyzed including survival and death; and responders and non-responders.

RESULTS

The study cohort was 66 COVID-19-positive patients with suspected IFS with a median age of 48.5 years. Mild disease was noted in 34 (51.52%), moderate in 28 (42.42%), and severe disease in 4 (6.06%) patients. There was a significant association of mortality and poor clinical response (P = 0.02) with disease bilaterality. Laterality and CTSI were significant predictors of response to treatment. The mean CTSI of responders was 6.3, of non-responders was 12.9 and the response to treatment was significantly associated with CTSI (t-test, P < 0.001). Receiver operating characteristic curve analysis (Liu method) to distinguish between responders and non-responders showed that the cut-off value for CTSI of 11 had a sensitivity of 78.26% and a specificity of 95.35% to predict response assessment.

CONCLUSION

CTSI can help in quantification of the disease burden, mapping out disease extent, triaging patients, and response assessment; especially patients with underlying comorbidities. A higher score would alert the clinician to initiate aggressive treatment, as severe disease correlates with slow response/non-response to the treatment.

Epidemiology and Ecology of Toscana Virus Infection and Its Global Risk Distribution

Toscana virus (TOSV), a member of the Phlebovirus genus transmitted by sandflies, is acknowledged for its capacity to cause neurological infections and is widely distributed across Mediterranean countries. The potential geographic distribution and risk to the human population remained obscure due to its neglected nature. We searched PubMed and Web of Science for articles published between 1 January 1971 and 30 June 2023 to extract data on TOSV detection in vectors, vertebrates and humans, clinical information of human patients, as well as the occurrence of two identified sandfly vectors for TOSV. We further predicted the global distribution of the two sandfly vectors, based on which the global risk of TOSV was projected, after incorporating the environmental, ecoclimatic, biological, and socioeconomic factors. A total of 1342 unique studies were retrieved, among which 389 met the selection criteria and were included for data extraction. TOSV infections were documented in 10 sandfly species and 14 species of vertebrates, as well as causing a total of 7571 human infections. The occurrence probabilities of two sandfly vectors have demonstrated the greatest contributions to the potential distribution of TOSV infection risk. This study provides a comprehensive overview of global TOSV distribution and potential risk zones. Future surveillance and intervention programs should prioritize high-risk areas based on updated quantitative analyses.

Understanding rhabdomyolysis induced acute kidney injury in patients with COVID-19

This work comments on an article published in the recent issue of the World Journal of Virology. Rhabdomyolysis is a complex condition with symptoms such as myalgia, changes to urination, and weakness. With the potential for substantial kidney impairment, it has also been shown to be a severe complication of coronavirus disease 2019 (COVID-19). To date, various theoretical explanations exist for the development of rhabdomyolysis induced acute kidney injury (RIAKI) in COVID-19 infection, including the accumulation of released striated muscle myoglobin in the urine (myoglobinuria). In their article, they (2024) demonstrate in a retrospective study that RIAKI in COVID-19 patients tended to have elevated levels of C-reactive protein, ferritin, and procalcitonin. These patients also had poorer overall prognoses when compared to COVID-19 patients who have acute kidney injury (AKI) due to other causes. It is clear from these findings that clinicians must closely monitor and assess for the presence of rhabdomyolysis in COVID-19 patients who have developed AKIs. Moreover, additional research is required to further understand the mechanisms behind the development of RIAKI in COVID-19 patients in order to better inform treatment guidelines and protocols.

In-vitro and in-silico evaluation of rue herb for SARS-CoV-2 treatment

SARS-CoV-2, a β-coronavirus responsible for the COVID-19 pandemic, has resulted in approximately 4.9 million fatalities worldwide. Despite the urgent need, there is currently no specific therapeutic developed for treating or preventing SARS-CoV-2 infections. The virus enters the host by engaging in a molecular interaction between the viral Spike glycoprotein (S protein) and the host ACE2 receptor, facilitating membrane fusion and initiating infection. Inhibiting this interaction could impede viral activity. Therefore, this study aimed to identify natural small molecules from perennial rue herb (Ruta graveolens) as potential inhibitors against the S protein, thus preventing virus infection. Initially, a screening process was conducted on 53 compounds identified from rue herbs, utilizing pharmacophore-based virtual screening approaches. This analysis resulted in the identification of 12 hit compounds. Four compounds, namely Amentoflavone (CID: 5281600), Agathisflavone (CID: 5281599), Vitamin P (CID: 24832108), and Daphnoretin (CID: 5281406), emerged as potential S protein inhibitors through molecular docking simulations, exhibiting binding energies in kcal/mol of -9.2, -8.8, -8.2, and -8.0, respectively. ADMET analysis revealed favorable pharmacokinetics and toxicity profiles for these compounds. The compounds' stability with respect to the target S protein was evaluated using MD simulation and MM-GBSA approaches. The analysis revealed the stability of the selected compounds with the target protein. Also, PCA revealed distinctive movement patterns in four selected compounds, offered valuable insights into their functional behaviors and potential interactions. In-vitro assays revealed that rue herb extracts containing these compounds displayed potential inhibitory properties against the virus, with an IC50 value of 1.299 mg/mL and a cytotoxic concentration (CC50) value of 11.991 mg/mL. The compounds derived from rue herb, specifically Amentoflavone, Agathisflavone, Vitamin P, and Daphnoretin, show promise as candidates for the therapeutic intervention of SARS-CoV-2-related complications.

Impact of vitamin D on COVID-19 and other viral diseases

This editorial aims to elucidate the intricate relationship between vitamin D and viral pathogenesis. It explores the anticipated role of vitamin D as a modulator in the immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other viral pathogens. The editorial comments are based on the review article by Engin et al. The potential role of vitamin D in modulating immune responses has been highlighted by several studies, suggesting that it may influence both the risk and severity of infections. Vitamin D receptors are present in immunocompetent cells, which indicates that vitamin D can potentially modulate innate and adaptive immune responses. This context is relevant in the pathophysiology of coronavirus disease 2019 (COVID-19), where the immune response to the virus can significantly impact the disease progression and outcome. The immunomodulatory effects of vitamin D can protect against SARS-CoV-2 infection by enhancing innate and adaptive immune responses. It also maintains the integrity of the body's physical barriers and modulates inflammatory responses, thereby preventing entry and replication of the virus. Many studies have suggested that adequate vitamin D levels help alleviate morbidity and mortality associated with COVID-19. Furthermore, vitamin D supplementation has been linked with a lower risk of severe disease and mortality in COVID-19 patients, particularly in those with a deficiency during seasons with less sunlight exposure.

Role of viruses in periodontitis: An extensive review of herpesviruses, human immunodeficiency virus, coronavirus-19, papillomavirus and hepatitis viruses

Periodontitis is the inflammation of the supporting structures around the dentition. Several microbial agents, mostly bacteria, have been identified as causative factors for periodontal disease. On the other hand, oral cavity is a rich reservoir for viruses since it contains a wide variety of cell types that can be targeted by viruses. Traditionally, the focus of research about the oral flora has been on bacteria because the most widespread oral diseases, like periodontitis and dental caries, are outcomes of bacterial infection. However, recently and especially after the emergence of coronavirus disease 2019, there is a growing tendency toward including viruses also into the scope of oral microbiome investigations. The global high prevalence of periodontitis and viral infections may point out to a concomitant or synergistic effect between the two. Although the exact nature of the mechanism still is not clearly understood, this could be speculated through the manipulation of the immune system by viruses; hence facilitating the furthermore colonization of the oral tissues by bacteria. This review provides an extensive and detailed update on the role of the most common viruses including herpes family (herpes simplex, varicella-zoster, Epstein-Barr, cytomegalovirus), Human papillomaviruses, Human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2 in the initiation, progression and prognosis of periodontitis.

Possible viral agents to consider in the differential diagnosis of blepharoconjunctivitis

BACKGROUND

Blepharoconjunctivitis poses a diagnostic challenge due to its diverse etiology, including viral infections. Blepharoconjunctivits can be acute or chronic, self-limiting, or needing medical therapy.

AIM

To review possible viral agents crucial for accurate differential diagnosis in cases of blepharoconjunctivitis.

METHODS

The PubMed database was searched for records relating to viral blepharoconjunctivitis. The search string generated was "("virally"[All Fields] OR "virals"[All Fields] OR "virology"[MeSH Terms] OR "virology"[All Fields] OR "viral"[All Fields]) AND "Blepharoconjunctivitis"[All Fields]".

RESULTS

A total of 24 publications were generated from the search string. Reference lists from each relevant article were also searched for more information and included in this review. Viral etiologies such as adenovirus, herpes simplex virus (HSV), varicella-zoster virus (VZV), and Epstein-Barr virus (EBV) are frequently implicated. Adenoviral infections manifest with follicular conjunctivitis and preauricular lymphadenopathy, often presenting as epidemic keratoconjunctivitis. HSV and VZV infections can result in herpetic keratitis and may exhibit characteristic dendritic corneal ulcers. EBV, although less common, can cause unilateral or bilateral follicular conjunctivitis, particularly in immunocompromised individuals. Other potential viral agents, such as enteroviruses and molluscum contagiosum virus, should also be considered, especially in pediatric cases.

CONCLUSION

Prompt recognition of these viral etiologies is essential for appropriate management and prevention of complications. Thus, a thorough understanding of the clinical presentation, epidemiology, and diagnostic modalities is crucial for accurate identification and management of viral blepharoconjunctivitis.

An Overview of Zika Virus and Zika Virus Induced Neuropathies

Flaviviruses pose a major public health concern across the globe. Among them, Zika virus (ZIKV) is an emerging and reemerging arthropod-borne flavivirus that has become a major international public health problem following multiple large outbreaks over the past two decades. The majority of infections caused by ZIKV exhibit mild symptoms. However, the virus has been found to be associated with a variety of congenital neural abnormalities, including microcephaly in children and Guillain-Barre syndrome in adults. The exact prediction of the potential of ZIKV transmission is still enigmatic and underlines the significance of routine detection of the virus in suspected areas. ZIKV transmission from mother to fetus (including fetal abnormalities), viral presence in immune-privileged areas, and sexual transmission demonstrate the challenges in understanding the factors governing viral persistence and pathogenesis. This review illustrates the transmission patterns, epidemiology, control strategies (through vaccines, antivirals, and vectors), oncolytic aspects, molecular insights into neuro-immunopathogenesis, and other neuropathies caused by ZIKV. Additionally, we summarize in vivo and in vitro models that could provide an important platform to study ZIKV pathogenesis and the underlying governing cellular and molecular mechanisms.

Evolutionary variation of the monkeypox virus detected for the first time in Nantong, Jiangsu

Monkeypox (MPOX) is a zoonotic disease caused by Orthopoxvirus monkeypox (MPXV), belonging to the Orthopoxvirus genus, and exhibits symptoms similar to smallpox. In 2024, the monkeypox outbreak in the Democratic Republic of the Congo continued to develop, raising widespread global public health concerns. In September 2023, the first local monkeypox outbreak was reported in Nantong, Jiangsu Province, China. Whole-genome sequencing of samples from seven confirmed patients identified a new lineage, C.1.1, which may be related to imported cases from Japan. Evolutionary analysis of MPXV showed fewer mutations mediated by Apolipoprotein B mRNA Editing Catalytic polypeptide-like 3 (APOBEC3). Additionally, mutations in the N2L protein disrupted transcription initiation, while changes in the Cytomegalovirus-encoded immunomodulatory protein B (CrmB) led to structural instability of the protein. It is hoped that these findings will provide insights for future research on the evolutionary mechanisms of the monkeypox virus and the development of vaccines.

Viral Oncogenesis: Synergistic Role of Genome Integration and Persistence

Persistence is a strategy used by many viruses to evade eradication by the immune system, ensuring their permanence and transmission within the host and optimizing viral fitness. During persistence, viruses can trigger various phenomena, including target organ damage, mainly due to an inflammatory state induced by infection, as well as cell proliferation and/or immortalization. In addition to immune evasion and chronic inflammation, factors contributing to viral persistence include low-level viral replication, the accumulation of viral mutants, and, most importantly, maintenance of the viral genome and reliance on viral oncoprotein production. This review focuses on the process of genome integration, which may occur at different stages of infection (e.g., HBV), during the chronic phase of infection (e.g., HPV, EBV), or as an essential part of the viral life cycle, as seen in retroviruses (HIV, HTLV-1). It also explores the close relationship between integration, persistence, and oncogenesis. Several models have been proposed to describe the genome integration process, including non-homologous recombination, looping, and microhomology models. Integration can occur either randomly or at specific genomic sites, often leading to genome destabilization. In some cases, integration results in the loss of genomic regions or impairs the regulation of oncogene and/or oncosuppressor expression, contributing to tumor development.

From Tradition to Innovation: Diverse Molecular Techniques in the Fight Against Infectious Diseases

Infectious diseases impose a significant burden on global health systems due to high morbidity and mortality rates. According to the World Health Organization, millions die from infectious diseases annually, often due to delays in accurate diagnosis. Traditional diagnostic methods in clinical microbiology, primarily culture-based techniques, are time-consuming and may fail with hard-to-culture pathogens. Molecular biology advancements, notably the polymerase chain reaction (PCR), have revolutionized infectious disease diagnostics by allowing rapid and sensitive detection of pathogens' genetic material. PCR has become the gold standard for many infections, particularly highlighted during the COVID-19 pandemic. Following PCR, next-generation sequencing (NGS) has emerged, enabling comprehensive genomic analysis of pathogens, thus facilitating the detection of new strains and antibiotic resistance tracking. Innovative approaches like CRISPR technology are also enhancing diagnostic precision by identifying specific DNA/RNA sequences. However, the implementation of these methods faces challenges, particularly in low- and middle-income countries due to infrastructural and financial constraints. This review will explore the role of molecular diagnostic methods in infectious disease diagnosis, comparing their advantages and limitations, with a focus on PCR and NGS technologies and their future potential.

RNA-dependent RNA polymerase of predominant human norovirus forms liquid-liquid phase condensates as viral replication factories

Many viral proteins form biomolecular condensates via liquid-liquid phase separation (LLPS) to support viral replication and evade host antiviral responses, and thus, they are potential targets for designing antivirals. In the case of nonenveloped positive-sense RNA viruses, forming such condensates for viral replication is unclear and less understood. Human noroviruses (HuNoVs) are positive-sense RNA viruses that cause epidemic and sporadic gastroenteritis worldwide. Here, we show that the RNA-dependent RNA polymerase (RdRp) of pandemic GII.4 HuNoV forms distinct condensates that exhibit all the signature properties of LLPS with sustained polymerase activity and the capability of recruiting components essential for viral replication. We show that such condensates are formed in HuNoV-infected human intestinal enteroid cultures and are the sites for genome replication. Our studies demonstrate the formation of phase-separated condensates as replication factories in a positive-sense RNA virus, which plausibly is an effective mechanism to dynamically isolate RdRp replicating the genomic RNA from interfering with the ribosomal translation of the same RNA.

The Intersection of Trauma and Immunity: Immune Dysfunction Following Hemorrhage

Hemorrhagic shock is caused by rapid loss of a significant blood volume, which leads to insufficient blood flow and oxygen delivery to organs and tissues, resulting in severe physiological derangements, organ failure, and death. Physiologic derangements after hemorrhage are due in a large part to the body's strong inflammatory response, which leads to severe immune dysfunction, and secondary complications such as chronic immunosuppression, increased susceptibility to infection, coagulopathy, multiple organ failure, and unregulated inflammation. Immediate management of hemorrhagic shock includes timely control of the source of bleeding, restoring intravascular volume, preferably with whole blood, and prevention of ischemia and organ failure by optimizing tissue oxygenation. However, currently, there are no clinically effective treatments available that can stabilize the immune response to hemorrhage and reinstate homeostatic conditions. In this review, we will discuss what is known about immunologic dysfunction following hemorrhage and potential therapeutic strategies.

Sociodemographic factors, clinical characteristics, outcomes and short-term follow-up in COVID-19 patients with new onset hyperglycemia and pre-existing diabetes on admission in a tertiary-care hospital in Bangladesh

BACKGROUND

COVID-19 has been linked to hyperglycemia and diabetes, with noteworthy variation in outcomes. This study aimed to compare the sociodemographic factors, clinical characteristics, and in-hospital and short-term post-discharge outcomes between COVID-19 patients with new onset hyperglycemia and pre-existing diabetes patients in tertiary care hospitals in Bangladesh.

METHODS

A prospective observational study was conducted among adult COVID-19 patients with new onset hyperglycemia or pre-existing diabetes admitted to the COVID-19 unit of Dhaka Medical College Hospital between April 2021 and October 2021. Patients were conveniently selected from indoors. Bivariate analysis was used to compare sociodemographic and clinical characteristics at admission and short-term outcomes. The Cox proportional hazard model was used to examine factors associated with time to death in the hospital. All statistical analyses were performed using Stata Version 17.

RESULTS

A total of 169 patients were included. Of these, 29 died in the hospital, and four left against medical advice. Out of the 136 survivors, 135 came for follow-up two weeks after discharge. At baseline, 30.18% of patients had new onset hyperglycemia, and 69.8% had pre-existing diabetes. The average age of patients was 56.38 ± 14.21 years, and 60.36% were male. A significantly higher proportion of COVID-19 patients with new onset hyperglycemia were smokers than those with pre-existing diabetes (p = 0.003). However, pre-existing diabetes was associated with higher lung involvement (p = 0.047) and comorbidities (p = 0.002). Age, income over 35,000 BDT (USD 335.5$), and a BMI over 25 kg/m2 emerged as significant predictors of prolonged hospital stay and mortality. Post-discharge follow-up indicated that new-onset hyperglycemia resolved in 8.89% of patients, whereas 19.26% continued to exhibit hyperglycemia, with smoking being a significant determinant of its persistence (p = 0.001).

CONCLUSION

In conclusion, our investigation illuminates the clinical trajectory of new-onset hyperglycemia in the context of COVID-19 and reinforces the necessity for diligent monitoring and management post-discharge. Therefore, close monitoring and follow-up of COVID-19 patients is recommended for the early detection and management of hyperglycemia and the prevention of diabetes development in the long run.

Assessing the impact of the COVID-19 pandemic on neglected tropical diseases in India: a perspective

The COVID-19 pandemic has significantly challenged healthcare systems worldwide, particularly in India, a country already burdened with a high prevalence of Neglected Tropical Diseases (NTDs). This perspective examines the pandemic's direct and indirect impacts on the prevalence, diagnosis, and management of NTDs in India. Using a narrative review approach, we analyzed literature published between January 2020 and September 2023 from databases such as PubMed, Scopus, and Google Scholar, along with grey literature. The focus was on studies reporting the pandemic's influence on NTDs, especially among vulnerable populations in both rural and urban settings. The review incorporated 49 studies, revealing a twofold impact of COVID-19 on India's healthcare. Directly, the surge in COVID-19 cases strained healthcare resources, disrupted services, and overwhelmed healthcare personnel. Indirectly, the pandemic exacerbated the burden of NTDs by delaying diagnoses, limiting access to treatment, and redirecting resources toward pandemic response efforts. These findings highlight the urgent need for resilient healthcare strategies that address both the immediate and long-term impacts of the pandemic on NTDs. By understanding and mitigating these effects, policymakers and public health experts can better protect vulnerable populations from the compounded challenges posed by these neglected diseases.

Clinical characteristics and prediction model of re-positive nucleic acid tests among Omicron infections by machine learning: a real-world study of 35,488 cases

BACKGROUND

During the Omicron BA.2 variant outbreak in Shanghai, China, from April to May 2022, PCR nucleic acid test re-positivity (TR) occurred frequently, yet the risk factors and predictive models for TR remain unclear. This study aims to identify the factors influencing Omicron TR and to develop machine learning models to predict TR risk. Accurately predicting re-positive patients is crucial for identifying high-risk individuals, optimizing resource allocation, and developing personalized treatment and management plans, thereby effectively controlling the spread of the epidemic, reducing community burden, and ensuring public health.

METHODS

A retrospective study was conducted among individuals infected with Omicron BA.2 variant from April 12 to May 25, 2022, in the largest Shanghai Fangcang shelter hospital. Five machine learning models were compared, including k-nearest-neighbors (KNN), logistic regression (logistic), bootstrap aggregation (bagging), error back-propagation (BP) neural network, and support vector machines (SVM), to select the best prediction model for the TR risk factors.

RESULTS

A total of 35,488 cases were included in this real-world study. The TR and control groups comprised of 6,171 and 29,317 cases respectively, with a re-positive rate of 17.39%. Higher occurrence of TR was observed in young age, males, those with obvious symptoms, underlying diseases, and a low Ct value. The KNN model proved to be the best in predicting the prognosis in the overall evaluation (accuracy = 0.8198, recall = 0.8026, and AUC = 0.8110 in the test set).

INTERPRETATION

Higher TR risk was found in infected cases who were underage or with underlying diseases; vaccine brand and inoculation status were not significantly associated with TR. KNN was the most effective machine learning model to predict TR occurrence in isolation.

Effect of SARS-CoV-2 infection on liver function in patients with hepatitis B

OBJECTIVE

To investigate the impact of SARS-CoV-2 infection on liver function and prognosis in patients with HBV infection.

METHODS

A total of 154 HBV-positive patients (HBV ( +) group) and 154 HBV-negative patients (HBV (-) group) diagnosed with COVID-19 at Taizhou Hospital between December 10, 2022, and January 31, 2023, were included in this study. Clinical characteristics, treatment, and laboratory findings were collected from patients at three time points: before (T1), during (T2), and at the time of discharge (T3) from SARS-CoV-2 infection.

RESULTS

Compared to the HBV (-) group, the HBV ( +) group had a longer hospital stay (15 (9-22) days vs. 9 (5-16) days). Longitudinal comparisons of laboratory indicators from T1 to T3 showed a continuous decline in TP and ALB levels and a continuous increase in PT and TT levels in the HBV ( +) group. BUN levels increased during T2 and decreased thereafter. These differences were considered statistically significant (P < 0.05). Notably, the HBV ( +) group had a higher proportion of indicators elevated > 3 ULN from T1 to T2, including ALT (1.95%/5.19%), AST (3.25%/12.99%), ALP (1.95%/3.25%), GGT (4.55%/9.09%), TBIL (6.49%/9.09%), and DBIL (18.18%/22.73%). In the HBV (-) group, the elevations were mainly concentrated within 1-2 ULN, including AST (12.99%/22.08%), DBIL (10.39%/21.43%), BUN (12.99%/22.08%), CREA (20.13%/29.22%), and PLT (7.79%/14.94%). Furthermore, the incidence of liver injury from T1 to T3 was higher in the HBV ( +) group compared to the HBV (-) group (15.7% (20/127) vs. 7.2% (11/152), P < 0.05). Multivariate analysis showed that liver cirrhosis (HR = 4.847, 95% CI: 1.224-19.20, P = 0.025) and liver cancer (HR = 8.333, 95% CI: 2.156-32.209, P = 0.002) were independent risk factors for liver injury in the presence of SARS-CoV-2 infection.

CONCLUSION

SARS-CoV-2 infection has a higher proportion of liver injury in HBV-infected patients, affecting hepatic protein synthesis function. Those with cirrhosis and hepatocellular carcinoma are at higher risk of severe liver injury.

Associations Between Clinical Manifestations of SARS-CoV-2 Infection and HLA Alleles in a Caucasian Population: A Molecular HLA Typing Study

Background and Objectives: Severe COVID-19 still constitutes an important health problem. Taking into account the crucial role of HLA in immune reactions, evaluation of the impact of HLA on COVID-19 risk and clinical course seemed necessary, as the already available data are inconsistent. The aim of the present study was to compare the HLA profiles of patients with symptomatic SARS-CoV-2 infection and a healthy control group, as well as to compare HLA allele frequencies in patients with severe and non-severe courses of COVID-19. Materials and Methods: HLA classes were genotyped using a next-generation sequencing method in 2322 persons, including 2217 healthy hematopoietic stem cell potential donors and 105 patients with symptomatic COVID-19. Results: Symptomatic course of SARS-CoV-2 infection appeared to be associated with the presence of HLA-A*30:01, B*44:02, B*52:01, C*05:01, C*17:01, and DRB1*11:02, while HLA-C*07:04 and DQB1*03:03 seem to play a protective role. Moreover, we demonstrated that the severe symptomatic course of COVID-19 can be associated with the presence of HLA-B*08:01, C*04:01, DRB1*03:01, and DQB1*03:01, while HLA-DRB1*08:01 appeared to be protective against severe COVID-19 disease. Conclusions: Identification of alleles that are potentially associated with symptomatic SARS-CoV-2 infection as well as the severe course of COVID-19 broadens the knowledge on the genetic background of COVID-19 course and can constitute an important step in the development of personalized medicine.

In-depth analysis of serum antibodies against Epstein-Barr virus lifecycle proteins, and EBNA1, ANO2, GlialCAM and CRYAB peptides in patients with multiple sclerosis

Background

A strong association between multiple sclerosis (MS) and Epstein-Barr virus (EBV) has been established but the exact role of EBV in MS remains controversial. Recently, molecular mimicry between EBNA1 and specific GlialCAM, CRYAB and ANO2 peptides has been suggested as a possible pathophysiological mechanism. The aim of this study was to analyse anti-EBV antibodies in MS patients against (I) EBV lifecycle proteins, (II) putative cross-reactive peptides, and (III) during treatment.

Methods

In this retrospective cross-sectional study, 258 serum samples were included consisting of EBV-negative (n = 25) and EBV-positive (n = 36) controls, 192 MS samples including untreated relapsing-remitting MS (RRMS) with and without relapses, secondary progressive MS (SPMS) and primary progressive MS (PPMS) patients, and 106 patients on 8 different treatment regimens. IgG and IgM antibody titers against EBV docking/fusion proteins (gp350, gh/gp42, gh/gL/gp42), immediate early antigen (BZLF1), early antigens (EA p85, EA P138, EA P54), capsid antigens (VCA P18, VCA P23, VCA gp125) and late antigens (EBNA1) were measured. Specific EBNA1 and GlialCAM, CRYAB and ANO2 peptides were synthesized and also incorporated in our custom magnetic bead based multiplex assay.

Results

We observed significantly elevated IgG antibody titers in EBV-positive controls, RRMS with and without relapse, SPMS and PPMS patients for all lifecycle antigens except for several early antigens when compared to EBV-negative controls. Significantly higher IgG antibody titers were observed in RRMS patients for fusion proteins and EBNA1 peptides when compared to EBV-positive controls. An MS specific response was observed for ANO2 but not for GlialCAM or CRYAB. No significant treatment effects or a specific IgM response were detectable.

Conclusion

The MS-specific, differential antibody response to EBV antigens confirms an altered immunological response to EBV in MS patients. EBV reactivation does not appear to play an important role in MS pathogenesis and no differential antibody signatures were observed between MS disease phases. The MS-specific anti-ANO2 antibody response suggests a potential role for EBNA1 as an antigenic driver, although the exact role of anti-ANO2 antibodies needs to be determined. The precise pathophysiological role of EBV in MS remains uncertain and requires further investigation.

West Nile Virus Monitoring in Flanders (Belgium) During 2022-2023 Reveals Endemic Usutu Virus Circulation in Birds

The recent emergence of West Nile virus (WNV) and Usutu virus (USUV) in some European countries has triggered an increase in animal and human cases across Europe. Wild birds, serving as key reservoirs for WNV and USUV, often act as crucial indicators for the introduction and spread of these viruses. Currently, there is no durable large-scale monitoring for WNV in Belgium, and specific monitoring for USUV is lacking. In Flanders, passive WNV monitoring in birds has been in place for many years, while initial efforts to initiate active monitoring started in 2022. Here, we present the results of a limited study conducted during the vector seasons of 2022 and 2023 in Flemish bird populations to actively and passively monitor the prevalence of WNV and additionally assess the presence of USUV. Several real-time reverse transcription-PCR tests were employed for virus detection, revealing the absence of WNV-RNA during both vector seasons. Conversely, USUV-RNA was identified in 2022 through active surveillance, affecting two (5.5%) out of 36 birds (Corvus corone), and in passive surveillance, impacting eight (72.7%) out of 11 birds (Turdus merula [6] and Rhea pennata [2]). In 2023, active surveillance was more extensive and identified 16 (7.2%) USUV-RNA positive birds (Buteo buteo [1], T. merula [14] and Athene noctua [1]) out of 222 examined birds, while passive surveillance detected two (7.1%) positive birds (T. merula [1], and Larus marinus [1]) out of 28. Viral sequence information was obtained from seven USUV-positive birds using whole genome sequencing or Sanger sequencing. Phylogenetic analysis placed all identified strains within the Africa 3 lineage. This restricted WVN monitoring effort in Flanders did not reveal WNV presence, but found indications of an endemic USUV circulation in Belgium. It is crucial to intensify monitoring efforts for WNV in the coming years, considering its endemic status in several European countries and its expanding geographical range in northern Europe.

Phage-resistance alters Lipid A reactogenicity: a new strategy for LPS-based conjugate vaccines against Salmonella Rissen

Salmonella enterica serovar Rissen (S. Rissen) is an emerging causative agent of foodborne diseases. The current emergence of antibiotic resistance makes necessary alternative therapeutic strategies. In this study, we investigated the potential of a phage-resistant strain of S. Rissen (RR) as a tool for developing an effective lipopolysaccharide (LPS)-based vaccine. The LPS O-antigen is known to play critical roles in protective immunity against Salmonella. However, the high toxicity of the LPS lipid A moiety limits its use in vaccines. Here, we demonstrated that the acquisition of bacteriophage resistance by S. Rissen leads to structural modifications in the LPS structure. Using NMR and mass spectrometry, we characterized the LPS from phage-resistant strains as a smooth variant bearing under-acylated Lipid A portions (penta- and tetra-acylated forms). We then combined RT-qPCR and NMR-based metabolomics to explore the effects of phage resistance and LPS modification on bacterial fitness and virulence. Finally, we conducted in vivo studies to determine whether lysogeny-induced remodeling of LPS affects the host immune response. Results revealed that the under-acylated variant of LPS from RR attenuates the inflammatory response in BALB/c mice, while eliciting a specific antibody response that protects against S. Rissen (RW) infection. In conclusion, our findings suggest that phage resistance, through lipid A modification, may offer a novel strategy for reducing LPS toxicity, highlighting its potential as a promising biological approach for developing LPS-based vaccines against Salmonella infections.

Sociodemographic factors and comorbidities are associated with an elevated risk of herpes simplex keratitis: a population-based study in Taiwan

To investigate the association among comorbidities, sociodemographic factors, and herpes simplex keratitis (HSK). This nationwide, population-based, retrospective, matched case-control study included 27,651 patients with HSK identified from the Taiwan National Health Insurance Research Database based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 054.42 for dendritic keratitis and 054.43 for herpes simplex disciform keratitis. The age-, sex-, and index date-matched control group included 27,651 non-HSK individuals selected from the Taiwan Longitudinal Health Insurance Database 2000. Associations between HSK, sociodemographic conditions, and comorbidities were examined using univariate logistic regression analyses, and paired t-tests were used for continuous variables. Adjusted logistic regression was used to compare odds ratios (OR) for HSK development. Patients with corneal abrasion were more likely to develop HSK than controls [OR, 402.80; 95% confidence interval (CI), 167.47-968.79; P < 0.0001] even after conditional logistic regression (adjusted OR, 407.36; 95% CI, 169.35-979.89; P < 0.0001). Other conditions that increase the odds of HSK development include systemic diseases such as hyperlipidemia, diabetes mellitus, coronary artery disease, chronic renal disease, and human immunodeficiency virus infection. Regarding sociodemographic factors, >50% of patients with HSK were aged ≥55 years. Moreover, patients living in Northern Taiwan and metropolitan cities had higher odds of developing HSK. HSK is significantly associated with corneal abrasion, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic renal disease, and human immunodeficiency virus infection.