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Fox T, Sguassero Y, Chaplin M, Rose W, Doum D, Arevalo-Rodriguez I, Villanueva G. Wolbachia-carrying Aedes mosquitoes for preventing dengue infection. Cochrane Database Syst Rev 2024; 4:CD015636. [PMID: 38597256 PMCID: PMC11005084 DOI: 10.1002/14651858.cd015636.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Dengue is a global health problem of high significance, with 3.9 billion people at risk of infection. The geographic expansion of dengue virus (DENV) infection has resulted in increased frequency and severity of the disease, and the number of deaths has increased in recent years. Wolbachia,an intracellular bacterial endosymbiont, has been under investigation for several years as a novel dengue-control strategy. Some dengue vectors (Aedes mosquitoes) can be transinfected with specific strains of Wolbachia, which decreases their fitness (ability to survive and mate) and their ability to reproduce, inhibiting the replication of dengue. Both laboratory and field studies have demonstrated the potential effect of Wolbachia deployments on reducing dengue transmission, and modelling studies have suggested that this may be a self-sustaining strategy for dengue prevention, although long-term effects are yet to be elucidated. OBJECTIVES To assess the efficacy of Wolbachia-carrying Aedes speciesdeployments (specifically wMel-, wMelPop-, and wAlbB- strains of Wolbachia) for preventing dengue virus infection. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, four other databases, and two trial registries up to 24 January 2024. SELECTION CRITERIA Randomized controlled trials (RCTs), including cluster-randomized controlled trials (cRCTs), conducted in dengue endemic or epidemic-prone settings were eligible. We sought studies that investigated the impact of Wolbachia-carrying Aedes deployments on epidemiological or entomological dengue-related outcomes, utilizing either the population replacement or population suppression strategy. DATA COLLECTION AND ANALYSIS Two review authors independently selected eligible studies, extracted data, and assessed the risk of bias using the Cochrane RoB 2 tool. We used odds ratios (OR) with the corresponding 95% confidence intervals (CI) as the effect measure for dichotomous outcomes. For count/rate outcomes, we planned to use the rate ratio with 95% CI as the effect measure. We used adjusted measures of effect for cRCTs. We assessed the certainty of evidence using GRADE. MAIN RESULTS One completed cRCT met our inclusion criteria, and we identified two further ongoing cRCTs. The included trial was conducted in an urban setting in Yogyakarta, Indonesia. It utilized a nested test-negative study design, whereby all participants aged three to 45 years who presented at healthcare centres with a fever were enrolled in the study provided they had resided in the study area for the previous 10 nights. The trial showed that wMel-Wolbachia infected Ae aegypti deployments probably reduce the odds of contracting virologically confirmed dengue by 77% (OR 0.23, 95% CI 0.15 to 0.35; 1 trial, 6306 participants; moderate-certainty evidence). The cluster-level prevalence of wMel Wolbachia-carrying mosquitoes remained high over two years in the intervention arm of the trial, reported as 95.8% (interquartile range 91.5 to 97.8) across 27 months in clusters receiving wMel-Wolbachia Ae aegypti deployments, but there were no reliable comparative data for this outcome. Other primary outcomes were the incidence of virologically confirmed dengue, the prevalence of dengue ribonucleic acid in the mosquito population, and mosquito density, but there were no data for these outcomes. Additionally, there were no data on adverse events. AUTHORS' CONCLUSIONS The included trial demonstrates the potential significant impact of wMel-Wolbachia-carrying Ae aegypti mosquitoes on preventing dengue infection in an endemic setting, and supports evidence reported in non-randomized and uncontrolled studies. Further trials across a greater diversity of settings are required to confirm whether these findings apply to other locations and country settings, and greater reporting of acceptability and cost are important.
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Affiliation(s)
- Tilly Fox
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Marty Chaplin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Winsley Rose
- Department of Child Health, Christian Medical College, Vellore, India
| | - Dyna Doum
- Health Forefront Organization, Phnom Penh, Cambodia
| | - Ingrid Arevalo-Rodriguez
- Cochrane Response, Cochrane, London, UK
- Evidence Production & Methods Directorate, Cochrane, London, UK
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Samrat SK, Bashir Q, Huang Y, Trieshmann CW, Tharappel AM, Zhang R, Chen K, Geoge Zheng Y, Li Z, Li H. Broad-Spectrum Small-Molecule Inhibitors Targeting the SAM-Binding Site of Flavivirus NS5 Methyltransferase. ACS Infect Dis 2023; 9:1319-1333. [PMID: 37348028 PMCID: PMC10436986 DOI: 10.1021/acsinfecdis.2c00571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Flavivirus infections, such as those caused by dengue virus (DENV), West Nile virus (WNV), yellow fever virus (YFV), and Zika virus (ZIKV), pose a rising threat to global health. There are no FDA-approved drugs for flaviviruses, although a small number of flaviviruses have vaccines. For flaviviruses or unknown viruses that may appear in the future, it is particularly desirable to identify broad-spectrum inhibitors. The NS5 protein is regarded as one of the most promising flavivirus drug targets because it is conserved across flaviviruses. In this study, we used FL-NAH, a fluorescent analog of the methyl donor S-adenosyl methionine (SAM), to develop a fluorescence polarization (FP)-based high throughput screening (HTS) assay to specifically target methyltransferase (MTase), a vital enzyme for flaviviruses that methylates the N7 and 2'-O positions of the viral 5'-RNA cap. Pilot screening identified two candidate MTase inhibitors, NSC 111552 and 288387. The two compounds inhibited the FL-NAH binding to the DENV3 MTase with low micromolar IC50. Functional assays verified the inhibitory potency of these molecules for the flavivirus MTase activity. Binding studies indicated that these molecules are bound directly to the DENV3 MTase with similar low micromolar affinity. Furthermore, we showed that these compounds greatly reduced ZIKV replication in cell-based experiments at dosages that did not cause cytotoxicity. Finally, docking studies revealed that these molecules bind to the SAM-binding region on the DENV3 MTase, and further mutagenesis studies verified residues important for the binding of these compounds. Overall, these compounds are innovative and attractive candidates for the development of broad-spectrum inhibitors for the treatment of flavivirus infections.
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Affiliation(s)
- Subodh Kumar Samrat
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Qamar Bashir
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Yiding Huang
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Carl William Trieshmann
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia, 30602, USA
| | - Anil Mathew Tharappel
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Ran Zhang
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Ke Chen
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Y. Geoge Zheng
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
- Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy, University of Georgia, Athens, Georgia, 30602, USA
| | - Zhong Li
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
| | - Hongmin Li
- Department of Pharmacology and Toxicology, R Ken Coit College of Pharmacy, The University of Arizona, 1703 E Mabel St, Tucson AZ, 85721-0207, USA
- Department of Chemistry and Biochemistry, College of Science & College of Medicine, The University of Arizona, Tucson AZ, 85721, USA
- The BIO5 Institute, The University of Arizona, Tucson, AZ 85721, USA
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3
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Lwin MO, Ong Z, Panchapakesan C, Sheldenkar A, Soh LT, Chen I, Li X, Niah W, Vasquez K, Sim S, Ng LC. Influence of public hesitancy and receptivity on reactive behaviours towards releases of male Wolbachia-Aedes mosquitoes for dengue control. PLoS Negl Trop Dis 2022; 16:e0010910. [PMID: 36367848 PMCID: PMC9651544 DOI: 10.1371/journal.pntd.0010910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
Singapore, a highly urbanized Asian tropical country that experiences periodic dengue outbreaks, is piloting field releases of male Wolbachia-carrying Aedes aegypti mosquitoes with the aim of suppressing urban populations of the primary dengue vector Aedes aegypti. This study proposes and assesses a model to explain the roles of hesitancy and receptivity towards Project Wolbachia-Singapore in influencing reactive mosquito prevention behaviors (reactive behaviors) towards the release of Wolbachia-Aedes mosquitoes for residents living in the release sites. Interestingly, both hesitancy and receptivity predicted greater instances of reactive behaviors. The model also examines the roles of general knowledge about Wolbachia technology, perceived severity of mosquito bites, perceived density of mosquitoes, and social responsibility as predictors of hesitancy, receptivity, and reactive behaviors towards the release of Wolbachia-Aedes mosquitoes. Hesitancy towards the project mediated the effects of general knowledge, perceived severity of mosquito bites, and perceived density of mosquitoes on reactive behaviors towards the releases, although receptivity towards the project did not. Having less knowledge about Project Wolbachia-Singapore was associated with higher hesitancy towards the project and higher likelihood of performing reactive behaviors towards the releases. Individuals who perceive mosquito bites to be more severe and think that there are more mosquitoes in their living environments were also more likely to be hesitant about the project and practice reactive behaviors. However, both hesitancy and receptivity towards the project mediated the effect of social responsibility on reactive behaviors. Receptivity towards the project was driven by social responsibility, which was also associated with reduced hesitancy towards the project. Our findings suggest that, to address the hesitancy reported by a minority of participants, future outreach efforts should focus on strengthening the public's sense of social responsibility and on tailored education campaigns targeting groups with low levels of knowledge of the project.
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Affiliation(s)
- May O. Lwin
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
| | - Zoe Ong
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
- Global Asia, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore
| | - Chitra Panchapakesan
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
- Affective Computing Group, Institute of High Performance Computing (IHPC), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Anita Sheldenkar
- Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore
| | - Li Ting Soh
- Environmental Health Institute, National Environment Agency, Singapore
| | - Irene Chen
- Environmental Health Institute, National Environment Agency, Singapore
| | - Xiaoxi Li
- Environmental Health Institute, National Environment Agency, Singapore
| | - Weixin Niah
- Environmental Health Institute, National Environment Agency, Singapore
| | - Kathryn Vasquez
- Environmental Health Institute, National Environment Agency, Singapore
| | - Shuzhen Sim
- Environmental Health Institute, National Environment Agency, Singapore
| | - Lee-Ching Ng
- Environmental Health Institute, National Environment Agency, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore
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Yong YK, Wong WF, Vignesh R, Chattopadhyay I, Velu V, Tan HY, Zhang Y, Larsson M, Shankar EM. Dengue Infection - Recent Advances in Disease Pathogenesis in the Era of COVID-19. Front Immunol 2022; 13:889196. [PMID: 35874775 PMCID: PMC9299105 DOI: 10.3389/fimmu.2022.889196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022] Open
Abstract
The dynamics of host-virus interactions, and impairment of the host’s immune surveillance by dengue virus (DENV) serotypes largely remain ambiguous. Several experimental and preclinical studies have demonstrated how the virus brings about severe disease by activating immune cells and other key elements of the inflammatory cascade. Plasmablasts are activated during primary and secondary infections, and play a determinative role in severe dengue. The cross-reactivity of DENV immune responses with other flaviviruses can have implications both for cross-protection and severity of disease. The consequences of a cross-reactivity between DENV and anti-SARS-CoV-2 responses are highly relevant in endemic areas. Here, we review the latest progress in the understanding of dengue immunopathogenesis and provide suggestions to the development of target strategies against dengue.
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Affiliation(s)
- Yean Kong Yong
- Laboratory Centre, Xiamen University Malaysia, Sepang, Malaysia
- *Correspondence: Esaki M. Shankar, ; Yean Kong Yong,
| | - Won Fen Wong
- Department of Medical Microbiology, Faculty Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ramachandran Vignesh
- Preclinical Department, Royal College of Medicine Perak (UniKL RCMP), Universiti Kuala Lumpur, Ipoh, Malaysia
| | - Indranil Chattopadhyay
- Cancer and Microbiome Biology, Department of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Vijayakumar Velu
- Division of Microbiology and Immunology, Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, United States
- Department of Pathology and Laboratory Medicine, Emory National Primate Research Center, Emory University, Atlanta GA, United States
| | - Hong Yien Tan
- School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Ying Zhang
- Chemical Engineering, Xiamen University Malaysia, Sepang, Malaysia
| | - Marie Larsson
- Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Esaki M. Shankar
- Infection Biology, Department of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
- *Correspondence: Esaki M. Shankar, ; Yean Kong Yong,
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Biggs JR, Sy AK, Ashall J, Santoso MS, Brady OJ, Reyes MAJ, Quinones MA, Jones-Warner W, Tandoc AO, Sucaldito NL, Mai HK, Lien LT, Thai HD, Nguyen HAT, Anh DD, Iwasaki C, Kitamura N, Van Loock M, Herrera-Taracena G, Menten J, Rasschaert F, Van Wesenbeeck L, Masyeni S, Haryanto S, Yohan B, Cutiongco-de la Paz E, Yoshida LM, Hue S, Rosario Z. Capeding M, Padilla CD, Sasmono RT, Hafalla JCR, Hibberd ML. Combining rapid diagnostic tests to estimate primary and post-primary dengue immune status at the point of care. PLoS Negl Trop Dis 2022; 16:e0010365. [PMID: 35507552 PMCID: PMC9067681 DOI: 10.1371/journal.pntd.0010365] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/28/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Characterising dengue virus (DENV) infection history at the point of care is challenging as it relies on intensive laboratory techniques. We investigated how combining different rapid diagnostic tests (RDTs) can be used to accurately determine the primary and post-primary DENV immune status of reporting patients during diagnosis. METHODS AND FINDINGS Serum from cross-sectional surveys of acute suspected dengue patients in Indonesia (N:200) and Vietnam (N: 1,217) were assayed using dengue laboratory assays and RDTs. Using logistic regression modelling, we determined the probability of being DENV NS1, IgM and IgG RDT positive according to corresponding laboratory viremia, IgM and IgG ELISA metrics. Laboratory test thresholds for RDT positivity/negativity were calculated using Youden's J index and were utilized to estimate the RDT outcomes in patients from the Philippines, where only data for viremia, IgM and IgG were available (N:28,326). Lastly, the probabilities of being primary or post-primary according to every outcome using all RDTs, by day of fever, were calculated. Combining NS1, IgM and IgG RDTs captured 94.6% (52/55) and 95.4% (104/109) of laboratory-confirmed primary and post-primary DENV cases, respectively, during the first 5 days of fever. Laboratory test predicted, and actual, RDT outcomes had high agreement (79.5% (159/200)). Among patients from the Philippines, different combinations of estimated RDT outcomes were indicative of post-primary and primary immune status. Overall, IgG RDT positive results were confirmatory of post-primary infections. In contrast, IgG RDT negative results were suggestive of both primary and post-primary infections on days 1-2 of fever, yet were confirmatory of primary infections on days 3-5 of fever. CONCLUSION We demonstrate how the primary and post-primary DENV immune status of reporting patients can be estimated at the point of care by combining NS1, IgM and IgG RDTs and considering the days since symptoms onset. This framework has the potential to strengthen surveillance operations and dengue prognosis, particularly in low resource settings.
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Affiliation(s)
- Joseph R. Biggs
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ava Kristy Sy
- Department of Virology, Research Institute for Tropical Medicine, Manila, Philippines
- Dengue Study Group, Research Institute for Tropical Medicine, Manila, Philippines
| | - James Ashall
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marsha S. Santoso
- Dengue Research Unit, Eijkman Institute for Molecular Biology, National Agency for Research and Innovation of the Republic of Indonesia, Jakarta, Indonesia
| | - Oliver J. Brady
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mary Anne Joy Reyes
- Department of Virology, Research Institute for Tropical Medicine, Manila, Philippines
- Dengue Study Group, Research Institute for Tropical Medicine, Manila, Philippines
| | - Mary Ann Quinones
- Department of Virology, Research Institute for Tropical Medicine, Manila, Philippines
- Dengue Study Group, Research Institute for Tropical Medicine, Manila, Philippines
| | - William Jones-Warner
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Amadou O. Tandoc
- Department of Virology, Research Institute for Tropical Medicine, Manila, Philippines
| | - Nemia L. Sucaldito
- Philippine Epidemiology Bureau, Department of Health, Manila, Philippines
| | | | - Le Thuy Lien
- Pasteur Institute of Nha Trang, Nha Trang, Vietnam
| | - Hung Do Thai
- Pasteur Institute of Nha Trang, Nha Trang, Vietnam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Chihiro Iwasaki
- Paediatric Infectious Diseases Department, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Noriko Kitamura
- Paediatric Infectious Diseases Department, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Marnix Van Loock
- Janssen Global Public Health, Janssen Pharmaceutica NV, Beerse, Belgium
| | - Guillermo Herrera-Taracena
- Janssen Global Public Health, Janssen Research & Development, Horsham, Pennsylvania, United States of America
| | - Joris Menten
- Quantitative Sciences, Janssen Pharmaceutica NV, Beerse, Belgium
| | - Freya Rasschaert
- Janssen Global Public Health, Janssen Pharmaceutica NV, Beerse, Belgium
| | | | - Sri Masyeni
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa, Denpasar, Bali, Indonesia
| | | | - Benediktus Yohan
- Dengue Research Unit, Eijkman Institute for Molecular Biology, National Agency for Research and Innovation of the Republic of Indonesia, Jakarta, Indonesia
| | - Eva Cutiongco-de la Paz
- Institute of Human Genetics, University of the Philippines, Manila, Philippines
- Philippine Genome Centre, University of the Philippines, Manila, Philippines
| | - Lay-Myint Yoshida
- Paediatric Infectious Diseases Department, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Stephane Hue
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Maria Rosario Z. Capeding
- Dengue Study Group, Research Institute for Tropical Medicine, Manila, Philippines
- Institute of Human Genetics, University of the Philippines, Manila, Philippines
| | - Carmencita D. Padilla
- Institute of Human Genetics, University of the Philippines, Manila, Philippines
- Philippine Genome Centre, University of the Philippines, Manila, Philippines
| | - R. Tedjo Sasmono
- Dengue Research Unit, Eijkman Institute for Molecular Biology, National Agency for Research and Innovation of the Republic of Indonesia, Jakarta, Indonesia
| | - Julius Clemence R. Hafalla
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Martin L. Hibberd
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Institute of Human Genetics, University of the Philippines, Manila, Philippines
- Philippine Genome Centre, University of the Philippines, Manila, Philippines
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Cimica V, Galarza JM, Rashid S, Stedman TT. Current development of Zika virus vaccines with special emphasis on virus-like particle technology. Expert Rev Vaccines 2021; 20:1483-1498. [PMID: 34148481 DOI: 10.1080/14760584.2021.1945447] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Zika virus disease received little attention until its recent explosive emergence around the globe. The devastating consequences of this pandemic include congenital Zika syndrome (CZS) and the neurological autoimmune disorder Guillain-Barré syndrome. These potential outcomes prompted massive efforts to understand the course of Zika infection and to develop therapeutic and prophylactic strategies for treatment and prevention of disease.Area covered: Preclinical and clinical data demonstrate that a safe and efficacious vaccine for protection against Zika virus infection is possible in the near future. Nevertheless, significant knowledge gaps regarding the outcome of a mass vaccination strategy exist and must be addressed. Zika virus circulates in flavivirus-endemic regions, an ideal Zika vaccine should avoid the potential of antibody-dependent enhancement from exposure to dengue virus. Prevention of CZS is the primary goal for immunization, and the vaccine must provide protection against intrauterine transmission for use during pregnancy and in women of childbearing age. Ideally, a vaccine should also prevent sexual transmission of the virus through mucosal protection.Expert opinion: This review describes current vaccine approaches against Zika virus with particular attention to the application of virus-like particle (VLP) technology as a strategy for solving the challenges of Zika virus immunization.
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Affiliation(s)
- Velasco Cimica
- American Type Culture Collection (ATCC), Manassas, VA, USA
| | | | - Sujatha Rashid
- American Type Culture Collection (ATCC), Manassas, VA, USA
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7
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Fongwen N, Delrieu I, Ham LH, Gubler DJ, Durbin A, Ooi EE, Peeling RW, Flasche S, Hartigan-Go K, Clifford S, Martinez CT, de Lamballerie X, Barnighausen T, Wilder-Smith A. Implementation strategies for the first licensed dengue vaccine: A meeting report. Vaccine 2021; 39:4759-4765. [PMID: 34253416 DOI: 10.1016/j.vaccine.2021.06.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 06/21/2021] [Accepted: 06/27/2021] [Indexed: 01/18/2023]
Abstract
Dengue vaccination would enhance the control of dengue, one of the most frequent vector-borne viral diseases globally. CYD-TDV is the first dengue vaccine to be licensed, but global uptake has been hampered due to its use being limited to seropositive persons aged 9 years and above, and the need for a 3-dose schedule. The Partnership for Dengue Control (PDC) organized a meeting with key opinion leaders and stakeholders to deliberate on implementation strategies for the use of CYD-TDV. New data have emerged that support the shortening of the primary schedule from a 3 to 2 dose schedule, extending the age range below 9 to 6 years of age, and expanding the indication from endemic populations to also include travelers to endemic areas. Cost-effectiveness may improve with the modified 2-dose regimen and with multiple testing. Strategies to implement a dengue vaccination program have been developed, in particular school-based strategies. A range of delivery scenarios can then be considered, using various settings for each step of the intervention. However, several challenges remain, including communication about limiting the use of this vaccine to seropositive individuals only. Affordability will vary from country to country, as will government commitment and community acceptance. Well-tailored communication strategies that target key stakeholders are expected to make up a significant part of any future dengue vaccination program.
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Affiliation(s)
- Noah Fongwen
- International Diagnostics Centre, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | | | - Duane J Gubler
- Partnership for Dengue Control, Fondation Merieux, France
| | | | | | - Rosanna W Peeling
- International Diagnostics Centre, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Stefan Flasche
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | | | - Sam Clifford
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Carlos Torres Martinez
- Director of Cafettor Medical, Professor of Pediatric Infectious Diseases, Universidad del Bosque, in Bogotá, Colombia
| | - Xavier de Lamballerie
- UMR IRD 190, Inserm 1207 "Unité des Virus Émergents", Aix-Marseille Université - Institut de Recherche pour le Développement - Institut National de la Santé et de la Recherche Médicale - Institut de Recherche Biomédicale des Armées - Établissement Français du Sang, France
| | - Till Barnighausen
- Heidelberg Institute of Global Health, University of Heidelberg, Germany
| | - Annelies Wilder-Smith
- Heidelberg Institute of Global Health, University of Heidelberg, Germany; Institute for Social and Preventive Medicine, University of Bern, Switzerland.
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8
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Effectiveness of a single-dose mass dengue vaccination in Cebu, Philippines: A case-control study. Vaccine 2021; 39:5318-5325. [PMID: 34373121 DOI: 10.1016/j.vaccine.2021.07.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Dengue fever is an important public health problem in the Philippines. In April 2016, the Department of Health launched a three-dose school based dengue vaccination program of nine- to fourteen-year-old children in three regions with the highest number of dengue cases using CYD-TDV (Dengvaxia, Sanofi Pasteur). In July 2017, a community-based dengue vaccination program was implemented in Cebu province. The program was discontinued in December 2017 amidst public controversy, after the first dose had been administered. We assessed the effectiveness of a single dose of CYD-TDV against hospitalized virologically confirmed dengue (VCD). METHODS We conducted a case-control study in Cebu province following the dengue mass vaccination. Children who were nine to fourteen years of age during the mass vaccination and subsequently admitted to any of four participating public hospitals with suspected dengue were enrolled in the study as cases. Blood for RT-PCR and clinical and socio-demographic information were obtained. To estimate the level of vaccine protection, vaccination status was compared between children with hospitalized virologically confirmed dengue and controls of the same six-year age-group as the cases, matched on sex, neighborhood and time of occurrence of cases. FINDINGS We enrolled 490 cases and 980 controls. Receipt of one dose of CYD-TDV was associated with 26% (95 % CI, -2 to 47%; p = 0 0675) overall protection against hospitalized virologically confirmed dengue and 51% (95 % CI, 23 to 68; p = 0 0016) protection against dengue with warning signs. INTERPRETATION A single dose of CYD-TDV given to nine to fourteen-year-old children through a community-based mass vaccination program conferred protection against dengue with warning signs and severe dengue but we were unable to conclude on protection against milder illness.
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Sierra B, Magalhães AC, Soares D, Cavadas B, Perez AB, Alvarez M, Aguirre E, Bracho C, Pereira L, Guzman MG. Multi-Tissue Transcriptomic-Informed In Silico Investigation of Drugs for the Treatment of Dengue Fever Disease. Viruses 2021; 13:v13081540. [PMID: 34452405 PMCID: PMC8402662 DOI: 10.3390/v13081540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/22/2021] [Accepted: 07/31/2021] [Indexed: 12/19/2022] Open
Abstract
Transcriptomics, proteomics and pathogen-host interactomics data are being explored for the in silico–informed selection of drugs, prior to their functional evaluation. The effectiveness of this kind of strategy has been put to the test in the current COVID-19 pandemic, and it has been paying off, leading to a few drugs being rapidly repurposed as treatment against SARS-CoV-2 infection. Several neglected tropical diseases, for which treatment remains unavailable, would benefit from informed in silico investigations of drugs, as performed in this work for Dengue fever disease. We analyzed transcriptomic data in the key tissues of liver, spleen and blood profiles and verified that despite transcriptomic differences due to tissue specialization, the common mechanisms of action, “Adrenergic receptor antagonist”, “ATPase inhibitor”, “NF-kB pathway inhibitor” and “Serotonin receptor antagonist”, were identified as druggable (e.g., oxprenolol, digoxin, auranofin and palonosetron, respectively) to oppose the effects of severe Dengue infection in these tissues. These are good candidates for future functional evaluation and clinical trials.
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Affiliation(s)
- Beatriz Sierra
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Pedro Kourí Institute of Tropical Medicine (IPK), Havana 11400, Cuba; (B.S.); (A.B.P.); (M.A.); (E.A.); (C.B.); (M.G.G.)
| | - Ana Cristina Magalhães
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (A.C.M.); (D.S.); (B.C.)
- IPATIMUP—Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
- ICBAS—Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
| | - Daniel Soares
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (A.C.M.); (D.S.); (B.C.)
- IPATIMUP—Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
| | - Bruno Cavadas
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (A.C.M.); (D.S.); (B.C.)
- IPATIMUP—Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
| | - Ana B. Perez
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Pedro Kourí Institute of Tropical Medicine (IPK), Havana 11400, Cuba; (B.S.); (A.B.P.); (M.A.); (E.A.); (C.B.); (M.G.G.)
| | - Mayling Alvarez
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Pedro Kourí Institute of Tropical Medicine (IPK), Havana 11400, Cuba; (B.S.); (A.B.P.); (M.A.); (E.A.); (C.B.); (M.G.G.)
| | - Eglis Aguirre
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Pedro Kourí Institute of Tropical Medicine (IPK), Havana 11400, Cuba; (B.S.); (A.B.P.); (M.A.); (E.A.); (C.B.); (M.G.G.)
| | - Claudia Bracho
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Pedro Kourí Institute of Tropical Medicine (IPK), Havana 11400, Cuba; (B.S.); (A.B.P.); (M.A.); (E.A.); (C.B.); (M.G.G.)
| | - Luisa Pereira
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal; (A.C.M.); (D.S.); (B.C.)
- IPATIMUP—Instituto de Patologia e Imunologia Molecular, Universidade do Porto, 4200-135 Porto, Portugal
- Correspondence: ; Tel.: +351-22-607-4900
| | - Maria G. Guzman
- Virology Department, PAHO/WHO Collaborating Center for the Study of Dengue and its Vector, Pedro Kourí Institute of Tropical Medicine (IPK), Havana 11400, Cuba; (B.S.); (A.B.P.); (M.A.); (E.A.); (C.B.); (M.G.G.)
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10
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Castanha PMS, Marques ETA. Zika vaccines: can we solve one problem without creating another one? THE LANCET. INFECTIOUS DISEASES 2021; 21:1198-1200. [PMID: 34019803 DOI: 10.1016/s1473-3099(20)30768-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 10/21/2022]
Affiliation(s)
- Priscila M S Castanha
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Ernesto T A Marques
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA 15261, USA.
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11
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S AH, Pujar GV, Sethu AK, Bhagyalalitha M, Singh M. Dengue structural proteins as antiviral drug targets: Current status in the drug discovery & development. Eur J Med Chem 2021; 221:113527. [PMID: 34020338 DOI: 10.1016/j.ejmech.2021.113527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/30/2021] [Accepted: 04/20/2021] [Indexed: 01/04/2023]
Abstract
Dengue virus belongs to the class of RNA viruses and subclass of enveloped single-stranded positive-sense RNA virus. It causes dengue fever (DF), dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS), where DHF and DSS are life-threatening. Even though dengue is an age-old disease, it is still a mystery and continues to be a global threat. Numerous attempts have been carried out in the past few decades to eradicate the virus through vaccine and antiviral drugs, but still battle continues. In this review, the possible drug targets for discovery and development of potential antiviral drugs against structural proteins of dengue virus, the current development status of the antiviral drugs against dengue around the world, and challenges that need to be addressed to overcome the shortcomings in the process of drug discovery have been discussed.
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Affiliation(s)
- Akshatha H S
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Sri Shivarathreeshwara Nagara, Mysuru, 570015, India
| | - Gurubasavaraj V Pujar
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Sri Shivarathreeshwara Nagara, Mysuru, 570015, India.
| | - Arun Kumar Sethu
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Sri Shivarathreeshwara Nagara, Mysuru, 570015, India
| | - Meduri Bhagyalalitha
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Sri Shivarathreeshwara Nagara, Mysuru, 570015, India
| | - Manisha Singh
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Sri Shivarathreeshwara Nagara, Mysuru, 570015, India
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12
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Brouqui P, Colson P, Melenotte C, Houhamdi L, Bedotto M, Devaux C, Gautret P, Million M, Parola P, Stoupan D, La Scola B, Lagier JC, Raoult D. COVID-19 re-infection. Eur J Clin Invest 2021; 51:e13537. [PMID: 33675046 PMCID: PMC8250303 DOI: 10.1111/eci.13537] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Philippe Brouqui
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
| | - Philippe Colson
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
| | - Cléa Melenotte
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
| | - Linda Houhamdi
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
| | | | - Christian Devaux
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
| | - Philipe Gautret
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IRD, APHM, Aix-Marseille University, VITROME, Marseille, France
| | - Matthieu Million
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
| | - Philippe Parola
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IRD, APHM, Aix-Marseille University, VITROME, Marseille, France
| | | | - Bernard La Scola
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
| | - Jean-Christophe Lagier
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
| | - Didier Raoult
- IRD, APHM, Aix-Marseille University, MEPHI, Marseille, France.,IHU-Méditerranée Infection, APHM, Marseille, France
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13
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Robust Plasma Cell Response to Skin-Inoculated Dengue Virus in Mice. J Immunol Res 2021; 2021:5511841. [PMID: 33997054 PMCID: PMC8096554 DOI: 10.1155/2021/5511841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 11/17/2022] Open
Abstract
Dengue is a worldwide expanding threat caused by dengue virus (DENV) infection. To date, no specific treatment or effective vaccine is available. Antibodies produced by plasma cells (PCs) might be involved concomitantly in protection and severe dengue immunopathology. Although a massive appearance of PCs has been reported during acute DENV infection in humans, this response has been poorly characterized. Here, we show the dynamic of PC generation in immune-competent mice cutaneously inoculated with DENV compared with two control experimental groups: mice inoculated with inactivated DENV or with PBS. We found that PC numbers increased significantly in the skin-draining lymph node (DLN), peaking at day 10 and abruptly decreasing by day 14 after DENV inoculation. Class-switched IgG+ PCs appeared from day 7 and dominated the response, while in contrast, the frequency of IgM+ PCs decreased from day 7 onwards. Even though the kinetic of the response was similar between DENV- and iDENV-inoculated mice, the intensity of the response was significantly different. Interestingly, we demonstrated a similar PC response to virus antigens (E and prM) by ELISPOT. In situ characterization showed that PCs were distributed in the medullary cords and in close proximity to germinal centers (GCs), suggesting both an extrafollicular and a GC origin. Proliferating PCs (Ki-67+) were found as early as 3-day postinoculation, and in-depth analysis showed that these PCs were in active phases of cell cycle during the kinetic. Finally, we found a progressive appearance of high-affinity neutralizing DENV-specific IgG further supporting GC involvement. Of note, these antibodies seem to be highly cross-reactive, as a large proportion recognizes Zika virus (ZIKV). The strong PC response to skin-inoculated DENV in this work resembles the findings already described in humans. We consider that this study contributes to the understanding of the in vivo biology of the humoral immune response to DENV in an immunocompetent murine model.
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Ogunlade ST, Meehan MT, Adekunle AI, Rojas DP, Adegboye OA, McBryde ES. A Review: Aedes-Borne Arboviral Infections, Controls and Wolbachia-Based Strategies. Vaccines (Basel) 2021; 9:32. [PMID: 33435566 PMCID: PMC7827552 DOI: 10.3390/vaccines9010032] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/28/2020] [Accepted: 01/05/2021] [Indexed: 12/31/2022] Open
Abstract
Arthropod-borne viruses (Arboviruses) continue to generate significant health and economic burdens for people living in endemic regions. Of these viruses, some of the most important (e.g., dengue, Zika, chikungunya, and yellow fever virus), are transmitted mainly by Aedes mosquitoes. Over the years, viral infection control has targeted vector population reduction and inhibition of arboviral replication and transmission. This control includes the vector control methods which are classified into chemical, environmental, and biological methods. Some of these control methods may be largely experimental (both field and laboratory investigations) or widely practised. Perceptively, one of the biological methods of vector control, in particular, Wolbachia-based control, shows a promising control strategy for eradicating Aedes-borne arboviruses. This can either be through the artificial introduction of Wolbachia, a naturally present bacterium that impedes viral growth in mosquitoes into heterologous Aedes aegypti mosquito vectors (vectors that are not natural hosts of Wolbachia) thereby limiting arboviral transmission or via Aedes albopictus mosquitoes, which naturally harbour Wolbachia infection. These strategies are potentially undermined by the tendency of mosquitoes to lose Wolbachia infection in unfavourable weather conditions (e.g., high temperature) and the inhibitory competitive dynamics among co-circulating Wolbachia strains. The main objective of this review was to critically appraise published articles on vector control strategies and specifically highlight the use of Wolbachia-based control to suppress vector population growth or disrupt viral transmission. We retrieved studies on the control strategies for arboviral transmissions via arthropod vectors and discussed the use of Wolbachia control strategies for eradicating arboviral diseases to identify literature gaps that will be instrumental in developing models to estimate the impact of these control strategies and, in essence, the use of different Wolbachia strains and features.
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Affiliation(s)
- Samson T. Ogunlade
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia; (M.T.M.); (A.I.A.); (O.A.A.); (E.S.M.)
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Michael T. Meehan
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia; (M.T.M.); (A.I.A.); (O.A.A.); (E.S.M.)
| | - Adeshina I. Adekunle
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia; (M.T.M.); (A.I.A.); (O.A.A.); (E.S.M.)
| | - Diana P. Rojas
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
| | - Oyelola A. Adegboye
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia; (M.T.M.); (A.I.A.); (O.A.A.); (E.S.M.)
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia;
| | - Emma S. McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia; (M.T.M.); (A.I.A.); (O.A.A.); (E.S.M.)
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
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15
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Luyten J, van Hoek AJ. Integrating Alternative Social Value Judgments Into Cost-Effectiveness Analysis of Vaccines: An Application to Varicella-Zoster Virus Vaccination. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:41-49. [PMID: 33431152 DOI: 10.1016/j.jval.2020.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/24/2020] [Accepted: 07/16/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Cost-effectiveness analyses (CEA) are based on the value judgment that health outcomes (eg, quantified in quality-adjusted life-years; QALYs) are all equally valuable irrespective of their context. Whereas most published CEAs perform extensive sensitivity analysis on various parameters and assumptions, only rarely is the influence of the QALY-equivalence assumption on cost-effectiveness results investigated. We illustrate how the integration of alternative social value judgments in CEA can be a useful form of sensitivity analysis. METHODS Because varicella-zoster virus (VZV) vaccination affects 2 distinct diseases (varicella zoster and herpes zoster) and likely redistributes infections across different age groups, the program has an important equity dimension. We used a cost-effectiveness model and disentangled the share of direct protection and herd immunity within the total projected QALYs resulting from a 50-year childhood VZV program in the UK. We use the UK population's preferences for QALYs in the vaccine context to revalue QALYs accordingly. RESULTS Revaluing different types of QALYs for different age groups in line with public preferences leads to a 98% change in the projected net impact of the program. The QALYs gained among children through direct varicella protection become more important, whereas the QALYs lost indirectly through zoster in adults diminish in value. Weighting of vaccine-related side effects made a large difference. CONCLUSIONS Our study shows that a sensitivity analysis in which alternative social value judgments about the value of health outcomes are integrated into CEA of vaccines is relatively straightforward and provides important additional information for decision makers to interpret cost-effectiveness results.
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Affiliation(s)
- Jeroen Luyten
- Leuven Institute for Healthcare Policy, KULeuven, Kapucijnenvoer 35, 3000 Leuven, Belgium; Personal Social Services Research Unit, Department of Health Policy, London School of Economics, Houghton Street, London, England, United Kingdom
| | - Albert Jan van Hoek
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, England, United Kingdom; Centre for Infectious Diseases, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan, Bilthoven, The Netherlands.
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16
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Recent patents in dengue disease management. Pharm Pat Anal 2020; 9:173-185. [PMID: 33350353 DOI: 10.4155/ppa-2020-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dengue, an illness caused by four serotypes of the dengue virus is most prevalent in Asia and Latin America. Its manifestation varies from asymptomatic cases to severe forms and even deaths and is a growing health concern. Despite attempts to curtail it, the infection continues to intensify in endemic areas and spread to new areas of the world. Development of a safe and effective vaccine and a potent antiviral drug is ongoing but so far there has been no breakthrough. Nonetheless, researchers are carrying out studies with newer vaccine candidates and antiviral moieties, and some of these hold promise for the future. The current article describes the recent patents targeted at dengue control.
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17
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Halstead SB, Katzelnick LC, Russell PK, Markoff L, Aguiar M, Dans LR, Dans AL. Ethics of a partially effective dengue vaccine: Lessons from the Philippines. Vaccine 2020; 38:5572-5576. [PMID: 32654899 PMCID: PMC7347470 DOI: 10.1016/j.vaccine.2020.06.079] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 12/31/2022]
Abstract
Dengvaxia, a chimeric yellow fever tetravalent dengue vaccine developed by SanofiPasteur is widely licensed in dengue-endemic countries. In a large cohort study Dengvaxia was found to partially protect children who had prior dengue virus (DENV) infections but sensitized seronegative children to breakthrough DENV disease of enhanced severity. In 2019, the European Medicines Agency and the US FDA issued licenses that reconciled safety issues by restricting vaccine to individuals with prior dengue infections. Using revised Dengvaxia efficacy and safety data we sought to estimate hospitalized and severe dengue cases among the more than 800,000 9 year-old children vaccinated in the Philippines. Despite an overall vaccine efficacy of 69% during 4 years post-vaccination we project there will be more than one thousand vaccinated seronegative and seropositive children hospitalized for severe dengue. Assisting these children through a program of enhanced surveillance leading to improved care deserves widespread support. Clinical responses observed during breakthrough dengue infections in vaccinated individuals counsel prudence in design of vaccine policies. Recommendations concerning continued use of this dengue vaccine are: (1) obtain a better definition of vaccine efficacy and safety through enhanced phase 4 surveillance, (2) obtain a valid, accessible, sensitive, specific and affordable serological test that identifies past wild-type dengue virus infection and (3) clarify safety and efficacy of Dengvaxia in flavivirus immunes. In the absence of an acceptable serological screening test these unresolved ethical issues suggest Dengvaxia be given only to those signing informed consent.
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Affiliation(s)
- Scott B Halstead
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD 20817, United States.
| | - Leah C Katzelnick
- Research Associate, Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA 94720, United States; Department of Biology, University of Florida, Gainesville, FL 32611, United States
| | - Philip K Russell
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | - Lewis Markoff
- Consultant, 6908 Nevis Road, Bethesda MD 20817, United States
| | - Maira Aguiar
- Dipartimento di Matematica, Università degli Studi di Trento, Via Sommarive 14, 38123 Povo Trento, Italy; Basque Center for Applied Mathematics (BCAM), Alameda Mazarredo, 14, 48009 Bilbao, Spain; Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Leonila R Dans
- Department of Pediatrics, College of Medicine, University of the Philippines, Manila, 547 Pedro Gil Street, Ermita, Manila 1000, Philippines
| | - Antonio L Dans
- Department of Medicine, College of Medicine, University of the Philippines, Manila 547 Pedro Gil Streeet, Ermita, Manila 1000, Philippines
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Taychakhoonavudh S, Chumchujan W, Hutubessy R, Chaiyakunapruk N. Landscape of vaccine access and health technology assessment role in decision-making process in ASEAN countries. Hum Vaccin Immunother 2020; 16:1728-1737. [PMID: 32574124 PMCID: PMC7482843 DOI: 10.1080/21645515.2020.1769388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/09/2020] [Indexed: 12/29/2022] Open
Abstract
Over the past few years, many innovative vaccines became available that offer protection for diseases which have never been prevented before. While there are several factors that could have an impact on access, the use of health technology assessment (HTA) undoubtedly is also one of the contributing factors. Objectives: To explore the landscape of vaccine access and the role of HTA in new vaccine adoption in Association of Southeast Asian Nations (ASEAN) countries. Results: A great deal of progress has been made in terms of access to new and innovation vaccine in the region. Variation in access to these vaccines comparing between countries, however, is still observed. The use of HTA in supporting new vaccine adoption is still in an early stage especially in Gavi, the Vaccine Alliance-eligible countries. Conclusions: Improving the use of HTA evidences to support decision making could accelerate the efficient adoption of new vaccine in ASEAN region.
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Affiliation(s)
- Suthira Taychakhoonavudh
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Woralak Chumchujan
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Raymond Hutubessy
- Immunization, Vaccines and Biologicals (IVB) Department, World Health Organization, Geneva, Switzerland
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
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19
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Wilken L, Rimmelzwaan GF. Adaptive Immunity to Dengue Virus: Slippery Slope or Solid Ground for Rational Vaccine Design? Pathogens 2020; 9:pathogens9060470. [PMID: 32549226 PMCID: PMC7350362 DOI: 10.3390/pathogens9060470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/15/2022] Open
Abstract
The four serotypes of dengue virus are the most widespread causes of arboviral disease, currently placing half of the human population at risk of infection. Pre-existing immunity to one dengue virus serotype can predispose to severe disease following secondary infection with a different serotype. The phenomenon of immune enhancement has complicated vaccine development and likely explains the poor long-term safety profile of a recently licenced dengue vaccine. Therefore, alternative vaccine strategies should be considered. This review summarises studies dissecting the adaptive immune responses to dengue virus infection and (experimental) vaccination. In particular, we discuss the roles of (i) neutralising antibodies, (ii) antibodies to non-structural protein 1, and (iii) T cells in protection and pathogenesis. We also address how these findings could translate into next-generation vaccine approaches that mitigate the risk of enhanced dengue disease. Finally, we argue that the development of a safe and efficacious dengue vaccine is an attainable goal.
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20
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Yen PS, Failloux AB. A Review: Wolbachia-Based Population Replacement for Mosquito Control Shares Common Points with Genetically Modified Control Approaches. Pathogens 2020; 9:E404. [PMID: 32456036 PMCID: PMC7281599 DOI: 10.3390/pathogens9050404] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022] Open
Abstract
The growing expansion of mosquito vectors has made mosquito-borne arboviral diseases a global threat to public health, and the lack of licensed vaccines and treatments highlight the urgent need for efficient mosquito vector control. Compared to genetically modified control strategies, the intracellular bacterium Wolbachia, endowing a pathogen-blocking phenotype, is considered an environmentally friendly strategy to replace the target population for controlling arboviral diseases. However, the incomplete knowledge regarding the pathogen-blocking mechanism weakens the reliability of a Wolbachia-based population replacement strategy. Wolbachia infections are also vulnerable to environmental factors, temperature, and host diet, affecting their densities in mosquitoes and thus the virus-blocking phenotype. Here, we review the properties of the Wolbachia strategy as an approach to control mosquito populations in comparison with genetically modified control methods. Both strategies tend to limit arbovirus infections but increase the risk of selecting arbovirus escape mutants, rendering these strategies less reliable.
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Affiliation(s)
- Pei-Shi Yen
- Unit Arboviruses and Insect Vectors, Department of Virology, Institut Pasteur, F-75724 Paris, France
| | - Anna-Bella Failloux
- Unit Arboviruses and Insect Vectors, Department of Virology, Institut Pasteur, F-75724 Paris, France
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Affiliation(s)
- Tikki Pang
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.
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