1
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Fan H, Luo SH, Zhu Y, Shi J, Yin F, Li J. trans-Cleavage of the CRISPR-Cas12a-aptamer system for one-step antigen detection. Chem Commun (Camb) 2023; 59:13151-13154. [PMID: 37846511 DOI: 10.1039/d3cc04532c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Rapid detection of prostate-specific antigen (PSA) is pivotal for the early screening of prostate cancer (PCa). Here, we devise a one-step, amplification-free fluorescent detection strategy for PSA, employing the trans-cleavage principle of a CRISPR-Cas12a-aptamer system. This method offers a linear range of 0.31-5 ng mL-1 and a detection limit of 0.16 ng mL-1. The high-confidence quantification of PSA is demonstrated through the analysis of real samples, effectively distinguishing between PCa patients and healthy individuals.
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Affiliation(s)
- Hongxuan Fan
- Shanghai Soong Ching Ling School, Shanghai 201700, China
| | - Shi-Hua Luo
- Department of Traumatology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Ying Zhu
- Institute of Materiobiology, Department of Chemistry, College of Science, Shanghai University, Shanghai 200444, China.
- CAS Key Laboratory of Interfacial Physics and Technology, Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - Jiye Shi
- CAS Key Laboratory of Interfacial Physics and Technology, Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - Fangfei Yin
- Institute of Molecular Medicine, Shanghai Key Laboratory for Nucleic Acid Chemistry and Nanomedicine, Renji Hospital, School of Medicine, National Center for Translational Medicine, School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200127, China.
| | - Jiang Li
- Institute of Materiobiology, Department of Chemistry, College of Science, Shanghai University, Shanghai 200444, China.
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2
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Mia MM, Hasan M, Ahmed S, Rahman MN. Insight into the first multi-epitope-based peptide subunit vaccine against avian influenza A virus (H5N6): An immunoinformatics approach. INFECTION, GENETICS AND EVOLUTION 2022; 104:105355. [PMID: 36007760 PMCID: PMC9394107 DOI: 10.1016/j.meegid.2022.105355] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/22/2022] [Accepted: 08/18/2022] [Indexed: 11/26/2022]
Abstract
The rampant spread of highly pathogenic avian influenza A (H5N6) virus has drawn additional concerns along with ongoing Covid-19 pandemic. Due to its migration-related diffusion, the situation is deteriorating. Without an existing effective therapy and vaccines, it will be baffling to take control measures. In this regard, we propose a revers vaccinology approach for prediction and design of a multi-epitope peptide based vaccine. The induction of humoral and cell-mediated immunity seems to be the paramount concern for a peptide vaccine candidate; thus, antigenic B and T cell epitopes were screened from the surface, membrane and envelope proteins of the avian influenza A (H5N6) virus, and passed through several immunological filters to determine the best possible one. Following that, the selected antigenic with immunogenic epitopes and adjuvant were linked to finalize the multi-epitope-based peptide vaccine by appropriate linkers. For the prediction of an effective binding, molecular docking was carried out between the vaccine and immunological receptors (TLR8). Strong binding affinity and good docking scores clarified the stringency of the vaccines. Furthermore, molecular dynamics simulation was performed within the highest binding affinity complex to observe the stability, and minimize the designed vaccine's high mobility region to order to increase its stability. Then, Codon optimization and other physicochemical properties were performed to reveal that the vaccine would be suitable for a higher expression at cloning level and satisfactory thermostability condition. In conclusion, predicting the overall in silico assessment, we anticipated that our designed vaccine would be a plausible prevention against avian influenza A (H5N6) virus.
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Affiliation(s)
- Md Mukthar Mia
- Department of Poultry Science, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet 3100, Bangladesh; Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet 3100, Bangladesh
| | - Mahamudul Hasan
- Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet 3100, Bangladesh.
| | - Shakil Ahmed
- Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet 3100, Bangladesh
| | - Mohammad Nahian Rahman
- Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet 3100, Bangladesh
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3
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Rajwa P, Syed J, Leapman MS. How should radiologists incorporate non-imaging prostate cancer biomarkers into daily practice? Abdom Radiol (NY) 2020; 45:4031-4039. [PMID: 32232525 PMCID: PMC7529677 DOI: 10.1007/s00261-020-02496-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To review the current body of evidence surrounding non-imaging biomarkers in patients with known or suspected prostate cancer. RESULTS Several non-imaging biomarkers have been developed and are available that aim to improve risk estimates at several clinical junctures. For patients with suspicion of prostate cancer who are considering first-time or repeat biopsy, blood- and urine-based assays can improve the prediction of harboring clinically significant disease and may reduce unnecessary biopsy. Blood- and urine-based biomarkers have been evaluated in association with prostate MRI, offering insights that might augment decision-making in the pre and post-MRI setting. Tissue-based genomic and proteomic assays have also been developed that provide independent assessments of prostate cancer aggressiveness that can complement imaging. CONCLUSION A growing number of non-imaging biomarkers are available to assist in clinical decision-making for men with known or suspected prostate cancer. An appreciation for the intersection of imaging and biomarkers may improve clinical care and resource utilization for men with prostate cancer.
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Affiliation(s)
- Pawel Rajwa
- Department of Urology, Medical University of Silesia, 41-800, Zabrze, Poland
| | - Jamil Syed
- Department of Urology, Yale University School of Medicine, 310 Cedar Street BML 238c, PO Box 208058, New Haven, CT, 06520, USA
| | - Michael S Leapman
- Department of Urology, Yale University School of Medicine, 310 Cedar Street BML 238c, PO Box 208058, New Haven, CT, 06520, USA.
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4
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Mishra S, Kim ES, Sharma PK, Wang ZJ, Yang SH, Kaushik AK, Wang C, Li Y, Kim NY. Tailored Biofunctionalized Biosensor for the Label-Free Sensing of Prostate-Specific Antigen. ACS APPLIED BIO MATERIALS 2020; 3:7821-7830. [DOI: 10.1021/acsabm.0c01002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Sachin Mishra
- NDAC Centre, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
- Department of Electronic Engineering, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
| | - Eun-Seong Kim
- Department of Electronic Engineering, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
| | - Parshant Kumar Sharma
- Department of Electronic Engineering, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
| | - Zhi-Ji Wang
- Department of Electronic Engineering, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
| | - Sung-Hyun Yang
- Department of Electronic Engineering, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
| | - Ajeet Kumar Kaushik
- NanoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Arts, & Mathematics, Florida Polytechnic University, Lakeland, Florida 33805, United States
| | - Cong Wang
- Department of Electronic Engineering, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
- School of Electronics and Information Engineering, Harbin Institute of Technology, Harbin 150001, China
| | - Yang Li
- School of Electronics and Information Engineering, Harbin Institute of Technology, Harbin 150001, China
- School of Information Science and Engineering, University of Jinan, Jinan 250022, China
| | - Nam-Young Kim
- NDAC Centre, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
- Department of Electronic Engineering, Kwangwoon University, Nowon-gu, Seoul 01897, South Korea
- School of Electronics and Information Engineering, Harbin Institute of Technology, Harbin 150001, China
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5
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Martinez L, Cheng W, Wang X, Ling F, Mu L, Li C, Huo X, Ebell MH, Huang H, Zhu L, Li C, Chen E, Handel A, Shen Y. A Risk Classification Model to Predict Mortality Among Laboratory-Confirmed Avian Influenza A H7N9 Patients: A Population-Based Observational Cohort Study. J Infect Dis 2020; 220:1780-1789. [PMID: 31622983 DOI: 10.1093/infdis/jiz328] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/22/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Avian influenza A H7N9 (A/H7N9) is characterized by rapid progressive pneumonia and respiratory failure. Mortality among laboratory-confirmed cases is above 30%; however, the clinical course of disease is variable and patients at high risk for death are not well characterized. METHODS We obtained demographic, clinical, and laboratory information on all A/H7N9 patients in Zhejiang province from China Centers for Disease Control and Prevention electronic databases. Risk factors for death were identified using logistic regression and a risk score was created using regression coefficients from multivariable models. We externally validated this score in an independent cohort from Jiangsu province. RESULTS Among 305 A/H7N9 patients, 115 (37.7%) died. Four independent predictors of death were identified: older age, diabetes, bilateral lung infection, and neutrophil percentage. We constructed a score with 0-13 points. Mortality rates in low- (0-3), medium- (4-6), and high-risk (7-13) groups were 4.6%, 32.1%, and 62.7% (Ptrend < .0001). In a validation cohort of 111 A/H7N9 patients, 61 (55%) died. Mortality rates in low-, medium-, and high-risk groups were 35.5%, 55.8, and 67.4% (Ptrend = .0063). CONCLUSIONS We developed and validated a simple-to-use, predictive risk score for clinical use, identifying patients at high mortality risk.
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Affiliation(s)
- Leonardo Martinez
- Department of Epidemiology and Biostatistics, College of Public Health, Athens.,Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, California
| | - Wei Cheng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaoxiao Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Feng Ling
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Lan Mu
- Department of Geography, University of Georgia, Athens
| | - Changwei Li
- Department of Epidemiology and Biostatistics, College of Public Health, Athens
| | - Xiang Huo
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Mark H Ebell
- Department of Epidemiology and Biostatistics, College of Public Health, Athens
| | - Haodi Huang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Limei Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Chao Li
- Department of Epidemiology and Biostatistics, College of Public Health, Athens
| | - Enfu Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Andreas Handel
- Department of Epidemiology and Biostatistics, College of Public Health, Athens
| | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public Health, Athens
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6
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Characterization of antibody and memory T-cell response in H7N9 survivors: a cross-sectional analysis. Clin Microbiol Infect 2019; 26:247-254. [PMID: 31229595 DOI: 10.1016/j.cmi.2019.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/23/2019] [Accepted: 06/13/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Despite the importance of immunological memory for protective immunity against viral infection, whether H7N9-specific antibodies and memory T-cell responses remain detectable years after the original infection is unknown. METHODS A cross-sectional study was conducted to investigate the immune memory responses of H7N9 patients who contracted the disease and survived during the 2013-2016 epidemics in China. Sustainability of antibodies and T-cell memory to H7N9 virus were examined. Healthy individuals receiving routine medical examinations in a physical examination centre were recruited as control. RESULTS A total of 75 survivors were enrolled and classified into four groups based on the time elapsed from illness onset to specimen collection: 3 months (n = 14), 14 months (n = 14), 26 months (n = 28) and 36 months (n = 19). Approximately 36 months after infection, the geometric mean titres of virus-specific antibodies were significantly lower than titres in patients 3 months after infection, but 16 of 19 (84.2%) survivors in the 36-month interval had microneutralization (MN) titres ≥40. Despite the overall declining trend, the percentages of virus-specific cytokine-secreting memory CD4+ and CD8+ T cells remained higher in survivors at nearly all time-points in comparison with control individuals. Linear regression analysis showed that severe disease (mean titre ratio 2.77, 95% CI 1.17-6.49) was associated with higher haemagglutination inhibition (HI) titre and female sex for both HI (1.92, 1.02-3.57) and MN (3.33, 1.26-9.09) antibody, whereas female sex (mean percentage ratio 1.69, 95% CI 1.08-2.63), underlying medical conditions (1.94, 95% CI 1.09-3.46) and lack of antiviral therapy (2.08, 95% CI 1.04-4.17) were predictors for higher T-cell responses. CONCLUSIONS Survivors of H7N9 virus infection produced long-term antibodies and memory T-cell responses. Our findings warrant further serological investigation in general and high-risk populations and have important implications for vaccine design and development.
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Zhang W, Zhao K, Jin J, He J, Zhou W, Wu J, Tang R, Ma W, Ding C, Liu W, Zhang L, Gao R. A hospital cluster combined with a family cluster of avian influenza H7N9 infection in Anhui Province, China. J Infect 2019; 79:49-55. [PMID: 31100362 PMCID: PMC7112695 DOI: 10.1016/j.jinf.2019.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/07/2019] [Accepted: 05/10/2019] [Indexed: 12/09/2022]
Abstract
We reported a hospital cluster combined with family cluster of H7N9 infection. A poultry farm was the initially infectious source of the H7N9 virus infection. Airborne transmission may result in the hospital cluster.
Objectives To identify human-to-human transmission of H7N9 avian influenza virus, we investigated a hospital cluster combined with family cluster in this study. Methods We obtained and analyzed clinical, epidemiological and virological data from the three patients. RT-PCR, viral culture and sequencing were conducted for determination of causative pathogen. Results The index case presented developed pneumonia with fever after exposure to chicken in a poultry farm. Case A presented pneumonia with high fever on day 3 after she shared a hospital room with the index case. Case B, the father of the index case, presented pneumonia with high fever on day 15 after he took care of the index case. H7N9 virus circulated in the local farm to which the index case was exposed. Full genomic sequence of virus showed 99.8–100% identity shared between the index case and case A or case B. Compared to the earliest virus of Anhui, a total of 29 amino acid variation sites were observed in the 8 segments. Conclusions A hospital cluster combined with family cluster of H7N9 avian influenza infection was identified. Air transmission resulted in the hospital cluster possibly. A poultry farm was the initially infectious source of the cluster.
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Affiliation(s)
- Wenyan Zhang
- Hefei Center for Disease Control and Prevention, Heifei, Anhui Province, 230061, China
| | - Kefu Zhao
- Hefei Center for Disease Control and Prevention, Heifei, Anhui Province, 230061, China
| | - Jing Jin
- Hefei Center for Disease Control and Prevention, Heifei, Anhui Province, 230061, China
| | - Jun He
- Anhui Provincial Center for Disease Control and Prevention, Heifei, Anhui Province, 230601, China
| | - Wei Zhou
- Hefei Center for Disease Control and Prevention, Heifei, Anhui Province, 230061, China
| | - Jinju Wu
- Hefei Center for Disease Control and Prevention, Heifei, Anhui Province, 230061, China
| | - Renshu Tang
- Hefei Center for Disease Control and Prevention, Heifei, Anhui Province, 230061, China
| | - Wenbo Ma
- Lujiang County People's Hospital, Heifei, Anhui Province, 231501, China
| | - Caiyu Ding
- The Second Hospital of Anhui Medical University, Heifei, Anhui Province, 230601, China
| | - Wei Liu
- Hefei Center for Disease Control and Prevention, Heifei, Anhui Province, 230061, China
| | - Lei Zhang
- Hefei Center for Disease Control and Prevention, Heifei, Anhui Province, 230061, China
| | - Rongbao Gao
- National Institute for Viral Disease Control and Prevention, China CDC, Key Laboratory of Medical Virology and Viral Diseases, National Health Commission of People's Republic of China, Beijing, 102206, China.
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8
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Moise L, M Biron B, Boyle CM, Kurt Yilmaz N, Jang H, Schiffer C, M Ross T, Martin WD, De Groot AS. T cell epitope engineering: an avian H7N9 influenza vaccine strategy for pandemic preparedness and response. Hum Vaccin Immunother 2018; 14:2203-2207. [PMID: 30015562 PMCID: PMC6183197 DOI: 10.1080/21645515.2018.1495303] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The delayed availability of vaccine during the 2009 H1N1 influenza pandemic created a sense of urgency to better prepare for the next influenza pandemic. Advancements in manufacturing technology, speed and capacity have been achieved but vaccine effectiveness remains a significant challenge. Here, we describe a novel vaccine design strategy called immune engineering in the context of H7N9 influenza vaccine development. The approach combines immunoinformatic and structure modeling methods to promote protective antibody responses against H7N9 hemagglutinin (HA) by engineering whole antigens to carry seasonal influenza HA memory CD4+ T cell epitopes – without perturbing native antigen structure – by galvanizing HA-specific memory helper T cells that support sustained antibody development against the native target HA. The premise for this vaccine concept rests on (i) the significance of CD4+ T cell memory to influenza immunity, (ii) the essential role CD4+ T cells play in development of neutralizing antibodies, (iii) linked specificity of HA-derived CD4+ T cell epitopes to antibody responses, (iv) the structural plasticity of HA and (v) an illustration of improved antibody response to a prototype engineered recombinant H7-HA vaccine. Immune engineering can be applied to development of vaccines against pandemic concerns, including avian influenza, as well as other difficult targets.
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Affiliation(s)
- Leonard Moise
- a EpiVax, Inc ., Providence , RI , USA.,b Institute for Immunology and Informatics , University of Rhode Island , Providence , RI , USA.,c Department of Cell and Molecular Biology , University of Rhode Island , Providence , RI , USA
| | | | | | - Nese Kurt Yilmaz
- d Department of Biochemistry and Molecular Pharmacology , UMass Medical School , Worcester , MA , USA
| | - Hyesun Jang
- e Center for Vaccines and Immunology , University of Georgia , Athens , GA , USA
| | - Celia Schiffer
- d Department of Biochemistry and Molecular Pharmacology , UMass Medical School , Worcester , MA , USA
| | - Ted M Ross
- e Center for Vaccines and Immunology , University of Georgia , Athens , GA , USA.,f Department of Infectious Diseases , University of Georgia , Athens , GA , USA
| | | | - Anne S De Groot
- a EpiVax, Inc ., Providence , RI , USA.,b Institute for Immunology and Informatics , University of Rhode Island , Providence , RI , USA.,c Department of Cell and Molecular Biology , University of Rhode Island , Providence , RI , USA
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9
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Horman WSJ, Nguyen THO, Kedzierska K, Bean AGD, Layton DS. The Drivers of Pathology in Zoonotic Avian Influenza: The Interplay Between Host and Pathogen. Front Immunol 2018; 9:1812. [PMID: 30135686 PMCID: PMC6092596 DOI: 10.3389/fimmu.2018.01812] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/23/2018] [Indexed: 12/19/2022] Open
Abstract
The emergence of zoonotic strains of avian influenza (AI) that cause high rates of mortality in people has caused significant global concern, with a looming threat that one of these strains may develop sustained human-to-human transmission and cause a pandemic outbreak. Most notable of these viral strains are the H5N1 highly pathogenic AI and the H7N9 low pathogenicity AI viruses, both of which have mortality rates above 30%. Understanding of their mechanisms of infection and pathobiology is key to our preparation for these and future viral strains of high consequence. AI viruses typically circulate in wild bird populations, commonly infecting waterfowl and also regularly entering commercial poultry flocks. Live poultry markets provide an ideal environment for the spread AI and potentially the selection of mutants with a greater propensity for infecting humans because of the potential for spill over from birds to humans. Pathology from these AI virus infections is associated with a dysregulated immune response, which is characterized by systemic spread of the virus, lymphopenia, and hypercytokinemia. It has been well documented that host/pathogen interactions, particularly molecules of the immune system, play a significant role in both disease susceptibility as well as disease outcome. Here, we review the immune/virus interactions in both avian and mammalian species, and provide an overview or our understanding of how immune dysregulation is driven. Understanding these susceptibility factors is critical for the development of new vaccines and therapeutics to combat the next pandemic influenza.
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Affiliation(s)
- William S J Horman
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia.,Australian Animal Health Laboratory, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), East Geelong, VIC, Australia
| | - Thi H O Nguyen
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia
| | - Katherine Kedzierska
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Parkville, VIC, Australia
| | - Andrew G D Bean
- Australian Animal Health Laboratory, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), East Geelong, VIC, Australia
| | - Daniel S Layton
- Australian Animal Health Laboratory, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), East Geelong, VIC, Australia
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10
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Abstract
PURPOSE OF REVIEW The prevalence and incidence of viral nosocomial influenza infections in healthcare settings are underestimated. Nosocomial influenza outbreaks are frequent, and control remains challenging in acute care and long-term healthcare settings. This review examines recent publications on the determinants of nosocomial influenza prevention and control. RECENT FINDINGS Nosocomial influenza outbreaks occur in various healthcare settings, especially among the frail and elderly. The correct diagnosis is commonly missed because a substantial proportion of asymptomatic cases can transmit infections. Rapid diagnosis will facilitate rapid identification of cases and the implementation of control measures but needs confirmation in some circumstances, such as the description of transmission chains. Links between patients and healthcare personnel (HCP) have been well explored by phylogenetic virus characterization and need additional refinement and study. The preventive role of HCP vaccination in influenza incidence among patients should be investigated further in various settings to take into account different strategies for vaccination (i.e. voluntary or mandatory vaccination policies). Indeed, in Europe, influenza vaccination remains modest, whereas in North America hospitals and some states and provinces are now mandating influenza vaccination among HCP. The variability of vaccine effectiveness by seasonal epidemics is also an important consideration for control strategies. SUMMARY When influenza cases occur in the community, the risk of transmission and nosocomial cases increase in healthcare settings requiring vigilance among staff. Surveillance and early warning systems should be encouraged. Outbreak control needs appropriate identification of cases and transmission chains, and rapid implementation of control measures. Vaccination policies in conjunction with appropriate infection control measures could reduce virus spreading in hospitals. HCP vaccination coverage must be improved.
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11
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Liu B, Havers FP, Zhou L, Zhong H, Wang X, Mao S, Li H, Ren R, Xiang N, Shu Y, Zhou S, Liu F, Chen E, Zhang Y, Widdowson MA, Li Q, Feng Z. Clusters of Human Infections With Avian Influenza A(H7N9) Virus in China, March 2013 to June 2015. J Infect Dis 2017; 216:S548-S554. [PMID: 28934462 DOI: 10.1093/infdis/jix098] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Multiple clusters of human infections with novel avian influenza A(H7N9) virus have occurred since the virus was first identified in spring 2013. However, in many situations it is unclear whether these clusters result from person-to-person transmission or exposure to a common infectious source. We analyzed the possibility of person-to-person transmission in each cluster and developed a framework to assess the likelihood that person-to-person transmission had occurred. We described 21 clusters with 22 infected contact cases that were identified by the Chinese Center for Disease Control and Prevention from March 2013 through June 2015. Based on detailed epidemiological information and the timing of the contact case patients' exposures to infected persons and to poultry during their potential incubation period, we graded the likelihood of person-to-person transmission as probable, possible, or unlikely. We found that person-to-person transmission probably occurred 12 times and possibly occurred 4 times; it was unlikely in 6 clusters. Probable nosocomial transmission is likely to have occurred in 2 clusters. Limited person-to-person transmission is likely to have occurred on multiple occasions since the H7N9 virus was first identified. However, these transmission events represented a small fraction of all identified cases of H7N9 human infection, and sustained person-to-person transmission was not documented.
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Affiliation(s)
- Bo Liu
- Public Health Emergency Center
| | - Fiona P Havers
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Haojie Zhong
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou
| | - Xianjun Wang
- Shandong Provincial Center for Disease Control and Prevention, Jinan
| | - Shenghua Mao
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai
| | - Hai Li
- Guangxi Provincial Center for Disease Control and Prevention, Nanning
| | | | | | - Yuelong Shu
- Institute for Viral Disease Control and Prevention
| | - Suizan Zhou
- China Office, US Centers for Disease Control and Prevention, Beijing
| | - Fuqiang Liu
- Hunan Provincial Center for Disease Control and Prevention, Changsha City
| | - Enfu Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | | | - Marc-Alain Widdowson
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Qun Li
- Public Health Emergency Center
| | - Zijian Feng
- Chinese Center for Disease Control and Prevention
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12
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Affiliation(s)
- Ryan K Dare
- Division of Infectious Diseases, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Thomas R Talbot
- Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, 1161 21st Avenue South, Nashville, TN 37232, USA.
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13
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Abstract
Influenza is an acute respiratory illness, caused by influenza A, B, and C viruses, that occurs in local outbreaks or seasonal epidemics. Clinical illness follows a short incubation period and presentation ranges from asymptomatic to fulminant, depending on the characteristics of both the virus and the individual host. Influenza A viruses can also cause sporadic infections or spread worldwide in a pandemic when novel strains emerge in the human population from an animal host. New approaches to influenza prevention and treatment for management of both seasonal influenza epidemics and pandemics are desirable. In this Seminar, we discuss the clinical presentation, transmission, diagnosis, management, and prevention of seasonal influenza infection. We also review the animal-human interface of influenza, with a focus on current pandemic threats.
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Affiliation(s)
- Catharine Paules
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kanta Subbarao
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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14
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An avian influenza H7 DNA priming vaccine is safe and immunogenic in a randomized phase I clinical trial. NPJ Vaccines 2017; 2:15. [PMID: 29263871 PMCID: PMC5627236 DOI: 10.1038/s41541-017-0016-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 04/12/2017] [Accepted: 04/24/2017] [Indexed: 11/18/2022] Open
Abstract
A novel avian influenza subtype, A/H7N9, emerged in 2013 and represents a public health threat with pandemic potential. We have previously shown that DNA vaccine priming increases the magnitude and quality of antibody responses to H5N1 monovalent inactivated boost. We now report the safety and immunogenicity of a H7 DNA-H7N9 monovalent inactivated vaccine prime-boost regimen. In this Phase 1, open label, randomized clinical trial, we evaluated three H7N9 vaccination regimens in healthy adults, with a prime-boost interval of 16 weeks. Group 1 received H7 DNA vaccine prime and H7N9 monovalent inactivated vaccine boost. Group 2 received H7 DNA and H7N9 monovalent inactivated vaccine as a prime and H7N9 monovalent inactivated vaccine as a boost. Group 3 received H7N9 monovalent inactivated vaccine in a homologous prime-boost regimen. Overall, 30 individuals between 20 to 60 years old enrolled and 28 completed both vaccinations. All injections were well tolerated with no serious adverse events. 2 weeks post-boost, 50% of Group 1 and 33% of Group 2 achieved a HAI titer ≥1:40 compared with 11% of Group 3. Also, at least a fourfold increase in neutralizing antibody responses was seen in 90% of Group 1, 100% of Group 2, and 78% of Group 3 subjects. Peak neutralizing antibody geometric mean titers were significantly greater for Group 1 (GMT = 440.61, p < 0.05) and Group 2 (GMT = 331, p = 0.02) when compared with Group 3 (GMT = 86.11). A novel H7 DNA vaccine was safe, well-tolerated, and immunogenic when boosted with H7N9 monovalent inactivated vaccine, while priming for higher HAI and neutralizing antibody titers than H7N9 monovalent inactivated vaccine alone. A vaccine candidate to treat a deadly subtype of avian influenza was shown to induce protective antibodies in initial clinical trials. As of March 2017, avian influenza strain A/H7N9 has killed 497 people since 2013, with 1349 confirmed cases. Julie Ledgerwood and her team from the United States’ National Institutes of Health in collaboration with colleagues at the Centers for Disease Control and Prevention tested their two-stage vaccine protocol in humans, showing it to be effective and safe. The vaccine consists of an initial injection of viral DNA, which ‘primes’ the immune system to the pathogen, followed by a follow-up injection of an inactivated purified viral protein, which further boosts the host’s production of protective antibodies. The study shows the viability of this vaccine regimen and suggests further investigation into its appropriateness for treating avian influenza in humans.
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Comparative Epidemiology of Human Fatal Infections with Novel, High (H5N6 and H5N1) and Low (H7N9 and H9N2) Pathogenicity Avian Influenza A Viruses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030263. [PMID: 28273867 PMCID: PMC5369099 DOI: 10.3390/ijerph14030263] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 02/20/2017] [Accepted: 02/28/2017] [Indexed: 12/17/2022]
Abstract
This study aimed to assess the mortality risks for human infection with high (HPAI) and low (LPAI) pathogenicity avian influenza viruses. The HPAI case fatality rate (CFR) was far higher than the LPAI CFR [66.0% (293/444) vs. 68.75% (11/16) vs. 40.4% (265/656) vs. 0.0% (0/18) in the cases with H5N1, H5N6, H7N9, and H9N2 viruses, respectively; p < 0.001]. Similarly, the CFR of the index cases was greater than the secondary cases with H5N1 [100% (43/43) vs. 43.3% (42/97), p < 0.001]. Old age [22.5 vs. 17 years for H5N1, p = 0.018; 61 vs. 49 years for H7H9, p < 0.001], concurrent diseases [18.8% (15/80) vs. 8.33% (9/108) for H5N1, p = 0.046; 58.6% (156/266) vs. 34.8% (135/388) for H7H9, p < 0.001], delayed confirmation [13 vs. 6 days for H5N1, p < 0.001; 10 vs. 8 days for H7N9, p = 0.011] in the fatalities and survivors, were risk factors for deaths. With regard to the H5N1 clusters, exposure to poultry [67.4% (29/43) vs. 45.2% (19/42), p = 0.039] was the higher risk for the primary than the secondary deaths. In conclusion, old age, comorbidities, delayed confirmation, along with poultry exposure are the major risks contributing to fatal outcomes in human HPAI and LPAI infections.
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Wilson JR, Guo Z, Reber A, Kamal RP, Music N, Gansebom S, Bai Y, Levine M, Carney P, Tzeng WP, Stevens J, York IA. An influenza A virus (H7N9) anti-neuraminidase monoclonal antibody with prophylactic and therapeutic activity in vivo. Antiviral Res 2016; 135:48-55. [PMID: 27713074 DOI: 10.1016/j.antiviral.2016.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/16/2016] [Accepted: 10/03/2016] [Indexed: 12/09/2022]
Abstract
Zoonotic A(H7N9) avian influenza viruses emerged in China in 2013 and continue to be a threat to human public health, having infected over 800 individuals with a mortality rate approaching 40%. Treatment options for people infected with A(H7N9) include the use of neuraminidase (NA) inhibitors. However, like other influenza viruses, A(H7N9) can become resistant to these drugs. The use of monoclonal antibodies is a rapidly developing strategy for controlling influenza virus infection. Here we generated a murine monoclonal antibody (3c10-3) directed against the NA of A(H7N9) and show that prophylactic systemic administration of 3c10-3 fully protected mice from lethal challenge with wild-type A/Anhui/1/2013 (H7N9). Further, post-infection treatment with a single systemic dose of 3c10-3 at either 24, 48 or 72 h post A(H7N9) challenge resulted in both dose- and time-dependent protection of up to 100% of mice, demonstrating therapeutic potential for 3c10-3. Epitope mapping revealed that 3c10-3 binds near the enzyme active site of NA, and functional characterization showed that 3c10-3 inhibits the enzyme activity of NA and restricts the cell-to-cell spread of the virus in cultured cells. Affinity analysis also revealed that 3c10-3 binds equally well to recombinant NA of wild-type A/Anhui/1/2013 and to a variant NA carrying a R289K mutation known to infer NAI resistance. These results suggest that 3c10-3 has the potential to be used as a therapeutic to treat A(H7N9) infections either as an alternative to, or in combination with, current NA antiviral inhibitors.
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Affiliation(s)
- Jason R Wilson
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA; Carter Consulting, Inc., Atlanta, GA, USA
| | - Zhu Guo
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adrian Reber
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ram P Kamal
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA; Battelle Memorial Institute, Atlanta, GA, USA
| | - Nedzad Music
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA; Battelle Memorial Institute, Atlanta, GA, USA
| | - Shane Gansebom
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA; Carter Consulting, Inc., Atlanta, GA, USA
| | - Yaohui Bai
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Min Levine
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul Carney
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wen-Pin Tzeng
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James Stevens
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ian A York
- Influenza Division, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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