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Grywalska E, Siwicka-Gieroba D, Mielnik M, Podgajna M, Gosik K, Dąbrowski W, Roliński J. Effectiveness of Haemophilus influenzae type b vaccination after splenectomy - impact on selected immunological parameters. Hum Vaccin Immunother 2018; 15:339-348. [PMID: 30352001 PMCID: PMC6422483 DOI: 10.1080/21645515.2018.1537744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Splenectomy is a surgery indicated in case of splenic rupture after injury, when there are tumors in the spleen, or as a treatment for certain diseases, such as idiopathic thrombocytopenic purpura and spherocytosis. The aims of the study were to assess the immunological response to the Haemophilus influenzae type b (Hib) vaccine and the post-vaccination changes in lymphocyte subsets and cell activation markers in splenectomized patients and healthy volunteers. Blood samples were collected from 25 patients that had undergone splenectomy and from 15 healthy, non-splenectomized volunteers. All participants received a single dose of Hib vaccine. The concentration of specific Hib antibodies was assessed by an enzyme-linked immunosorbent assay. Selected immune cell populations were evaluated using flow cytometry. The analysis of the antibody titers against Hib showed statistically significant differences in both groups. There was a significantly higher percentage (p = 0.0012) and absolute value (p = 0.0003) of natural killer T (NKT)-like cells (CD3+/CD16+ CD56+) in the study group, compared to the control group. The levels of natural killer (NK) and NKT cells did not change relative to the cause and age of splenectomy. The quantity and percentage of regulatory T (Treg) cells were higher in the study group compared to the control group (p < 0.0001). No significant correlations were found between the time elapsed since splenectomy, the age of the patients, and the Treg levels. Our study showed that spleen resection results in an important deterioration of Treg cells and Th17 cell balance which may contribute to an incomplete immunological response.
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Affiliation(s)
- Ewelina Grywalska
- a Department of Clinical Immunology and Immunotherapy , Medical University of Lublin , Lublin , Poland
| | - Dorota Siwicka-Gieroba
- b Department of Anesthesiology and Intensive Care , Medical University of Lublin , Lublin , Poland
| | - Michał Mielnik
- a Department of Clinical Immunology and Immunotherapy , Medical University of Lublin , Lublin , Poland
| | - Martyna Podgajna
- a Department of Clinical Immunology and Immunotherapy , Medical University of Lublin , Lublin , Poland
| | - Krzysztof Gosik
- a Department of Clinical Immunology and Immunotherapy , Medical University of Lublin , Lublin , Poland
| | - Wojciech Dąbrowski
- b Department of Anesthesiology and Intensive Care , Medical University of Lublin , Lublin , Poland
| | - Jacek Roliński
- a Department of Clinical Immunology and Immunotherapy , Medical University of Lublin , Lublin , Poland
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Nussbaumer-Streit B, Klerings I, Wagner G, Heise TL, Dobrescu AI, Armijo-Olivo S, Stratil JM, Persad E, Lhachimi SK, Van Noord MG, Mittermayr T, Zeeb H, Hemkens L, Gartlehner G. Abbreviated literature searches were viable alternatives to comprehensive searches: a meta-epidemiological study. J Clin Epidemiol 2018; 102:1-11. [DOI: 10.1016/j.jclinepi.2018.05.022] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/11/2018] [Accepted: 05/25/2018] [Indexed: 10/14/2022]
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3
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O'Grady KAF, Chang AB, Cripps A, Mulholland EK, Smith-Vaughan H, Wood N, Danchin M, Thornton R, Wilson A, Torzillo PJ, Morris PM, Richmond P, Rablin S, Arnold D, Connor A, Goyal V, Stoney T, Perrett K, Grimwood K. The clinical, immunological and microbiological impact of the 10-valent pneumococcal-Protein D conjugate vaccine in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis: A multi-centre, double-blind, randomised controlled trial. Hum Vaccin Immunother 2018; 14:2768-2779. [PMID: 29944440 DOI: 10.1080/21645515.2018.1488562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We aimed to determine the efficacy of the 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in children aged 18-months to <18-years with recurrent protracted bacterial bronchitis (rPBB), chronic suppurative lung disease (CSLD) or bronchiectasis. In a multi-centre, double-blind randomised controlled trial, children received two doses, 2-months apart of the 10vPHiD-CV or quadrivalent meningococcal-ACYW135 conjugate vaccine. Active surveillance for acute exacerbations, respiratory symptoms and antibiotic use was undertaken through to 12-months after the second vaccine dose (clinical cohort only). Serum, saliva and nasopharyngeal swabs were collected to measure immunological and microbiological effects (immunology cohort). Between December 2012 and August 2015, 62 children were enrolled onto the clinical protocol (1 excluded from clinical analyses due to unblinding), while 74 contributed to the immunology cohort (overall mean age = 6.8-years (standard deviation = 3.7), 42 (56.8%) male). The absolute risk difference comparing the 10vPHiD-CV group (n = 31 children) to the MenACYW135 group (n = 30 children) for acute exacerbations was -0.5 exacerbations/100-weeks at risk (95% confidence interval (CI) -2.0, 0.9). Compared to the MenACYW135 group, children who received the 10vPHiD-CV were less likely to have respiratory symptoms in each fortnight of surveillance (incidence density ratio (IDR) 0.82, 95%CI 0.61, 1.10) and required fewer short-course (<14-days duration) antibiotics (IDR 0.81, 95% CI 0.61, 1.09). The vaccine was immunogenic and no serious adverse events related to the vaccine were reported. In conclusion, 10vPHiD-CV might have a future role in managing children with rPBB, CSLD and bronchiectasis, but larger multicentre trials are needed to confirm or refute findings from this preliminary study.
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Affiliation(s)
- Kerry-Ann F O'Grady
- a Centre for Children's Health Research, Institute of Health & Biomedical Innovation, Queensland University of Technology , South Brisbane , Queensland , Australia
| | - Anne B Chang
- a Centre for Children's Health Research, Institute of Health & Biomedical Innovation, Queensland University of Technology , South Brisbane , Queensland , Australia.,b Child Health Division, Menzies School of Health Research, Charles Darwin University , Tiwi , Northern Territory , Australia.,c Department of Respiratory Medicine , Lady Cilento Children's Hospital , South Brisbane , Queensland , Australia
| | - Allan Cripps
- d School of Medicine and Menzies Health Institute Queensland, Griffith University , Southport , Queensland , Australia
| | - Edward K Mulholland
- e Murdoch Children's Research Institute, The University of Melbourne , Parkville , Victoria , Australia.,f London School of Hygiene and Tropical Medicine , Bloomsbury , London , UK
| | - Heidi Smith-Vaughan
- b Child Health Division, Menzies School of Health Research, Charles Darwin University , Tiwi , Northern Territory , Australia.,d School of Medicine and Menzies Health Institute Queensland, Griffith University , Southport , Queensland , Australia
| | - Nicholas Wood
- g National Centre for Immunisation Surveillance and Research, The University of Sydney , Westmead , New South Wales , Australia
| | - Margaret Danchin
- e Murdoch Children's Research Institute, The University of Melbourne , Parkville , Victoria , Australia
| | - Ruth Thornton
- h Telethon Kids Institute, University of Western Australia , Subiaco , Western Australia , Australia
| | - Andrew Wilson
- i Department of Respiratory Medicine , Princess Margaret Hospital for Children , Perth , Western Australia , Australia
| | - Paul J Torzillo
- j School of Medicine, University of Sydney , Camperdown , New South Wales , Australia
| | - Peter M Morris
- b Child Health Division, Menzies School of Health Research, Charles Darwin University , Tiwi , Northern Territory , Australia
| | - Peter Richmond
- h Telethon Kids Institute, University of Western Australia , Subiaco , Western Australia , Australia
| | - Sheree Rablin
- a Centre for Children's Health Research, Institute of Health & Biomedical Innovation, Queensland University of Technology , South Brisbane , Queensland , Australia
| | - Daniel Arnold
- a Centre for Children's Health Research, Institute of Health & Biomedical Innovation, Queensland University of Technology , South Brisbane , Queensland , Australia
| | - Ann Connor
- k UQ Child Health Research Centre, The University of Queensland , South Brisbane , Queensland , Australia
| | - Vikas Goyal
- c Department of Respiratory Medicine , Lady Cilento Children's Hospital , South Brisbane , Queensland , Australia.,k UQ Child Health Research Centre, The University of Queensland , South Brisbane , Queensland , Australia
| | - Tanya Stoney
- h Telethon Kids Institute, University of Western Australia , Subiaco , Western Australia , Australia
| | - Kirsten Perrett
- e Murdoch Children's Research Institute, The University of Melbourne , Parkville , Victoria , Australia
| | - Keith Grimwood
- d School of Medicine and Menzies Health Institute Queensland, Griffith University , Southport , Queensland , Australia.,l Departments of Infectious Diseases and Paediatrics , Gold Coast Health , Southport , Queensland , Australia
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Teo E, Lockhart K, Purchuri SN, Pushparajah J, Cripps AW, van Driel ML. Haemophilus influenzae oral vaccination for preventing acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2017; 6:CD010010. [PMID: 28626902 PMCID: PMC6481520 DOI: 10.1002/14651858.cd010010.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic bronchitis and chronic obstructive pulmonary disease (COPD) are serious conditions in which patients are predisposed to viral and bacterial infections resulting in potentially fatal acute exacerbations. Chronic obstructive pulmonary disease is defined as a lung disease characterised by obstruction to lung airflow that interferes with normal breathing. Antibiotic therapy has not been particularly useful in eradicating bacteria such as non-typeable Haemophilus influenzae (NTHi) because they are naturally occurring flora of the upper respiratory tract in many people. However, they can cause opportunistic infection. An oral NTHi vaccine has been developed to protect against recurrent infective acute exacerbations in chronic bronchitis. OBJECTIVES To assess the effectiveness of an oral, whole-cell NTHi vaccine in protecting against recurrent episodes of acute exacerbations of chronic bronchitis and COPD in adults. To assess the effectiveness of NTHi vaccine in reducing NTHi colonising the respiratory tract during recurrent episodes of acute exacerbations of COPD. SEARCH METHODS We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (2017, Issue 1), MEDLINE (1946 to January 2017), Embase (1974 to January 2017), CINAHL (1981 to January 2017), LILACS (1985 to January 2017), and Web of Science (1955 to January 2017). We also searched trials registries and contacted authors of trials requesting unpublished data. SELECTION CRITERIA We included randomised controlled trials comparing the effects of an oral monobacterial NTHi vaccine in adults with recurrent acute exacerbations of chronic bronchitis or COPD when there was overt matching of the vaccine and placebo groups on clinical grounds. The selection criteria considered populations aged less than 65 years and those older than 65 years. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data from original records and publications for incidence and severity of bronchitis episodes and carriage rate of NTHi measured in the upper respiratory tract, as well as data relevant to other primary and secondary outcomes. MAIN RESULTS We identified six placebo-controlled randomised controlled trials with a total of 557 participants. These trials investigated the efficacy of enteric-coated, killed preparations of H influenzae in populations prone to recurrent acute exacerbations of chronic bronchitis or COPD. The vaccine preparation and immunisation regimen in all trials consisted of at least three courses of formalin-killed H influenzae in enteric-coated tablets taken at intervals (e.g. days 0, 28, and 56). Each course generally consisted of two tablets taken after breakfast over three consecutive days. In all cases the placebo groups took enteric-coated tablets containing glucose. Risk of bias was moderate across the studies, namely due to the lack of information provided about methods and inadequate presentation of results.Meta-analysis of the oral NTHi vaccine showed a small, non-statistically significant reduction in the incidence of acute exacerbations of chronic bronchitis or COPD (risk ratio (RR) 0.79, 95% confidence interval (CI) 0.57 to 1.10; P = 0.16). There was no significant difference in mortality rate between the vaccine and placebo groups (odds ratio (OR) 1.62, 95% CI 0.63 to 4.12; P = 0.31).We were unable to meta-analyse the carriage levels of NTHi in participants as each trial reported this result using different units and tools of measurement. Four trials showed no significant difference in carriage levels, while two trials showed a significant decrease in carriage levels in the vaccinated group compared with the placebo group.Four trials assessed severity of exacerbations measured by requirement for antibiotics. Three of these trials were comparable and when meta-analysed showed a statistically significant 80% increase in antibiotic courses per person in the placebo group (RR 1.81, 95% CI 1.35 to 2.44; P < 0.001). There was no significant difference between the groups with regard to hospital admission rates (OR 0.96, 95% CI 0.13 to 7.04; P = 0.97). Adverse events were reported in five trials but were not necessarily related to the vaccine; a point estimate is suggestive that they occurred more frequently in the vaccine group, however this result was not statistically significant (RR 1.43, 95% CI 0.70 to 2.92; P = 0.87). Quality of life was not meta-analysed but was reported in two trials, with results at six months showing an improvement in quality of life in the vaccinated group (scoring at least two points better than placebo). AUTHORS' CONCLUSIONS Analyses demonstrate that NTHi oral vaccination of people with recurrent exacerbations of chronic bronchitis or COPD does not yield a significant reduction in the number and severity of exacerbations. Evidence was mixed, and the individual trials that showed a significant benefit of the vaccine are too small to advocate widespread oral vaccination of people with COPD.
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Affiliation(s)
- Edward Teo
- Concord Repatriation General HospitalEmergency DepartmentHospital RoadConcordSydneyNew South WalesAustralia2137
- Griffith UniversitySchool of MedicineGold CoastQueenslandAustralia
- The University of QueenslandSchool of MedicineBrisbaneQueenslandAustralia
| | - Kathleen Lockhart
- Townsville Hospital100 Angus Smith DriveDouglasQueenslandAustralia4814
| | | | | | - Allan W Cripps
- Griffith UniversitySchool of Medicine, Menzies Health Institute QueenslandUniversity DriveMeadowbrookQueenslandAustralia4121
| | - Mieke L van Driel
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineBrisbaneQueenslandAustralia4029
- Bond UniversityCentre for Research in Evidence‐Based Practice (CREBP)Gold CoastQueenslandAustralia4229
- Ghent UniversityDepartment of Family Medicine and Primary Health Care1K3, De Pintelaan 185GhentBelgium9000
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Tan DBA, Teo TH, Setiawan AM, Ong NE, Zimmermann M, Price P, Kirkham LAS, Moodley YP. Increased CTLA-4 + T cells may contribute to impaired T helper type 1 immune responses in patients with chronic obstructive pulmonary disease. Immunology 2017; 151:219-226. [PMID: 28190271 DOI: 10.1111/imm.12725] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/17/2017] [Accepted: 02/05/2017] [Indexed: 11/29/2022] Open
Abstract
Impaired T helper type 1 (Th1) function is implicated in the susceptibility of patients with chronic obstructive pulmonary disease (COPD) to respiratory infections, which are common causes of acute exacerbations of COPD (AECOPD). To understand the underlying mechanisms, we assessed regulatory T (Treg) cells and the expression of an inhibitory T-cell receptor, cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4). Cryopreserved peripheral blood mononuclear cells (PBMC) from patients with AECOPD (n = 17), patients with stable COPD (sCOPD; n = 24) and age-matched healthy non-smoking controls (n = 26) were cultured for 24 hr with brefeldin-A or monensin to detect intracellular or surface CTLA-4 (respectively) by flow cytometry. T cells in PBMC from AECOPD (n = 9), sCOPD (n = 14) and controls (n = 12) were stimulated with anti-CD3 with and without anti-CTLA-4 blocking antibodies and cytokines were quantified by ELISA. Frequencies of circulating T cells expressing intracellular CTLA-4 were higher in sCOPD (P = 0·01), whereas patients with AECOPD had more T cells expressing surface CTLA-4 than healthy controls (P = 0·03). Increased frequencies of surface CTLA-4+ CD4+ T cells and CTLA-4+ Treg cells paralleled increases in plasma soluble tumour necrosis factor receptor-1 levels (r = 0·32, P = 0·01 and r = 0·29, P = 0·02, respectively) in all subjects. Interferon-γ responses to anti-CD3 stimulation were inversely proportional to frequencies of CD4+ T cells expressing intracellular CTLA-4 (r = -0·43, P = 0·01). Moreover, CTLA-4 blockade increased the induction of interferon-γ, tumour necrosis factor-α and interleukin-6 in PBMC stimulated with anti-CD3. Overall, chronic inflammation may expand sub-populations of T cells expressing CTLA-4 in COPD patients and therefore impair T-cell function. CTLA-4 blockade may restore Th1 function in patients with COPD and so aid the clearance of bacterial pathogens responsible for AECOPD.
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Affiliation(s)
- Dino B A Tan
- Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, WA, Australia.,Stem Cell Unit, Institute of Respiratory Health, Perth, WA, Australia
| | - Teck-Hui Teo
- Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, WA, Australia
| | - Abdul M Setiawan
- Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, WA, Australia
| | - Nathanael E Ong
- Stem Cell Unit, Institute of Respiratory Health, Perth, WA, Australia
| | - Maja Zimmermann
- Stem Cell Unit, Institute of Respiratory Health, Perth, WA, Australia
| | - Patricia Price
- School of Biomedical Science, Curtin University, Perth, WA, Australia
| | - Lea-Ann S Kirkham
- School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Yuben P Moodley
- Centre for Respiratory Health, School of Medicine & Pharmacology, University of Western Australia, Perth, WA, Australia.,Stem Cell Unit, Institute of Respiratory Health, Perth, WA, Australia.,Department of Respiratory and Sleep Medicine, Fiona Stanley Hospital, Perth, WA, Australia
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6
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Abstract
Chronic obstructive pulmonary disease (COPD) is a disease with high prevalence and substantial associated economical burden. A significant determinant of quality of life, long-term survival, and health care costs is an acute exacerbation of COPD. Acute exacerbations are provoked by respiratory viruses, altered airway microbiome, and environmental factors. The current treatment options are limited. In order to develop specific therapeutic measures, it is important to understand how acute exacerbations evolve. This review focuses on pathophysiology of stable and exacerbated COPD.
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Affiliation(s)
- Xianghui Zhou
- Department of Respiratory Medicine, The First Xuzhou People's Hospital, 19 Zhongshan North Road, Xuzhou, 221003, Jiangsu, China
| | - Qingling Li
- Department of Respiratory Medicine, The First Xuzhou People's Hospital, 19 Zhongshan North Road, Xuzhou, 221003, Jiangsu, China.
| | - Xincan Zhou
- Department of Respiratory Medicine, The First Xuzhou People's Hospital, 19 Zhongshan North Road, Xuzhou, 221003, Jiangsu, China
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Pizzutto SJ, Hare KM, Upham JW. Bronchiectasis in Children: Current Concepts in Immunology and Microbiology. Front Pediatr 2017; 5:123. [PMID: 28611970 PMCID: PMC5447051 DOI: 10.3389/fped.2017.00123] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/08/2017] [Indexed: 12/26/2022] Open
Abstract
Bronchiectasis is a complex chronic respiratory condition traditionally characterized by chronic infection, airway inflammation, and progressive decline in lung function. Early diagnosis and intensive treatment protocols can stabilize or even improve the clinical prognosis of children with bronchiectasis. However, understanding the host immunologic mechanisms that contribute to recurrent infection and prolonged inflammation has been identified as an important area of research that would contribute substantially to effective prevention strategies for children at risk of bronchiectasis. This review will focus on the current understanding of the role of the host immune response and important pathogens in the pathogenesis of bronchiectasis (not associated with cystic fibrosis) in children.
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Affiliation(s)
- Susan J Pizzutto
- Child Health Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Kim M Hare
- Child Health Division, Menzies School of Health Research, Darwin, NT, Australia
| | - John W Upham
- Department of Respiratory Medicine, Princess Alexandra Hospital, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Pickering JL, Prosser A, Corscadden KJ, de Gier C, Richmond PC, Zhang G, Thornton RB, Kirkham LAS. Haemophilus haemolyticus Interaction with Host Cells Is Different to Nontypeable Haemophilus influenzae and Prevents NTHi Association with Epithelial Cells. Front Cell Infect Microbiol 2016; 6:50. [PMID: 27242968 PMCID: PMC4860508 DOI: 10.3389/fcimb.2016.00050] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/18/2016] [Indexed: 02/02/2023] Open
Abstract
Nontypeable Haemophilus influenzae (NTHi) is an opportunistic pathogen that resides in the upper respiratory tract and contributes to a significant burden of respiratory related diseases in children and adults. Haemophilus haemolyticus is a respiratory tract commensal that can be misidentified as NTHi due to high levels of genetic relatedness. There are reports of invasive disease from H. haemolyticus, which further blurs the species boundary with NTHi. To investigate differences in pathogenicity between these species, we optimized an in vitro epithelial cell model to compare the interaction of 10 H. haemolyticus strains with 4 NTHi and 4 H. influenzae-like haemophili. There was inter- and intra-species variability but overall, H. haemolyticus had reduced capacity to attach to and invade nasopharyngeal and bronchoalveolar epithelial cell lines (D562 and A549) within 3 h when compared with NTHi. H. haemolyticus was cytotoxic to both cell lines at 24 h, whereas NTHi was not. Nasopharyngeal epithelium challenged with some H. haemolyticus strains released high levels of inflammatory mediators IL-6 and IL-8, whereas NTHi did not elicit an inflammatory response despite higher levels of cell association and invasion. Furthermore, peripheral blood mononuclear cells stimulated with H. haemolyticus or NTHi released similar and high levels of IL-6, IL-8, IL-10, IL-1β, and TNFα when compared with unstimulated cells but only NTHi elicited an IFNγ response. Due to the relatedness of H. haemolyticus and NTHi, we hypothesized that H. haemolyticus may compete with NTHi for colonization of the respiratory tract. We observed that in vitro pre-treatment of epithelial cells with H. haemolyticus significantly reduced NTHi attachment, suggesting interference or competition between the two species is possible and warrants further investigation. In conclusion, H. haemolyticus interacts differently with host cells compared to NTHi, with different immunostimulatory and cytotoxic properties. This study provides an in vitro model for further investigation into the pathogenesis of Haemophilus species and the foundation for exploring whether H. haemolyticus can be used to prevent NTHi disease.
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Affiliation(s)
- Janessa L Pickering
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western AustraliaPerth, WA, Australia; School of Paediatrics and Child Health, The University of Western AustraliaPerth, WA, Australia
| | - Amy Prosser
- School of Paediatrics and Child Health, The University of Western Australia Perth, WA, Australia
| | - Karli J Corscadden
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia Perth, WA, Australia
| | - Camilla de Gier
- School of Paediatrics and Child Health, The University of Western Australia Perth, WA, Australia
| | - Peter C Richmond
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western AustraliaPerth, WA, Australia; School of Paediatrics and Child Health, The University of Western AustraliaPerth, WA, Australia; Department of Paediatrics, Princess Margaret Hospital for ChildrenPerth, WA, Australia
| | - Guicheng Zhang
- School of Public Health, Curtin University Perth, WA, Australia
| | - Ruth B Thornton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western AustraliaPerth, WA, Australia; School of Paediatrics and Child Health, The University of Western AustraliaPerth, WA, Australia
| | - Lea-Ann S Kirkham
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western AustraliaPerth, WA, Australia; School of Paediatrics and Child Health, The University of Western AustraliaPerth, WA, Australia
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King PT, Sharma R. The Lung Immune Response to Nontypeable Haemophilus influenzae (Lung Immunity to NTHi). J Immunol Res 2015; 2015:706376. [PMID: 26114124 PMCID: PMC4465770 DOI: 10.1155/2015/706376] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/12/2015] [Accepted: 05/13/2015] [Indexed: 11/18/2022] Open
Abstract
Haemophilus influenzae is divided into typeable or nontypeable strains based on the presence or absence of a polysaccharide capsule. The typeable strains (such as type b) are an important cause of systemic infection, whilst the nontypeable strains (designated as NTHi) are predominantly respiratory mucosal pathogens. NTHi is present as part of the normal microbiome in the nasopharynx, from where it may spread down to the lower respiratory tract. In this context it is no longer a commensal and becomes an important respiratory pathogen associated with a range of common conditions including bronchitis, bronchiectasis, pneumonia, and particularly chronic obstructive pulmonary disease. NTHi induces a strong inflammatory response in the respiratory tract with activation of immune responses, which often fail to clear the bacteria from the lung. This results in recurrent/persistent infection and chronic inflammation with consequent lung pathology. This review will summarise the current literature about the lung immune response to nontypeable Haemophilus influenzae, a topic that has important implications for patient management.
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Affiliation(s)
- Paul T. King
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, VIC 3168, Australia
- Monash University Department of Medicine, Monash Medical Centre, Melbourne, VIC 3168, Australia
| | - Roleen Sharma
- Monash Lung and Sleep, Monash Medical Centre, Melbourne, VIC 3168, Australia
- Monash University Department of Medicine, Monash Medical Centre, Melbourne, VIC 3168, Australia
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Vestbo J, Lange P. Prevention of COPD exacerbations: medications and other controversies. ERJ Open Res 2015; 1:00011-2015. [PMID: 27730132 PMCID: PMC5005132 DOI: 10.1183/23120541.00011-2015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 04/15/2015] [Indexed: 12/14/2022] Open
Abstract
Exacerbations have significant impact on the morbidity and mortality of patients with chronic obstructive pulmonary disease. Most guidelines emphasise prevention of exacerbations by treatment with long-acting bronchodilators and/or anti-inflammatory drugs. Whereas most of this treatment is evidence-based, it is clear that patients differ regarding the nature of exacerbations and are likely to benefit differently from different types of treatment. In this short review, we wish to highlight this, suggest a first step in differentiating pharmacological exacerbation prevention and call for more studies in this area. Finally, we wish to highlight that there are perhaps easier ways of achieving similar success in exacerbation prevention using nonpharmacological tools.
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Affiliation(s)
- Jørgen Vestbo
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
| | - Peter Lange
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Respiratory Medicine, Hvidovre University Hospital, Hvidovre, Denmark
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Finney LJ, Ritchie A, Pollard E, Johnston SL, Mallia P. Lower airway colonization and inflammatory response in COPD: a focus on Haemophilus influenzae. Int J Chron Obstruct Pulmon Dis 2014; 9:1119-32. [PMID: 25342897 DOI: 10.2147/copd.s54477] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Bacterial infection of the lower respiratory tract in chronic obstructive pulmonary disease (COPD) patients is common both in stable patients and during acute exacerbations. The most frequent bacteria detected in COPD patients is Haemophilus influenzae, and it appears this organism is uniquely adapted to exploit immune deficiencies associated with COPD and to establish persistent infection in the lower respiratory tract. The presence of bacteria in the lower respiratory tract in stable COPD is termed colonization; however, there is increasing evidence that this is not an innocuous phenomenon but is associated with airway inflammation, increased symptoms, and increased risk for exacerbations. In this review, we discuss host immunity that offers protection against H. influenzae and how disturbance of these mechanisms, combined with pathogen mechanisms of immune evasion, promote persistence of H. influenzae in the lower airways in COPD. In addition, we examine the role of H. influenzae in COPD exacerbations, as well as interactions between H. influenzae and respiratory virus infections, and review the role of treatments and their effect on COPD outcomes. This review focuses predominantly on data derived from human studies but will refer to animal studies where they contribute to understanding the disease in humans.
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Affiliation(s)
- Lydia J Finney
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Andrew Ritchie
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | | | - Sebastian L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Patrick Mallia
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, United Kingdom
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