|
1
|
Li SY, Li PW, Shen B, Zhi M, Gu YB, Wang XY, Guo H, Li Y, Fan YH, Yang BL, Xue M, Wang XY, Lv MF, Li Y, Ye B, Zhu XJ, Chen Y. Insufficient awareness and vaccination practices for inflammatory bowel disease patients in China: A multi-center survey of Chinese gastroenterologists. J Dig Dis 2020; 21:46-51. [PMID: 31794121 DOI: 10.1111/1751-2980.12834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/23/2019] [Accepted: 12/01/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The prevalence of inflammatory bowel disease (IBD) has been increasing worldwide, and the risk of infection has increased due to the use of immunosuppressive and biologic medications. Some of these infections can be prevented with vaccinations. The aim of this study was to evaluate the vaccination practices of Chinese gastroenterologists for patients with IBD. METHODS Questionnaires based on quick response codes were sent using email and the WeChat platform to gastroenterologists at 20 hospitals in China. The vaccination practices of the gastroenterologists, including vaccinating for hepatitis B, hepatitis A, and varicella, were assessed. RESULTS Of the 468 gastroenterologists who received the questionnaire, 307 (65.6%) completed it. Of the gastroenterologists who were most concerned about hepatitis B; 83.4% always or frequently asked about an infection history, 53.7% took an immunization history, and 73.6% tested patients for hepatitis B infection. However, few gastroenterologists did so for hepatitis A or varicella. The proportion of patients who were asked about an infection and immunization history and tested for varicella infection was 16.0%, 15.0%, and 9.4%, respectively. Only a few gastroenterologists recommended vaccination for patients without an infection before IBD medical treatment (26.7% for hepatitis A, 45.6% for hepatitis B, and 28% for varicella vaccination). CONCLUSION Vaccination practices for patients with IBD used by Chinese gastroenterologists vary greatly, suggesting that education about immunization is needed.
Collapse
Affiliation(s)
- Shu Yan Li
- Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Pei Wei Li
- Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Bo Shen
- Center for Inflammatory Bowel Diseases, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Min Zhi
- Department of Gastroenterology, Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Yu Bei Gu
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Ying Wang
- Department of Gastroenterology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Hong Guo
- Department of Gastroenterology, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Yue Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China
| | - Yi Hong Fan
- Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Bo Lin Yang
- Department of Colorectal Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
| | - Meng Xue
- Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xiao Ying Wang
- Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Min Fang Lv
- Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Yan Li
- Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Bin Ye
- Department of Gastroenterology, Lishui Municipal Central Hospital, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang Province, China
| | - Xin Jian Zhu
- Department of Gastroenterology, Shaoxing Shangyu People's Hospital, Shaoxing, Zhejiang Province, China
| | - Yan Chen
- Department of Gastroenterology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| |
Collapse
|
|
2
|
Gilkes AP, Albin TJ, Manna S, Supnet M, Ruiz S, Tom J, Badten AJ, Jain A, Nakajima R, Felgner J, Davies DH, Stetkevich SA, Zlotnik A, Pearlman E, Nalca A, Felgner PL, Esser-Kahn AP, Burkhardt AM. Tuning Subunit Vaccines with Novel TLR Triagonist Adjuvants to Generate Protective Immune Responses against Coxiella burnetii. THE JOURNAL OF IMMUNOLOGY 2019; 204:611-621. [PMID: 31871024 DOI: 10.4049/jimmunol.1900991] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/16/2019] [Indexed: 12/11/2022]
Abstract
Coxiella burnetii is an obligate intracellular bacterium and the causative agent of Q fever. C. burnetii is considered a potential bioterrorism agent because of its low infectious dose; resistance to heat, drying, and common disinfectants; and lack of prophylactic therapies. Q-Vax, a formalin-inactivated whole-bacteria vaccine, is currently the only prophylactic measure that is protective against C. burnetii infections but is not U.S. Food and Drug Administration approved. To overcome the safety concerns associated with the whole-bacteria vaccine, we sought to generate and evaluate recombinant protein subunit vaccines against C. burnetii To accomplish this, we formulated C. burnetii Ags with a novel TLR triagonist adjuvant platform, which used combinatorial chemistry to link three different TLR agonists together to form one adjuvanting complex. We evaluated the immunomodulatory activity of a panel of TLR triagonist adjuvants and found that they elicited unique Ag-specific immune responses both in vitro and in vivo. We evaluated our top candidates in a live C. burnetii aerosol challenge model in C56BL/6 mice and found that several of our novel vaccine formulations conferred varying levels of protection to the challenged animals compared with sham immunized mice, although none of our candidates were as protective as the commercial vaccine across all protection criteria that were analyzed. Our findings characterize a novel adjuvant platform and offer an alternative approach to generating protective and effective vaccines against C. burnetii.
Collapse
Affiliation(s)
- Adrienne P Gilkes
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - Tyler J Albin
- Department of Chemistry, University of California, Irvine, Irvine, CA 92697
| | - Saikat Manna
- Department of Chemistry, University of California, Irvine, Irvine, CA 92697.,The Institute for Molecular Engineering, The University of Chicago, Chicago, IL 60637; and
| | - Medalyn Supnet
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - Sara Ruiz
- U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702
| | - Janine Tom
- Department of Chemistry, University of California, Irvine, Irvine, CA 92697
| | - Alexander J Badten
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - Aarti Jain
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - Rie Nakajima
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - Jiin Felgner
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - D Huw Davies
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | | | - Albert Zlotnik
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - Eric Pearlman
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - Aysegul Nalca
- U.S. Army Medical Research Institute of Infectious Diseases, Frederick, MD 21702
| | - Philip L Felgner
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697.,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| | - Aaron P Esser-Kahn
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697; .,The Institute for Molecular Engineering, The University of Chicago, Chicago, IL 60637; and
| | - Amanda M Burkhardt
- Vaccine Research and Design Center, Department of Physiology and Biophysics, University of California, Irvine, Irvine, CA 92697; .,Institute for Immunology, University of California, Irvine, Irvine, CA 92697
| |
Collapse
|