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Haaland RE, Fountain J, Edwards TE, Dinh C, Martin A, Omoyege D, Conway-Washington C, Kelley CF, Heneine W. Pharmacokinetics of single dose doxycycline in the rectum, vagina, and urethra: implications for prevention of bacterial sexually transmitted infections. EBioMedicine 2024; 101:105037. [PMID: 38428259 PMCID: PMC10910237 DOI: 10.1016/j.ebiom.2024.105037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Clinical trials showed a single oral dose of doxycycline taken after sex protects against STIs among men who have sex with men (MSM) but not women. Pharmacokinetic data at vaginal, rectal and penile sites of STI exposure are lacking. We examined vaginal, rectal and urethral doxycycline concentrations in men and women to better inform STI prevention. METHODS Doxycycline pharmacokinetics in male and female participants 18-59 years of age were evaluated in blood and urine and on rectal and vaginal swabs collected at 1, 2, 4, 8, 24, 48, 72, 96 and 168 h after receiving a 200 mg oral doxycycline dose in a non-randomised single dose open label single centre study in Atlanta, Georgia. Rectal, vaginal, and cervical biopsies and male urethral swabs were collected 24 h after dosing (Trial registration: NCT04860505). Doxycycline was measured by liquid chromatography-mass spectrometry. FINDINGS Eleven male and nine female participants participated in the study. Doxycycline concentrations on rectal and vaginal swabs collected up to 96 h after dosing were approximately twice those of plasma and remained above minimum inhibitory concentrations (MICs) for at least four, three, and two days for Chlamydia trachomatis, Treponema pallidum, and tetracycline-sensitive Neisseria gonorrhoeae, respectively. Geometric mean doxycycline concentrations in male urethral secretions (1.166 μg/mL; 95% CI 0.568-2.394 μg/mL), male rectal (0.596 μg/g; 0.442-0.803 μg/g), vaginal (0.261 μg/g; 0.098-0.696 μg/g) and cervical tissue (0.410 μg/g; 0.193-0.870 μg/g) in biopsies collected 24 h after dosing exceeded MICs. Plasma and urine doxycycline levels defined adherence markers up to four and seven days postdosing, respectively. No adverse events were reported in this study. INTERPRETATION Doxycycline efficiently distributes to the rectum, vagina and urethra. Findings can help explain efficacy of STI prevention by doxycycline. FUNDING Funded by CDC intramural funds, CDC contract HCVJCG-2020-45044 (to CFK).
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Affiliation(s)
- Richard E Haaland
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Jeffrey Fountain
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tiancheng E Edwards
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chuong Dinh
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amy Martin
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deborah Omoyege
- The Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Christopher Conway-Washington
- The Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Colleen F Kelley
- The Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Walid Heneine
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Scanlon F, Remch M, Scheidell JD, Brewer R, Dyer TV, Albis-Burdige B, Irvine N, Turpin R, Parker S, Cleland CM, Hucks-Ortiz C, Gaydos CA, Mayer KH, Khan MR. Posttraumatic Stress Disorder Symptoms and Incarceration: The Impact on Sexual Risk-Taking, Sexually Transmitted Infections, and Depression Among Black Sexual Minority Men in HIV Prevention Trials Network (HPTN) 061. PSYCHOLOGY OF MEN & MASCULINITY 2024; 25:44-56. [PMID: 38854997 PMCID: PMC11156418 DOI: 10.1037/men0000458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Black men and people belonging to sexual minority groups are disproportionately impacted by criminal legal involvement and sexually transmitted infections (STIs). Traumatic experiences are often associated with later criminal legal involvement, depression symptoms, sexual risk behavior, and STIs. Research on the joint influence of trauma and incarceration on STI risk among racial and/or sexual minority people is limited. This study tested the association between post-traumatic stress disorder (PTSD) symptoms and incarceration on sexual risk behavior and STI among Black sexual minority men, a population that may be at higher risk for contracting STIs. Using data from the HIV Prevention Trials Network 061 Study, a longitudinal study of adult Black sexual minority men in six U.S. cities (N = 855), we tested associations between past six-month incarceration and subsequent sexual risk behavior, STI, and depression symptoms, for those with and without pre-incarceration PTSD symptoms. PTSD symptoms were elevated among participants who reported Hispanic ethnicity, having sex with both men and women, and previous incarceration. Although there were not significant differences between recent incarceration and sexual risk for those with and without PTSD, incarceration was linked to some sexual risk behaviors regardless of PTSD symptoms. Among people with PTSD symptoms, there was a higher prevalence of sexual risk and depression symptoms, regardless of incarceration. These findings suggest a potentially compounding influence of PTSD symptoms and incarceration on sexual risk and infection among Black sexual minority men.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sharon Parker
- North Carolina Agricultural and Technical State University
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Abou Chacra L, Ly C, Hammoud A, Iwaza R, Mediannikov O, Bretelle F, Fenollar F. Relationship between Bacterial Vaginosis and Sexually Transmitted Infections: Coincidence, Consequence or Co-Transmission? Microorganisms 2023; 11:2470. [PMID: 37894128 PMCID: PMC10609101 DOI: 10.3390/microorganisms11102470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/23/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023] Open
Abstract
Sexually transmitted infections (STIs) are a serious global problem, causing disease, suffering, and death. Although bacterial vaginosis (BV) is not considered to be an STI, it may be associated with an increased risk of contracting a wide range of STIs. We sought to assess the link between the different microorganisms involved in STIs and BV. A total of 290 vaginal swabs from 290 women sent for diagnostic purposes to the clinical microbiology laboratory of the Marseille University Public Hospitals were tested by specific qPCR targeting STI-causing microorganisms and BV. Of these 290 swabs, 15.2% (44/290) were diagnosed with at least one STI-causing microorganism and 17.2% (50/290) with BV. The prevalence of STIs was significantly higher in women with BV (28%, 14/50) than in those without (20.4%, 51/240). The prevalence of co-infections involving two STI-causing microorganisms was significantly more frequent in women with BV than in those without (18% [8/50] vs. 2% [5/250]; p < 0.001). The prevalence of monoinfections and polyinfections with STI-causing microorganisms was lower in women without BV than in those with (8.8% [21/240] vs. 28% [14/50]), p < 0.001 and 2% (5/240) vs. 8% (4/50), p = 0.05, respectively). Our data suggest that a correlation between BV and STI may exist, with a higher prevalence of both monoinfections and polyinfections involving STI-causing microorganisms in women with BV. Further research is needed to better understand BV and its links to STIs.
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Affiliation(s)
- Linda Abou Chacra
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
| | - Claudia Ly
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
| | - Alissa Hammoud
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
| | - Rim Iwaza
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
| | - Oleg Mediannikov
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
| | - Florence Bretelle
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France;
- Department of Gynaecology and Obstetrics, Gynépole, La Conception, AP-HM, 13005 Marseille, France
| | - Florence Fenollar
- Campus Santé Timone, Aix-Marseille University, IRD, AP-HM, SSA, VITROME, 13005 Marseille, France; (L.A.C.); (C.L.)
- IHU-Méditerranée Infection, 13005 Marseille, France (R.I.); (O.M.)
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Luetkemeyer AF, Donnell D, Dombrowski JC, Cohen S, Grabow C, Brown CE, Malinski C, Perkins R, Nasser M, Lopez C, Vittinghoff E, Buchbinder SP, Scott H, Charlebois ED, Havlir DV, Soge OO, Celum C. Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections. N Engl J Med 2023; 388:1296-1306. [PMID: 37018493 PMCID: PMC10140182 DOI: 10.1056/nejmoa2211934] [Citation(s) in RCA: 119] [Impact Index Per Article: 119.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
BACKGROUND Interventions to reduce sexually transmitted infections (STIs) among men who have sex with men (MSM) are needed. METHODS We conducted an open-label, randomized study involving MSM and transgender women who were taking preexposure prophylaxis (PrEP) against human immunodeficiency virus (HIV) infection (PrEP cohort) or living with HIV infection (persons living with HIV infection [PLWH] cohort) and who had had Neisseria gonorrhoeae (gonorrhea), Chlamydia trachomatis (chlamydia), or syphilis in the past year. Participants were randomly assigned in a 2:1 ratio to take 200 mg of doxycycline within 72 hours after condomless sex (doxycycline postexposure prophylaxis) or receive standard care without doxycycline. STI testing was performed quarterly. The primary end point was the incidence of at least one STI per follow-up quarter. RESULTS Of 501 participants (327 in the PrEP cohort and 174 in the PLWH cohort), 67% were White, 7% Black, 11% Asian or Pacific Islander, and 30% Hispanic or Latino. In the PrEP cohort, an STI was diagnosed in 61 of 570 quarterly visits (10.7%) in the doxycycline group and 82 of 257 quarterly visits (31.9%) in the standard-care group, for an absolute difference of -21.2 percentage points and a relative risk of 0.34 (95% confidence interval [CI], 0.24 to 0.46; P<0.001). In the PLWH cohort, an STI was diagnosed in 36 of 305 quarterly visits (11.8%) in the doxycycline group and 39 of 128 quarterly visits (30.5%) in the standard-care group, for an absolute difference of -18.7 percentage points and a relative risk of 0.38 (95% CI, 0.24 to 0.60; P<0.001). The incidences of the three evaluated STIs were lower with doxycycline than with standard care; in the PrEP cohort, the relative risks were 0.45 (95% CI, 0.32 to 0.65) for gonorrhea, 0.12 (95% CI, 0.05 to 0.25) for chlamydia, and 0.13 (95% CI, 0.03 to 0.59) for syphilis, and in the PLWH cohort, the relative risks were 0.43 (95% CI, 0.26 to 0.71), 0.26 (95% CI, 0.12 to 0.57), and 0.23 (95% CI, 0.04 to 1.29), respectively. Five grade 3 adverse events and no serious adverse events were attributed to doxycycline. Of the participants with gonorrhea culture available, tetracycline-resistant gonorrhea occurred in 5 of 13 in the doxycycline groups and 2 of 16 in the standard-care groups. CONCLUSIONS The combined incidence of gonorrhea, chlamydia, and syphilis was lower by two thirds with doxycycline postexposure prophylaxis than with standard care, a finding that supports its use among MSM with recent bacterial STIs. (Funded by the National Institutes of Health; DoxyPEP ClinicalTrials.gov number, NCT03980223.).
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Affiliation(s)
- Anne F Luetkemeyer
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Deborah Donnell
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Julia C Dombrowski
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Stephanie Cohen
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Cole Grabow
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Clare E Brown
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Cheryl Malinski
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Rodney Perkins
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Melody Nasser
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Carolina Lopez
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Eric Vittinghoff
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Susan P Buchbinder
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Hyman Scott
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Edwin D Charlebois
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Diane V Havlir
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Olusegun O Soge
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
| | - Connie Celum
- From Zuckerberg San Francisco General Hospital and Trauma Center (A.F.L., C.L., D.V.H.), and the Departments of Medicine (A.F.L., S.C., C.L., E.V., D.V.H.) and Epidemiology and Biostatistics (E.D.C), University of California, San Francisco, and San Francisco Department of Public Health, Population Health Division (S.C., M.N., S.P.B., H.S.) - both in San Francisco; and Fred Hutchinson Cancer Center (D.D.), the Departments of Medicine (J.C.D., O.O.S., C.C.), Global Health (C.G., C.E.B., R.P., O.O.S., C.C.), and Epidemiology (C.C.), and the School of Nursing (R.P.), University of Washington, and Public Health-Seattle and King County (J.C.D., C.M.) - all in Seattle
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Wang S, Luan J, Chen L, Liu H, Li W, Wang J. Computational characteristics of the structure-activity relationship of inhibitors targeting Pks13-TE domain. Comput Biol Chem 2023; 104:107864. [PMID: 37028177 DOI: 10.1016/j.compbiolchem.2023.107864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/22/2023] [Accepted: 04/01/2023] [Indexed: 04/09/2023]
Abstract
Multiple studies have established the Pks13-TE domain as a promising target for anti-tuberculosis drug development. However, recent findings have revealed that the lead compound currently in the pipeline for Pks13-TE has significant cardiotoxicity issues. Given the pressing need for new chemical structures for Pks13-TE inhibitors, this study aims to provide a detailed understanding of the Pks13-TE domain binding site through the application of computational chemical biology techniques. Our results highlight the size and shape of the Pks13-TE domain binding pocket, key residues including Asp1644, Asn1640, Phe1670, and Tyr1674 within the pocket, and inhibitor pharmacophore characteristics such as aromatic ring sites, positively charged sites, and hydrogen bond donors. To our knowledge, these simulation results are novel and contribute to the discovery of next-generation Pks13-TE inhibitors without similar prior studies.
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Affiliation(s)
- Shizun Wang
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang 110016, China; Key Laboratory of Intelligent Drug Design and New Drug Discovery of Liaoning Province, Shenyang Pharmaceutical University, Shenyang 110016, China; School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Jiasi Luan
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang 110016, China; Key Laboratory of Intelligent Drug Design and New Drug Discovery of Liaoning Province, Shenyang Pharmaceutical University, Shenyang 110016, China; School of Medical Devices, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Lu Chen
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang 110016, China; Key Laboratory of Intelligent Drug Design and New Drug Discovery of Liaoning Province, Shenyang Pharmaceutical University, Shenyang 110016, China; School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Haihan Liu
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang 110016, China; Key Laboratory of Intelligent Drug Design and New Drug Discovery of Liaoning Province, Shenyang Pharmaceutical University, Shenyang 110016, China; School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Weixia Li
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang 110016, China; Key Laboratory of Intelligent Drug Design and New Drug Discovery of Liaoning Province, Shenyang Pharmaceutical University, Shenyang 110016, China; School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Jian Wang
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, Shenyang Pharmaceutical University, Shenyang 110016, China; Key Laboratory of Intelligent Drug Design and New Drug Discovery of Liaoning Province, Shenyang Pharmaceutical University, Shenyang 110016, China; School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Shenyang 110016, China.
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Shifting the power: scale-up of access to point-of-care and self-testing for sexually transmitted infections in low-income and middle-income settings. Curr Opin Infect Dis 2023; 36:49-56. [PMID: 36753705 DOI: 10.1097/qco.0000000000000895] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE OF REVIEW Point-of-care (POC) testing for sexually transmitted infections (STIs) can provide complementary coverage to existing HIV testing services in LMICs. This review summarizes current and emerging technologies for detecting STIs in LMICs, with an emphasis on women, discharge-causing infections (chlamydia, gonorrhoea, trichomoniasis, and syphilis), true POC, self-testing, ethics, and economic considerations related to equitable access. RECENT FINDINGS The WHO have recently adapted guidelines for treatment of STIs in women that advise the use of true-POC or near-POC tests to improve case finding. The number of rapid, sensitive, and specific POC diagnostics for STIs has increased significantly over the past 10 years, although adoption of these in low-income and middle-income countries (LMICs) remains limited. Barriers to POC adoption by patients include the cost of tests, the inconvenience of lengthy clinic visits, low perceived risk, stigma, lack of partner notification, and lack of trust in healthcare providers. Lowering the cost of true POC lateral flow devices, interfacing these with digital or eHealth technologies, and enabling self-testing/self-sampling will overcome some of these barriers in LMICs. Ensuring linkage of diagnostic tests to subsequent care remains one of the major concerns about self-testing, irrespective of geography, although available evidence from HIV self-testing suggests that linkage to care is similar to that for facility-based testing. SUMMARY Increasing access to sensitive STI true POC tests will strengthen reproductive healthcare in LMICs. Although HIV self-testing is demonstrably useful in LMICs, there is an urgent need for randomized trials evaluating the utility and cost-effectiveness of similar tests for other sexually transmitted infections.
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Young MR, Broadwell C, Kacanek D, Chadwick EG, Jao J, Moscicki AB, Powis K, Tassiopoulos K, Yee LM, Haddad LB. Sexually Transmitted Infections in Pregnant People With Human Immunodeficiency Virus: Temporal Trends, Demographic Correlates, and Association With Preterm Birth. Clin Infect Dis 2022; 75:2211-2218. [PMID: 35486952 PMCID: PMC10200300 DOI: 10.1093/cid/ciac321] [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] [Received: 11/09/2021] [Revised: 03/29/2022] [Accepted: 04/18/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND We describe trends in prevalence and identify factors associated with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), syphilis, and Trichomonas vaginalis (TV) diagnosed in pregnancy among US people with human immunodeficiency virus (PWH) and evaluate associations of sexually transmitted infections (STIs) with preterm birth (PTB). METHODS We included pregnant PWH enrolled in the Surveillance Monitoring for ART Toxicities dynamic cohort of the Pediatric HIV/AIDS Cohort Study network who delivered between 2010 and 2019. Multivariable log-binomial or Poisson generalized estimating equation models were used to estimate the association of calendar year with each STI, controlling for confounders; the association of demographic and clinical factors with each STI; and the association of each STI with PTB. RESULTS The sample included 2241 pregnancies among 1821 PWH. Median age at delivery was 29.2 years; 71% of participants identified as Black or African American. STI prevalence was: CT 7.7%, NG 2.3%, syphilis 2.4%, and TV 14.5%; 30% had unknown TV status. There were no temporal changes in STI prevalence. Younger age and initial HIV viral load ≥400 copies/mL were associated with increased risk of CT, NG, and TV. Recreational substance use was a risk factor for NG, syphilis, and TV. No STI was associated with PTB. CONCLUSIONS Unlike nationwide trends, no changes in STI prevalence during the study period were observed. The large proportion with unknown TV status underscores the need for increased adherence to screening guidelines. STIs diagnosed during pregnancy in PWH were not associated with risk of PTB.
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Affiliation(s)
- Marisa R Young
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Carly Broadwell
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Deborah Kacanek
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ellen G Chadwick
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jennifer Jao
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anna-Barbara Moscicki
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, California, USA
| | - Kathleen Powis
- Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Katherine Tassiopoulos
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lynn M Yee
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lisa B Haddad
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
- Population Council, Center for Biomedical Research, New York, New York, USA
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Barros GMC, Carvalho DDA, Cruz AS, Morais EKL, Sales-Moioli AIL, Pinto TKB, Almeida MCD, Sanchez-Gendriz I, Fernandes F, Barbalho IMP, Santos JPQ, Henriques JMO, Teixeira CAD, Gil P, Gama L, Miranda AE, Coutinho KD, Galvão-Lima LJ, Valentim RAM. Development of a Cyclic Voltammetry-Based Method for the Detection of Antigens and Antibodies as a Novel Strategy for Syphilis Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16206. [PMID: 36498280 PMCID: PMC9738993 DOI: 10.3390/ijerph192316206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
The improvement of laboratory diagnosis is a critical step for the reduction of syphilis cases around the world. In this paper, we present the development of an impedance-based method for detecting T. pallidum antigens and antibodies as an auxiliary tool for syphilis laboratory diagnosis. We evaluate the voltammetric signal obtained after incubation in carbon or gold nanoparticle-modified carbon electrodes in the presence or absence of Poly-L-Lysine. Our results indicate that the signal obtained from the electrodes was sufficient to distinguish between infected and non-infected samples immediately (T0') or 15 min (T15') after incubation, indicating its potential use as a point-of-care method as a screening strategy.
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Affiliation(s)
- Gabriel M. C. Barros
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Dionísio D. A. Carvalho
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Agnaldo S. Cruz
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Ellen K. L. Morais
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Ana Isabela L. Sales-Moioli
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Talita K. B. Pinto
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
- Health Sciences Research Unit: Nursing (UICISA:E), The Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Melise C. D. Almeida
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Ignacio Sanchez-Gendriz
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Felipe Fernandes
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Ingridy M. P. Barbalho
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - João P. Q. Santos
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Jorge M. O. Henriques
- Centre for Informatics and Systems of the University of Coimbra (CISUC), Department of Informatics Engineering, University of Coimbra, 3004-531 Coimbra, Portugal
| | - César A. D. Teixeira
- Centre for Informatics and Systems of the University of Coimbra (CISUC), Department of Informatics Engineering, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Paulo Gil
- Department of Electrical and Computer Engineering, School of Science and Technology, New University of Lisbon, 1099-085 Lisbon, Portugal
| | - Lúcio Gama
- Department of Molecular and Comparative Biology, School of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Angélica E. Miranda
- Postgraduate Program in Infectious Diseases, Federal University of Espírito Santo, Vitória 29075-910, Brazil
| | - Karilany D. Coutinho
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Leonardo J. Galvão-Lima
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Hospital Universitário Onofre Lopes, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
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Hirsch MS, Hooper DC. Thank You-Tony Fauci. J Infect Dis 2022; 226:1861-1862. [PMID: 36441645 DOI: 10.1093/infdis/jiac381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 01/06/2024] Open
Affiliation(s)
- Martin S Hirsch
- Infectious Disease Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - David C Hooper
- Infectious Disease Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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10
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Dawkins M, Bishop L, Walker P, Otmaskin D, Ying J, Schmidt R, Harnett G, Abraham T, Gaydos CA, Schoolnik G, DiBenedetto K. Clinical Integration of a Highly Accurate Polymerase Chain Reaction Point-of-Care Test Can Inform Immediate Treatment Decisions for Chlamydia, Gonorrhea, and Trichomonas. Sex Transm Dis 2022; 49:262-267. [PMID: 34813579 DOI: 10.1097/olq.0000000000001586] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Accurate same-day sexually transmitted infection (STI) diagnostic testing is generally unavailable, leading to syndromic management with high rates of overtreatment and undertreatment. We analyzed the ease of integration of the Visby STI Panel into clinical practice, studied acceptance by patients and clinic personnel, and assessed the potential to inform accurate treatment decisions. METHODS In a cross-sectional single-visit study of 55 women aged 18 to 56 years, women self-collected vaginal swab samples that were analyzed using the Visby STI Panel for Chlamydia trachomatis, Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV). Results were compared with standard-of-care clinic results from send-out laboratory polymerase chain reaction tests. Surveys assessed patient and device operator experiences with the Visby STI Panel and clinicians' perceived need for and acceptance of the device. Time parameters were measured to evaluate the impact on clinical workflow, and syndromic treatment decisions were compared with anticipated treatment based on the Visby STI Panel results. RESULTS Patients strongly agreed that sample self-collection was easy, and operators reported the device easy to use. Clinicians valued the rapid return of results, and patients were comfortable waiting up to 30 minutes to receive them. In 13 of 15 cases, the Visby STI Panel correctly identified undertreated patients as infected and correctly identified all 33 incidences of overtreatment. CONCLUSIONS Clinical adoption of the Visby STI Panel into primary care clinics and doctors' offices could reduce overtreatment and undertreatment of STIs. If integrated efficiently into the clinical workflow, the test would have minimal impact on staff time and visit duration for patients.
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Affiliation(s)
- Megan Dawkins
- From the Premier Health Urgent Care, Baton Rouge, LA
| | - Lisa Bishop
- From the Premier Health Urgent Care, Baton Rouge, LA
| | | | | | | | | | | | | | - Charlotte A Gaydos
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
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11
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Scurtu LG, Jinga V, Simionescu O. Fascinating Molecular and Immune Escape Mechanisms in the Treatment of STIs (Syphilis, Gonorrhea, Chlamydia, and Herpes Simplex). Int J Mol Sci 2022; 23:ijms23073550. [PMID: 35408911 PMCID: PMC8998805 DOI: 10.3390/ijms23073550] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023] Open
Abstract
The incidence of syphilis, gonorrhea, chlamydia, and herpes simplex has increased over the last decade, despite the numerous prevention strategies. Worldwide scientists report a surge in drug-resistant infections, particularly in immunocompromised patients. Antigenic variations in syphilis enable long-term infection, but benzathine penicillin G maintains its efficiency, whereas macrolides should be recommended with caution. Mupirocin and zoliflodacin were recently introduced as therapies against ceftriaxone-resistant gonococcus, which poses a larger global threat. The gastrointestinal and prostatic potential reservoirs of Chlamydia trachomatis may represent the key towards complete eradication. Similar to syphilis, macrolides resistance has to be considered in genital chlamydiosis. Acyclovir-resistant HSV may respond to the novel helicase-primase inhibitors and topical imiquimod, particularly in HIV-positive patients. Novel drugs can overcome these challenges while nanocarriers enhance their potency, particularly in mucosal areas. This review summarizes the most recent and valuable discoveries regarding the immunopathogenic mechanisms of these sexually transmitted infections and discusses the challenges and opportunities of the novel molecules and nanomaterials.
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Affiliation(s)
- Lucian G. Scurtu
- Department of Dermatology I, Colentina Clinical Hospital, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020125 Bucharest, Romania;
| | - Viorel Jinga
- Department of Urology, Clinical Hospital Prof. Dr. Th. Burghele, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 030167 Bucharest, Romania;
| | - Olga Simionescu
- Department of Dermatology I, Colentina Clinical Hospital, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020125 Bucharest, Romania;
- Correspondence:
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12
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Ma Z, Gharizadeh B, Cai X, Li M, Fellner MD, Basiletti JA, Correa RM, Colucci MC, Baldoni G, Vacchino M, Galarza P, Picconi MA, Wang C. A comprehensive HPV-STI NGS assay for detection of 29 HPV types and 14 non-HPV sexually transmitted infections. Infect Agent Cancer 2022; 17:9. [PMID: 35313939 PMCID: PMC8935747 DOI: 10.1186/s13027-022-00420-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) are prevalent throughout the world and impose a significant burden on individual health and public health systems. Missed diagnosis and late treatment of STIs can lead to serious complications such as infertility and cervical cancer. Although sexually transmitted co-infections are common, most commercial assays target one or a few STIs. The HPV-STI ChapterDx Next Generation Sequencing (NGS) assay detects and quantifies 29 HPVs and 14 other STIs in a single-tube and single-step PCR reaction and can be applied to tens to thousands of samples in a single sequencing run. METHODS A cohort of 274 samples, previously analyzed by conventional cytology/histology and Roche cobas HPV Test, were analyzed by ChapterDx HPV-STI NGS assay for detection of 43 HPV and STI. A set of 43 synthetic control DNA fragments for 43 HPV and STI were developed to evaluate the limit of detection, specificity, and sensitivity of ChapterDx HPV-STI NGS assay. RESULTS The assay was evaluated in this study, and the limit of detection was 100% at 50 copies for all targets, and 100%, 96%, 88% at 20 copies for 34, 8, and 1 target, respectively. The performance of this assay has been compared to Roche cobas HPV test, showing an overall agreement of 97.5% for hr-HPV, and 98.5% for both, HPV16 and HPV18. The assay also detected all HPV-infected CIN2/3 with 100% agreement with Roche cobas HPV results. Moreover, several co-infections with non-HPV STIs, such as C. trachomatis, T. vaginalis, M. genitalium, and HSV2 were identified. CONCLUSIONS The ChapterDx HPV-STI NGS assay is a user-friendly, easy to automate and cost-efficient assay, which provides accurate and comprehensive results for a wide spectrum of HPVs and STIs.
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Affiliation(s)
- Zhihai Ma
- Chapter Diagnostics Inc., 1455 Adams Drive, Menlo Park, CA, 94025, USA
| | - Baback Gharizadeh
- Chapter Diagnostics Inc., 1455 Adams Drive, Menlo Park, CA, 94025, USA
| | - Xingsheng Cai
- Maijing Gene Medical Technology, No. 9, Spiral 4th Road, International Biological Island, Guangzhou, China
| | - Mengzhen Li
- Maijing Gene Medical Technology, No. 9, Spiral 4th Road, International Biological Island, Guangzhou, China
| | - María Dolores Fellner
- Oncogenic Viruses Service, National and Regional HPV Reference Laboratory, National Institute of Infectious Diseases-ANLIS "Dr. Malbrán", Av. Velez Sarsfield 563, C1282AFF, Buenos Aires, Argentina
| | - Jorge Alejandro Basiletti
- Oncogenic Viruses Service, National and Regional HPV Reference Laboratory, National Institute of Infectious Diseases-ANLIS "Dr. Malbrán", Av. Velez Sarsfield 563, C1282AFF, Buenos Aires, Argentina
| | - Rita Mariel Correa
- Oncogenic Viruses Service, National and Regional HPV Reference Laboratory, National Institute of Infectious Diseases-ANLIS "Dr. Malbrán", Av. Velez Sarsfield 563, C1282AFF, Buenos Aires, Argentina
| | - María Celeste Colucci
- Oncogenic Viruses Service, National and Regional HPV Reference Laboratory, National Institute of Infectious Diseases-ANLIS "Dr. Malbrán", Av. Velez Sarsfield 563, C1282AFF, Buenos Aires, Argentina
| | - Gabriela Baldoni
- Sexually Transmitted Diseases Service, National Reference Laboratory for STDs, National Institute of Infectious Diseases-ANLIS "Dr. Malbrán", Av. Velez Sarsfield 563, C1282AFF, Buenos Aires, Argentina
| | - Martín Vacchino
- Sexually Transmitted Diseases Service, National Reference Laboratory for STDs, National Institute of Infectious Diseases-ANLIS "Dr. Malbrán", Av. Velez Sarsfield 563, C1282AFF, Buenos Aires, Argentina
| | - Patricia Galarza
- Sexually Transmitted Diseases Service, National Reference Laboratory for STDs, National Institute of Infectious Diseases-ANLIS "Dr. Malbrán", Av. Velez Sarsfield 563, C1282AFF, Buenos Aires, Argentina
| | - María Alejandra Picconi
- Oncogenic Viruses Service, National and Regional HPV Reference Laboratory, National Institute of Infectious Diseases-ANLIS "Dr. Malbrán", Av. Velez Sarsfield 563, C1282AFF, Buenos Aires, Argentina
| | - Chunlin Wang
- Chapter Diagnostics Inc., 1455 Adams Drive, Menlo Park, CA, 94025, USA.
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13
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Otu A, Danhoundo G, Toskin I, Govender V, Yaya S. Refocusing on sexually transmitted infections (STIs) to improve reproductive health: a call to further action. Reprod Health 2021; 18:242. [PMID: 34852842 PMCID: PMC8634744 DOI: 10.1186/s12978-021-01296-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Akaninyene Otu
- Department of Infection and Travel Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Department of Internal Medicine, College of Medical Sciences, University of Calabar, Calabar, Cross River State, Nigeria
| | - Georges Danhoundo
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Igor Toskin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Veloshnee Govender
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, Imperial College London, London, UK.
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Stewart J, Baeten JM. HIV pre-exposure prophylaxis and sexually transmitted infections: intersection and opportunity. Nat Rev Urol 2021; 19:7-15. [PMID: 34697493 DOI: 10.1038/s41585-021-00527-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 12/29/2022]
Abstract
Pre-exposure prophylaxis (PrEP) has revolutionized HIV prevention, but PrEP does not protect against other sexually transmitted infections (STIs). Rates of STIs are rising worldwide, with notably high incidences among PrEP-using men who have sex with men in high-income countries; in low-income and middle-income countries, data are sparse, but results from a limited number of studies among African women initiating and taking PrEP have shown high STI prevalence and incidence. Efforts aimed at markedly reducing HIV in populations worldwide include a major focus on increasing PrEP use, along with improving HIV testing and treatment in order to eliminate HIV transmission. Together, these efforts could augment continued expansion of the global STI epidemic, but they could alternatively create an opportunity to improve STI control, including the development of comprehensive sexual health programmes and research to develop new STI prevention strategies. The introduction of PrEP globally has been characterized by challenges and many successes, and its role as part of a range of robust strategies to reduce HIV infections is clear. Looking ahead, understanding rising rates of curable STIs and their relationship to HIV prevention, and considering the future directions for synergies in PrEP and STI prevention will be integral to improving sexual health.
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Affiliation(s)
- Jenell Stewart
- Department of Medicine, University of Washington, Seattle, WA, USA. .,Department of Global Health, University of Washington, Seattle, WA, USA.
| | - Jared M Baeten
- Department of Medicine, University of Washington, Seattle, WA, USA.,Department of Global Health, University of Washington, Seattle, WA, USA.,Epidemiology, University of Washington, Seattle, WA, USA
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15
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Tam CC, Nguyen K, Nguyen D, Hamada S, Kwon O, Kuang I, Gong S, Escobar S, Liu M, Kim J, Hou T, Tam J, Cheng LW, Kim JH, Land KM, Friedman M. Antimicrobial properties of tomato leaves, stems, and fruit and their relationship to chemical composition. BMC Complement Med Ther 2021; 21:229. [PMID: 34517859 PMCID: PMC8436577 DOI: 10.1186/s12906-021-03391-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/17/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND We previously reported that the tomato glycoalkaloid tomatine inhibited the growth of Trichomonas vaginalis strain G3, Tritrichomonas foetus strain D1, and Tritrichomonas foetus-like strain C1 that cause disease in humans and farm and domesticated animals. The increasing prevalence of antibiotic resistance requires development of new tools to enhance or replace medicinal antibiotics. METHODS Wild tomato plants were harvested and divided into leaves, stems, and fruit of different colors: green, yellow, and red. Samples were freeze dried and ground with a handheld mill. The resulting powders were evaluated for their potential anti-microbial effects on protozoan parasites, bacteria, and fungi. A concentration of 0.02% (w/v) was used for the inhibition of protozoan parasites. A high concentration of 10% (w/v) solution was tested for bacteria and fungi as an initial screen to evaluate potential anti-microbial activity and results using this high concentration limits its clinical relevance. RESULTS Natural powders derived from various parts of tomato plants were all effective in inhibiting the growth of the three trichomonads to varying degrees. Test samples from leaves, stems, and immature 'green' tomato peels and fruit, all containing tomatine, were more effective as an inhibitor of the D1 strain than those prepared from yellow and red tomato peels which lack tomatine. Chlorogenic acid and quercetin glycosides were present in all parts of the plant and fruit, while caffeic acid was only found in the fruit peels. Any correlation between plant components and inhibition of the G3 and C1 strains was not apparent, although all the powders were variably effective. Tomato leaf was the most effective powder in all strains, and was also the highest in tomatine. S. enterica showed a minor susceptibility while B. cereus and C. albicans fungi both showed a significant growth inhibition with some of the test powders. The powders inhibited growth of the pathogens without affecting beneficial lactobacilli found in the normal flora of the vagina. CONCLUSIONS The results suggest that powders prepared from tomato leaves, stems, and green tomato peels and to a lesser extent from peels from yellow and red tomatoes offer potential multiple health benefits against infections caused by pathogenic protozoa, bacteria, and fungi, without affecting beneficial lactobacilli that also reside in the normal flora of the vagina.
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Affiliation(s)
- Christina C Tam
- Foodborne Toxin Detection and Prevention Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, California, 94710, USA
| | - Kevin Nguyen
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Daniel Nguyen
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Sabrina Hamada
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Okhun Kwon
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Irene Kuang
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Steven Gong
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Sydney Escobar
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Max Liu
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Jihwan Kim
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Tiffany Hou
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Justin Tam
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Luisa W Cheng
- Foodborne Toxin Detection and Prevention Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, California, 94710, USA
| | - Jong H Kim
- Foodborne Toxin Detection and Prevention Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, California, 94710, USA
| | - Kirkwood M Land
- Department of Biological Sciences, University of the Pacific, Stockton, California, 95211, USA
| | - Mendel Friedman
- Healthy Processed Foods Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, California, 94710, USA.
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16
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Celum C, Luetkemeyer AF. Doxycycline for Sexually Transmitted Infection Prevention: Evolving Evidence and Implementation Perspectives. Sex Transm Dis 2021; 48:620-621. [PMID: 34117188 PMCID: PMC8360665 DOI: 10.1097/olq.0000000000001501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 11/29/2022]
Abstract
Editorial for Sexually Transmitted Diseases (STD20–495): Interest, concerns, and attitudes among men who have sex with men and healthcare providers toward prophylactic use of doxycycline against Chlamydia trachomatis infections and syphilis.
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Affiliation(s)
- Connie Celum
- From the Departments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, WA
| | - Anne F. Luetkemeyer
- Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General, University of California San Francisco, San Francisco, CA
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17
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Morris SR, Bristow CC, Wierzbicki MR, Sarno M, Asbel L, French A, Gaydos CA, Hazan L, Mena L, Madhivanan P, Philip S, Schwartz S, Brown C, Styers D, Waymer T, Klausner JD. Performance of a single-use, rapid, point-of-care PCR device for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis: a cross-sectional study. THE LANCET. INFECTIOUS DISEASES 2021; 21:668-676. [PMID: 33242473 PMCID: PMC9884536 DOI: 10.1016/s1473-3099(20)30734-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/13/2020] [Accepted: 08/26/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Timely detection and treatment are important for the control of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. The objective of this study was to measure the performance of the Visby Medical Sexual Health Test, a single-use, point-of-care PCR device. METHODS Women aged 14 years and older who presented consecutively to ten clinical sites across seven US states were enrolled for a cross-sectional, single-visit study. Patients who consented to participate, and who had not used any exclusionary products in the genital area in the previous 48 h, provided self-collected vaginal swabs for testing with the investigational device. Untrained operators received the specimens and ran the device using the guide provided. Specimens had to be run within 2 h of collection to be considered valid. For comparison, patient-infected status was derived by testing clinician-collected vaginal specimens with the Hologic Aptima Combo 2 Assay and Aptima Trichomonas vaginalis Assay, as well as the BD ProbeTec CT/GC Qx Amplified DNA Assay and BD ProbeTec Trichomonas vaginalis Qx Assay. If the results of those assays did not match, the BD MAX CT/GC/TV was used as a tiebreaker. The primary outcomes were the sensitivity and specificity of the investigational device for the detection of C trachomatis, N gonorrhoeae, and T vaginalis compared with patient-infected status. FINDINGS Between Feb 25, 2019, and Jan 6, 2020, 1585 participants aged between 14 years and 80 years (mean 34·8 [SD 14·2]) were enrolled. 1555 participants had tests run with the investigational device, of whom 1532 (98·5%) had a valid result on either the first or repeat test. Among the patients with evaluable results (including a determinate patient-infected status), the device had a sensitivity of 97·6% (95% CI 93·2-99·2) and specificity of 98·3% (97·5-98·9) for C trachomatis (n=1457), sensitivity of 97·4% (86·5-99·5) and specificity of 99·4% (98·9-99·7) for N gonorrhoeae (n=1468), and sensitivity of 99·2% (95·5-99·9) and specificity of 96·9% (95·8-97·7) for T vaginalis (n=1449). INTERPRETATION This innovative, rapid, easy-to-use, single-use, point-of-care device to detect C trachomatis, N gonorrhoeae, and T vaginalis infections showed excellent sensitivity and specificity, and could represent an important advance in the development of rapid diagnostics for sexually transmitted infections and other infectious diseases. FUNDING Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases.
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Affiliation(s)
- Sheldon R Morris
- Department of Medicine, University of California San Diego, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA.
| | - Claire C Bristow
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | | | - Mark Sarno
- Vision Clinical Research, San Marcos, CA, USA
| | - Lenore Asbel
- Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - Audrey French
- Ruth M Rothstein CORE Center-Cook County Health, Chicago, IL, USA
| | | | | | - Leandro Mena
- University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Susan Philip
- San Francisco Department of Public Health, San Francisco, CA, USA
| | | | | | | | - Toni Waymer
- Social & Scientific Systems, Silver Spring, MD, USA
| | - Jeffrey D Klausner
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Department of Epidemiology, University of California Los Angeles, Los Angeles, CA, USA
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18
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de la Maza LM, Darville TL, Pal S. Chlamydia trachomatis vaccines for genital infections: where are we and how far is there to go? Expert Rev Vaccines 2021; 20:421-435. [PMID: 33682583 DOI: 10.1080/14760584.2021.1899817] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen in the world. Antibiotic treatment does not prevent against reinfection and a vaccine is not yet available. AREAS COVERED We focus the review on the progress made of our understanding of the immunological responses required for a vaccine to elicit protection, and on the antigens, adjuvants, routes of immunization and delivery systems that have been tested in animal models. PubMed and Google Scholar were used to search publication on these topics for the last 5 years and recent Reviews were examined. EXPERT OPINION The first Phase 1 clinical trial of a C. trachomatis vaccine to protect against genital infections was successfully completed. We expect that, in the next five years, additional vaccine clinical trials will be implemented.
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Affiliation(s)
- Luis M de la Maza
- Department of Pathology and Laboratory Medicine Medical Sciences, I, Room D440 University of California, Irvine, California, USA
| | - Toni L Darville
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sukumar Pal
- Department of Pathology and Laboratory Medicine Medical Sciences, I, Room D440 University of California, Irvine, California, USA
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19
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Chlamydia-Specific IgA Secretion in the Female Reproductive Tract Induced via Per-Oral Immunization Confers Protection against Primary Chlamydia Challenge. Infect Immun 2020; 89:IAI.00413-20. [PMID: 33139380 DOI: 10.1128/iai.00413-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022] Open
Abstract
Chlamydia trachomatis is an obligate intracellular pathogen that causes sexually transmitted disease. In women, chlamydial infections may cause pelvic inflammatory disease (PID), ectopic pregnancy, and infertility. The role of antibodies in protection against a primary Chlamydia infection is unclear and was a focus of this work. Using the C. muridarum mouse infection model, we show that intestinal mucosa is infected via intranasal (i.n.) or per-oral (p.o.) Chlamydia inoculation and that unlike the female reproductive tract (FRT) mucosa, it halts systemic Chlamydia dissemination. Moreover, p.o. immunization or infection with Chlamydia confers protection against per-vaginal (p.v.) challenge, resulting in significantly decreased bacterial burden in the FRT, accelerated Chlamydia clearance, and reduced hydrosalpinx pathology. In contrast, subcutaneous (s.c.) immunization conferred no protection against the p.v. challenge. Both p.o. and s.c. immunizations induced Chlamydia-specific serum IgA. However, IgA was found only in the vaginal washes and fecal extracts of p.o.-immunized animals. Following a p.v. challenge, unimmunized control and s.c.-s.c.-immunized animals developed Chlamydia-specific intestinal IgA yet failed to develop IgA in the FRT, indicating that IgA response in the FRT relies on the FRT to gastrointestinal tract (GIT) antigen transport. Vaginal secretions of p.o.-immunized animals neutralize Chlamydia in vivo, resulting in significantly lower Chlamydia burden in the FRT and Chlamydia transport to the GIT. We also show that infection of the GIT is not necessary for induction of protective immunity in the FRT, a finding that is important for the development of p.o. subunit vaccines to target Chlamydia and possibly other sexually transmitted pathogens.
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20
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Chee WJY, Chew SY, Than LTL. Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health. Microb Cell Fact 2020; 19:203. [PMID: 33160356 PMCID: PMC7648308 DOI: 10.1186/s12934-020-01464-4] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022] Open
Abstract
Human vagina is colonised by a diverse array of microorganisms that make up the normal microbiota and mycobiota. Lactobacillus is the most frequently isolated microorganism from the healthy human vagina, this includes Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, and Lactobacillus jensenii. These vaginal lactobacilli have been touted to prevent invasion of pathogens by keeping their population in check. However, the disruption of vaginal ecosystem contributes to the overgrowth of pathogens which causes complicated vaginal infections such as bacterial vaginosis (BV), sexually transmitted infections (STIs), and vulvovaginal candidiasis (VVC). Predisposing factors such as menses, pregnancy, sexual practice, uncontrolled usage of antibiotics, and vaginal douching can alter the microbial community. Therefore, the composition of vaginal microbiota serves an important role in determining vagina health. Owing to their Generally Recognised as Safe (GRAS) status, lactobacilli have been widely utilised as one of the alternatives besides conventional antimicrobial treatment against vaginal pathogens for the prevention of chronic vaginitis and the restoration of vaginal ecosystem. In addition, the effectiveness of Lactobacillus as prophylaxis has also been well-founded in long-term administration. This review aimed to highlight the beneficial effects of lactobacilli derivatives (i.e. surface-active molecules) with anti-biofilm, antioxidant, pathogen-inhibition, and immunomodulation activities in developing remedies for vaginal infections. We also discuss the current challenges in the implementation of the use of lactobacilli derivatives in promotion of human health. In the current review, we intend to provide insights for the development of lactobacilli derivatives as a complementary or alternative medicine to conventional probiotic therapy in vaginal health.
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Affiliation(s)
- Wallace Jeng Yang Chee
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Shu Yih Chew
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Leslie Thian Lung Than
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
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21
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Kardani K, Basimi P, Fekri M, Bolhassani A. Antiviral therapy for the sexually transmitted viruses: recent updates on vaccine development. Expert Rev Clin Pharmacol 2020; 13:1001-1046. [PMID: 32838584 DOI: 10.1080/17512433.2020.1814743] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The sexually transmitted infections (STIs) caused by viruses including human T cell leukemia virus type-1 (HTLV-1), human immunodeficiency virus-1 (HIV-1), human simplex virus-2 (HSV-2), hepatitis C virus (HCV), hepatitis B virus (HBV), and human papillomavirus (HPV) are major public health issues. These infections can cause cancer or result in long-term health problems. Due to high prevalence of STIs, a safe and effective vaccine is required to overcome these fatal viruses. AREAS COVERED This review includes a comprehensive overview of the literatures relevant to vaccine development against the sexually transmitted viruses (STVs) using PubMed and Sciencedirect electronic search engines. Herein, we discuss the efforts directed toward development of effective vaccines using different laboratory animal models including mice, guinea pig or non-human primates in preclinical trials, and human in clinical trials with different phases. EXPERT OPINION There is no effective FDA approved vaccine against the sexually transmitted viruses (STVs) except for HBV and HPV as prophylactic vaccines. Many attempts are underway to develop vaccines against these viruses. There are several approaches for improving prophylactic or therapeutic vaccines such as heterologous prime/boost immunization, delivery system, administration route, adjuvants, etc. In this line, further studies can be helpful for understanding the immunobiology of STVs in human. Moreover, development of more relevant animal models is a worthy goal to induce effective immune responses in humans.
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Affiliation(s)
- Kimia Kardani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Parya Basimi
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Mehrshad Fekri
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Azam Bolhassani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
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22
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Friedman M, Tam CC, Cheng LW, Land KM. Anti-trichomonad activities of different compounds from foods, marine products, and medicinal plants: a review. BMC Complement Med Ther 2020; 20:271. [PMID: 32907567 PMCID: PMC7479404 DOI: 10.1186/s12906-020-03061-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023] Open
Abstract
Human trichomoniasis, caused by the pathogenic parasitic protozoan Trichomonas vaginalis, is the most common non-viral sexually transmitted disease that contributes to reproductive morbidity in affected women and possibly to prostate cancer in men. Tritrichomonas foetus strains cause the disease trichomoniasis in farm animals (cattle, bulls, pigs) and diarrhea in domestic animals (cats and dogs). Because some T. vaginalis strains have become resistant to the widely used drug metronidazole, there is a need to develop alternative treatments, based on safe natural products that have the potential to replace and/or enhance the activity of lower doses of metronidazole. To help meet this need, this overview collates and interprets worldwide reported studies on the efficacy of structurally different classes of food, marine, and medicinal plant extracts and some of their bioactive pure compounds against T. vaginalis and T. foetus in vitro and in infected mice and women. Active food extracts include potato peels and their glycoalkaloids α-chaconine and α-solanine, caffeic and chlorogenic acids, and quercetin; the tomato glycoalkaloid α-tomatine; theaflavin-rich black tea extracts and bioactive theaflavins; plant essential oils and their compounds (+)-α-bisabolol and eugenol; the grape skin compound resveratrol; the kidney bean lectin, marine extracts from algae, seaweeds, and fungi and compounds that are derived from fungi; medicinal extracts and about 30 isolated pure compounds. Also covered are the inactivation of drug-resistant T. vaginalis and T. foetus strains by sensitized light; anti-trichomonad effects in mice and women; beneficial effects of probiotics in women; and mechanisms that govern cell death. The summarized findings will hopefully stimulate additional research, including molecular-mechanism-guided inactivations and human clinical studies, that will help ameliorate adverse effects of pathogenic protozoa.
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Affiliation(s)
- Mendel Friedman
- United States Department of Agriculture, Healthy Processed Foods Research Unit, Agricultural Research Service, Albany, CA, 94710, USA.
| | - Christina C Tam
- United States Department of Agriculture, Foodborne Toxins Detection and Prevention Research Unit, Agricultural Research Service, Albany, California, 94710, USA
| | - Luisa W Cheng
- United States Department of Agriculture, Foodborne Toxins Detection and Prevention Research Unit, Agricultural Research Service, Albany, California, 94710, USA
| | - Kirkwood M Land
- Department of Biological Sciences, University of the Pacific, Stockton, CA, 95211, USA
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23
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Friedman M, Xu A, Lee R, N. Nguyen D, A. Phan T, M. Hamada S, Panchel R, C. Tam C, H. Kim J, W. Cheng L, M. Land K. The Inhibitory Activity of Anthraquinones against Pathogenic Protozoa, Bacteria, and Fungi and the Relationship to Structure. Molecules 2020; 25:molecules25133101. [PMID: 32646028 PMCID: PMC7411742 DOI: 10.3390/molecules25133101] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/01/2020] [Accepted: 07/02/2020] [Indexed: 01/09/2023] Open
Abstract
Plant-derived anthraquinones were evaluated in cell assays for their inhibitory activities against the parasitic protozoa Trichomonas vaginalis human strain G3 that causes the sexually transmitted disease trichomoniasis in women, Tritrichomonas foetus bovine strain D1 that causes sexually transmitted diseases in farm animals (bulls, cows, and pigs), Tritrichomonas foetus-like strain C1 that causes diarrhea in domestic animals (cats and dogs), and bacteria and fungi. The anthraquinones assessed for their inhibitory activity were anthraquinone, aloe-emodin (1,8-dihydroxy-3-hydroxymethylanthraquinone), anthrarufin (1,5-dihydroxyanthraquinone), chrysazin (1,8-dihydroxyanthraquinone), emodin (1,3,8-trihydroxy-6-methylanthraquinone), purpurin (1,2,4-trihydroxyanthraquinone), and rhein (1,8-dihydroxy-3-carboxyanthraquinone). Their activities were determined in terms of IC50 values, defined as the concentration that inhibits 50% of the cells under the test conditions and calculated from linear dose response plots for the parasitic protozoa, and zone of inhibition for bacteria and fungi, respectively. The results show that the different substituents on the anthraquinone ring seem to influence the relative potency. Analysis of the structure–activity relationships in protozoa indicates that the aloe-emodin and chrysazin with the highest biological activities merit further study for their potential to help treat the diseases in women and domestic and farm animals. Emodin also exhibited antifungal activity against Candida albicans. The suggested mechanism of action and the additional reported beneficial biological properties of anthraquinones suggest that they have the potential to ameliorate a broad spectrum of human diseases.
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Affiliation(s)
- Mendel Friedman
- Healthy Processed Foods Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, CA 94710, USA
- Correspondence: ; Tel.: +1-510-559-5615
| | - Alexander Xu
- Department of Biological Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.X.); (R.L.); (D.N.N.); (T.A.P.); (S.M.H.); (R.P.); (K.M.L.)
| | - Rani Lee
- Department of Biological Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.X.); (R.L.); (D.N.N.); (T.A.P.); (S.M.H.); (R.P.); (K.M.L.)
| | - Daniel N. Nguyen
- Department of Biological Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.X.); (R.L.); (D.N.N.); (T.A.P.); (S.M.H.); (R.P.); (K.M.L.)
| | - Tina A. Phan
- Department of Biological Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.X.); (R.L.); (D.N.N.); (T.A.P.); (S.M.H.); (R.P.); (K.M.L.)
| | - Sabrina M. Hamada
- Department of Biological Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.X.); (R.L.); (D.N.N.); (T.A.P.); (S.M.H.); (R.P.); (K.M.L.)
| | - Rima Panchel
- Department of Biological Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.X.); (R.L.); (D.N.N.); (T.A.P.); (S.M.H.); (R.P.); (K.M.L.)
| | - Christina C. Tam
- Foodborne Toxins Detection and Prevention Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, CA 94710, USA; (C.C.T.); (J.H.K.); (L.W.C.)
| | - Jong H. Kim
- Foodborne Toxins Detection and Prevention Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, CA 94710, USA; (C.C.T.); (J.H.K.); (L.W.C.)
| | - Luisa W. Cheng
- Foodborne Toxins Detection and Prevention Research Unit, Agricultural Research Service, United States Department of Agriculture, Albany, CA 94710, USA; (C.C.T.); (J.H.K.); (L.W.C.)
| | - Kirkwood M. Land
- Department of Biological Sciences, University of the Pacific, Stockton, CA 95211, USA; (A.X.); (R.L.); (D.N.N.); (T.A.P.); (S.M.H.); (R.P.); (K.M.L.)
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24
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Addetia A, Tantalo LC, Lin MJ, Xie H, Huang ML, Marra CM, Greninger AL. Comparative genomics and full-length Tprk profiling of Treponema pallidum subsp. pallidum reinfection. PLoS Negl Trop Dis 2020; 14:e0007921. [PMID: 32251462 PMCID: PMC7162541 DOI: 10.1371/journal.pntd.0007921] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/16/2020] [Accepted: 02/08/2020] [Indexed: 12/25/2022] Open
Abstract
Developing a vaccine against Treponema pallidum subspecies pallidum, the causative agent of syphilis, remains a public health priority. Syphilis vaccine design efforts have been complicated by lack of an in vitro T. pallidum culture system, prolific antigenic variation in outer membrane protein TprK, and lack of functional annotation for nearly half of the genes. Understanding the genetic basis of T. pallidum reinfection can provide insights into variation among strains that escape cross-protective immunity. Here, we present comparative genomic sequencing and deep, full-length tprK profiling of two T. pallidum isolates from blood from the same patient that were collected six years apart. Notably, this patient was diagnosed with syphilis four times, with two of these episodes meeting the definition of neurosyphilis, during this interval. Outside of the highly variable tprK gene, we identified 14 coding changes in 13 genes. Nine of these genes putatively localized to the periplasmic or outer membrane spaces, consistent with a potential role in serological immunoevasion. Using a newly developed full-length tprK deep sequencing protocol, we profiled the diversity of this gene that far outpaces the rest of the genome. Intriguingly, we found that the reinfecting isolate demonstrated less diversity across each tprK variable region compared to the isolate from the first infection. Notably, the two isolates did not share any full-length TprK sequences. Our results are consistent with an immunodominant-evasion model in which the diversity of TprK explains the ability of T. pallidum to successfully reinfect individuals, even when they have been infected with the organism multiple times.
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Affiliation(s)
- Amin Addetia
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, United States of America
| | - Lauren C. Tantalo
- Department of Neurology, University of Washington, Seattle, Washington, United States of America
| | - Michelle J. Lin
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, United States of America
| | - Hong Xie
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, United States of America
| | - Meei-Li Huang
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, United States of America
| | - Christina M. Marra
- Department of Neurology, University of Washington, Seattle, Washington, United States of America
| | - Alexander L. Greninger
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, United States of America
- * E-mail:
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