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Bibi N, Wajeeha AW, Mukhtar M, Tahir M, Zaidi NUSS. In Vivo Validation of Novel Synthetic tbp1 Peptide-Based Vaccine Candidates against Haemophilus influenzae Strains in BALB/c Mice. Vaccines (Basel) 2023; 11:1651. [PMID: 38005983 PMCID: PMC10675187 DOI: 10.3390/vaccines11111651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/16/2023] [Accepted: 10/16/2023] [Indexed: 11/26/2023] Open
Abstract
Haemophilus influenzae is a Gram-negative bacterium characterized as a small, nonmotile, facultative anaerobic coccobacillus. It is a common cause of a variety of invasive and non-invasive infections. Among six serotypes (a-f), H. influenzae type b (Hib) is the most familiar and predominant mostly in children and immunocompromised individuals. Following Hib vaccination, infections due to other serotypes have increased in number, and currently, there is no suitable effective vaccine to induce cross-strain protective antibody responses. The current study was aimed to validate the capability of two 20-mer highly conserved synthetic tbp1 (transferrin-binding protein 1) peptide-based vaccine candidates (tbp1-E1 and tbp1-E2) predicted using in silico approaches to induce immune responses against H. influenzae strains. Cytokine induction ability, immune simulations, and molecular dynamics (MD) simulations were performed to confirm the candidacy of epitopic docked complexes. Synthetic peptide vaccine formulations in combination with two different adjuvants, BGs (Bacterial Ghosts) and CFA/IFA (complete/incomplete Freund's adjuvant), were used in BALB/c mouse groups in three booster shots at two-week intervals. An indirect ELISA was performed to determine endpoint antibody titers using the Student's t-distribution method. The results revealed that the synergistic use of both peptides in combination with BG adjuvants produced better results. Significant differences in absorbance values were observed in comparison to the rest of the peptide-adjuvant combinations. The findings of this study indicate that these tbp1 peptide-based vaccine candidates may present a preliminary set of peptides for the development of an effective cross-strain vaccine against H. influenzae in the future due to their highly conserved nature.
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Affiliation(s)
- Naseeha Bibi
- Vaccinology and Therapeutics Research Group, Department of Industrial Biotechnology, Atta Ur Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan; (N.B.); (A.W.W.); (M.M.)
| | - Amtul Wadood Wajeeha
- Vaccinology and Therapeutics Research Group, Department of Industrial Biotechnology, Atta Ur Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan; (N.B.); (A.W.W.); (M.M.)
| | - Mamuna Mukhtar
- Vaccinology and Therapeutics Research Group, Department of Industrial Biotechnology, Atta Ur Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan; (N.B.); (A.W.W.); (M.M.)
| | - Muhammad Tahir
- Department of Plant Biotechnology, Atta Ur Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan;
| | - Najam us Sahar Sadaf Zaidi
- Vaccinology and Therapeutics Research Group, Department of Industrial Biotechnology, Atta Ur Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan; (N.B.); (A.W.W.); (M.M.)
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Purcell RA, Theisen RM, Arnold KB, Chung AW, Selva KJ. Polyfunctional antibodies: a path towards precision vaccines for vulnerable populations. Front Immunol 2023; 14:1183727. [PMID: 37600816 PMCID: PMC10433199 DOI: 10.3389/fimmu.2023.1183727] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/30/2023] [Indexed: 08/22/2023] Open
Abstract
Vaccine efficacy determined within the controlled environment of a clinical trial is usually substantially greater than real-world vaccine effectiveness. Typically, this results from reduced protection of immunologically vulnerable populations, such as children, elderly individuals and people with chronic comorbidities. Consequently, these high-risk groups are frequently recommended tailored immunisation schedules to boost responses. In addition, diverse groups of healthy adults may also be variably protected by the same vaccine regimen. Current population-based vaccination strategies that consider basic clinical parameters offer a glimpse into what may be achievable if more nuanced aspects of the immune response are considered in vaccine design. To date, vaccine development has been largely empirical. However, next-generation approaches require more rational strategies. We foresee a generation of precision vaccines that consider the mechanistic basis of vaccine response variations associated with both immunogenetic and baseline health differences. Recent efforts have highlighted the importance of balanced and diverse extra-neutralising antibody functions for vaccine-induced protection. However, in immunologically vulnerable populations, significant modulation of polyfunctional antibody responses that mediate both neutralisation and effector functions has been observed. Here, we review the current understanding of key genetic and inflammatory modulators of antibody polyfunctionality that affect vaccination outcomes and consider how this knowledge may be harnessed to tailor vaccine design for improved public health.
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Affiliation(s)
- Ruth A. Purcell
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Robert M. Theisen
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Kelly B. Arnold
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Amy W. Chung
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Kevin J. Selva
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
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Muri L, Schubart A, Thorburn C, Zamurovic N, Holbro T, Kammüller M, Pluschke G, Ispasanie E. Inhibition of the different complement pathways has varying impacts on the serum bactericidal activity and opsonophagocytosis against Haemophilus influenzae type b. Front Immunol 2022; 13:1020580. [PMID: 36578495 PMCID: PMC9791579 DOI: 10.3389/fimmu.2022.1020580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
Defense against Haemophilus influenzae type b (Hib) is dependent on antibodies and complement, which mediate both serum bactericidal activity (SBA) and opsonophagocytosis. Here we evaluated the influence of capsule-specific antibodies and complement inhibitors targeting the central component C3, the alternative pathway (AP; fB, fD), the lectin pathway (LP; MASP-2) and the terminal pathway (C5) on both effector functions. Findings may be relevant for the treatment of certain diseases caused by dysregulation of the complement system, where inhibitors of complement factors C3 or C5 are used. Inhibitors against other complement components are being evaluated as potential alternative treatment options that may carry a reduced risk of infection by encapsulated bacteria. Serum and reconstituted blood of healthy adults were tested for bactericidal activity before and after vaccination with the Hib capsule-conjugate vaccine ActHIB. Most sera had bactericidal activity prior to vaccination, but vaccination significantly enhanced SBA titers. Independently of the vaccination status, both C3 and C5 inhibition abrogated SBA, whereas inhibition of the LP had no effect. AP inhibition had a major inhibitory effect on SBA of pre- vaccination serum, but vaccination mitigated this inhibition for all disease isolates tested. Despite this, SBA-mediated killing of some Hib isolates remained retarded. Even for the most serum-resistant isolate, SBA was the dominating defense mechanism in reconstituted whole blood, as addition of blood cells to the serum did not enhance bacterial killing. Limited Fc receptor-mediated opsonophagocytosis was unmasked when bacterial killing by the membrane attack complex was blocked. In the presence of C3 or C5 inhibitors, addition of post-vaccination, but not of pre-vaccination serum to the blood cells triggered opsonophagocytosis, leading to suppression of bacterial multiplication. Taken together, our data indicate that for host defense against Hib, killing by SBA is more efficient than by blood cell opsonophagocytosis. However, additional defense mechanisms, such as bacterial clearance by spleen and liver, may play an important role in preventing Hib-mediated sepsis, in particular for Hib isolates with increased serum-resistance. Results indicate potentially improved safety profile of AP inhibitors over C3 and C5 inhibitors as alternative therapeutic agents in patients with increased susceptibility to Hib infection.
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Affiliation(s)
- Lukas Muri
- Molecular Immunology Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
| | - Anna Schubart
- Department Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | | | - Natasa Zamurovic
- Translational Medicine-Preclinical Safety, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Thomas Holbro
- Global Drug Development, Novartis Pharma AG, Basel, Switzerland
| | - Michael Kammüller
- Translational Medicine-Preclinical Safety, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Gerd Pluschke
- Molecular Immunology Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland,*Correspondence: Gerd Pluschke,
| | - Emma Ispasanie
- Molecular Immunology Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland,University of Basel, Basel, Switzerland
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4
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Britto C, Alter G. The next frontier in vaccine design: blending immune correlates of protection into rational vaccine design. Curr Opin Immunol 2022; 78:102234. [PMID: 35973352 PMCID: PMC9612370 DOI: 10.1016/j.coi.2022.102234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/27/2022] [Accepted: 07/13/2022] [Indexed: 02/02/2023]
Abstract
Despite the extraordinary speed and success in SARS-Cov-2 vaccine development, the emergence of variants of concern perplexed the vaccine development community. Neutralizing antibodies waned antibodies waned and were evaded by viral variants, despite the preservation of protection against severe disease and death across vaccinated populations. Similar to other vaccine design efforts, the lack of mechanistic correlates of immunity against Coronavirus Disease 2019, raised questions related to the need for vaccine redesign and boosting. Hence, our limited understanding of mechanistic correlates of immunity - across pathogens - remains a major obstacle in vaccine development. The identification and incorporation of mechanistic correlates of immunity are key to the accelerated design of highly impactful globally relevant vaccines. Systems-biology tools can be applied strategically to define a complete understanding of mechanistic correlates of immunity. Embedding immunological dissection and target immune profile identification, beyond canonical antibody binding and neutralization, may accelerate the design and success of durable protective vaccines.
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Affiliation(s)
- Carl Britto
- Department of Pediatrics, Boston Children's Hospital, USA; Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
| | - Galit Alter
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA.
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Generation of a Universal Human Complement Source by Large-Scale Depletion of IgG and IgM from Pooled Human Plasma. METHODS IN MOLECULAR BIOLOGY (CLIFTON, N.J.) 2021; 2414:341-362. [PMID: 34784045 DOI: 10.1007/978-1-0716-1900-1_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Complement is a key component of functional immunological assays used to evaluate vaccine-mediated immunity to a range of bacterial and viral pathogens. However, standardization of these assays is complicated due to the availability of a human complement source that lacks existing antibodies acquired either through vaccination or natural circulation of the pathogen of interest. We have developed a method for depleting both IgG and IgM in 200 mL batches from pooled hirudin-derived human plasma by sequential affinity chromatography using a Protein G Sepharose column followed by POROS™ CaptureSelect™ IgM Affinity resin. The production of large IgG- and IgM-depleted batches of human plasma that retains total hemolytic and alternative pathway activities allows for improved assay standardization and comparison of immune responses in large clinical trials.
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Toh ZQ, Higgins RA, Mazarakis N, Abbott E, Nathanielsz J, Balloch A, Mulholland K, Licciardi PV. Evaluating Functional Immunity Following Encapsulated Bacterial Infection and Vaccination. Vaccines (Basel) 2021; 9:677. [PMID: 34203030 PMCID: PMC8234458 DOI: 10.3390/vaccines9060677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 11/19/2022] Open
Abstract
Encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae type b and Neisseria meningitidis cause significant morbidity and mortality in young children despite the availability of vaccines. Highly specific antibodies are the primary mechanism of protection against invasive disease. Robust and standardised assays that measure functional antibodies are also necessary for vaccine evaluation and allow for the accurate comparison of data between clinical studies. This mini review describes the current state of functional antibody assays and their importance in measuring protective immunity.
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Affiliation(s)
- Zheng Quan Toh
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (Z.Q.T.); (R.A.H.); (N.M.); (E.A.); (J.N.); (A.B.); (K.M.)
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Rachel A. Higgins
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (Z.Q.T.); (R.A.H.); (N.M.); (E.A.); (J.N.); (A.B.); (K.M.)
| | - Nadia Mazarakis
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (Z.Q.T.); (R.A.H.); (N.M.); (E.A.); (J.N.); (A.B.); (K.M.)
| | - Elysia Abbott
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (Z.Q.T.); (R.A.H.); (N.M.); (E.A.); (J.N.); (A.B.); (K.M.)
| | - Jordan Nathanielsz
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (Z.Q.T.); (R.A.H.); (N.M.); (E.A.); (J.N.); (A.B.); (K.M.)
| | - Anne Balloch
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (Z.Q.T.); (R.A.H.); (N.M.); (E.A.); (J.N.); (A.B.); (K.M.)
| | - Kim Mulholland
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (Z.Q.T.); (R.A.H.); (N.M.); (E.A.); (J.N.); (A.B.); (K.M.)
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
- London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HT, UK
| | - Paul V. Licciardi
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (Z.Q.T.); (R.A.H.); (N.M.); (E.A.); (J.N.); (A.B.); (K.M.)
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
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7
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Giufrè M, Lindh E, Cardines R, Pezzotti P, Cerquetti M. Invasive Haemophilus influenzae type b (Hib) disease in children in Italy, after 20 years of routine use of conjugate Hib vaccines. Vaccine 2020; 38:6533-6538. [PMID: 32859435 DOI: 10.1016/j.vaccine.2020.08.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 11/26/2022]
Abstract
Haemophilus influenzae serotype b (Hib) was the leading cause of bacterial meningitis in children before the implementation of infant immunization with conjugate Hib vaccines. Despite the effectiveness of the vaccine, invasive Hib disease cases (i.e. isolation of Hib from a normally sterile site) are still reported in children. All invasive Hib disease cases in children ≤ 15 years reported through the National Surveillance System of Invasive Bacterial Disease, during 2012-2018 in Italy, were analyzed. Hib PCR-confirmed isolates were subjected to MLST and PFGE analysis. The number of copies of the capb locus, a virulence factor potentially contributing to true vaccine failures (TVFs), was determined by Southern blot analysis. Vaccine effectiveness (VE) was determined using a multiple Poisson regression model. 31 cases of invasive Hib disease in children were reported. Fourteen children were vaccinated (TVFs), 14 were unvaccinated and 2 partially vaccinated (vaccination status was unknown for 1 case). The median age of children was 12 months (range 3 months-15 years). A decrease in vaccination coverage was observed in 2014-2016 (source Ministry of Health), and a rise in incidence was documented from 2016 until 2018, especially in children < 5 years. Vaccine effectiveness was estimated to be 83% (95% CI:45-95). 24 isolates were available. The predominant ST was ST6 (70.8%). Cluster analysis of ST6 isolates by PFGE identified five variants. Six isolates (25%) contained multiple copies of the capb locus distributed among TVFs (30%) and unvaccinated children (16.7%). Our data show that both failures to vaccinate and TVFs are associated with invasive Hib disease in children in Italy, during the vaccination era. Most cases in children ≤ 2 years were vaccine-preventable, since they occurred in unvaccinated subjects (13/21 cases, 62%). No host predisposing factors for TVF were recognized. TVFs were not significantly associated with either specific genotypes or amplification status of the capb locus.
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Affiliation(s)
- Maria Giufrè
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
| | - Erika Lindh
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; European Program for Public Health Microbiology Training (EUPHEM), European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden
| | - Rita Cardines
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marina Cerquetti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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8
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Plotkin SA. Updates on immunologic correlates of vaccine-induced protection. Vaccine 2019; 38:2250-2257. [PMID: 31767462 DOI: 10.1016/j.vaccine.2019.10.046] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 02/06/2023]
Abstract
Correlates of protection (CoPs) are increasingly important in the development and licensure of vaccines. Although the study of CoPs was initially directed at identifying a single immune function that could explain vaccine efficacy, it has become increasingly clear that there are often multiple functions responsible for efficacy. This review is meant to supplement prior articles on the subject, illustrating both simple and complex CoPs.
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Affiliation(s)
- Stanley A Plotkin
- Emeritus Professor of Pediatrics, University of Pennsylvania, Vaxconsult, 4650 Wismer Rd., Doylestown, PA 18902, United States.
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9
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Thomas SR, Leung S, Knox K, Wilkinson TMA, Staples KJ, Lestrate P, Wauters D, Gorringe A, Taylor SC. Development of flow cytometric opsonophagocytosis and antibody-mediated complement deposition assays for non-typeable Haemophilus influenzae. BMC Microbiol 2018; 18:167. [PMID: 30373523 PMCID: PMC6206646 DOI: 10.1186/s12866-018-1314-5] [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] [Received: 12/19/2017] [Accepted: 10/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Haemophilus influenzae is found in the nasopharynx of 80% of the human population. While colonisation with non-typeable Haemophilus influenzae (NTHi) is usually asymptomatic, it is capable of causing acute and chronic otitis media (OM) in infants, invasive disease in susceptible groups and is the leading cause of exacerbations of patients with chronic obstructive pulmonary disease (COPD). Current methods for assessing functional antibody immunity to NTHi are limited and labour intensive. Flow cytometric assays could provide an attractive alternative to evaluate immune responses to candidate vaccines in clinical trials. RESULTS We have developed a duplexed flow-cytometric uptake and oxidative burst opsonophagocytosis assay (fOPA). We have also developed a duplexed antibody-mediated complement C3b/iC3b and C5b-9 deposition assay (CDA). Antibody-mediated C3b/iC3b deposition correlated with opsonophagocytic uptake (r = 0.65) and with opsonophagocytic oxidative burst (r = 0.69). Both fOPA and CDA were reproducible, with the majority of samples giving a coefficient of variation (CV) of < 20% and overall assay CVs of 14% and 16% respectively. CONCLUSIONS The high-throughput flow cytometric assays developed here were successfully optimised for use with NTHi. Assays proved to be sensitive and highly reproducible for the measurement of bacterial uptake and oxidative burst opsonophagocytosis and antibody-mediated deposition of C3b/iC3b and C5b-9. These assays are useful tools for use in large scale epidemiological studies and to assist in the assessment of functional antibody induced by NTHi candidate vaccines.
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Affiliation(s)
- Stephen R Thomas
- Public Health England, Microbiological Services, Porton Down, Salisbury, SP4 0JG, UK.
| | - Stephanie Leung
- Public Health England, Microbiological Services, Porton Down, Salisbury, SP4 0JG, UK
| | - Katy Knox
- Public Health England, Microbiological Services, Porton Down, Salisbury, SP4 0JG, UK
| | - Tom M A Wilkinson
- Clinical & Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Tremona Road, Southampton, UK
| | - Karl J Staples
- Clinical & Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Tremona Road, Southampton, UK
| | | | | | - Andrew Gorringe
- Public Health England, Microbiological Services, Porton Down, Salisbury, SP4 0JG, UK
| | - Stephen C Taylor
- Public Health England, Microbiological Services, Porton Down, Salisbury, SP4 0JG, UK
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Akeda Y, Koizumi Y, Takanami Y, Sumino S, Hattori Y, Sugizaki K, Mitsuya N, Oishi K. Comparison of serum bactericidal and antibody titers induced by two Haemophilus influenzae type b conjugate vaccines: A phase III randomized double-blind study. Vaccine 2018; 36:1528-1532. [PMID: 29459064 DOI: 10.1016/j.vaccine.2018.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/01/2018] [Accepted: 02/03/2018] [Indexed: 11/30/2022]
Abstract
Haemophilus influenzae type b (Hib) conjugate vaccines have drastically reduced disease incidence worldwide. Protection against Hib infection has relied on the serum bactericidal activity (SBA) of antibodies to the Hib capsular polysaccharide (polyribosylribitol phosphate). However, licensure usually relies on measuring induction of antibodies to PRP as a surrogate for SBA. In a phase III clinical trial we compared a PRP-conjugate vaccine using the nontoxic diphtheria toxin mutant, CRM197, as carrier protein with the licensed tetanus toxoid conjugate when administered subcutaneously as a three dose primary series in Japanese infants. As an addition to the phase III study, we have now evaluated SBA and show PRP-CRM197 induces higher levels of SBA than PRP-T four weeks after the primary series, with a statistically significant correlation with anti-PRP titers. This data confirms the superior immunogenicity of PRP-CRM197 compared with PRP-T assessed as SBA following a three-dose primary series by subcutaneous administration. Clinical trial registry: Registered on ClinicalTrials.gov (NCT01379846).
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Affiliation(s)
- Yukihiro Akeda
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan; Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Osaka, Japan; Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan.
| | - Yuka Koizumi
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | | | - Shuji Sumino
- Takeda Pharmaceutical Company Limited, Osaka, Japan
| | - Yumi Hattori
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | | | | | - Kazunori Oishi
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
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11
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Bornstein K, Hungerford L, Hartley D, Sorkin JD, Tapia MD, Sow SO, Onwuchekwa U, Simon R, Tennant SM, Levine MM. Modeling the Potential for Vaccination to Diminish the Burden of Invasive Non-typhoidal Salmonella Disease in Young Children in Mali, West Africa. PLoS Negl Trop Dis 2017; 11:e0005283. [PMID: 28182657 PMCID: PMC5300129 DOI: 10.1371/journal.pntd.0005283] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/22/2016] [Indexed: 11/30/2022] Open
Abstract
Background In sub-Saharan Africa, systematic surveillance of young children with suspected invasive bacterial disease (e.g., septicemia, meningitis) has revealed non-typhoidal Salmonella (NTS) to be a major pathogen exhibiting high case fatality (~20%). Where infant vaccination against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae has been introduced to prevent invasive disease caused by these pathogens, as in Bamako, Mali, their burden has decreased markedly. In parallel, NTS has become the predominant invasive bacterial pathogen in children aged <5 years. While NTS is believed to be acquired orally via contaminated food/water, epidemiologic studies have failed to identify the reservoir of infection or vehicles of transmission. This has precluded targeting food chain interventions to diminish disease transmission but conversely has fostered the development of vaccines to prevent invasive NTS (iNTS) disease. We developed a mathematical model to estimate the potential impact of NTS vaccination programs in Bamako. Methodology/Principal Findings A Markov chain transmission model was developed utilizing age-specific Bamako demographic data and hospital surveillance data for iNTS disease in children aged <5 years and assuming vaccine coverage and efficacy similar to the existing, successfully implemented, Hib vaccine. Annual iNTS hospitalizations and deaths in children <5 years, with and without a Salmonella Enteritidis/Salmonella Typhimurium vaccine, were the model’s outcomes of interest. Per the model, high coverage/high efficacy iNTS vaccination programs would drastically diminish iNTS disease except among infants age <8 weeks. Conclusions/Significance The public health impact of NTS vaccination shifts as disease burden, vaccine coverage, and serovar distribution vary. Our model shows that implementing an iNTS vaccine through an analogous strategy to the Hib vaccination program in Bamako would markedly reduce cases and deaths due to iNTS among the pediatric population. The model can be adjusted for use elsewhere in Africa where NTS epidemiologic patterns, serovar prevalence, and immunization schedules differ from Bamako. A surveillance program at Gabriel Touré Hospital in Mali observed a high burden of invasive disease caused by non-typhoidal Salmonella (iNTS). This surveillance program was originally instituted to measure the amount of invasive disease (e.g., septicemia, meningitis) caused by two bacteria that invade the respiratory tract: Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae (pneumococcus). While documenting the burden of these pathogens, the surveillance program also found that serotypes of iNTS, mainly Salmonella Typhimurium and Salmonella Enteritidis, were common causes of severe invasive disease. As the number of cases of Hib and pneumococcus markedly decreased following the introduction of relevant vaccines, the relative threat of iNTS increased. Little is known about the reservoir of iNTS, whether it resides in humans, animals, or the environment, or how it is spread to susceptible children. Without this knowledge, it is not possible to employ certain disease control methods useful in interrupting the transmission of other pathogens. Therefore, vaccination remains the one promising control strategy for this disease. Our research modeled the potential effects of introducing an iNTS vaccine. The findings are of great importance to Mali and other developing countries where young children are at a high risk of developing iNTS disease.
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Affiliation(s)
- Kristin Bornstein
- Center for Vaccine Development and Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Laura Hungerford
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - David Hartley
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - John D. Sorkin
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Baltimore VA Medical Center GRECC (Geriatric Research, Education, and Clinical Center), Baltimore Maryland
| | - Milagritos D. Tapia
- Center for Vaccine Development and Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Samba O. Sow
- Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali, Africa
| | - Uma Onwuchekwa
- Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali, Africa
| | - Raphael Simon
- Center for Vaccine Development and Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Sharon M. Tennant
- Center for Vaccine Development and Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Myron M. Levine
- Center for Vaccine Development and Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States of America
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, United States of America
- * E-mail:
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12
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Ullmann AJ, Schmidt-Hieber M, Bertz H, Heinz WJ, Kiehl M, Krüger W, Mousset S, Neuburger S, Neumann S, Penack O, Silling G, Vehreschild JJ, Einsele H, Maschmeyer G. Infectious diseases in allogeneic haematopoietic stem cell transplantation: prevention and prophylaxis strategy guidelines 2016. Ann Hematol 2016; 95:1435-55. [PMID: 27339055 PMCID: PMC4972852 DOI: 10.1007/s00277-016-2711-1] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/28/2016] [Indexed: 12/13/2022]
Abstract
Infectious complications after allogeneic haematopoietic stem cell transplantation (allo-HCT) remain a clinical challenge. This is a guideline provided by the AGIHO (Infectious Diseases Working Group) of the DGHO (German Society for Hematology and Medical Oncology). A core group of experts prepared a preliminary guideline, which was discussed, reviewed, and approved by the entire working group. The guideline provides clinical recommendations for the preventive management including prophylactic treatment of viral, bacterial, parasitic, and fungal diseases. The guideline focuses on antimicrobial agents but includes recommendations on the use of vaccinations. This is the updated version of the AGHIO guideline in the field of allogeneic haematopoietic stem cell transplantation utilizing methods according to evidence-based medicine criteria.
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Affiliation(s)
- Andrew J Ullmann
- Department of Internal Medicine II, Division of Hematology and Oncology, Division of Infectious Diseases, Universitätsklinikum, Julius Maximilian's University, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
| | - Martin Schmidt-Hieber
- Clinic for Hematology, Oncology und Tumor Immunology, Helios Clinic Berlin-Buch, Berlin, Germany
| | - Hartmut Bertz
- Department of Hematology/Oncology, University of Freiburg Medical Center, 79106, Freiburg, Germany
| | - Werner J Heinz
- Department of Internal Medicine II, Division of Hematology and Oncology, Division of Infectious Diseases, Universitätsklinikum, Julius Maximilian's University, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Michael Kiehl
- Medical Clinic I, Klinikum Frankfurt (Oder), Frankfurt (Oder), Germany
| | - William Krüger
- Haematology and Oncology, Stem Cell Transplantation, Palliative Care, University Hospital Greifswald, Greifswald, Germany
| | - Sabine Mousset
- Medizinische Klinik III, Palliativmedizin und interdisziplinäre Onkologie, St. Josefs-Hospital Wiesbaden, Wiesbaden, Germany
| | - Stefan Neuburger
- Sindelfingen-Böblingen Clinical Centre, Medical Department I, Division of Hematology and Oncology, Klinikverbund Südwest, Sindelfingen, Germany
| | | | - Olaf Penack
- Hematology, Oncology and Tumorimmunology, Charité University Medicine Berlin, Campus Virchow Klinikum, Berlin, Germany
| | - Gerda Silling
- Department of Internal Medicine IV, University Hospital RWTH Aachen, Aachen, Germany
| | - Jörg Janne Vehreschild
- Department I of Internal Medicine, German Centre for Infection Research, Partner-site: Bonn-Cologne, University Hospital of Cologne, Cologne, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, Division of Hematology and Oncology, Division of Infectious Diseases, Universitätsklinikum, Julius Maximilian's University, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
| | - Georg Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany
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13
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Townsend-Payne K, Ladhani SN, Findlow H, Slack M, Borrow R. Children with Haemophilus influenzae type b (Hib) vaccine failure have long-term bactericidal antibodies against virulent Hib strains with multiple capsular loci. Vaccine 2016; 34:3931-4. [PMID: 27317452 DOI: 10.1016/j.vaccine.2016.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/02/2016] [Accepted: 06/09/2016] [Indexed: 10/21/2022]
Abstract
Children who develop invasive Haemophilus influenzae serotype b (Hib) disease after immunisation with a highly-effective conjugate vaccine are more likely to have been infected with Hib strains possessing multiple copies of the capsulation locus. Using a recently-validated serum bactericidal antibody (SBA) assay, we tested convalescent sera from 127 Hib vaccine failure cases against clinical Hib strains expressing 1-5 copies of the capsulation locus. SBA titres correlated weakly with anti-capsular IgG antibody concentrations and there was no association between SBA geometric mean titres and number of capsulation locus copies. After infection, children with Hib vaccine failure were equally protected against Hib strains with 1-5 copies of the capsulation locus.
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Affiliation(s)
- Kelly Townsend-Payne
- Vaccine Evaluation Unit, Public Health England, Clinical Sciences Building, Manchester Royal Infirmary, Manchester, UK
| | - Shamez N Ladhani
- Immunisation Hepatitis and Blood Safety Department, Centre for Infectious Disease Surveillance and Control, Public Health England, Colindale, London, UK; Paediatric Infectious Diseases Research Group, St. George's University of London, London, UK.
| | - Helen Findlow
- Vaccine Evaluation Unit, Public Health England, Clinical Sciences Building, Manchester Royal Infirmary, Manchester, UK
| | - Mary Slack
- Institute of Hygiene and Microbiology, University of Wuerzburg, Germany; Department of Medicine, Griffith University, Queensland, Australia
| | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Clinical Sciences Building, Manchester Royal Infirmary, Manchester, UK; Inflammation Sciences Research Group, University of Manchester, School of Translational Medicine, Stopford Building, Manchester, UK
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14
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Shikano H, Ohnishi H, Fukutomi H, Ito K, Morimoto M, Teramoto T, Aoki M, Nishihori T, Akeda Y, Oishi K, Fukao T. Mondini dysplasia with recurrent bacterial meningitis caused by three different pathogens. Pediatr Int 2015; 57:1192-5. [PMID: 26542099 DOI: 10.1111/ped.12731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/20/2015] [Accepted: 04/30/2015] [Indexed: 12/01/2022]
Abstract
Mondini dysplasia is rare, but has an important association with recurrent bacterial meningitis. We herein describe the case of a 3-year-old girl with unilateral sensorineural hearing loss who presented with three independent episodes of bacterial meningitis within 8 months. Temporal bone computed tomography indicated the characteristic features of Mondini dysplasia in the right inner ear. This was treated by surgical closure of the inner ear defect via oval window and additional vaccination was administered. Appropriate vaccination might prevent the recurrent bacterial meningitis associated with Mondini dysplasia.
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Affiliation(s)
- Hiroaki Shikano
- Department of Pediatrics, Ogaki Municipal Hospital, Ogaki City, Gifu, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu City, Gifu, Japan
| | - Hisashi Fukutomi
- Department of Pediatrics, Ogaki Municipal Hospital, Ogaki City, Gifu, Japan
| | - Kimiko Ito
- Department of Pediatrics, Ogaki Municipal Hospital, Ogaki City, Gifu, Japan
| | - Masahiro Morimoto
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu City, Gifu, Japan
| | - Takahide Teramoto
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu City, Gifu, Japan
| | - Mitsuhiro Aoki
- Department of Otolaryngology, Graduate School of Medicine, Gifu University, Gifu City, Gifu, Japan
| | - Takezumi Nishihori
- Department of Otolaryngology, Graduate School of Medicine, Gifu University, Gifu City, Gifu, Japan
| | - Yukihiro Akeda
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
| | - Kazunori Oishi
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan.,Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Toshiyuki Fukao
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu City, Gifu, Japan
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15
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Ercoli G, Baddal B, Alessandra G, Marchi S, Petracca R, Aricò B, Pizza M, Soriani M, Rossi-Paccani S. Development of a serological assay to predict antibody bactericidal activity against non-typeable Haemophilus influenzae. BMC Microbiol 2015; 15:87. [PMID: 25927946 PMCID: PMC4409741 DOI: 10.1186/s12866-015-0420-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/01/2015] [Indexed: 11/23/2022] Open
Abstract
Background Non-typeable Haemophilus influenzae (NTHi) is a Gram negative microorganism residing in the human nasopharyngeal mucosa and occasionally causing infections of both middle ear and lower respiratory airways. A broadly protective vaccine against NTHi has been a long-unmet medical need, as the high genetic variability of this bacterium has posed great challenges. Results In this study, we developed a robust serum bactericidal assay (SBA) to optimize the selection of protective antigens against NTHi. SBA takes advantage of the complement-mediated lysis of bacterial cells and is a key in vitro method for measuring the functional activity of antibodies. As a proof of concept, we assessed the bactericidal activity of antibodies directed against antigens known to elicit a protective response, including protein D used as carrier protein in the Synflorix pneumococcal polysaccharide conjugate vaccine. Prior to SBA screening, the accessibility of antigens to antibodies and the capacity of the latter to induce C3 complement deposition was verified by flow cytometry. Using baby rabbit serum as a source of complement, the proposed assay not only confirmed the bactericidal activity of the antibodies against the selected vaccine candidates, but also showed a significant reproducibility. Conclusions Considering the rapidity and cost-effectiveness of this novel SBA protocol, we conclude that it is likely to become an important tool to prove the capability of antibodies directed against recombinant antigens to induce NTHi in vitro killing and to both select new protective vaccine candidates, and predict vaccine efficacy. Electronic supplementary material The online version of this article (doi:10.1186/s12866-015-0420-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giuseppe Ercoli
- University of Leicester, Department of Genetics, Adrian building, Leicester, UK.
| | - Buket Baddal
- Novartis Vaccines & Diagnostics s.r.l. (a GSK company), Via Fiorentina 1, 53100, Siena, Italy.
| | - Greco Alessandra
- Novartis Vaccines & Diagnostics s.r.l. (a GSK company), Via Fiorentina 1, 53100, Siena, Italy.
| | - Sara Marchi
- Novartis Vaccines & Diagnostics s.r.l. (a GSK company), Via Fiorentina 1, 53100, Siena, Italy.
| | - Roberto Petracca
- Novartis Vaccines & Diagnostics s.r.l. (a GSK company), Via Fiorentina 1, 53100, Siena, Italy.
| | - Beatrice Aricò
- Novartis Vaccines & Diagnostics s.r.l. (a GSK company), Via Fiorentina 1, 53100, Siena, Italy.
| | - Mariagrazia Pizza
- Novartis Vaccines & Diagnostics s.r.l. (a GSK company), Via Fiorentina 1, 53100, Siena, Italy.
| | - Marco Soriani
- Novartis Vaccines & Diagnostics s.r.l. (a GSK company), Via Fiorentina 1, 53100, Siena, Italy.
| | - Silvia Rossi-Paccani
- Novartis Vaccines & Diagnostics s.r.l. (a GSK company), Via Fiorentina 1, 53100, Siena, Italy.
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16
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Choi J, Nix EB, Gaultier GN, Cox AD, McCready W, Ulanova M. Naturally occurring bactericidal antibodies specific for Haemophilus influenzae Lipooligosaccharide are present in healthy adult individuals. Vaccine 2015; 33:1941-7. [DOI: 10.1016/j.vaccine.2015.02.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 02/03/2015] [Accepted: 02/22/2015] [Indexed: 11/30/2022]
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