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Gu Z, Zhang Y, Zhao X, Liu T, Sheng S, Song R, Jin R. Comparing sputum microbiota characteristics between severe and critically ill influenza patients. Front Cell Infect Microbiol 2023; 13:1297946. [PMID: 38188635 PMCID: PMC10766813 DOI: 10.3389/fcimb.2023.1297946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Background Currently, limited attention has been directed toward utilizing clinical cohorts as a starting point to elucidate alterations in the lower respiratory tract (LRT) microbiota following influenza A virus (IAV) infection. Objectives Our objective was to undertake a comparative analysis of the diversity and composition of sputum microbiota in individuals afflicted by severe and critically ill influenza patients. Methods Sputum specimens were procured from patients diagnosed with IAV infection for the purpose of profiling the microbiota using 16S-rDNA sequencing. To ascertain taxonomic differences between the severe and critically ill influenza cohorts, we leveraged Linear Discriminant Analysis Effect Size (LEfSe). Additionally, Spearman correlation analysis was employed to illuminate associations between sputum microbiota and influenza Ct values alongside laboratory indicators. Results Our study encompassed a total cohort of 64 patients, comprising 48 within the severe group and 16 within the critically ill group. Intriguingly, Bacteroidetes exhibited significant depletion in the critically ill cohort (p=0.031). The sputum microbiomes of the severe influenza group were hallmarked by an overrepresentation of Neisseria, Porphyromonas, Actinobacillus, Alloprevotella, TM7x, and Clostridia_UCG-014, yielding ROC-plot AUC values of 0.71, 0.68, 0.60, 0.70, 0.70, and 0.68, respectively. Notably, Alloprevotella exhibited an inverse correlation with influenza Ct values. Moreover, C-reactive protein (CRP) manifested a positive correlation with Haemophilus and Porphyromonas. Conclusion The outcomes of this investigation lay the groundwork for future studies delving into the connection between the LRT microbiome and respiratory disorders. Further exploration is warranted to elucidate the intricate mechanisms underlying the interaction between IAV and Alloprevotella, particularly in disease progression.
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Affiliation(s)
- Zhixia Gu
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing, China
| | - Yuanyuan Zhang
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing, China
| | - Xue Zhao
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Tingting Liu
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing, China
| | - Shugui Sheng
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing, China
| | - Rui Song
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing, China
| | - Ronghua Jin
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Infectious Diseases, Beijing, China
- National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing, China
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2
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Taha S, Hong E, Denizon M, Falguières M, Terrade A, Deghmane AE, Taha MK. The rapid rebound of invasive meningococcal disease in France at the end of 2022. J Infect Public Health 2023; 16:1954-1960. [PMID: 37875044 DOI: 10.1016/j.jiph.2023.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/26/2023] [Accepted: 10/01/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Invasive meningococcal disease (IMD) cases declined upon the implementation of non-pharmaceutical measures to control the COVID-19 pandemic. A rebound in IMD cases was feared upon easing these measures. METHODS We conducted a retrospective descriptive study using the French National Reference Center Database for meningococci between 2015 and 2022. We scored serogroups, sex, age groups, and clonal complexes of the corresponding isolates. FINDINGS Our data clearly show a decline in the number of IMD cases for all serogroups and age groups until 2021. This decline was mainly due to a decrease in IMD cases provoked by the hyperinvasive ST-11 clonal complex. However, since the fall of 2021, there has been an increase in IMD cases, which accelerated in the second half of 2022. This rebound concerned all age groups, in particular 16-24 years. The increase in cases due to serogroups B, W, and Y were mainly due to the expansion of isolates of the ST-7460, the clonal complex ST-9316 and the clonal complex ST-23, respectively. INTERPRETATION IMD epidemiology changes constantly and profound epidemiological changes have been recently observed. The surveillance of IMD needs to be enhanced using molecular tools. Additionally, vaccination strategies need to be updated to acknowledge recent epidemiological changes of these vaccine-preventable serogroups.
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Affiliation(s)
- Samy Taha
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Eva Hong
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Mélanie Denizon
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Michael Falguières
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Aude Terrade
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Ala-Eddine Deghmane
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France
| | - Muhamed-Kheir Taha
- Invasive Bacterial Infections Unit and National Reference Center for Meningococci and Haemophilus influnezae, Institut Pasteur, Université Paris Cité, France.
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3
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Vaccination against Community-Acquired Pneumonia in Spanish Adults: Practical Recommendations by the NeumoExperts Prevention Group. Antibiotics (Basel) 2023; 12:antibiotics12010138. [PMID: 36671339 PMCID: PMC9854614 DOI: 10.3390/antibiotics12010138] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
In the adult population, community-acquired pneumonia (CAP) is a serious disease that is responsible for high morbidity and mortality rates, being frequently associated with multidrug resistant pathogens. The aim of this review is to update a practical immunization prevention guideline for CAP in Spain caused by prevalent respiratory pathogens, based on the available scientific evidence through extensive bibliographic review and expert opinion. The emergence of COVID-19 as an additional etiological cause of CAP, together with the rapid changes in the availability of vaccines and recommendations against SARS-CoV-2, justifies the need for an update. In addition, new conjugate vaccines of broader spectrum against pneumococcus, existing vaccines targeting influenza and pertussis or upcoming vaccines against respiratory syncytial virus (RSV) will be very useful prophylactic tools to diminish the burden of CAP and all of its derived complications. In this manuscript, we provide practical recommendations for adult vaccination against the pathogens mentioned above, including their contribution against antibiotic resistance. This guide is intended for the individual perspective of protection and not for vaccination policies, as we do not pretend to interfere with the official recommendations of any country. The use of vaccines is a realistic approach to fight these infections and ameliorate the impact of antimicrobial resistance. All of the recently available scientific evidence included in this review gives support to the indications established in this practical guide to reinforce the dissemination and implementation of these recommendations in routine clinical practice.
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Escuret V, Terrier O. Co-infection of the respiratory epithelium, scene of complex functional interactions between viral, bacterial, and human neuraminidases. Front Microbiol 2023; 14:1137336. [PMID: 37213507 PMCID: PMC10192862 DOI: 10.3389/fmicb.2023.1137336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/03/2023] [Indexed: 05/23/2023] Open
Abstract
The activity of sialic acids, known to play critical roles in biology and many pathological processes, is finely regulated by a class of enzymes called sialidases, also known as neuraminidases. These are present in mammals and many other biological systems, such as viruses and bacteria. This review focuses on the very particular situation of co-infections of the respiratory epithelium, the scene of complex functional interactions between viral, bacterial, and human neuraminidases. This intrinsically multidisciplinary topic combining structural biology, biochemistry, physiology, and the study of host-pathogen interactions, opens up exciting research perspectives that could lead to a better understanding of the mechanisms underlying virus-bacteria co-infections and their contribution to the aggravation of respiratory pathology, notably in the context of pre-existing pathological contexts. Strategies that mimic or inhibit the activity of the neuraminidases could constitute interesting treatment options for viral and bacterial infections.
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Jbari S, Lahmini W, Boussaa S, Bourrous M. Impact of Covid-19 pandemic on pediatric meningitis incidence in central Morocco. SCIENTIFIC AFRICAN 2022; 16:e01213. [PMID: 36248769 PMCID: PMC9548638 DOI: 10.1016/j.sciaf.2022.e01213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/18/2022] [Accepted: 05/01/2022] [Indexed: 01/17/2023] Open
Abstract
Bacterial meningitis is a diagnostic, therapeutic, and prophylactic emergency, particularly for children. In Morocco, meningitis remains a major public health challenge with lethality between 10% and 12% of cases. Our objective is to determine the impact of COVID-19 pandemic on the incidence of pediatric meningitis in central Morocco. A retrospective epidemiological study was carried out in the Department of Pediatric Emergencies of the Mother and Child Hospital of Marrakech in Morocco. Data were collected from patient files of Meningitis cases reported during the confinement period in March, April, and May of 2019 and 2020 respectively. Then, data were analyzed using SPSS software. The results showed a notification of 72 cases of suspected meningitis between March 2019 and March 2020 with dominance of boys (up to 70%) and age range of 1 month to 2 years (up to 34%). We noted a decrease in the number of patients hospitalized for suspected meningitis during COVID-19 pandemic. The final diagnosis of suspected meningitis was confirmed for 20% of the cases during the containment period against only 2.38% before the pandemic. This difference was statistically significant (P<0.05). Our investigations confirm the effect of the COVID-19 pandemic on the incidence of bacterial meningitis of children in the study area, more investigations are needed to generalize and explain these results in Morocco.
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Affiliation(s)
- Siham Jbari
- Infectious Disease Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, 40000, Morocco,Childhood Health and Development Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, 40000, Morocco
| | - Widad Lahmini
- Childhood Health and Development Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, 40000, Morocco
| | - Samia Boussaa
- ISPITS-Higher Institute of Nursing and Health Techniques, Ministry of Health and Social Protection, Rabat, 10000, Morocco,Corresponding author
| | - Mounir Bourrous
- Childhood Health and Development Research Laboratory, Faculty of Medicine and Pharmacy, Cadi Ayyad University Marrakech, 40000, Morocco
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Taha S, Taha MK, Deghmane AE. Impact of mandatory vaccination against serogroup C meningococci in targeted and non-targeted populations in France. NPJ Vaccines 2022; 7:73. [PMID: 35768437 PMCID: PMC9243022 DOI: 10.1038/s41541-022-00488-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 05/16/2022] [Indexed: 11/15/2022] Open
Abstract
Since January 2018, mandatory vaccination against meningococci serogroup C has been implemented in France for children <2 years with a recommended catch-up vaccination until the age of 24 years. We aimed to analyse the impact of mandatory vaccination on populations not targeted by it (2–24 years old). We used the database of the national reference centre for meningococci to collect the number of invasive meningococcal disease (IMD) cases before (2016–2017) and after (2018–2019) the mandatory vaccination. The cultured isolates were sequenced and submitted for genomic comparison. The total number of cases was 1706, including 376 cases of IMD serogroup C. Mandatory vaccination correlated with a significant decrease among the <2 years old and a decreasing trend among the 2–14 years old group but not among 15–25 years of age. This observation may be explained by the vaccine coverage that is still low among adolescents and young adults. Moreover, the genomic analysis revealed the co-circulation of two major genotypes belonging to the clonal complex ST-11 whose distribution differed across the age groups in accord with cyclic variations of genotypes. It is important to increase specific knowledge on meningococcal epidemiology and vaccination to involve them in establishing the vaccination strategy.
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Affiliation(s)
- Samy Taha
- Institut Pasteur, Invasive bacterial infections Unit and National Reference centre for meningococci and Haemophilus influenzae, Paris, France.,Université de Paris Sud, Faculty of Medicine, Le Kremlin-Bicêtre, France
| | - Muhamed-Kheir Taha
- Institut Pasteur, Invasive bacterial infections Unit and National Reference centre for meningococci and Haemophilus influenzae, Paris, France
| | - Ala-Eddine Deghmane
- Institut Pasteur, Invasive bacterial infections Unit and National Reference centre for meningococci and Haemophilus influenzae, Paris, France.
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7
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Deghmane AE, Taha MK. Changes in Invasive Neisseria meningitidis and Haemophilus influenzae Infections in France during the COVID-19 Pandemic. Microorganisms 2022; 10:microorganisms10050907. [PMID: 35630352 PMCID: PMC9147110 DOI: 10.3390/microorganisms10050907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 11/20/2022] Open
Abstract
BackgroundSince the appearance of COVID-19 in January 2020, invasive bacterial infections have decreased significantly worldwide. However, alterations in age and sex distributions, clinical forms, phenotypes, and genotypes of isolates have not been analyzed. Our goal is to present and discuss these data considering the current COVID-19 pandemic situation. Methods: The data of the national reference center for meningococci and Haemophilus influenzae in France were mined to examine the above aspects of invasive bacterial infection before (2018−2019) and after (2020−2021) the COVID-19 pandemic. Detailed epidemiological, clinical, and microbiological data were collected, and whole genome sequencing was carried out on meningococcal isolates (n = 1466). Results: In addition to the overall decline in the number of cases, various changes in age, sex, and phenotypes of isolates were also noted. As for N. meningitidis, more cases were observed in adults, as well as more invasive pneumopathies. Furthermore, fewer hyperinvasive meningococcal genotypes have circulated since COVID-19 emerged. The situation has been different for H. influenzae, as the number of invasive cases among adults decreased due to a reduction in non-typeable isolates. In contrast, cases due to serotypeable isolates, particularly serotypes a and b, increased in children <5 years-old. Conclusions: It is possible that measures implemented to stop COVID-19 may have reduced the circulation of N. meningitidis and H. influenzae isolates, but to a variable extent. This may be due to differences in circulation between these two species according to age groups. Vaccination schedules against these two species may have also influenced the evolution of these invasive bacterial infections since the emergence of the COVID-19 pandemic.
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8
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Mikucki A, McCluskey NR, Kahler CM. The Host-Pathogen Interactions and Epicellular Lifestyle of Neisseria meningitidis. Front Cell Infect Microbiol 2022; 12:862935. [PMID: 35531336 PMCID: PMC9072670 DOI: 10.3389/fcimb.2022.862935] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/28/2022] [Indexed: 01/17/2023] Open
Abstract
Neisseria meningitidis is a gram-negative diplococcus and a transient commensal of the human nasopharynx. It shares and competes for this niche with a number of other Neisseria species including N. lactamica, N. cinerea and N. mucosa. Unlike these other members of the genus, N. meningitidis may become invasive, crossing the epithelium of the nasopharynx and entering the bloodstream, where it rapidly proliferates causing a syndrome known as Invasive Meningococcal Disease (IMD). IMD progresses rapidly to cause septic shock and meningitis and is often fatal despite aggressive antibiotic therapy. While many of the ways in which meningococci survive in the host environment have been well studied, recent insights into the interactions between N. meningitidis and the epithelial, serum, and endothelial environments have expanded our understanding of how IMD develops. This review seeks to incorporate recent work into the established model of pathogenesis. In particular, we focus on the competition that N. meningitidis faces in the nasopharynx from other Neisseria species, and how the genetic diversity of the meningococcus contributes to the wide range of inflammatory and pathogenic potentials observed among different lineages.
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Affiliation(s)
- August Mikucki
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Nicolie R. McCluskey
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
- College of Science, Health, Engineering and Education, Telethon Kids Institute, Murdoch University, Perth, WA, Australia
| | - Charlene M. Kahler
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
- *Correspondence: Charlene M. Kahler,
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9
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Meiring S, Tempia S, Dominic EM, de Gouveia L, McAnerney J, von Gottberg A, Cohen C. Excess invasive meningococcal disease associated with seasonal influenza, South Africa, 2003-2018. Clin Infect Dis 2021; 74:1729-1735. [PMID: 34389845 PMCID: PMC9155629 DOI: 10.1093/cid/ciab702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Indexed: 11/12/2022] Open
Abstract
Background Invasive meningococcal disease (IMD) is a devastating illness with high mortality rates. Like influenza, endemic IMD is seasonal, peaking in winter. Studies suggest that circulation of influenza virus may influence the timing and magnitude of IMD winter peaks. Methods This ecological study used weekly data from 2 nationwide surveillance programs: Viral Watch (proportion of outpatient influenza-positive cases from throat or nasal swab samples) and GERMS-SA (laboratory-confirmed cases of IMD), occurring across South Africa from 2003 through 2018 in all age bands. A bivariate time series analysis using wavelet transform was conducted to determine cocirculation of the diseases and the time lag between the peak seasons. We modeled excess meningococcal disease cases attributable to influenza cocirculation, using univariate regression spline models. Stata and R statistical software packages were used for the analysis. Results A total of 5256 laboratory-confirmed IMD cases were reported, with an average annual incidence of 0.23 episodes per 100 000 population and a mean seasonal peak during week 32 (±3 weeks). Forty-two percent of swab samples (10 421 of 24 741) were positive for influenza during the study period. The mean peak for all influenza occurred at week 26 (±4 weeks). There was an average lag time of 5 weeks between annual influenza and IMD seasons. Overall, 5% (1%–9%) of IMD cases can be attributable to influenza cocirculation, with, on average, 17 excess IMD cases per year attributable to influenza. Conclusions A quantifiable proportion of IMD in South Africa is associated with influenza cocirculation; therefore, seasonal influenza vaccination may have an effect on preventing a small portion of IMD in addition to preventing influenza.
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Affiliation(s)
- Susan Meiring
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Stefano Tempia
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Emanuel M Dominic
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, South Africa
| | - Linda de Gouveia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Jo McAnerney
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Cheryl Cohen
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa
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10
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Taha MK, Weil-Olivier C, Bouée S, Emery C, Nachbaur G, Pribil C, Loncle-Provot V. Risk factors for invasive meningococcal disease: a retrospective analysis of the French national public health insurance database. Hum Vaccin Immunother 2021; 17:1858-1866. [PMID: 33449835 PMCID: PMC8115611 DOI: 10.1080/21645515.2020.1849518] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Vaccination of at-risk populations against Neisseria meningitidis is an important strategy to prevent invasive meningococcal disease (IMD). The objective of this study was to characterize preexisting risk factors in patients with IMD and to compare their relative importance. This case-control analysis was performed in the French national public health insurance database (SNDS). Cases consisted of all people hospitalized for IMD in France over a six-year period (2012–2017). Controls were matched by age, gender, and district of residence. Medical risk factors were identified from ICD-10 codes in the SNDS. Socioeconomic risk factors studied were low household income and social deprivation of the municipality of residence. Associations of these risk factors with hospitalization for IMD were quantified as odds ratios (ORs) between cases and controls with their 95% confidence intervals (95%CI). The medical risk factors showing the most robust associations were congenital immunodeficiency (OR: 39.1 [95%CI: 5.1–299], acquired immunodeficiency (10.3 [4.5–24.0]) and asplenia/hyposplenia (6.7 [3.7–14.7]). In addition, certain chronic medical conditions, such as autoimmune disorders (5.4 [2.5–11.8]), hemophilia (4.7 [1.8–12.2]) and severe chronic respiratory disorders (4.3 [3.1–6.2]) were also strongly associated, as was low household income (1.68 [1.49–1.80]). In conclusion, this study has documented potential risk factors associated with hospitalization for IMD in a large and comprehensive sample of individuals with IMD in France. Several of the risk factors identified may help identify groups who could benefit from targeted prevention measures (such as vaccination) in order to reduce the burden of IMD.
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Affiliation(s)
| | | | | | | | | | - Céline Pribil
- Vaccine Medical Department, GSK, Rueil-Malmaison, France
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11
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Cropet C, Abboud P, Mosnier E, Epelboin L, Djossou F, Schrooten W, Sobesky M, Nacher M. Relationship between influenza and dengue outbreaks, and subsequent bacterial sepsis in French Guiana: A time series analysis. J Public Health Res 2021; 10:1768. [PMID: 33553058 PMCID: PMC7856828 DOI: 10.4081/jphr.2021.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/26/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Influenza has been shown to increase the risk for severe bacterial infection, in the tropics the seasonality of influenza epidemics is less marked, and this may not be the case. Dengue is often followed by prolonged asthenia and some physicians hypothesized increased susceptibility to infections based on anecdotal observations. Design and Methods: Time series of influenza and dengue surveillance were confronted bacterial sepsis admissions to test the hypotheses. Monthly surveillance data on influenza and dengue and aggregated sepsis data in Cayenne hospital were matched between 24/10/2007 and 27/09/2016. An ARIMA (1,0,1) model was used. Results The series of the number of monthly cases of sepsis was positively associated with the monthly number of cases of influenza at time t (β=0.001, p=0.0359). Forecasts were imperfectly correlated with sepsis since influenza is not the only risk factor for sepsis. None of the ARIMA models showed a significant link between the dengue series and the sepsis series. Conclusions: There was thus no link between dengue epidemics and sepsis, but it was estimated that for every 1,000 cases of flu there was one additional case of sepsis. In this tropical setting, influenza was highly seasonal, and improved vaccination coverage could have benefits on sepsis. Significance for public health Simultaneous infections may have complex consequences ranging from synergistic, neutral or antagonistic. Dengue fever and influenza cause repeated epidemics and may have consequences on the host’s immune response. Hypothesizing that an infection by dengue or influenza could increase the risk of bacterial infection we showed that there was no relation between dengue and sepsis, but that there was a relation between influenza and sepsis. Despite the tropical setting of French Guiana, the highly seasonal pattern of influenza suggests the vaccine reimbursement window should be extended.
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Affiliation(s)
- Claire Cropet
- Centre d'Investigation Clinique Antilles Guyane, CIC INSERM 1424
| | | | | | | | | | - Ward Schrooten
- Département d'Information Médicale, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Milko Sobesky
- Département d'Information Médicale, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles Guyane, CIC INSERM 1424
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12
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Koliou M, Kasapi D, Mazeri S, Maikanti P, Demetriou A, Skordi C, Agathocleous M, Tzanakaki G, Constantinou E. Epidemiology of invasive meningococcal disease in Cyprus 2004 to 2018. ACTA ACUST UNITED AC 2020; 25. [PMID: 32734853 PMCID: PMC7393851 DOI: 10.2807/1560-7917.es.2020.25.30.1900534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Despite progress in the management of invasive meningococcal disease (IMD) it causes significant mortality and sequelae. Aim This study aims to describe the epidemiology and clinical characteristics of IMD in Cyprus and discuss the current immunisation programmes. Methods This is a retrospective study of all cases of IMD notified to the Ministry of Health between 2004 and 2018. Demographic, epidemiological, clinical and microbiological data were collected when a new case was notified. Risk factors associated with mortality were investigated using univariable logistic regression. Results 54 cases of IMD were recorded, an overall incidence of 0.4 cases per 100,000 population. The incidence rate was highest among infants (7.2/100,000) and adolescents (1.4/100,000). Case fatality rate was 10.4%. Serogroup B accounted for 24 of 40 cases caused by known serogroup. Serogroups W and Y comprised nine cases and were responsible for most fatal cases. Serogroup C was the cause in only four cases. There was an increase in the odds of death with increasing age, while the presence of meningitis in the clinical picture was found to be associated with lower odds of death. Conclusion Despite the low incidence of IMD in Cyprus, it remains an important cause of morbidity and mortality. Serogroup B is the most frequent serogroup, while incidence of serogroups W and Y is rising. Monitoring new cases and yearly evaluation of the immunisation programmes by the National Immunization Technical Advisory Group (NITAG) is essential for successful control of the disease.
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Affiliation(s)
- Maria Koliou
- Unit for Surveillance and control of Communicable diseases, Medical and Public Health Services, Ministry of Health, Nicosia, Cyprus.,Medical School, University of Cyprus, Nicosia, Cyprus
| | | | - Stella Mazeri
- The Roslin Institute, Division of Genetics and Genomics, Easter Bush Veterinary Centre, Roslin, United Kingdom.,The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom
| | | | - Anna Demetriou
- Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | | | | | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
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13
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Saini V, Kaur T, Kalotra S, Kaur G. The neuroplasticity marker PSA-NCAM: Insights into new therapeutic avenues for promoting neuroregeneration. Pharmacol Res 2020; 160:105186. [DOI: 10.1016/j.phrs.2020.105186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 08/25/2020] [Accepted: 08/30/2020] [Indexed: 02/06/2023]
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14
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Taha MK, Deghmane AE. Impact of COVID-19 pandemic and the lockdown on invasive meningococcal disease. BMC Res Notes 2020; 13:399. [PMID: 32854773 PMCID: PMC7450896 DOI: 10.1186/s13104-020-05241-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/19/2020] [Indexed: 01/21/2023] Open
Abstract
Objective Few data are available on the association between SARS-CoV-2 and secondary bacterial infections. Such an association was described for flu and invasive meningococcal disease (IMD). We aimed exploring such a correlation between COVID-19 and IMD as well as the impact of the lockdown on IMD. Results We compared IMD cases received at the French National Reference Centre for meningococci and Haemophilus influenzae that are sent as part of the mandatory reporting of IMD. We compared these data during the period 01 January-15 May 2020 to those from the same period in 2018 and 2019. IMD cases that were associated with respiratory presentations significantly increased in 2020 compared to 2018 (P = 0.029) and 2019 (P = 0.002), involved elderly and were due to unusual isolates. However, IMD cases due to hyperinvasive isolates decreased during the lockdown. Enhancing IMD surveillance and anti-meningococcal vaccination in elderly should be addressed.
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Affiliation(s)
- Muhamed-Kheir Taha
- Invasive Bacterial Infections Unit and the National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France.
| | - Ala-Eddine Deghmane
- Invasive Bacterial Infections Unit and the National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
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15
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Spyromitrou-Xioufi P, Tsirigotaki M, Ladomenou F. Risk factors for meningococcal disease in children and adolescents: a systematic review and META-analysis. Eur J Pediatr 2020; 179:1017-1027. [PMID: 32405695 DOI: 10.1007/s00431-020-03658-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 03/06/2020] [Accepted: 04/22/2020] [Indexed: 12/20/2022]
Abstract
Invasive meningococcal disease (IMD) remains a major cause of mortality and morbidity in children worldwide. A systemic review in PubMed and Cochrane Controlled Trials Register was performed for articles on risk factors for IMD in children and adolescents published during a 20-year period (19/09/1998 to 19/09/2018). Inclusion and exclusion criteria were established and applied. The data were meta-analyzed using random-effect model and the results were presented on forest plots separately for each risk factor. We identified 12,559 studies (duplicates removed). Titles, abstracts, and full texts were screened and finally, six studies (five case-control and one cohort study) were included in qualitative synthesis, five in meta-analysis. The median age of meningococcal disease (MD) cases was 72.2 months (0-19 years). Household crowding, smoking exposure, close relationships, and recent respiratory tract infections conferred a more than twofold risk for IMD in exposed individuals compared to controls [overcrowded living OR 2.52 (95% CI 1.75-3.63), exposure to smoke OR 2.10 (95% CI 1.00-4.39), kissing OR 2.00 (95% CI: 1.13-3.51), and recent respiratory tract infection OR 3.13 (95% CI 2.02-4.86)]. Attendance of religious events was associated with a decreased risk [0.47 (95% CI, 0.28-0.79)].Conclusion: Our review highlights the importance of individual characteristics as risk factors for IMD in childhood and adolescence. Preventive policies may consider individual as well as social-environmental factors to target individuals at risk.What is Known:• Close relationships, household crowding, and recent respiratory tract infections are major risk factors for IMD.• Passive smoking is a major risk factor for IMD.What is New:• Intimate kissing, household crowding, and passive smoking were found to double the risk of IMD.• Recent respiratory tract infections almost tripled the risk for IMD.
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Affiliation(s)
| | - Maria Tsirigotaki
- Department of Neonatology and Neonatal Intensive Care Unit, Heraklion University Hospital, Crete, Greece
| | - Fani Ladomenou
- Department of Pediatrics, Venizeleion General Hospital, Crete, Greece.
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16
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Salomon A, Berry I, Tuite AR, Drews S, Hatchette T, Jamieson F, Johnson C, Kwong J, Lina B, Lojo J, Mosnier A, Ng V, Vanhems P, Fisman DN. Influenza increases invasive meningococcal disease risk in temperate countries. Clin Microbiol Infect 2020; 26:1257.e1-1257.e7. [PMID: 31935565 DOI: 10.1016/j.cmi.2020.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Invasive meningococcal disease (IMD) is a severe bacterial infection that displays wintertime seasonality in temperate countries. Mechanisms driving seasonality are poorly understood and may include environmental conditions and/or respiratory virus infections. We evaluated the contribution of influenza and environmental conditions to IMD risk, using standardized methodology, across multiple geographical regions. METHODS We evaluated 3276 IMD cases occurring between January 1999 and December 2011 in 11 jurisdictions in Australia, Canada, France and the United States. Effects of environmental exposures and normalized weekly influenza activity on IMD risk were evaluated using a case-crossover design. Meta-analytic methods were used to evaluate homogeneity of effects and to identify sources of between-region heterogeneity. RESULTS After adjustment for environmental factors, elevated influenza activity at a 2-week lag was associated with increased IMD risk (adjusted odds ratio (OR) per standard deviation increase 1.29; 95% confidence interval, 1.04-1.59). This increase was homogeneous across the jurisdictions studied. By contrast, although associations between environmental exposures and IMD were identified in individual jurisdictions, none was generalizable. CONCLUSIONS Using a self-matched design that adjusts for both coseasonality and case characteristics, we found that surges in influenza activity result in an acute increase in population-level IMD risk. This effect is seen across diverse geographic regions in North America, France and Australia. The impact of influenza infection on downstream meningococcal risk should be considered a potential benefit of influenza immunization programmes.
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Affiliation(s)
- A Salomon
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - I Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - A R Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - S Drews
- Canadian Blood Services, Ottawa, Canada; University of Alberta, Edmonton, Canada
| | - T Hatchette
- Nova Scotia Health Authority, Halifax, Canada; Dalhousie University, Halifax, Canada
| | | | - C Johnson
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - J Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - B Lina
- Université de Lyon, Lyon, France; Laboratory of Virology, Centre National de Référence des Virus Influenzae, Hospices Civils de Lyon, Lyon, France
| | - J Lojo
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
| | - A Mosnier
- Groupes Regionaux d'Observation de la Grippe, Open Rome, Paris, France
| | - V Ng
- Public Health Agency of Canada, Guelph, Canada
| | - P Vanhems
- Université de Lyon, Lyon, France; Unité d'Hygiène, Epidémiologie et Prévention, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - D N Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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17
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Rowe HM, Rosch JW. Close Encounters of the Viral Kind: Cross-Kingdom Synergies at the Host-Pathogen Interface. Bioessays 2019; 41:e1900128. [PMID: 31693223 PMCID: PMC7050635 DOI: 10.1002/bies.201900128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/27/2019] [Indexed: 12/29/2022]
Abstract
The synergies between viral and bacterial infections are well established. Most studies have been focused on the indirect mechanisms underlying this phenomenon, including immune modulation and alterations to the mucosal structures that promote pathogen outgrowth. A growing body of evidence implicates direct binding of virus to bacterial surfaces being an additional mechanism of synergy at the host-pathogen interface. These cross-kingdom interactions enhance bacterial and viral adhesion and can alter tissue tropism. These bacterial-viral complexes play unique roles in pathogenesis and can alter virulence potential. The bacterial-viral complexes may also play important roles in pathogen transmission. Additionally, the complexes are recognized by the host immune system in a distinct manner, thus presenting novel routes for vaccine development. These synergies are active for multiple species in both the respiratory and gastrointestinal tract, indicating that direct interactions between bacteria and virus to modulate host interactions are used by a diverse array of species.
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Affiliation(s)
- Hannah M Rowe
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
| | - Jason W Rosch
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA
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18
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Feldman C, Anderson R. Meningococcal pneumonia: a review. Pneumonia (Nathan) 2019; 11:3. [PMID: 31463180 PMCID: PMC6708554 DOI: 10.1186/s41479-019-0062-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/07/2019] [Indexed: 12/19/2022] Open
Abstract
Background Although Neisseria meningitidis is one of the major causes of meningitis, meningococcal pneumonia is the most common non-neurological organ disease caused by this pathogen. Methods We conducted a review of the literature to describe the risk factors, pathogenesis, clinical features, diagnosis, treatment and prevention of meningococcal pneumonia. Results Meningococcal pneumonia was first described in 1907 and during the 1918–1919 influenza pandemic large numbers of cases of meningococcal pneumonia occurred in patients following the initial viral infection. A number of publications, mainly case series or case reports, has subsequently appeared in the literature. Meningococcal pneumonia occurs mainly with serogroups Y, W-135 and B. Risk factors for meningococcal pneumonia have not been well characterised, but appear to include older age, smoking, people living in close contact (e.g. military recruits and students at university), preceding viral and bacterial infections, haematological malignancies, chronic respiratory conditions and various other non-communicable and primary and secondary immunodeficiency diseases. Primary meningococcal pneumonia occurs in 5–10% of patients with meningococcal infection and is indistinguishable clinically from pneumonia caused by other common pathogens. Fever, chills and pleuritic chest pain are the most common symptoms, occurring in > 50% of cases. Productive sputum and dyspnoea are less common. Diagnosis of meningococcal pneumonia may be made by the isolation of the organism in sputum, blood, or normally sterile site cultures, but is likely to underestimate the frequency of meningococcal pneumonia. If validated, PCR-based techniques may be of value for diagnosis in the future. While penicillin was the treatment of choice for meningococcal infection, including pneumonia, prior to 1991, a third generation cephalosporin has been more commonly used thereafter, because of concerns of penicillin resistance. Chemoprophylaxis, using one of a number of antibiotics, has been recommended for close contacts of patients with meningococcal meningitis, and similar benefits may be seen in contacts of patients with meningococcal pneumonia. Effective vaccines are available for the prevention of infection with certain meningococcal serogroups, but this field is still evolving. Conclusion Meningococcal pneumonia occurs fairly frequently and should be considered as a possible cause of pneumonia, particularly in patients with specific risk factors.
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Affiliation(s)
- Charles Feldman
- 1Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ronald Anderson
- 2Department of Immunology and Institute for Cellular and Molecular Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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19
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Domenech M, Sempere J, de Miguel S, Yuste J. Combination of Antibodies and Antibiotics as a Promising Strategy Against Multidrug-Resistant Pathogens of the Respiratory Tract. Front Immunol 2018; 9:2700. [PMID: 30515172 PMCID: PMC6256034 DOI: 10.3389/fimmu.2018.02700] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 11/01/2018] [Indexed: 12/13/2022] Open
Abstract
The emergence of clinical isolates associated to multidrug resistance is a serious threat worldwide in terms of public health since complicates the success of the antibiotic treatment and the resolution of the infectious process. This is of great concern in pathogens affecting the lower respiratory tract as these infections are one of the major causes of mortality in children and adults. In most cases where the respiratory pathogen is associated to multidrug-resistance, antimicrobial concentrations both in serum and at the site of infection may be insufficient and the resolution of the infection depends on the interaction of the invading pathogen with the host immune response. The outcome of these infections largely depends on the susceptibility of the pathogen to the antibiotic treatment, although the humoral and cellular immune responses also play an important role in this process. Hence, prophylactic measures or even immunotherapy are alternatives against these multi-resistant pathogens. In this sense, specific antibodies and antibiotics may act concomitantly against the respiratory pathogen. Alteration of cell surface structures by antimicrobial drugs even at sub-inhibitory concentrations might result in greater exposure of microbial ligands that are normally hidden or hardly exposed. This alteration of the bacterial envelope may stimulate opsonization by natural and/or specific antibodies or even by host defense components, increasing the recognition of the microbial pathogen by circulating phagocytes. In this review we will explain the most relevant studies, where vaccination or the use of monoclonal antibodies in combination with antimicrobial treatment has demonstrated to be an alternative strategy to overcome the impact of multidrug resistance in respiratory pathogens.
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Affiliation(s)
- Mirian Domenech
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
| | - Julio Sempere
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
| | - Sara de Miguel
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
| | - Jose Yuste
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
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20
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Belkacem N, Bourdet-Sicard R, Taha MK. Lactobacillus paracasei feeding improves the control of secondary experimental meningococcal infection in flu-infected mice. BMC Infect Dis 2018; 18:167. [PMID: 29636018 PMCID: PMC5894232 DOI: 10.1186/s12879-018-3086-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of probiotics to improve anti-microbial defence, such as for influenza infections, is increasingly recommended. However, no data are available on the effect of probiotics on flu-associated secondary bacterial infections. There is strong evidence of a spatiotemporal association between influenza virus infection and invasive Neisseria meningitidis. We thus investigated the effect of feeding mice Lactobacillus paracasei CNCM I-1518 in a mouse model of sequential influenza-meningococcal infection. METHODS We intranasally infected BALB/c mice with a strain of influenza A virus (IAV) H3N2 that was first adapted to mice. Seven days later, a secondary bacterial infection was induced by intranasal administration of bioluminescent N. meningitidis. During the experiment, mice orally received either L. paracasei CNCM I-1518 or PBS as a control. The effect of L. paracasei administration on secondary bacterial infection by N. meningitidis was evaluated. RESULTS Oral consumption of L. paracasei CNCM I-1518 reduced the weight loss of infected mice and lowered the bioluminescent signal of infecting meningococci. This improvement was associated with higher recruitment of inflammatory myeloid cells, such as interstitial monocytes and dendritic cells, to the lungs. CONCLUSIONS Our data highlight the role of the gut-lung axis. L. paracasei CNCM I-1518 may boost the defence against IAV infection and secondary bacterial infection, which should be further studied and validated in clinical trials.
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Affiliation(s)
- Nouria Belkacem
- Institut Pasteur, Invasive Bacterial Infections Unit , 28 rue du Dr. Roux, 75724, Paris, France.,Bioaster 28, rue du Docteur Roux, 75015, Paris, France
| | - Raphaëlle Bourdet-Sicard
- Bioaster 28, rue du Docteur Roux, 75015, Paris, France.,Danone Research, route de la Vauve, 91120, Palaiseau, France
| | - Muhamed-Kkeir Taha
- Institut Pasteur, Invasive Bacterial Infections Unit , 28 rue du Dr. Roux, 75724, Paris, France.
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21
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Opatowski L, Baguelin M, Eggo RM. Influenza interaction with cocirculating pathogens and its impact on surveillance, pathogenesis, and epidemic profile: A key role for mathematical modelling. PLoS Pathog 2018; 14:e1006770. [PMID: 29447284 PMCID: PMC5814058 DOI: 10.1371/journal.ppat.1006770] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Evidence is mounting that influenza virus interacts with other pathogens colonising or infecting the human respiratory tract. Taking into account interactions with other pathogens may be critical to determining the real influenza burden and the full impact of public health policies targeting influenza. This is particularly true for mathematical modelling studies, which have become critical in public health decision-making. Yet models usually focus on influenza virus acquisition and infection alone, thereby making broad oversimplifications of pathogen ecology. Herein, we report evidence of influenza virus interactions with bacteria and viruses and systematically review the modelling studies that have incorporated interactions. Despite the many studies examining possible associations between influenza and Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Neisseria meningitidis, respiratory syncytial virus (RSV), human rhinoviruses, human parainfluenza viruses, etc., very few mathematical models have integrated other pathogens alongside influenza. The notable exception is the pneumococcus-influenza interaction, for which several recent modelling studies demonstrate the power of dynamic modelling as an approach to test biological hypotheses on interaction mechanisms and estimate the strength of those interactions. We explore how different interference mechanisms may lead to unexpected incidence trends and possible misinterpretation, and we illustrate the impact of interactions on public health surveillance using simple transmission models. We demonstrate that the development of multipathogen models is essential to assessing the true public health burden of influenza and that it is needed to help improve planning and evaluation of control measures. Finally, we identify the public health, surveillance, modelling, and biological challenges and propose avenues of research for the coming years.
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Affiliation(s)
- Lulla Opatowski
- Université de Versailles Saint Quentin, Institut Pasteur, Inserm, Paris, France
| | - Marc Baguelin
- London School of Hygiene & Tropical Medicine, London, United Kingdom
- Public Health England, London, United Kingdom
| | - Rosalind M. Eggo
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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22
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Loers G, Astafiev S, Hapiak Y, Saini V, Mishra B, Gul S, Kaur G, Schachner M, Theis T. The polysialic acid mimetics idarubicin and irinotecan stimulate neuronal survival and neurite outgrowth and signal via protein kinase C. J Neurochem 2017; 142:392-406. [PMID: 28542923 PMCID: PMC5539918 DOI: 10.1111/jnc.14076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/11/2017] [Accepted: 05/15/2017] [Indexed: 02/05/2023]
Abstract
Polysialic acid (PSA) is a large, negatively charged, linear homopolymer of alpha2-8-linked sialic acid residues. It is generated by two polysialyltransferases and attached to N- and/or O-linked glycans, and its main carrier is the neural cell adhesion molecule (NCAM). PSA controls the development and regeneration of the nervous system by enhancing cell migration, axon pathfinding, synaptic targeting, synaptic plasticity, by regulating the differentiation of progenitor cells and by modulating cell-cell and cell-matrix adhesions. In the adult, PSA plays a role in the immune system, and PSA mimetics promote functional recovery after nervous system injury. In search for novel small molecule mimetics of PSA that are applicable for therapy, we identified idarubicin, an antineoplastic anthracycline, and irinotecan, an antineoplastic agent of the topoisomerase I inhibitor class, as PSA mimetics using a competition enzyme-linked immunosorbent assay. Idarubicin and irinotecan compete with the PSA-mimicking peptide and colominic acid, the bacterial analog of PSA, for binding to the PSA-specific monoclonal antibody 735. Idarubicin and irinotecan stimulate neurite outgrowth and survival of cultured cerebellar neurons after oxidative stress via protein kinase C and Erk1/2 in a similar manner as colominic acid, whereas Fyn, casein kinase II and the phosphatase and tensin homolog are only involved in idarubicin and irinotecan-stimulated neurite outgrowth. These novel results show that the structure and function of PSA can be mimicked by the small organic compounds irinotecan and idarubicin which trigger the same signaling cascades as PSA, thus introducing the possibility of retargeting these drugs to treat nervous system injuries.
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Affiliation(s)
- Gabriele Loers
- Zentrum für Molekulare Neurobiologie Hamburg, Universitätsklinikum Hamburg-Eppendorf, Falkenried 94, D-20251 Hamburg, Germany
| | - Steven Astafiev
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Piscataway, NJ 08854, USA
| | - Yuliya Hapiak
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Piscataway, NJ 08854, USA
| | - Vedangana Saini
- Zentrum für Molekulare Neurobiologie Hamburg, Universitätsklinikum Hamburg-Eppendorf, Falkenried 94, D-20251 Hamburg, Germany
- Department of Biotechnology, Guru Nanak Dev University, GT Road, 143005 Amritsar, India
| | - Bibhudatta Mishra
- Zentrum für Molekulare Neurobiologie Hamburg, Universitätsklinikum Hamburg-Eppendorf, Falkenried 94, D-20251 Hamburg, Germany
| | - Sheraz Gul
- Fraunhofer Institute for Molecular Biology and Applied Ecology Screening Port (Fraunhofer-IME SP), Schnackenburgalle114, D-22525 Hamburg, Germany
| | - Gurcharan Kaur
- Department of Biotechnology, Guru Nanak Dev University, GT Road, 143005 Amritsar, India
| | - Melitta Schachner
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Piscataway, NJ 08854, USA
- Center for Neuroscience, Shantou University Medical College, 22 Xin Ling Road, Shantou, Guangdong 515041, China
- To whom correspondence should be addressed: Melitta Schachner, Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Piscataway, NJ 08854, USA; phone: +1-732-445-1780; fax: +1-732-445-2063; ; or Melitta Schachner, Center for Neuroscience, Shantou University Medical College, 22 Xin Ling Road, Shantou, Guangdong 515041, China; phone: + 86 754 8890 0276; fax: + 86 754 8890 0236;
| | - Thomas Theis
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Piscataway, NJ 08854, USA
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23
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Billard L, Le Berre R, Pilorgé L, Payan C, Héry-Arnaud G, Vallet S. Viruses in cystic fibrosis patients' airways. Crit Rev Microbiol 2017; 43:690-708. [PMID: 28340310 DOI: 10.1080/1040841x.2017.1297763] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Although bacteria have historically been considered to play a major role in cystic fibrosis (CF) airway damage, a strong impact of respiratory viral infections (RVI) is also now recognized. Emerging evidence confirms that respiratory viruses are associated with deterioration of pulmonary function and exacerbation and facilitation of bacterial colonization in CF patients. The aim of this review is to provide an overview of the current knowledge on respiratory viruses in CF airways, to discuss the resulting inflammation and RVI response, to determine how to detect the viruses, and to assess their clinical consequences, prevalence, and interactions with bacteria. The most predominant are Rhinoviruses (RVs), significantly associated with CF exacerbation. Molecular techniques, and especially multiplex PCR, help to diagnose viral infections, and the coming rise of metagenomics will extend knowledge of viral populations in the complex ecosystem of CF airways. Prophylaxis and vaccination are currently available only for Respiratory syncytial and Influenza virus (IV), but antiviral molecules are being tested to improve CF patients' care. All the points raised in this review highlight the importance of taking account of RVIs and their potential impact on the CF airway ecosystem.
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Affiliation(s)
- Lisa Billard
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France
| | - Rozenn Le Berre
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,b Département de Médecine Interne et Pneumologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Léa Pilorgé
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Christopher Payan
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Geneviève Héry-Arnaud
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
| | - Sophie Vallet
- a EA 3882-Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM) , Groupe de Bactériologie-Virologie, Faculté de Médecine et des Sciences de la Santé , Université Bretagne Loire , Brest Cedex , France.,c Département de Bacteriologie-Virologie, Hygiène et Parasitologie-Mycologie, Pôle de Biologie-Pathologie , Centre Hospitalier Régional et Universitaire de Brest, Hôpital de la Cavale Blanche , Brest cedex , France
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24
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Weyand NJ. Neisseria models of infection and persistence in the upper respiratory tract. Pathog Dis 2017; 75:3078547. [DOI: 10.1093/femspd/ftx031] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/15/2017] [Indexed: 12/15/2022] Open
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25
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Impact of Moderate Temperature Changes on Neisseria meningitidis Adhesion Phenotypes and Proteome. Infect Immun 2016; 84:3484-3495. [PMID: 27672084 DOI: 10.1128/iai.00584-16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/20/2016] [Indexed: 11/20/2022] Open
Abstract
Neisseria meningitidis, the meningococcus, bears the potential to cause life-threatening invasive diseases, but it usually colonizes the nasopharynx without causing any symptoms. Within the nasopharynx, Neisseria meningitidis must face temperature changes depending on the ambient air temperature. Indeed, the nasopharyngeal temperature can be substantially lower than 37°C, the temperature commonly used in experimental settings. Here, we compared the levels of meningococcal biofilm formation, autoaggregation, and cellular adherence at 32°C and 37°C and found a clear increase in all these phenotypes at 32°C suggestive of a stronger in vivo colonization capability at this temperature. A comparative proteome analysis approach revealed differential protein expression levels between 32°C and 37°C, predominantly affecting the bacterial envelope. A total of 375 proteins were detected. Use of database annotation or the PSORTb algorithm predicted 49 of those proteins to be localized in the outer membrane, 21 in either the inner or outer membrane, 35 in the periplasm, 56 in the inner membrane, and 208 in the cytosol; for 6 proteins, no annotation or prediction was available. Temperature-dependent regulation of protein expression was seen particularly in the periplasm as well as in the outer and inner membranes. Neisserial heparin binding antigen (NHBA), NMB1030, and adhesin complex protein (ACP) showed the strongest upregulation at 32°C and were partially responsible for the observed temperature-dependent phenotypes. Screening of different global regulators of Neisseria meningitidis suggested that the extracytoplasmic sigma factor σE might be involved in temperature-dependent biofilm formation. In conclusion, subtle temperature changes trigger adaptation events promoting mucosal colonization by meningococci.
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26
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Bellinghausen C, Rohde GGU, Savelkoul PHM, Wouters EFM, Stassen FRM. Viral-bacterial interactions in the respiratory tract. J Gen Virol 2016; 97:3089-3102. [PMID: 27902340 DOI: 10.1099/jgv.0.000627] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In the respiratory tract, viruses and bacteria can interact on multiple levels. It is well known that respiratory viruses, particularly influenza viruses, increase the susceptibility to secondary bacterial infections. Numerous mechanisms, including compromised physical and immunological barriers, and changes in the microenvironment have hereby been shown to contribute to the development of secondary bacterial infections. In contrast, our understanding of how bacteria shape a response to subsequent viral infection is still limited. There is emerging evidence that persistent infection (or colonization) of the lower respiratory tract (LRT) with potential pathogenic bacteria, as observed in diseases like chronic obstructive pulmonary disease or cystic fibrosis, modulates subsequent viral infections by increasing viral entry receptors and modulating the inflammatory response. Moreover, recent studies suggest that even healthy lungs are not, as had long been assumed, sterile. The composition of the lung microbiome may thus modulate responses to viral infections. Here we summarize the current knowledge on the co-pathogenesis between viruses and bacteria in LRT infections.
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Affiliation(s)
- Carla Bellinghausen
- Department of Respiratory Medicine, NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Medical Microbiology, NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Gernot G U Rohde
- Department of Respiratory Medicine, NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Paul H M Savelkoul
- Department of Medical Microbiology, NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Medical Microbiology & Infection Control, VU University Medical Center, Amsterdam, The Netherlands
| | - Emiel F M Wouters
- Department of Respiratory Medicine, NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Frank R M Stassen
- Department of Medical Microbiology, NUTRIM - School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
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27
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Loers G, Saini V, Mishra B, Gul S, Chaudhury S, Wallqvist A, Kaur G, Schachner M. Vinorelbine and epirubicin share common features with polysialic acid and modulate neuronal and glial functions. J Neurochem 2016; 136:48-62. [PMID: 26443186 PMCID: PMC4904230 DOI: 10.1111/jnc.13383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/21/2015] [Accepted: 10/02/2015] [Indexed: 02/05/2023]
Abstract
Polysialic acid (PSA), a large, linear glycan composed of 8 to over 100 α2,8-linked sialic acid residues, modulates development of the nervous system by enhancing cell migration, axon pathfinding, and synaptic targeting and by regulating differentiation of progenitor cells. PSA also functions in developing and adult immune systems and is a signature of many cancers. In this study we identified vinorelbine, a semi-synthetic third generation vinca alkaloid, and epirubicin, an anthracycline and 4'-epimer of doxorubicin, as PSA mimetics. Similar to PSA, vinorelbine and epirubicin bind to the PSA-specific monoclonal antibody 735 and compete with the bacterial analog of PSA, colominic acid in binding to monoclonal antibody 735. Vinorelbine and epirubicin stimulate neurite outgrowth of cerebellar neurons via the neural cell adhesion molecule, via myristoylated alanine-rich C kinase substrate, and via fibroblast growth factor receptor, signaling through Erk pathways. Furthermore, the two compounds enhance process formation of Schwann cells and migration of cerebellar neurons in culture, and reduce migration of astrocytes after injury. These novel results show that the structure and function of PSA can be mimicked by the small organic compounds vinorelbine and epirubicin, thus raising the possibility to re-target drugs used in treatment of cancers to nervous system repair. Vinorelbine and epirubicin, identified as PSA mimetics, enhance, like PSA, neuronal migration, neuritogenesis, and formation of Schwann cell processes, and reduce astrocytic migration. Ablating NCAM, inhibiting fibroblast growth factor (FGFR) receptor, or adding the effector domain of myristoylated alanine-rich C kinase substrate (MARCKS) minimize the vinorelbine and epirubicin effects, indicating that they are true PSA mimetics triggering PSA-mediated functions.
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Affiliation(s)
- Gabriele Loers
- Zentrum für Molekulare Neurobiologie Hamburg, Universitätsklinikum Hamburg-Eppendorf, Falkenried 94, D-20251 Hamburg, Germany
| | - Vedangana Saini
- Department of Biotechnology, Guru Nanak Dev University, GT Road, 143005 Amritsar, India
| | - Bibhudatta Mishra
- Zentrum für Molekulare Neurobiologie Hamburg, Universitätsklinikum Hamburg-Eppendorf, Falkenried 94, D-20251 Hamburg, Germany
| | - Sheraz Gul
- Fraunhofer Institute for Molecular Biology and Applied Ecology ScreeningPort (Fraunhofer-IME SP), Schnackenburgalle114, D-22525 Hamburg, Germany
| | - Sidhartha Chaudhury
- DoD Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, US Army Medical Research and Materiel Command, Fort Detrick, MD 21702 (USA)
| | - Anders Wallqvist
- DoD Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, US Army Medical Research and Materiel Command, Fort Detrick, MD 21702 (USA)
| | - Gurcharan Kaur
- Department of Biotechnology, Guru Nanak Dev University, GT Road, 143005 Amritsar, India
| | - Melitta Schachner
- Zentrum für Molekulare Neurobiologie Hamburg, Universitätsklinikum Hamburg-Eppendorf, Falkenried 94, D-20251 Hamburg, Germany
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience, Rutgers University, 604 Allison Road, Piscataway, NJ 08854, USA
- Center for Neuroscience, Shantou University Medical College, 22 Xin Ling Road, Shantou, Guangdong 515041, China
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28
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Castro-Rodriguez JA, Jakubson L, Padilla O, Gallegos D, Fasce R, Bertrand P, Sanchez I, Perret C. Many respiratory viruses have temporal association with meningococcal disease. Allergol Immunopathol (Madr) 2015; 43:487-92. [PMID: 25456529 DOI: 10.1016/j.aller.2014.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 07/23/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous ecological studies have shown a temporal and spatial association between influenza epidemics and meningococcal disease (MNG); however, none have examined more than two respiratory viruses. METHODS Data were obtained in Chile between 2000 and 2005 on confirmed cases of MNG and all confirmed cases of respiratory viruses (influenza A and B; parainfluenza; adenovirus; and respiratory syncytial virus [RSV]). Both variables were divided by epidemiological weeks, age range, and regions. Models of transference functions were run for rates of MNG. RESULTS In this period, 1022 reported cases of MNG and 34,737 cases of respiratory virus were identified (25,137 RSV; 4300 parainfluenza; 2527 influenza-A; 356 influenza-B; and 2417 adenovirus). RSV was the major independent virus temporally associated to MNG (it appears one week before MNG), followed by parainfluenza, influenza-B, adenovirus, and influenza-A. CONCLUSIONS The rate of MNG in Chile is temporally associated to all of the respiratory viruses studied, but with variability according age range, and regions.
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Affiliation(s)
- J A Castro-Rodriguez
- Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - L Jakubson
- Department of Pediatrics, School of Medicine, Universidad de Chile, Santiago, Chile
| | - O Padilla
- Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - R Fasce
- Chilean Public Health Institute, Santiago, Chile
| | - P Bertrand
- Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - I Sanchez
- Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C Perret
- Department of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Koutangni T, Boubacar Maïnassara H, Mueller JE. Incidence, carriage and case-carrier ratios for meningococcal meningitis in the African meningitis belt: a systematic review and meta-analysis. PLoS One 2015; 10:e0116725. [PMID: 25658307 PMCID: PMC4319942 DOI: 10.1371/journal.pone.0116725] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 12/12/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND To facilitate the interpretation of meningococcal meningitis epidemiology in the "African meningitis belt", we aimed at obtaining serogroup-specific pooled estimates of incidence, carriage and case-carrier ratios for meningococcal meningitis in the African meningitis belt and describe their variations across the endemic, hyperendemic and epidemic context. METHODS We conducted a systematic review and meta-analysis of studies reporting serogroup-specific meningococcal meningitis monthly incidence and carriage in the same population and time period. Epidemiological contexts were defined as endemic (wet season, no epidemic), hyperendemic (dry season, no epidemic), and epidemic (dry season, epidemic). FINDINGS Eight studies reporting a total of eighty pairs of serogroup-specific meningococcal meningitis incidence and carriage estimates were included in this review. For serogroup A, changes associated with the transition from endemic to hyperendemic incidence and from hyperendemic to epidemic incidence were 15-fold and 120-fold respectively. Changes in carriage prevalence associated with both transitions were 1-fold and 30-fold respectively.
For serogroup W and X, the transition from endemic to hyperendemic incidence involved a 4-fold and 1•1-fold increase respectively. Increases in carriage prevalence for the later transition were 7-fold and 1•7-fold respectively. No data were available for the hyperendemic-epidemic transition for these serogroups. Our findings suggested that the regular seasonal variation in serogroup A meningococcal meningitis incidence between the rainy and the dry season could be mainly driven by seasonal change in the ratio of clinical cases to subclinical infections. In contrast appearance of epidemic incidences is related to a substantial increase in transmission and colonisation and to lesser extent with changes in the case-carrier ratio. CONCLUSION Seasonal change in the rate of progression to disease given carriage together with variations in frequency of carriage transmission should be considered in models attempting to capture the epidemiology of meningococcal meningitis and mainly to predict meningitis epidemics in the African meningitis belt.
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Affiliation(s)
- Thibaut Koutangni
- EHESP French School of Public Health, Sorbonne Paris Cité, Rennes, France
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
| | | | - Judith E. Mueller
- EHESP French School of Public Health, Sorbonne Paris Cité, Rennes, France
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Paris, France
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30
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The association of meningococcal disease with influenza in the United States, 1989-2009. PLoS One 2014; 9:e107486. [PMID: 25265409 PMCID: PMC4180274 DOI: 10.1371/journal.pone.0107486] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/12/2014] [Indexed: 11/28/2022] Open
Abstract
Importance and Objective Prior influenza infection is a risk factor for invasive meningococcal disease. Quantifying the fraction of meningococcal disease attributable to influenza could improve understanding of viral-bacterial interaction and indicate additional health benefits to influenza immunization. Design, Setting and Participants A time series analysis of the association of influenza and meningococcal disease using hospitalizations in 9 states from 1989–2009 included in the State Inpatient Databases from the Agency for Healthcare Research and Quality and the proportion of positive influenza tests by subtype reported to the Centers for Disease Control. The model accounts for the autocorrelation of meningococcal disease and influenza between weeks, temporal trends, co-circulating respiratory syncytial virus, and seasonality. The influenza-subtype-attributable fraction was estimated using the model coefficients. We analyzed the synchrony of seasonal peaks in hospitalizations for influenza, respiratory syncytial virus, and meningococcal disease. Results and Conclusions In 19 of 20 seasons, influenza peaked≤2 weeks before meningococcal disease, and peaks were highly correlated in time (ρ = 0.95; P <.001). H3N2 and H1N1 peaks were highly synchronized with meningococcal disease while pandemic H1N1, B, and respiratory syncytial virus were not. Over 20 years, 12.8% (95% CI, 9.1–15.0) of meningococcal disease can be attributable to influenza in the preceding weeks with H3N2 accounting for 5.2% (95% CI, 3.0–6.5), H1N1 4.3% (95% CI, 2.6–5.6), B 3.0% (95% CI, 0.8–4.9) and pH1N1 0.2% (95% CI, 0–0.4). During the height of influenza season, weekly attributable fractions reach 59%. While vaccination against meningococcal disease is the most important prevention strategy, influenza vaccination could provide further protection, particularly in young children where the meningococcal disease vaccine is not recommended or protective against the most common serogroup.
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31
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Kriz P, Wieffer H, Holl K, Rosenlund M, Budhia S, Vyse A. Changing epidemiology of meningococcal disease in Europe from the mid-20th to the early 21st Century. Expert Rev Vaccines 2014; 10:1477-86. [DOI: 10.1586/erv.11.117] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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32
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Zarantonelli ML, Skoczynska A, Antignac A, El Ghachi M, Deghmane AE, Szatanik M, Mulet C, Werts C, Peduto L, d'Andon MF, Thouron F, Nato F, Lebourhis L, Philpott DJ, Girardin SE, Vives FL, Sansonetti P, Eberl G, Pedron T, Taha MK, Boneca IG. Penicillin resistance compromises Nod1-dependent proinflammatory activity and virulence fitness of neisseria meningitidis. Cell Host Microbe 2013; 13:735-45. [PMID: 23768497 DOI: 10.1016/j.chom.2013.04.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 03/05/2013] [Accepted: 04/30/2013] [Indexed: 12/12/2022]
Abstract
Neisseria meningitidis is a life-threatening human bacterial pathogen responsible for pneumonia, sepsis, and meningitis. Meningococcal strains with reduced susceptibility to penicillin G (Pen(I)) carry a mutated penicillin-binding protein (PBP2) resulting in a modified peptidoglycan structure. Despite their antibiotic resistance, Pen(I) strains have failed to expand clonally. We analyzed the biological consequences of PBP2 alteration among clinical meningococcal strains and found that peptidoglycan modifications of the Pen(I) strain resulted in diminished in vitro Nod1-dependent proinflammatory activity. In an influenza virus-meningococcal sequential mouse model mimicking human disease, wild-type meningococci induced a Nod1-dependent inflammatory response, colonizing the lungs and surviving in the blood. In contrast, isogenic Pen(I) strains were attenuated for such response and were out-competed by meningococci sensitive to penicillin G. Our results suggest that antibiotic resistance imposes a cost to the success of the pathogen and may potentially explain the lack of clonal expansion of Pen(I) strains.
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33
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Loh E, Kugelberg E, Tracy A, Zhang Q, Gollan B, Ewles H, Chalmers R, Pelicic V, Tang CM. Temperature triggers immune evasion by Neisseria meningitidis. Nature 2013; 502:237-40. [PMID: 24067614 PMCID: PMC3836223 DOI: 10.1038/nature12616] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 08/29/2013] [Indexed: 11/10/2022]
Abstract
Neisseria meningitidis has several strategies to evade complement-mediated killing, and these contribute to its ability to cause septicaemic disease and meningitis. However, the meningococcus is primarily an obligate commensal of the human nasopharynx, and it is unclear why the bacterium has evolved exquisite mechanisms to avoid host immunity. Here we demonstrate that mechanisms of meningococcal immune evasion and resistance against complement increase in response to an increase in ambient temperature. We have identified three independent RNA thermosensors located in the 5' untranslated regions of genes necessary for capsule biosynthesis, the expression of factor H binding protein, and sialylation of lipopolysaccharide, which are essential for meningococcal resistance against immune killing. Therefore increased temperature (which occurs during inflammation) acts as a 'danger signal' for the meningococcus, enhancing its defence against human immune killing. Infection with viral pathogens, such as influenza, leads to inflammation in the nasopharynx with an increased temperature and recruitment of immune effectors. Thermoregulation of immune defence could offer an adaptive advantage to the meningococcus during co-infection with other pathogens, and promote the emergence of virulence in an otherwise commensal bacterium.
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Affiliation(s)
- Edmund Loh
- Sir William Dunn School of Pathology, University of Oxford, Sir Parks Road, Oxford OX1 3RE
| | | | - Alexander Tracy
- Sir William Dunn School of Pathology, University of Oxford, Sir Parks Road, Oxford OX1 3RE
| | - Qian Zhang
- Centre for Molecular Microbiology and Infection, Imperial College London
| | - Bridget Gollan
- Centre for Molecular Microbiology and Infection, Imperial College London
| | - Helen Ewles
- Centre for Molecular Microbiology and Infection, Imperial College London
| | | | - Vladimir Pelicic
- Centre for Molecular Microbiology and Infection, Imperial College London
| | - Christoph M. Tang
- Sir William Dunn School of Pathology, University of Oxford, Sir Parks Road, Oxford OX1 3RE
- Centre for Molecular Microbiology and Infection, Imperial College London
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Abstract
Despite considerable advances in the understanding of the pathogenesis of meningococcal disease, this infection remains a major cause of morbidity and mortality globally. The role of the complement system in innate immune defenses against invasive meningococcal disease is well established. Individuals deficient in components of the alternative and terminal complement pathways are highly predisposed to invasive, often recurrent meningococcal infections. Genome-wide analysis studies also point to a central role for complement in disease pathogenesis. Here we review the pathophysiologic events pertinent to the complement system that accompany meningococcal sepsis in humans. Meningococci use several often redundant mechanisms to evade killing by human complement. Capsular polysaccharide and lipooligosaccharide glycan composition play critical roles in complement evasion. Some of the newly described protein vaccine antigens interact with complement components and have sparked considerable research interest.
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Affiliation(s)
- Lisa A Lewis
- Division of Infectious Diseases and Immunology; University of Massachusetts Medical School; Worcester, MA USA
| | - Sanjay Ram
- Division of Infectious Diseases and Immunology; University of Massachusetts Medical School; Worcester, MA USA
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Capsular sialic acid of Streptococcus suis serotype 2 binds to swine influenza virus and enhances bacterial interactions with virus-infected tracheal epithelial cells. Infect Immun 2013; 81:4498-508. [PMID: 24082069 DOI: 10.1128/iai.00818-13] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Streptococcus suis serotype 2 is an important swine bacterial pathogen, and it is also an emerging zoonotic agent. It is unknown how S. suis virulent strains, which are usually found in low quantities in pig tonsils, manage to cross the first host defense lines to initiate systemic disease. Influenza virus produces a contagious infection in pigs which is frequently complicated by bacterial coinfections, leading to significant economic impacts. In this study, the effect of a preceding swine influenza H1N1 virus (swH1N1) infection of swine tracheal epithelial cells (NTPr) on the ability of S. suis serotype 2 to adhere to, invade, and activate these cells was evaluated. Cells preinfected with swH1N1 showed bacterial adhesion and invasion levels that were increased more than 100-fold compared to those of normal cells. Inhibition studies confirmed that the capsular sialic acid moiety is responsible for the binding to virus-infected cell surfaces. Also, preincubation of S. suis with swH1N1 significantly increased bacterial adhesion to/invasion of epithelial cells, suggesting that S. suis also uses swH1N1 as a vehicle to invade epithelial cells when the two infections occur simultaneously. Influenza virus infection may facilitate the transient passage of S. suis at the respiratory tract to reach the bloodstream and cause bacteremia and septicemia. S. suis may also increase the local inflammation at the respiratory tract during influenza infection, as suggested by an exacerbated expression of proinflammatory mediators in coinfected cells. These results give new insight into the complex interactions between influenza virus and S. suis in a coinfection model.
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Loers G, Saini V, Mishra B, Papastefanaki F, Lutz D, Chaudhury S, Ripoll DR, Wallqvist A, Gul S, Schachner M, Kaur G. Nonyloxytryptamine mimics polysialic acid and modulates neuronal and glial functions in cell culture. J Neurochem 2013; 128:88-100. [DOI: 10.1111/jnc.12408] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 07/19/2013] [Accepted: 08/12/2013] [Indexed: 01/09/2023]
Affiliation(s)
- Gabriele Loers
- Zentrum für Molekulare Neurobiologie Hamburg; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
| | - Vedangana Saini
- Department of Biotechnology; Guru Nanak Dev University; Amritsar Punjab India
| | - Bibhudatta Mishra
- Zentrum für Molekulare Neurobiologie Hamburg; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
| | - Florentia Papastefanaki
- Laboratory of Cellular and Molecular Neurobiology; Hellenic Pasteur Institute; Athens Greece
| | - David Lutz
- Zentrum für Molekulare Neurobiologie Hamburg; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
| | - Sidhartha Chaudhury
- DoD Biotechnology High Performance Computing Software Applications Institute; Telemedicine and Advanced Technology Research Center; US Army Medical Research and Materiel Command; Fort Detrick Maryland USA
| | - Daniel R. Ripoll
- DoD Biotechnology High Performance Computing Software Applications Institute; Telemedicine and Advanced Technology Research Center; US Army Medical Research and Materiel Command; Fort Detrick Maryland USA
| | - Anders Wallqvist
- DoD Biotechnology High Performance Computing Software Applications Institute; Telemedicine and Advanced Technology Research Center; US Army Medical Research and Materiel Command; Fort Detrick Maryland USA
| | - Sheraz Gul
- European ScreeningPort GmbH; Schnackenburgalle114; Hamburg Germany
| | - Melitta Schachner
- Zentrum für Molekulare Neurobiologie Hamburg; Universitätsklinikum Hamburg-Eppendorf; Hamburg Germany
- Keck Center for Collaborative Neuroscience and Department of Cell Biology and Neuroscience; Rutgers University; Piscataway New Jersey USA
| | - Gurcharan Kaur
- Department of Biotechnology; Guru Nanak Dev University; Amritsar Punjab India
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Johswich KO, McCaw SE, Islam E, Sintsova A, Gu A, Shively JE, Gray-Owen SD. In vivo adaptation and persistence of Neisseria meningitidis within the nasopharyngeal mucosa. PLoS Pathog 2013; 9:e1003509. [PMID: 23935487 PMCID: PMC3723569 DOI: 10.1371/journal.ppat.1003509] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 06/04/2013] [Indexed: 12/13/2022] Open
Abstract
Neisseria meningitidis (Nme) asymptomatically colonizes the human nasopharynx, yet can initiate rapidly-progressing sepsis and meningitis in rare instances. Understanding the meningococcal lifestyle within the nasopharyngeal mucosa, a phase of infection that is prerequisite for disease, has been hampered by the lack of animal models. Herein, we compare mice expressing the four different human carcinoembryonic antigen-related cell adhesion molecules (CEACAMs) that can bind the neisserial Opa protein adhesins, and find that expression of human CEACAM1 is necessary and sufficient to establish intranasal colonization. During infection, in vivo selection for phase variants expressing CEACAM1-specific Opa proteins occurs, allowing mucosal attachment and entry into the subepithelial space. Consistent with an essential role for Opa proteins in this process, Opa-deficient meningococci were unable to colonize the CEACAM1-humanized mice. While simple Opa-mediated attachment triggered an innate response regardless of meningococcal viability within the inoculum, persistence of viable Opa-expressing bacteria within the CEACAM1-humanized mice was required for a protective memory response to be achieved. Parenteral immunization with a capsule-based conjugate vaccine led to the accumulation of protective levels of Nme-specific IgG within the nasal mucus, yet the sterilizing immunity afforded by natural colonization was instead conferred by Nme-specific IgA without detectable IgG. Considered together, this study establishes that the availability of CEACAM1 helps define the exquisite host specificity of this human-restricted pathogen, displays a striking example of in vivo selection for the expression of desirable Opa variants, and provides a novel model in which to consider meningococcal infection and immunity within the nasopharyngeal mucosa. Neisseria meningitidis (Nme), a common cause of bacterial meningitis, are carried asymptomatically in the nasopharynx by a substantial proportion of healthy individuals. Their strict adaptation to the human as host has so far impeded the development of animal models to study the meningococcal lifestyle in vivo. While several human CEACAMs are recognized by the neisserial Opa protein adhesins, we show here that the expression of human CEACAM1 in transgenic mice is necessary and sufficient to allow nasal colonization by Nme. The dependence on human CEACAM1 is attributable to the Opa proteins, since intranasal infection with Opa-negative colonies of Nme selects for bacteria expressing Opa proteins, and genetically Opa-deficient meningococci are unable to colonize these animals. We use this new mouse model to examine how innate immune factors such as neutrophils and complement limit colonization. Furthermore, we compare how adaptive responses elicited by colonization and those generated by parenteral vaccination differentially confer sterilizing immunity. Together, this work provides the first evidence of the critical nature of Opa-CEACAM1 binding in vivo, demonstrates that this is a major determinant of the host restriction by Nme, and reveals a clear disparity between immune correlates of sterilizing immunity conferred by natural colonization versus parenteral immunization.
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Affiliation(s)
- Kay O Johswich
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
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Smith H, Rogers SL, Smith HV, Gillis D, Siskind V, Smith JA. Virus-associated apoptosis of blood neutrophils as a risk factor for invasive meningococcal disease. J Clin Pathol 2013; 66:976-81. [PMID: 23801496 PMCID: PMC3841771 DOI: 10.1136/jclinpath-2013-201579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims To quantify a range of haematological indicators of viral infection (leucocyte apoptosis, cytopenia of normal lymphocytes, reactive lymphocyte increase, neutropenia) in patients with recent onset invasive meningococcal disease (IMD), with a view to test the association of viral infection with IMD and identify possible haematological risk factors for its development. Subjects and methods 88 patients with recent onset IMD, classified on clinical severity as fatal (n=14), septic shock survived (n=26) and no shock (n=48), and 50 healthy controls were studied. Blood film microscopy and leucocyte counts were used to quantify the virus-associated indicators. Cocci-containing neutrophils were also quantified. Results All viral parameters were significantly more frequent or higher in patients than controls, with leucocyte apoptosis found only in the patients. A significant gradient in accord with clinical severity was found for neutrophil and lymphocyte apoptosis, neutropenia and cocci-containing neutrophils. Crucially, apoptotic neutrophils did not contain cocci, and cocci-containing neutrophils were not apoptotic. Conclusions The correlation between magnitude of neutrophil apoptosis and severity of IMD suggests a cause–effect relationship. We propose that neutrophil apoptosis is more likely a facilitator rather than an effect of IMD for these reasons: (1) apoptotic neutrophils did not contain cocci and cocci-containing neutrophils were not apoptotic, (2) leucocyte apoptosis is a recognised viral effect and (3) Neisseria meningitidis is incapable of producing a Panton–Valentine type leucocidin. The lymphocyte apoptosis which accompanies neutrophil death may contribute to risk by impairing the generation of microbicidal antibody. Leucocyte apoptosis is a morphological expression of viral immunosuppression and, we suggest, is a likely contributor to a range of viral effects.
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Affiliation(s)
- Harry Smith
- Department of Paediatrics, University of Queensland, Royal Children's Hospital, , Brisbane, Queensland, Australia
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Kimaro Mlacha SZ, Peret TCT, Kumar N, Romero-Steiner S, Dunning Hotopp JC, Ishmael N, Grinblat-Huse V, Riley DR, Erdman DD, Carlone GM, Sampson J, Scott JAG, Tettelin H. Transcriptional adaptation of pneumococci and human pharyngeal cells in the presence of a virus infection. BMC Genomics 2013; 14:378. [PMID: 23742656 PMCID: PMC3681581 DOI: 10.1186/1471-2164-14-378] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 05/24/2013] [Indexed: 11/26/2022] Open
Abstract
Background Viral upper respiratory tract infections are associated with increased colonization by Streptococcus pneumoniae but the mechanisms underlying this relationship are unclear. The objective of this study is to describe a comprehensive picture of the cellular interaction between the adhering bacteria and host cells in the presence or absence of a viral co-infection. Results Gene expression profiles of Detroit-562 pharyngeal cells, which were either mock-infected or infected with human respiratory syncytial virus (RSV) or human parainfluenza virus 3 (HPIV3), were analyzed using human microarrays. Transcription response of S. pneumoniae strain TIGR4 (serotype 4) in the presence of either mock- or viral-infected cells was analyzed by pneumococcal microarray. Significantly regulated genes were identified by both significance analysis of microarray (SAM) and a ≥ 2-fold change ratio cut-off. The adherence of S. pneumoniae to human pharyngeal cells was significantly augmented in the presence of RSV or HPIV3 infection. Global gene expression profiling of the host cells during infection with RSV or HPIV3 revealed increased transcription of carcinoembryonic antigen-related cell adhesion molecules (CEACAM1), CD47, fibronectin, interferon-stimulated genes and many other host cell adhesion molecules. Pneumococci increased transcription of several genes involved in adhesive functions (psaA, pilus islet), choline uptake and incorporation (lic operon), as well as transport and binding. Conclusions We have identified a core transcriptome that represents the basic machinery required for adherence of pneumococci to D562 cells infected or not infected with a virus. These bacterial genes and cell adhesion molecules can potentially be used to control pneumococcal adherence occurring secondary to a viral infection.
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Bousbia S, Raoult D, La Scola B. Pneumonia pathogen detection and microbial interactions in polymicrobial episodes. Future Microbiol 2013; 8:633-60. [DOI: 10.2217/fmb.13.26] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Recent reports show that microbial communities associated with respiratory infections, such as pneumonia and cystic fibrosis, are more complex than expected. Most of these communities are polymicrobial and might comprise microorganisms originating from several diverse biological and ecological sources. Moreover, unexpected bacteria in the etiology of these respiratory infections have been increasingly identified. These findings were established with the use of efficient microbiological diagnostic tools, particularly molecular tools based on common gene amplification, followed by cloning and sequencing approaches, which facilitated the identification of the polymicrobial flora. Similarly, recent investigations reported that microbial interactions might exist between species in polymicrobial communities, including typical pneumonia pathogens, such as Pseudomonas aeruginosa and Candida albicans. Here, we review recent tools for microbial diagnosis, in particular, of intensive care unit pneumonia and the reported interactions between microbial species that have primarily been identified in the etiology of these infections.
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Affiliation(s)
- Sabri Bousbia
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278, IRD 198, INSERM U1095, Facultés de Médecine, Marseille, France
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique – Hôpitaux de Marseille, Marseille, France
| | - Didier Raoult
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278, IRD 198, INSERM U1095, Facultés de Médecine, Marseille, France
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique – Hôpitaux de Marseille, Marseille, France
| | - Bernard La Scola
- IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Centre Hospitalo-Universitaire Timone, Assistance Publique – Hôpitaux de Marseille, Marseille, France
- Aix-Marseille Université, URMITE, UM 63, CNRS 7278, IRD 198, INSERM U1095, Facultés de Médecine, Marseille, France.
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Current insights in invasive group A streptococcal infections in pediatrics. Eur J Pediatr 2012; 171:1589-98. [PMID: 22367328 DOI: 10.1007/s00431-012-1694-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 02/07/2012] [Indexed: 01/17/2023]
Abstract
A rising incidence of invasive group A Streptococcus infections (IGASI) has been noted in children in the past three decades. The relative frequency of the infection types showed marked differences to IGASI in adults, and severity of the disease resulted in a mortality rate usually comprising between 3.6% and 8.3%. The emm1-type group A Streptococcus (GAS) subclone displaying a particular pattern of virulence factors was widely disseminated and prevalent in children with IGASI while the emm3-type GAS subclone appeared as a recent emerging genotype. However, the implication of these hypervirulent clones in the increase of IGASI in children is still controversial. Recent advances in our knowledge on pathogenesis of IGASI underlined that deregulation of virulence factor production, individual susceptibility, as well as exuberant cytokine response are important factors that may account for the severity of the disease in children. Future changes in IGASI epidemiology are awaited from current prospects for a safe and effective vaccine against GAS. IGASI are complex infections associating septic, toxic, and immunological disorders. Treatment has to be effective on both the etiologic agent and its toxins, due to the severity of the disease associated to the spread of highly virulent bacterial clones. More generally, emergence of virulent clones responsible for septic and toxic disease is a matter of concern in pediatric infectiology in the absence of vaccination strategy.
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Penicillin-resistant Neisseria meningitidis and pandemic 2009 H1N1 influenza coinfection in a child. Pediatr Infect Dis J 2012; 31:323-4. [PMID: 22330169 DOI: 10.1097/inf.0b013e318241f2c3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Experimental meningococcal sepsis in congenic transgenic mice expressing human transferrin. PLoS One 2011; 6:e22210. [PMID: 21811575 PMCID: PMC3141004 DOI: 10.1371/journal.pone.0022210] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 06/17/2011] [Indexed: 12/13/2022] Open
Abstract
Severe meningococcal sepsis is still of high morbidity and mortality. Its management may be improved by an experimental model allowing better understanding of its pathophysiology. We developed an animal model of meningococcal sepsis in transgenic BALB/c mice expressing human transferrin. We studied experimental meningococcal sepsis in congenic transgenic BALB/c mice expressing human transferrin by transcriptional profiling using microarray analysis of blood and brain samples. Genes encoding acute phase proteins, chemokines and cytokines constituted the largest strongly regulated groups. Dynamic bioluminescence imaging further showed high blood bacterial loads that were further enhanced after a primary viral infection by influenza A virus. Moreover, IL-1 receptor-associated kinase-3 (IRAK-3) was induced in infected mice. IRAK-3 is a negative regulator of Toll-dependant signaling and its induction may impair innate immunity and hence result in an immunocompromised state allowing bacterial survival and systemic spread during sepsis. This new approach should enable detailed analysis of the pathophysiology of meningococcal sepsis and its relationships with flu infection.
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Legriel S, Merceron S, Tattevin P, Mouvier MA, Marque-Juillet S, Le Monnier A, Bedos JP, Bruneel F. Favorable outcome after life-threatening meningococcal disease complicating influenza A(H1N1) infection. Infection 2011; 39:477-80. [PMID: 21706225 DOI: 10.1007/s15010-011-0134-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Accepted: 06/07/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE Neurological complications of influenza A(H1N1) have been reported in several patients since the onset of the pandemic in 2009. However, meningococcal disease complicating influenza A(H1N1) has not been reported. PATIENTS Two patients were admitted to an intensive care unit (ICU) for altered mental status, fever, and rapidly spreading petechial purpura. They were diagnosed with meningococcal meningitis and/or meningococcemia and influenza A(H1N1) co-infection. CONCLUSIONS Meningococcal disease presenting as meningitis and/or meningococcemia is among the potential complications of influenza A(H1N1) infection. Physicians should be aware of this co-infection, as it must be detected and treated promptly with antibiotics in addition to supportive care.
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Affiliation(s)
- S Legriel
- Intensive Care Unit, CH Versailles, Site André Mignot, 177 rue de Versailles, Le Chesnay, France.
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Tuite AR, Kinlin LM, Kuster SP, Jamieson F, Kwong JC, McGeer A, Fisman DN. Respiratory virus infection and risk of invasive meningococcal disease in central Ontario, Canada. PLoS One 2010; 5:e15493. [PMID: 21103353 PMCID: PMC2984510 DOI: 10.1371/journal.pone.0015493] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 10/03/2010] [Indexed: 11/21/2022] Open
Abstract
Background In temperate climates, invasive meningococcal disease (IMD) incidence tends to coincide with or closely follow peak incidence of influenza virus infection; at a seasonal level, increased influenza activity frequently correlates with increased seasonal risk of IMD. Methods We evaluated 240 cases of IMD reported in central Ontario, Canada, from 2000 to 2006. Associations between environmental and virological (influenza A, influenza B and respiratory syncytial virus (RSV)) exposures and IMD incidence were evaluated using negative binomial regression models controlling for seasonal oscillation. Acute effects of weekly respiratory virus activity on IMD risk were evaluated using a matched-period case-crossover design with random directionality of control selection. Effects were estimated using conditional logistic regression. Results Multivariable negative binomial regression identified elevated IMD risk with increasing influenza A activity (per 100 case increase, incidence rate ratio = 1.18, 95% confidence interval (CI): 1.06, 1.31). In case-crossover models, increasing weekly influenza A activity was associated with an acute increase in the risk of IMD (per 100 case increase, odds ratio (OR) = 2.03, 95% CI: 1.28 to 3.23). Increasing weekly RSV activity was associated with increased risk of IMD after adjusting for RSV activity in the previous 3 weeks (per 100 case increase, OR = 4.31, 95% CI: 1.14, 16.32). No change in disease risk was seen with increasing influenza B activity. Conclusions We have identified an acute effect of influenza A and RSV activity on IMD risk. If confirmed, these finding suggest that influenza vaccination may have the indirect benefit of reducing IMD risk.
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Affiliation(s)
- Ashleigh R. Tuite
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Stefan P. Kuster
- Mount Sinai Hospital, Toronto, Canada
- Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Frances Jamieson
- The Ontario Agency for Health Protection and Promotion, Toronto, Canada
| | - Jeffrey C. Kwong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- The Ontario Agency for Health Protection and Promotion, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Allison McGeer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Mount Sinai Hospital, Toronto, Canada
| | - David N. Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- * E-mail:
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A genetically engineered waterfowl influenza virus with a deletion in the stalk of the neuraminidase has increased virulence for chickens. J Virol 2009; 84:940-52. [PMID: 19889765 DOI: 10.1128/jvi.01581-09] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A deletion of about 20 amino acids in the stalk of the neuraminidase (NA) is frequently detected upon transmission of influenza A viruses from waterfowl to domestic poultry. Using reverse genetics, a recombinant virus derived from a wild duck influenza virus isolate, A/Mallard/Marquenterre/Z237/83 (MZ), and an NA stalk deletion variant (MZ-delNA) were produced. Compared to the wild type, the MZ-delNA virus showed a moderate growth advantage on avian cultured cells. In 4-week-old chickens inoculated intratracheally with the MZ-delNA virus, viral replication in the lungs, liver, and kidneys was enhanced and interstitial pneumonia lesions were more severe than with the wild-type virus. The MZ-delNA-inoculated chickens showed significantly increased levels of mRNAs encoding interleukin-6 (IL-6), transforming growth factor-beta4 (TGF-beta4), and CCL5 in the lungs and a higher frequency of apoptotic cells in the liver than did their MZ-inoculated counterparts. Molecular mechanisms possibly underlying the growth advantage of the MZ-delNA virus were explored. The measured enzymatic activities toward a small substrate were similar for the wild-type and deleted NA, but the MZ-delNA virus eluted from chicken erythrocytes at reduced rates. Pseudoviral particles expressing the MZ hemagglutinin in combination with the MZ-NA or MZ-delNA protein were produced from avian cultured cells with similar efficiencies, suggesting that the deletion in the NA stalk does not enhance the release of progeny virions and probably affects an earlier step of the viral cycle. Overall, our data indicate that a shortened NA stalk is a strong determinant of adaptation and virulence of waterfowl influenza viruses in chickens.
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