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Mahmoudi F, Jalayeri MHT, Montaseri A, MohamedKhosroshahi L, Baradaran B. Microbial natural compounds and secondary metabolites as Immunomodulators: A review. Int J Biol Macromol 2024; 278:134778. [PMID: 39153680 DOI: 10.1016/j.ijbiomac.2024.134778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 08/11/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024]
Abstract
Immunomodulatory therapies are beneficial strategies for the improvement of immune system function. Today, due to the increasing prevalence of immune disorders, cancer, and new viral diseases, there is a greater need to introduce immunomodulatory compounds with more efficiency and fewer side effects. Microbial derivatives are fertile and attractive grounds for discovering lots of novel compounds with various medical properties. The discovery of many natural compounds derived from bacterial sources, such as secondary metabolites with promising immunomodulating activities, represents the importance of this topic in drug discovery and emphasizes the necessity for a coherent source of study in this area. Considering this need, in this review, we aim to focus on the current information about the immunomodulatory effects of bacterial secondary metabolites and natural immunomodulators derived from microorganisms.
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Affiliation(s)
- Fariba Mahmoudi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Hadi Tajik Jalayeri
- Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital Golestan University of Medical Sciences, Gorgan, Iran
| | - Azadeh Montaseri
- Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Unit of Histology and Medical Embryology, Sapienza University of Rome, 00161 Rome, Italy.
| | - Leila MohamedKhosroshahi
- Department of Immunology, School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Esposito S, Cassano M, Cutrera R, Menzella F, Varricchio A, Uberti M. Expert consensus on the role of OM-85 in the management of recurrent respiratory infections: A Delphi study. Hum Vaccin Immunother 2022; 18:2106720. [PMID: 35985019 DOI: 10.1080/21645515.2022.2106720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Recurrent infections of upper and lower respiratory tract have an important clinical and economic impact, which can be reduced through appropriate preventive measures, including the use of immunomodulating agents, such as OM-85, which proved to be effective and safe in both adults and children. Although OM-85 can be useful for the prevention of respiratory tract infections, it is still underused in clinical practice. In order to evaluate the level of awareness of the disease burden of recurrent respiratory infections in adults and children and to assess the level of agreement on the prophylactic and therapeutic approach to the disease, including the use of immunomodulants, a Delphi study was performed. A board of six experts in the field of respiratory infections was appointed to elaborate a series of statements covering four main topics (disease, prevention, OM-85, and future strategies), which were thereafter voted by a panel of 30 experts. Results showed that prevention is unanimously recognized as the most important intervention to reduce disease burden, and the use of immunomodulation to improve the effectiveness of vaccination is gaining increasing favor among clinicians. In this respect, OM-85 is recognized as the most studied immunomodulating agent currently available, whose efficacy and safety make it a valuable tool to optimize the management of recurrent respiratory infections in both adults and children. In particular, the combined use of OM-85 and influenza vaccine was recognized as an effective and safe approach to improve the current prevention strategies in order to reduce the burden of recurrent respiratory infections.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Michele Cassano
- Otolaryngology Clinic, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Renato Cutrera
- Pediatrics Pulmonology & Respiratory Intermediate Care Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Francesco Menzella
- Pulmonology Unit, Arcispedale Santa Maria Nuova, Azienda USL - IRCSS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Marzio Uberti
- Società Italiana di Medicina generale e delle Cure Primarie (SIMG), Torino, Italy
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Fraser A, Poole P. Immunostimulants versus placebo for preventing exacerbations in adults with chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2022; 11:CD013343. [PMID: 36373977 PMCID: PMC9661939 DOI: 10.1002/14651858.cd013343.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Individuals with chronic obstructive pulmonary disease (COPD) or chronic bronchitis may experience recurrent exacerbations, which negatively impact prognosis and quality of life, and can impose a significant socioeconomic burden on the individual and wider society. Immunostimulants are a broad category of therapies that may theoretically enhance non-specific immunity against several respiratory insults, thereby reducing exacerbation risk and severity. However, evidence to date for their use in this population is limited. OBJECTIVES To determine the efficacy of immunostimulants in preventing respiratory exacerbations in adults with chronic obstructive pulmonary disease, chronic bronchitis, or both. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest literature search was conducted on 25 January 2022. SELECTION CRITERIA: We included parallel randomised controlled trials (RCTs) that compared immunostimulant therapy, administered by any method and with the intention of preventing (rather than treating) exacerbations, with placebo for a minimum treatment duration of one month in adults with chronic bronchitis or COPD, or both. We excluded participants with other respiratory conditions. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were number of participants with no exacerbations during the study period and all-cause mortality, secondary outcomes were respiratory-related mortality, quality of life, number of participants requiring antibiotics, exacerbation duration, respiratory-related hospitalisation duration and adverse events/side effects. We used GRADE to assess certainty of evidence for each outcome. MAIN RESULTS This review included 36 studies involving 6192 participants. Studies were published between 1981 and 2015. Duration ranged from three to 14 months. The mean age of study participants varied between 35.2 and 82 years. Twelve studies examined participants with COPD only. Seventeen studies reported baseline lung function values; most indicated a moderate-to-severe degree of airflow limitation. Nineteen studies indicated inclusion of participants with a mean baseline exacerbation frequency of two or more in the preceding year. Immunostimulants investigated were OM-85, AM3, RU41740 (Biostim), Ismigen, Diribiotine CK, thymomodulin, pidotimod, D53 (Ribomunyl), Lantigen B, Symbioflor, and hyaluronan; routes of administration were oral, sublingual, and subcutaneous. The risk of bias of the included studies was mostly low or unclear. Participants receiving immunostimulants for a mean duration of six months were slightly more likely to be free of exacerbations during that time (odds ratio (OR) 1.48, 95% confidence interval (CI) 1.15 to 1.90; 15 RCTs, 2961 participants; moderate-certainty evidence). The overall number needed to treat with immunostimulants for a mean of six months, to prevent one participant from experiencing an exacerbation, was 11 (95% CI 7 to 29). This outcome was associated with a moderate degree of unexplained heterogeneity (I2 = 53%). Type of immunostimulant, baseline lung function, baseline exacerbation frequency, treatment duration, and follow-up duration did not modify the effect size, although due to heterogeneity and limited study and participant numbers within some subgroups, the validity of the subgroup treatment effect estimates were uncertain. Immunostimulants probably result in little to no difference in all-cause mortality (OR 0.64, 95% CI 0.37 to 1.10; 5 RCTs, 1558 participants; moderate-certainty evidence) and respiratory-related mortality (OR 0.40, 95% CI 0.15 to 1.07; 2 RCTs, 735 participants; low-certainty evidence) compared to placebo; however, the effects were imprecise and data quality limited the certainty of these results. There was a small improvement in health-related quality of life, as measured by the St George's Respiratory Questionnaire (SGRQ), with immunostimulant compared to placebo (mean difference -4.59, 95% CI -7.59 to -1.59; 2 RCTs, 617 participants; very-low certainty evidence). The effect estimate just met the minimum clinically important difference (MCID) score of 4 units; however, the CI width means the possibility of a non-meaningful difference cannot be excluded. The pooled result from five studies indicated that immunostimulants likely reduce the number of participants requiring antibiotics over a mean duration of six months (OR 0.34, 95% CI 0.18 to 0.63; 542 participants; moderate-certainty evidence). This outcome had a low-to-moderate degree of heterogeneity (I2 = 38%), but the direction of effect was consistent across all studies. There was no evidence of a difference in the odds of experiencing an adverse event with immunostimulant compared to placebo, over a mean duration of six months (OR 1.01, 95% CI 0.84 to 1.21; 20 RCTs, 3780 participants; high-certainty evidence). The CI limits for the associated risk ratio (RR) did not cross thresholds for appreciable harm or benefit (RR 1.02, 95% CI 0.92 to 1.13). An additional seven studies reported no events rates in either study arm. Meta-analyses were not performed for the outcomes of exacerbation duration and respiratory-related hospitalisation duration, due to high levels of heterogeneity across the included studies (exacerbation duration: I2 = 92%; respiratory-related hospitalisation duration: I2 = 83%). Results from an effect direction plot and binomial probability test for exacerbation duration indicated that a significant proportion of studies (94% (95% CI 73% to 99%); P = 0.0002) favoured intervention, possibly indicating that immunostimulants are efficacious in reducing the mean exacerbation duration compared to placebo. However, the degree of uncertainty associated with this estimate remained high due to data quality and heterogeneity. Three studies reported mean duration of respiratory-related hospitalisation, two of which demonstrated a direction of effect that favoured immunostimulant over placebo. AUTHORS' CONCLUSIONS In participants with chronic bronchitis or COPD, we are moderately confident that treatment with immunostimulants is associated with a small reduction in the likelihood of having an exacerbation and a moderate reduction in the requirement for antibiotics. Low numbers of events limit interpretation of the effect of immunostimulants on all-cause and respiratory-related mortality. We are uncertain whether immunostimulants improve quality of life, and whether they are associated with a reduction in exacerbation and respiratory-related hospitalisation durations, although immunostimulants were generally associated with a positive effect direction in the studies that examined these outcomes. Immunostimulants appear to be safe and well-tolerated, and are not associated with an increased risk of adverse events.
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Affiliation(s)
| | - Phillippa Poole
- Department of Medicine, University of Auckland, Auckland, New Zealand
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Kaczynska A, Klosinska M, Janeczek K, Zarobkiewicz M, Emeryk A. Promising Immunomodulatory Effects of Bacterial Lysates in Allergic Diseases. Front Immunol 2022; 13:907149. [PMID: 35812388 PMCID: PMC9257936 DOI: 10.3389/fimmu.2022.907149] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/30/2022] [Indexed: 01/04/2023] Open
Abstract
In light of an escalating prevalence of allergic disorders, it is crucial to fully comprehend their pathophysiology and etiology. Such knowledge would play a pivotal role in the search for new therapeutic approaches concerning not only diseases’ symptoms, but also their underlying causes. The hygiene hypothesis indicates a high correlation between limited exposure to pathogens in early childhood and the risk of developing allergic disorders. Bearing in mind the significance of respiratory and digestive systems’ mucous membrane’s first-line exposure to pathogens as well as its implications on the host’s immune response, a therapy targeted at aforesaid membranes could guarantee promising and extensive treatment outcomes. Recent years yielded valuable information about bacterial lysates (BLs) known for having immunomodulatory properties. They consist of antigen mixtures obtained through lysis of bacteria which are the most common etiologic agents of respiratory tract infections. They interact with dendritic cells located in the mucous membranes of the upper respiratory tract and the gastrointestinal tract by toll-like receptors. The dendritic cells present acquired antigens resulting in innate immune response development on the release of chemokines, both stimulating monocytes and NK cells maturation and promoting polymorphonuclear neutrophil migration. Moreover, they influence the adaptive immune system by stimulating an increase of specific antibodies against administered bacterial antigens. The significance of BLs includes not only an anti-inflammatory effect on local infections but also restoration of Th1/Th2 balance, as demonstrated mainly in animal models. They decrease Th2-related cytokine levels (IL-4, IL-13) and increase Th1-related cytokine levels (IFN-γ). The reestablishment of the balance of the immune response leads to lowering atopic reactions incidence which, in addition to reduced risk of inflammation, provides the alleviation and improvement of clinical manifestations of allergic disorders. In this review, we hereby describe mechanisms of BLs action, considering their significant immunomodulatory role in innate immunity. The correlation between local, innate, and adaptive immune responses and their impact on the clinical course of allergic disorders are discussed as well. To conclude our review, we present up-to-date literature regarding the outcomes of BLs implemented in atopic dermatitis, allergic rhinitis, and asthma prevention and treatment, especially in children.
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Affiliation(s)
- Agnieszka Kaczynska
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland
| | - Martyna Klosinska
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland
| | - Kamil Janeczek
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland
- *Correspondence: Kamil Janeczek,
| | - Michał Zarobkiewicz
- Department of Clinical Immunology, Medical University of Lublin, Lublin, Poland
| | - Andrzej Emeryk
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland
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Janeczek K, Kaczyńska A, Emeryk A, Cingi C. Perspectives for the Use of Bacterial Lysates for the Treatment of Allergic Rhinitis: A Systematic Review. J Asthma Allergy 2022; 15:839-850. [PMID: 35769192 PMCID: PMC9236485 DOI: 10.2147/jaa.s360828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/13/2022] [Indexed: 12/13/2022] Open
Abstract
Bacterial lysates (BLs) are mixtures of bacterial antigens that have been used for many decades to minimize the risk of recurrent respiratory tract infections in both pediatric and adult populations. Research on the use of BLs is also conducted in allergology. Biomedical databases were searched for articles on the use of BLs in the treatment of allergic rhinitis (AR). After rejecting ineligible articles, six remaining reports were reviewed. Based on this review, it can be concluded that adding BL to standard therapy for seasonal or perennial AR reduces the severity of nasal symptoms and the need for antiallergic medications in both children and adults. Concurrently, these formulations have a high safety profile. An analysis of studies shows that the first effects of BLs therapy appear at the earliest 2–6 weeks after the start of treatment and persist at least 3 months after treatment.
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Affiliation(s)
- Kamil Janeczek
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland
- Correspondence: Kamil Janeczek, Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Prof. A. Gębali 6, Lublin, 20-093, Poland, Tel +48817185477, Email
| | - Agnieszka Kaczyńska
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland
| | - Andrzej Emeryk
- Department of Pulmonary Diseases and Children Rheumatology, Medical University of Lublin, Lublin, Poland
| | - Cemal Cingi
- Department of Otorhinolaryngology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
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Li C, Zhou H, Zhang W, Che D. Bacterial lysate treatment in allergic disease: A systematic review and meta-analysis. Pediatr Allergy Immunol 2021; 32:1813-1823. [PMID: 34097747 PMCID: PMC8597000 DOI: 10.1111/pai.13572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/29/2021] [Accepted: 05/31/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this review was to assess the efficacy of bacterial lysate treatment in patients with allergic disease. METHOD Randomized controlled trials (RCTs) of bacterial lysate therapy for patients with allergic diseases (asthma, atopic dermatitis, and allergic rhinitis) were searched using PubMed, EMBASE, Cochrane, China National Knowledge Infrastructure, Chinese Biomedical literature, and Wanfang databases up to March 2020. Based on the guidelines of the Cochrane collaboration, risk of bias was assessed. RESULTS This meta-analysis based on 19 studies comparing bacterial lysate-treated patients with a control group showed a 24% (RR: 1.24, 95% CI [1.19, 1.30]) increase in improvement of allergy symptom control. In addition, the improvement of asthma symptom control was 22% (RR: 1.22, 95% CI [1.14, 1.26]) higher in the bacterial lysate treatment group. Moreover, the levels of immunoglobulin (IgA and IgG), T lymphocyte subtype (CD3+, CD4+, CD4+/CD8+, Th1), and cytokines (IFN-γ, IL-2, and IL-12) were increased in the treated group compared with controls. There was no significant difference in adverse event rate between the two groups. CONCLUSION Treatment with bacterial lysate improves symptom control in patients with allergic diseases on the basis of routine therapy. No adverse risk was found in this meta-analysis.
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Affiliation(s)
- Chengmei Li
- International Medical Department, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hua Zhou
- International Medical Department, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Zhang
- International Medical Department, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Datian Che
- International Medical Department, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Zhang W, Huang J, Liu H, Wen X, Zheng Q, Li L. Whether Immunostimulants Are Effective in Susceptible Children Suffering From Recurrent Respiratory Tract Infections: A Modeling Analysis Based on Literature Aggregate Data. J Clin Pharmacol 2021; 62:245-253. [PMID: 34535904 DOI: 10.1002/jcph.1969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/15/2021] [Indexed: 11/08/2022]
Abstract
Immunostimulants are gradually being used in the prevention and treatment of recurrent respiratory tract infections in susceptible children, but their drug effects have not been quantified. The purpose of this study was to confirm the efficacy of immunostimulants in the prevention and treatment of recurrent respiratory tract infections in susceptible children. A model-based meta-analysis was used to describe the time course of placebo and immunostimulants in the prevention of respiratory tract infections in children. The cumulative number of respiratory tract infections was used as an indicator of efficacy. A meta-analysis was used to analyze the incidence of drug-related adverse events. Fourteen articles with 2400 pediatric subjects were finally included in the analysis. The results showed that the cumulative number of respiratory tract infections increased linearly with time, with the incidence of respiratory tract infections in the placebo group being 0.65 (95% confidence interval [CI], 0.55-0.75) per month. OM-85 BV and pidotimod reduced the incidence of respiratory tract infections by 0.21 (95%CI, 0.16-0.26) and 0.19 (95%CI, 0.17-0.21) compared to placebo per month, respectively. Pidotimod and OM-85 BV can effectively reduce the incidence of respiratory tract infections in susceptible children, with no significant increase in the incidence of drug-related adverse events when compared with placebo (risk ratio values were 1.07 [95%CI, 0.66-1.71] and 1.31 [95%CI, 0.54-3.19], respectively). This study provides quantitative support for the application of immunostimulants for the prevention of recurrent respiratory tract infections in children.
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Affiliation(s)
- Weilong Zhang
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jihan Huang
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongxia Liu
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin Wen
- Clinical Research Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Qingshan Zheng
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lujin Li
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Cantarutti A, Barbieri E, Scamarcia A, Cantarutti L, Canova C, Giaquinto C. Use of the Bacterial Lysate OM-85 in the Paediatric Population in Italy: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136871. [PMID: 34206831 PMCID: PMC8297025 DOI: 10.3390/ijerph18136871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 01/22/2023]
Abstract
Background: In Italy, the bacterial lysate OM-85 (Broncho-Vaxom®, Broncho-Munal®, Ommunal®, Paxoral®, Vaxoral®) is registered for the prophylaxis of recurrent respiratory tract infections (RTIs) in adults and children above one year of age, but there are limited data on its use in the paediatric population. We aim to estimate the impact of OM-85 treatment on RTIs and antibiotic prescriptions in children. Methods: This study included children aged 1 to 14 years enrolled in Pedianet, a paediatric general practice research database, from January 2007 to June 2017, having at least one prescription of OM-85. Children with less than 12 months of follow-up before (PRE period) and after (POST period) the OM-85 prescription were excluded. The frequency of antibiotic prescriptions and the frequency of RTI episodes in the PRE and POST periods were compared through the post-hoc test. Subgroup analysis was performed in children with recurrent RTIs. Results: 1091 children received 1382 OM-85 prescriptions for a total follow-up of 619,525.5 person-years. Overall, antibiotic prescriptions decreased from a mean of 2.8 (SD (standard deviation) 2.7) prescriptions in the PRE period to a mean of 2.2 (SD 2.6) prescriptions in the POST period (p < 0.0001). RTIs decreased from a mean of 3.4 (SD 2.9) episodes in the PRE period to a mean of 2.5 (SD 2.6) episodes in the POST period (p < 0.0001). No change in antibiotic class was noted, and co-amoxiclav remained the preferred therapy in 28% of cases, followed by amoxicillin. These results were confirmed among children with recurrent RTIs. Conclusions: OM-85 is effective in preventing both antibiotic prescriptions and RTIs in children.
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Affiliation(s)
- Anna Cantarutti
- Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
- Società Servizi Telematici-Pedianet, 35121 Padua, Italy
| | - Elisa Barbieri
- Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35128 Padua, Italy
| | | | | | - Cristina Canova
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | - Carlo Giaquinto
- Società Servizi Telematici-Pedianet, 35121 Padua, Italy
- Division of Pediatric Infectious Diseases, Department for Woman and Child Health, University of Padua, 35128 Padua, Italy
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Ochoa-Grullón J, Benavente Cuesta C, González Fernández A, Cordero Torres G, Pérez López C, Peña Cortijo A, Conejero Hall L, Mateo Morales M, Rodríguez de la Peña A, Díez-Rivero CM, Rodríguez de Frías E, Guevara-Hoyer K, Fernández-Arquero M, Sánchez-Ramón S. Trained Immunity-Based Vaccine in B Cell Hematological Malignancies With Recurrent Infections: A New Therapeutic Approach. Front Immunol 2021; 11:611566. [PMID: 33679698 PMCID: PMC7928395 DOI: 10.3389/fimmu.2020.611566] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/15/2020] [Indexed: 12/16/2022] Open
Abstract
Infectious complications are a major cause of morbidity and mortality in B-cell hematological malignancies (HM). Prophylaxis for recurrent infections in HM patients with antibody deficiency consists of first-line antibiotics and when unsuccessful, gammaglobulin replacement therapy (IgRT). Recent knowledge of trained immunity-based vaccines (TIbV), such as the sublingual polybacterial formulation MV130, has shown a promising strategy in the management of patients with recurrent infections. We sought to determine the clinical benefit of MV130 in a cohort of HM patients with recurrent respiratory tract infections (RRTIs) who underwent immunization with MV130 for 3 months. Clinical information included the frequency of infections, antibiotic use, number of visits to the GP and hospitalizations previous and after MV130 immunotherapy. Improvement on infection rate was classified as: clear (>60% reduction of infection), partial (26%-60%) and low (≤25%) improvement. Fifteen HM patients (aged 42 to 80 years; nine females) were included in the study. All patients reduced their infection rate. Analysis of paired data revealed that the median (range, min - max) of respiratory infectious rate significantly decreased from 4.0 (8.0-3.0) to 2.0 (4.0-0.0) (p<0.001) at 12 months of MV130. A clear clinical improvement was observed in 53% (n = 8) of patients, partial improvement in 40% (n = 6) and low improvement in 7% (n = 1). These data correlated with a decrease on antibiotic consumption from 3.0 (8.0-1.0) to 1.0 (2.0-0.0) (p = 0.002) during 12 months after initiation of treatment with MV130. The number of infectious-related GP or emergency room visits declined from 4.0 (8.0-2.0) to 2.0 (3.0-0.0) (p<0.001), in parallel with a reduction in hospital admissions due to infections (p = 0.032). Regarding safety, no adverse events were observed. On the other hand, immunological assessment of serum IgA and IgG levels demonstrated an increase in specific antibodies to MV130-contained bacteria following MV130 immunotherapy. In conclusion, MV130 may add clinical benefit reducing the rate of infections and enhancing humoral immune responses in these vulnerable patients.
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Affiliation(s)
- Juliana Ochoa-Grullón
- Department of Clinical Immunology, IML and IdISSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain
| | | | | | - Gustavo Cordero Torres
- Department of Clinical Immunology, IML and IdISSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain
| | | | | | | | | | | | | | - Edgard Rodríguez de Frías
- Department of Clinical Immunology, IML and IdISSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain
| | - Kissy Guevara-Hoyer
- Department of Clinical Immunology, IML and IdISSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain
| | - Miguel Fernández-Arquero
- Department of Clinical Immunology, IML and IdISSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain
| | - Silvia Sánchez-Ramón
- Department of Clinical Immunology, IML and IdISSC, Hospital Clínico San Carlos, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University, Madrid, Spain
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Prophylaxis of Upper Airway Infections in a Patient with Partial IgA Deficiency: Concurrent Use of Sublingual Immunotherapy with Inactivated Whole-Cell Bacterial Extract and Der p1. Case Rep Otolaryngol 2020; 2020:6313176. [PMID: 32908754 PMCID: PMC7463416 DOI: 10.1155/2020/6313176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/01/2020] [Accepted: 08/04/2020] [Indexed: 11/21/2022] Open
Abstract
Selective IgA deficiency is the most common type of primary immunodeficiency, but there is not yet a specific effective treatment. The most prevalent clinical manifestations are infectious diseases of the respiratory system. We report herein the case of an 11-year-old female with selective IgA deficiency and recurring episodes of respiratory infections associated with rhinitis and asthma. We evaluated the efficacy of sublingual immunotherapy combined with inactivated whole-cell bacterial extract and Der p1-specific immunotherapy. After 18 months of clinical follow-up, we observed a significant reduction in the number of episodes of respiratory infections associated with control of atopic diseases. We also observed a 3-fold increase in serum IgA levels compared to treatment initiation. This case demonstrates the potential utility of the concurrent use of sublingual immunotherapy with inactivated whole-cell bacterial extract and Der p1 for successful control of allergy and infection in partial selective IgA deficiency.
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Cardinale F, Lombardi E, Rossi O, Bagnasco D, Bellocchi A, Menzella F. Epithelial dysfunction, respiratory infections and asthma: the importance of immunomodulation. A focus on OM-85. Expert Rev Respir Med 2020; 14:1019-1026. [PMID: 32635771 DOI: 10.1080/17476348.2020.1793673] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Damage to the respiratory epithelium, is often a multifactorial phenomenon. The risk for developing a damage in respiratory epithelium and recurrent respiratory infections may vary among individuals. Preventive measures are based on strengthening the immune function, thus increasing the natural response to pathogens. Immunomodulatory agents are: i. synthetic molecules; ii. Probiotics, prebiotics, symbiotics; iii. Lysates, bacterial extracts immunomodulators: OM-85, RU 41740, D53; iv. Trace elements, vitamins. OM-85 is used for the prevention of recurrent respiratory tract infections and/or exacerbations both in adults and children, showing a good efficacy and safety profile. Its active principle, an extract of bacterial lysates isolated from 21 known respiratory pathogenic strains, shows protection against airway infections of bacterial and viral origin. AREAS COVERED This non-systematic review focuses on bacterial lysates and in particular on OM-85 and its effects on respiratory epithelium function and activity in asthma respiratory infections. Studies were selected by PubMed search of "bacterial lysate" or "OM-85" and "respiratory epithelium" or "respiratory infections", from 1993 to 2019. EXPERT OPINION Results highlight the ability of OM-85 to trigger immunomodulatory and protective immune responses against different pathogens in vivo, including influenza and respiratory syncytial virus as well bacterial superinfection following influenza.
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Affiliation(s)
- Fabio Cardinale
- University of Bari, Azienda Ospedaliero-Universitaria 'Policlinico-Giovanni XXIII', UOC di Pediatria e Pronto Soccorso , Bari, Italy
| | - Enrico Lombardi
- 'Meyer' Pediatric University Hospital, Pediatric Pumonary Unit , Firenze, Italy
| | - Oliviero Rossi
- Azienda Ospedaliero-Universitaria Careggi, UOC di Immunoallergologia , Firenze, Italy
| | - Diego Bagnasco
- Casa di Cura Villa Montallegro, Unità di Malattie Dell'apparato Respiratorio , Genova, Italy
| | - Aldo Bellocchi
- ASL ROMA 4/Dist.4, Pediatrician- Family Doctor , Roma, Italy
| | - Francesco Menzella
- Azienda USL di Reggio Emilia-IRCSS, Department of Medical Specialties, Santa Maria Nuova Hospital, Pneumology Unit , Reggio Emilia, Italy
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12
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Marengo R, Ortega Martell JA, Esposito S. Paediatric Recurrent Ear, Nose and Throat Infections and Complications: Can We Do More? Infect Dis Ther 2020; 9:275-290. [PMID: 32333286 PMCID: PMC7237599 DOI: 10.1007/s40121-020-00289-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Indexed: 12/14/2022] Open
Abstract
Recurrent respiratory tract infections (rRTIs), of which there are three main groups-otitis media, tonsillitis and sinusopathies-are very common in paediatric populations and are associated with significant morbidity and mortality due to complications. These infections substantially reduce quality of life for paediatric patients and their families and are a significant personal, medical and economic burden on the patients, the patients' families and the healthcare system. Most rRTIs are of viral origin; however, indiscriminate use of antibiotics in their treatment has led to development of bacterial resistance. Effective management of rRTIs to reduce the burden of disease and to avoid overuse of antibiotics has become a great therapeutic challenge. New strategies for the management of paediatric rRTIs include focus on prevention using non-specific immunomodulators to boost the body's natural defences against infection and to downregulate infection- and allergen-induced airway inflammation. The oral immunomodulator, OM-85, a bacterial lysate, acts on the innate and adaptive branches of the immune system, conferring protection against viral and bacterial infections, and controls inflammation, thereby reducing tissue damage. OM-85 has demonstrated good tolerability and clinical efficacy in reducing the number and duration of RTIs in children with recurrent airway infections. It has also been reported to reduce the use of concomitant medications, including antibiotics, time to cure and school absenteeism. OM-85 is efficacious and well tolerated when administered concomitantly with inactivated influenza vaccine (IIV) and has been shown to reduce wheezing attacks induced by RTI in young children. Clinical results show that the greater the risk of rRTIs, the greater the benefit with OM-85. OM-85 may be considered a promising tool to add to the limited armamentarium of the ear, nose and throat (ENT) physician dealing with rRTIs and their complications, such as recurrent wheeze and asthma inception.
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Affiliation(s)
- Ricardo Marengo
- ENT and Audiology Department of CEMIC Surgery Department, University Institute CEMIC, Valdenegro, Buenos Aires, Argentina
| | - José A Ortega Martell
- Department of Immunology, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico.
- Consejo Nacional de Inmunología Clínica y Alergia, Mexico city, Mexico.
- Organización Mundial de Alergia (World Allergy Organization), Milwaukee, WI, USA.
- Colegio Mexicano de Inmunología Clínica y Alergia (CMICA), Mexico city, Mexico.
- Colegio Mexicano de Pediatras Especialistas en Inmunología Clínica y Alergia (COMPEDIA), Colonia Nápoles, Mexico.
| | - Susanna Esposito
- Pietro Barilla Children's Hospital, Milan, Italy
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- World Association for Infectious Diseases and Immunological Disorders (WAidid), Milan, Italy
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13
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Mohamed MSM, Mostafa HM, Mohamed SH, Abd El-Moez SI, Kamel Z. Combination of Silver Nanoparticles and Vancomycin to Overcome Antibiotic Resistance in Planktonic/Biofilm Cell from Clinical and Animal Source. Microb Drug Resist 2020; 26:1410-1420. [PMID: 32354252 DOI: 10.1089/mdr.2020.0089] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This study aims to evaluate the prevalence of multidrug-resistant (MDR) and biofilm-forming pathogens from animal source compared to clinical ones. In addition, to assess the antibacterial and antibiofilm activity of silver nanoparticles (AgNPs) alone and/or mixed with vancomycin. Out of 62 bacterial isolates from animal respiratory tract infection (RTI), 50.00% were defined as MDR, while among human ones, 44.00% were MDR. The bacteria Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus pneumoniae were the predominant isolated bacteria from both animal and human origin with frequency percentage of 50.00, 22.32, and 18.75, respectively. Among Staph. aureus strains, mecA gene was detected in 60.00% and 61.54% of animal and human isolates, respectively, while mecALGA251 (mecC) gene was detected in 13.33% and 15.38% of animal and human isolates, respectively. Biofilm formation ability among animal isolates was 83.87%, while among human ones was 86.00%. AgNPs were effective in inhibiting planktonic cells with minimal inhibitory concentration (MIC) values (0.625-10 μg/mL), as well as eradicating biofilm with minimal biofilm eradication concentration values (1.25-10 μg/mL). Noticeable low MIC of AgNPs was required for the isolates from animal source (0.625-5 μg/mL) compared to clinical ones (0.625-10 μg/mL). Remarkable reduction in AgNP effective concentration was observed after combination with 1/4 MIC of vancomycin with minimum recorded concentration of 0.08 μg/mL. In conclusion, the prevalence of MDR among RT pathogens was recorded with high ability to produce biofilm and virulence factors from both animal and human pathogens. AgNPs showed strong antibacterial and antibiofilm activity alone and mixed with vancomycin, with up to fourfold reduction of AgNP inhibitory dose.
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Affiliation(s)
- Mahmoud S M Mohamed
- Department of Botany and Microbiology, Faculty of Science, Cairo University, Giza, Egypt
| | - Heba M Mostafa
- Department of Botany and Microbiology, Faculty of Science, Cairo University, Giza, Egypt
| | - Sara H Mohamed
- Department of Microbiology, National Organization for Drug Control and Research, Giza, Egypt
| | - Sherein I Abd El-Moez
- Department of Microbiology and Immunology, Veterinary Research Division, National Research Center, Dokki, Giza, Egypt
| | - Zeinat Kamel
- Department of Botany and Microbiology, Faculty of Science, Cairo University, Giza, Egypt
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14
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Souza FCD, Mocellin M, Ongaratto R, Leitão LADA, Friedrich FO, Silveira VD, Scotta MC, Pitrez PM, Pinto LA. OM-85 BV for primary prevention of recurrent airway infections: a pilot randomized, double-blind, placebo-controlled study. EINSTEIN-SAO PAULO 2020; 18:eAO5262. [PMID: 32130328 PMCID: PMC7032885 DOI: 10.31744/einstein_journal/2020ao5262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/03/2019] [Indexed: 11/10/2022] Open
Abstract
Objective To compare the frequency of respiratory tract infections in children treated with OM-85 BV and placebo during the 3-month therapy period, and observation for a further 3 months after treatment. Methods A randomized, double-blind, placebo-controlled trial was conducted with 54 children (6 months to 5 years old) with no past history of recurrent respiratory infections attending daycare center. Family members were instructed to administer one capsule per day for 10 consecutive days, for 3 months of OM-85 BV or placebo. Telephone interviews were conducted every 30 days. Results There was no significant difference in the number of respiratory infections between the groups. The mean number of respiratory tract infection in the OM-85 BV Group in the first 3 months was 0.92±0.87, and in the Placebo Group was 0.74±1.02, and at 6 months it was 1.62±1.47 and 1.03±1.34, respectively. Conclusion OM-85 BV was not effective in the primary prevention of respiratory tract infections. Although most authors recommend the use of this immunostimulant in children with a history of recurrent respiratory infections, more studies are needed to define its usefulness in the primary prevention of respiratory infections in healthy children exposed to few risk factors.
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Affiliation(s)
| | - Magáli Mocellin
- Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | - Renata Ongaratto
- Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
| | | | | | | | | | - Paulo Márcio Pitrez
- Pontifícia Universidade Católica do Rio Grande do Sul , Porto Alegre , RS , Brazil
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15
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Effect and Analysis of Bacterial Lysates for the Treatment of Recurrent Urinary Tract Infections in Adults. Pathogens 2020; 9:pathogens9020102. [PMID: 32041185 PMCID: PMC7168004 DOI: 10.3390/pathogens9020102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 12/23/2022] Open
Abstract
Urinary tract infection (UTI) is a relevant public health problem, economically and socially affecting the lives of patients. The increase of antimicrobial bacterial resistance significantly hinders the treatment of UTIs, raising the need to search for alternative therapies. Bacterial lysates (BL) obtained from Escherichia coli and other pathogens have been used to treat different infectious diseases with promising results. This work aims to evaluate the effect and composition of an autologous BL for the treatment and control of recurrent UTIs in adults. The results show remission in 70% of the patients within the first three months after the administration of BL, while the infection is maintained under control for 6-12 months. The analysis by liquid chromatography-mass spectrometry (LC-MS) of the BL fractions recognized by the sera of patients shows the presence of cytosolic proteins, fimbriae, OMPs, and LPS. Our study demonstrates that the autologous BL contributed to the treatment and control of recurrent UTIs in adults, and its composition shows that different surface components of E. coli are potential immunogens that could be used to create a polyvalent protective vaccine.
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16
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Fraser A, Poole P. Immunostimulants versus placebo for preventing exacerbations in adults with chronic bronchitis or chronic obstructive pulmonary disease. Hippokratia 2019. [DOI: 10.1002/14651858.cd013343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Phillippa Poole
- University of Auckland; Department of Medicine; Private Bag 92019 Auckland New Zealand
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17
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Percopo CM, Ma M, Brenner TA, Krumholz JO, Break TJ, Laky K, Rosenberg HF. Critical Adverse Impact of IL-6 in Acute Pneumovirus Infection. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2019; 202:871-882. [PMID: 30578308 PMCID: PMC6365009 DOI: 10.4049/jimmunol.1800927] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 11/21/2018] [Indexed: 12/17/2022]
Abstract
Severe respiratory virus infections feature robust local host responses that contribute to disease severity. Immunomodulatory strategies that limit virus-induced inflammation may be of critical importance, notably in the absence of antiviral vaccines. In this study, we examined the role of the pleiotropic cytokine IL-6 in acute infection with pneumonia virus of mice (PVM), a natural rodent pathogen that is related to respiratory syncytial virus and that generates local inflammation as a feature of severe infection. In contrast to Influenza A, PVM is substantially less lethal in IL-6 -/- mice than it is in wild-type, a finding associated with diminished neutrophil recruitment and reduced fluid accumulation in lung tissue. Ly6Chi proinflammatory monocytes are recruited in response to PVM via a CCR2-dependent mechanism, but they are not a major source of IL-6 nor do they contribute to lethal sequelae of infection. By contrast, alveolar macrophages are readily infected with PVM in vivo; ablation of alveolar macrophages results in prolonged survival in association with a reduction in virus-induced IL-6. Finally, as shown previously, administration of immunobiotic Lactobacillus plantarum to the respiratory tracts of PVM-infected mice promoted survival in association with diminished levels of IL-6. We demonstrated in this study that IL-6 suppression is a critical feature of the protective mechanism; PVM-infected IL-6 -/- mice responded to low doses of L. plantarum, and administration of IL-6 overcame L. plantarum-mediated protection in PVM-infected wild-type mice. Taken together, these results connect the actions of IL-6 to PVM pathogenesis and suggest cytokine blockade as a potential therapeutic modality in severe infection.
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Affiliation(s)
- Caroline M Percopo
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Michelle Ma
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Todd A Brenner
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Julia O Krumholz
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Timothy J Break
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
| | - Karen Laky
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
| | - Helene F Rosenberg
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892; and
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18
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Shen J, Hu R, Zhou T, Wang Z, Zhang Y, Li S, Gui C, Jiang M, Qin A, Tang BZ. Fluorescent Sensor Array for Highly Efficient Microbial Lysate Identification through Competitive Interactions. ACS Sens 2018; 3:2218-2222. [PMID: 30350949 DOI: 10.1021/acssensors.8b00650] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Optical cross-reactive sensor arrays have recently been proven to be a powerful tool for high-throughput bioanalytes identification. Nevertheless, identification and classification of microbes, especially using microbial lysates as the analytes, still is a great challenge due to their complex composition. Herein, we achieve this goal by using luminogens featuring aggregation-induced emission characteristics (AIEgens) and graphene oxide (GO) to construct a microbial lysate responsive fluorescent sensor array. The combination of AIEgen with GO not only reduces the background signal but also induces the competition interactions among AIEgen, microbial lysates, and GO, which highly improves the discrimination ability of the sensor array. As a result, six microbes, including two fungi, two Gram-positive bacteria, and two Gram-negative bacteria are precisely identified. Thus, this work provides a new way to design safer and simpler sensor arrays for the discrimination of complex analytes.
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Affiliation(s)
- Jianlei Shen
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
| | - Rong Hu
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
| | - Taotao Zhou
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
| | - Zhiming Wang
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
| | - Yiru Zhang
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
| | - Shiwu Li
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
| | - Chen Gui
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration and Reconstruction, Institute for Advanced Study, and Department of Chemical and Biological Engineering, The Hong Kong University of Science & Technology, Clear Water Bay, Kowloon, Hong Kong, China
| | - Meijuan Jiang
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration and Reconstruction, Institute for Advanced Study, and Department of Chemical and Biological Engineering, The Hong Kong University of Science & Technology, Clear Water Bay, Kowloon, Hong Kong, China
| | - Anjun Qin
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
| | - Ben Zhong Tang
- State Key Laboratory of Luminescent Materials and Devices, Center for Aggregation-Induced Emission, South China University of Technology, Guangzhou 510640, China
- Department of Chemistry, Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration and Reconstruction, Institute for Advanced Study, and Department of Chemical and Biological Engineering, The Hong Kong University of Science & Technology, Clear Water Bay, Kowloon, Hong Kong, China
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19
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Regan KH, Hill AT. Emerging therapies in adult and paediatric bronchiectasis. Respirology 2018; 23:1127-1137. [DOI: 10.1111/resp.13407] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/06/2018] [Accepted: 08/15/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Kate H. Regan
- University of Edinburgh/MRC Centre for Inflammation ResearchThe Queen's Medical Research Institute Edinburgh UK
- Department of Respiratory MedicineRoyal Infirmary of Edinburgh Edinburgh UK
| | - Adam T. Hill
- University of Edinburgh/MRC Centre for Inflammation ResearchThe Queen's Medical Research Institute Edinburgh UK
- Department of Respiratory MedicineRoyal Infirmary of Edinburgh Edinburgh UK
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Shen Y, Zhang ZH, Hu D, Ke X, Gu Z, Zou QY, Hu GH, Song SH, Kang HY, Hong SL. The airway inflammation induced by nasal inoculation of PM2.5 and the treatment of bacterial lysates in rats. Sci Rep 2018; 8:9816. [PMID: 29959403 PMCID: PMC6026196 DOI: 10.1038/s41598-018-28156-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 06/13/2018] [Indexed: 12/12/2022] Open
Abstract
Particulate matter (PM) is one of the most important environmental issues in China. This study aimed to explore the correlation between PM2.5 and airway inflammation in healthy rats. The PM2.5 group was given an intranasal instillation of PM2.5 suspension on 15 consecutive days, and each received oral saline from day 16 to 90. The BV intervention group was treated as the PM2.5 exposure group, except that BV instead of saline was given daily. A histopathologic examination was performed to evaluate the airway inflammation. The prevalence and function of Th1/Th2/Treg/Th17 cells were detected by flow cytometry and ELISA. The expression of AhR was detected by western blot and real-time PCR. We found that epithelial damage and increased infiltration of inflammatory cell were present in the airways after PM2.5 exposure; there was an immune imbalance of Th cells in the PM2.5 group; the expression of AhR was increased in the airways after PM2.5 exposure. In the PM2.5 + BV group, we demonstrated alleviated immune imbalance and reduced inflammatory cell infiltration in the airways. Our study showed that exposure to PM2.5 induced airway inflammation. The imbalance of Th1/Th2/Treg/Th17 in PM2.5-induced airway inflammation might be associated with activation of the AhR pathway. Oral BV reduces PM2.5-induced airway inflammation and regulates systemic immune responses in rats.
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Affiliation(s)
- Yang Shen
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhi-Hai Zhang
- Chongqing Key Laboratory of Ophthalmology, Chongqing, People's Republic of China
| | - Di Hu
- Chongqing Key Laboratory of Ophthalmology, Chongqing, People's Republic of China
| | - Xia Ke
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zheng Gu
- Chongqing Key Laboratory of Ophthalmology, Chongqing, People's Republic of China
| | - Qi-Yuan Zou
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Guo-Hua Hu
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Shang-Hua Song
- Chongqing Key Laboratory of Ophthalmology, Chongqing, People's Republic of China
| | - Hou-Yong Kang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
| | - Su-Ling Hong
- Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
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Jin X, Ji Z, Li X, Liu R, Guan Y. Bioinformatics analysis and verification of key genes associated with recurrent respiratory tract infections. Int J Mol Med 2018; 42:514-524. [PMID: 29693136 DOI: 10.3892/ijmm.2018.3640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/02/2018] [Indexed: 11/05/2022] Open
Abstract
We evaluated the key genes related with recurrent respiratory tract infections (RRTIs), and then elucidated the possible molecular mechanisms of RRTIs. Neutrophil was isolated from peripheral bloods of the recurrent lower respiratory tract infection patients and healthy volunteers, respectively. The next generation sequencing information was obtained after RNA extraction, purification, library construction and sequencing. The sequencing information was preprocessed. Bioinformatics analysis including analysis of differentially expre-ssed genes (DEGs), Gene Ontology (GO) and pathway enrichment analysis, protein-protein interaction (PPI) analysis and transcription factors analysis were performed. The key genes were verified by real-time PCR. In total, 17 significant DEGs were obtained in case group compared with the control group by bioinformatics analysis. Then, 6 of 17 genes were detected by real-time PCR. There was statistical significance between case and control groups for peroxisome proliferator-activated receptor-γ (PPARG), prostaglandin-endoperoxide synthase 2 (PTGS2), transferrin (TF) and interleukin-10 (IL-10) (P<0.05), and there was no statistical significance between case and control groups for TIMP metallopeptidase inhibitor 1 (TIMP1) and matrix metallopeptidase 1 (MMP1). PPARG, PTGS2, TF and IL-10 are key genes associated with the progression of RRTIs. We speculate that TIMP1 and MMP1 may also be involved in the progression of RRTIs, but further studies with large number of samples are needed for verification.
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Affiliation(s)
- Xiang Jin
- Department of Respiratory Medicine, The First Hospital, Jilin University, Changchun, Jilin 130000, P.R. China
| | - Zhiyong Ji
- Department of ICU, The First Hospital, Jilin University, Changchun, Jilin 130000, P.R. China
| | - Xiaodan Li
- Department of Respiratory Medicine, The First Hospital, Jilin University, Changchun, Jilin 130000, P.R. China
| | - Rui Liu
- Department of Respiratory Medicine, The First Hospital, Jilin University, Changchun, Jilin 130000, P.R. China
| | - Yinghui Guan
- Department of Respiratory Medicine, The First Hospital, Jilin University, Changchun, Jilin 130000, P.R. China
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22
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Percopo CM, Ma M, Rosenberg HF. Administration of immunobiotic Lactobacillus plantarum delays but does not prevent lethal pneumovirus infection in Rag1-/- mice. J Leukoc Biol 2017; 102:905-913. [PMID: 28619948 DOI: 10.1189/jlb.3ab0217-050rr] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 12/11/2022] Open
Abstract
Administration of immunobiotic Lactobacillus plantarum (Lp) directly to the respiratory mucosa promotes cross-protection against lethal pneumovirus infection via B-cell-independent mechanisms. In this study, we examined Lp-mediated cross protection in Rag1-/- mice which cannot clear virus from lung tissue. Although Lp was initially protective, Rag1-/- mice ultimately succumbed to a delayed lethal outcome associated with local production of the proinflammatory cytokines CCL1, -2, and -7, granulocyte recruitment, and ongoing virus replication. By contrast, CD8null mice, which are fully capable of clearing virus, are protected by Lp with no delayed lethal outcome, granulocyte recruitment to the airways, or induction of CCL7. Repeated administration of Lp to virus-infected Rag1-/- mice had no impact on delayed mortality. Moreover, administration of Lp to the respiratory mucosa resulted in no induction of IFN-α or -β in Rag1-/- or wild-type mice, and IFN-abR gene deletion had no impact on Lp-mediated protection. Overall, our findings indicate that although Lp administered to the respiratory tract has substantial impact on lethal virus-induced inflammation in situ, endogenous virus clearance mechanisms are needed to promote sustained protection. Our results suggest that a larger understanding of the mechanisms and mediators that limit acute virus-induced inflammation may yield new and useful therapeutic modalities.
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Affiliation(s)
- Caroline M Percopo
- Inflammation Immunobiology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Michelle Ma
- Inflammation Immunobiology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Helene F Rosenberg
- Inflammation Immunobiology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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23
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The Immunotherapeutic Role of Bacterial Lysates in a Mouse Model of Asthma. Lung 2017; 195:563-569. [DOI: 10.1007/s00408-017-0003-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 04/17/2017] [Indexed: 12/23/2022]
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Bacterial lysate for the prevention of chronic rhinosinusitis recurrence in children. The Journal of Laryngology & Otology 2017; 131:523-528. [DOI: 10.1017/s0022215117000524] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AbstractBackground:Chronic rhinosinusitis is a common nasal disorder in children that is prone to recurrence. This study investigated the prevention of chronic rhinosinusitis recurrence with bacteria lysate in children.Methods:Bacteria lysate was administered 10 days per month for 3 months to children with chronic rhinosinusitis, who had just entered a remission phase. Visual analogue score, nasal symptoms scores, rhinitis attack frequency and antibiotic use were assessed at three months and one year.Results:At one year of follow up, the visual analogue score, nasal discharge and obstruction scores, number of days with rhinitis attacks per month and number of days with antibiotic use per month were significantly decreased in the prevention group versus the control group (p< 0.05).Conclusion:Bacterial lysate used in the remission period of rhinosinusitis in children was shown to provide long-term prophylaxis. Bacterial lysate can effectively reduce the frequency of rhinosinusitis attacks and ameliorate attack symptoms.
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Onakpoya IJ, Hayward G, Heneghan CJ. Antibiotics for preventing lower respiratory tract infections in high-risk children aged 12 years and under. Cochrane Database Syst Rev 2015; 2015:CD011530. [PMID: 26408070 PMCID: PMC10624245 DOI: 10.1002/14651858.cd011530.pub2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Lower respiratory tract infections (LRTIs) in young children account for 1.4 million deaths annually worldwide. Antibiotics could be beneficial in preventing LRTIs in high-risk children, and may also help prevent school absenteeism and work days missed by children and/or carers. While it is well documented that the efficacy of antibiotic prophylaxis for RTIs decreases over time, there are no reviews that describe the use of antibiotic prophylaxis to prevent LRTIs in high-risk children aged 12 years and under. OBJECTIVES To assess the effectiveness and safety of antibiotic prophylaxis in the prevention of bacterial LRTIs in high-risk children aged 12 years and under. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 1) and the Database of Abstracts of Reviews of Effects (DARE), MEDLINE and MEDLINE In-Process (OvidSP) (1946 to 13 February 2015), EMBASE (OvidSP) (1974 to 12 February 2015), Science Citation Index Expanded (1945 to 13 February 2015) and Conference Proceedings Citation Index-Science (Web of Science Core Collection) (1990 to 13 February 2015). We searched for ongoing studies on ClinicalTrials.gov and the World Health Organization ICTRP. We handsearched the bibliographies of retrieved full texts of relevant studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing oral or intravenous antibiotics versus placebo or no treatment to prevent infections in high-risk children aged 12 years and under. We used a combination of the Centers for Disease Control and Prevention (CDC), National Health Service (NHS), American Academy of Paediatrics (AAP) and National Institute for Health and Care Excellence (NICE) guidelines to define conditions at higher risk of complications. Our primary outcome was the incidence of bacterial lower respiratory infections. Secondary outcomes included clinical function, hospital admission, mortality, growth, use of secondary antibiotics, time off school or parental work, quality of life and adverse events. DATA COLLECTION AND ANALYSIS We extracted data using a customised data extraction sheet, assessed the risk of bias of included studies using the Cochrane 'Risk of bias' criteria, and used the GRADE criteria to rate the quality of the evidence. We used a random-effects model for meta-analysis. We presented the results narratively where we could not statistically combine data. MAIN RESULTS We included 10 RCTs of high-risk children using antibiotics (azithromycin, ciprofloxacin, co-trimoxazole, isoniazid, oral penicillin V or vancomycin) to prevent LRTIs. Three studies included HIV-infected children (n = 1345), four cystic fibrosis (n = 429) and one each sickle cell disease (n = 219), cancer (n = 160) and low birth weight neonates with underlying respiratory disorders (n = 40). The study duration ranged from seven days to three years. The quality of the evidence from studies including children with HIV infection, cystic fibrosis or cancer was moderate. Due to inadequate data, we were unable to rate the quality of the evidence for two studies: one in children with sickle cell disease (low risk of bias), and another in low birth weight neonates with underlying respiratory disorders (high risk of bias).In HIV-infected children receiving continuous isoniazid prophylaxis, there was no significant difference in the incidence of pulmonary tuberculosis (risk ratio (RR) 0.64, 95% confidence interval (CI) 0.32 to 1.29, I(2) statistic = 47%, P value = 0.21). There was no significant effect on mortality with co-trimoxazole or isoniazid prophylaxis (RR 0.82, 0.46 to 1.46, I(2) statistic = 76%, P value = 0.58); however, analysis of one study that used co-trimoxazole showed a significant reduction in mortality (RR 0.67, 95% CI 0.53 to 0.85, P value = 0.001). There was a significant decrease in the rates of hospital admission per child-year of follow-up with co-trimoxazole prophylaxis in one study (P value = 0.01). There was no evidence of increased adverse events due to antibiotic prophylaxis (RR 1.10, 95% CI 0.75 to 1.64, I(2) statistic = 22%, P value = 0.28); however, there was scant reporting of antibiotic resistance - the one study that did assess this found no increase.In two studies of children with cystic fibrosis receiving ciprofloxacin prophylaxis, there was no significant difference in Pseudomonas infections (RR 0.76, 0.44 to 1.31, I(2) statistic = 0%, P value = 0.33). In two studies assessing the benefit of azithromycin prophylaxis, there was a significant reduction in the frequency of pulmonary exacerbations (RR 0.60, 95% CI 0.48 to 0.76, I(2) statistic = 0%, P value < 0.0001). The effect of antibiotic prophylaxis on growth in children with cystic fibrosis was inconsistent across the studies. There was an increased risk of emergence of pathogenic strains with either azithromycin or ciprofloxacin prophylaxis in two studies reporting this outcome. There was no significant difference in the quality of life (one study). In three studies, there was no significant increase in the frequency of adverse events with prophylaxis with azithromycin (two studies) or ciprofloxacin (one study). There was no evidence of increased antibiotic resistance in two studies.In the one study of children with sickle cell disease, a significantly lesser proportion of children with pneumococcal septicaemia was reported with penicillin V prophylaxis (P value = 0.0025).In the one study of children with cancer there was a significant decrease in Pneumocystis carinii pneumonia with trimethoprim-sulfamethoxazole prophylaxis (RR 0.03, 95% CI 0.00 to 0.47, P value < 0.01). There was no significant increase in the frequency of adverse events with antibiotic prophylaxis.In low birth weight children with underlying respiratory disorders, there was no significant difference in the proportion of children with pulmonary infection with vancomycin prophylaxis (P value = 0.18).No included studies reported time off school or carer time off work. AUTHORS' CONCLUSIONS There is inconclusive evidence that antibiotic prophylaxis in certain groups of high-risk children can reduce pneumonia, exacerbations, hospital admission and mortality in certain conditions. However, limitations in the evidence base mean more clinical trials assessing the effectiveness of antibiotics for preventing LRTIs in children at high risk should be conducted. Specifically, clinical trials assessing the effectiveness of antibiotics for preventing LRTIs in congenital heart disease, metabolic disease, endocrine and renal disorders, neurological disease or prematurity should be a priority.
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Affiliation(s)
- Igho J Onakpoya
- Nuffield Department of Primary Care Health Sciences, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK, Oxon
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Pan L, Jiang XG, Guo J, Tian Y, Liu CT. Effects of OM-85 BV in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Clin Pharmacol 2015; 55:1086-92. [PMID: 25903441 DOI: 10.1002/jcph.518] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/15/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Lei Pan
- Nanlou Respiratory Diseases Department; Chinese PLA General Hospital; Beijing China
- Department of Respiratory and Critical Care Medicine; Affiliated Hospital of Binzhou Medical University; Binzhou China
| | - Xue-Ge Jiang
- Nanlou Respiratory Diseases Department; Chinese PLA General Hospital; Beijing China
| | - Jun Guo
- Nanlou Respiratory Diseases Department; Chinese PLA General Hospital; Beijing China
| | - Yuan Tian
- Nanlou Respiratory Diseases Department; Chinese PLA General Hospital; Beijing China
| | - Chang-Ting Liu
- Nanlou Respiratory Diseases Department; Chinese PLA General Hospital; Beijing China
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Lu Y, Li Y, Xu L, Xia M, Cao L. Bacterial lysate increases the percentage of natural killer T cells in peripheral blood and alleviates asthma in children. Pharmacology 2015; 95:139-44. [PMID: 25833066 DOI: 10.1159/000377683] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 01/30/2015] [Indexed: 11/19/2022]
Abstract
AIMS To assess the efficacy of conventional treatment combined with bacterial lysate [OM-85 Broncho-Vaxom (BV)] in the prevention of asthma in children as well as its influence on the number of natural killer T (NKT) cells and their cytokine production. MATERIALS AND METHODS Sixty children diagnosed with asthma were divided into either a BV-treated group (with oral OM-85 BV) or a conventional inhaled corticosteroid (ICS) group. The numbers of NKT cells and CD4+ NKT cells were measured in the peripheral blood by flow cytometry. The levels of IFN-γ, IL-4, and IL-10 after the blood cells had been cultured with an NKT cell agonist were detected by ELISA. RESULTS After therapy, asthma attacks were significantly decreased compared with before therapy in both groups. However, after therapy, respiratory tract infections were reduced compared with before therapy in the BV-treated group only. Additionally, the frequency of asthma attacks and use of antibiotics in the BV-treated group were lower than in the ICS group. With BV treatment, the numbers of peripheral blood NKT cells and CD4+ NKT cells were higher after therapy than before therapy. After therapy, the ratio of IFN-γ/IL-4 and IL-10 levels were increased in the BV-treated group, whereas IL-4 was reduced in the BV-treated group compared with the ICS group. CONCLUSION BV combined with conventional asthma treatment can prevent recurrent respiratory tract infections and suppress the severity of asthma attacks, possibly by altering the rates and cytokines of NKT cells.
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Affiliation(s)
- Yanming Lu
- Department of Pediatrics, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Chang AB, Marsh RL, Smith-Vaughan HC, Hoffman LR. Emerging drugs for bronchiectasis: an update. Expert Opin Emerg Drugs 2015; 20:277-97. [DOI: 10.1517/14728214.2015.1021683] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Xuan J, Wang L, Yin H, Xuan D, Zhou Y, Hu S. The cost-effectiveness of OM-85 in managing respiratory tract infections in China. J Med Econ 2015; 18:167-72. [PMID: 25275426 DOI: 10.3111/13696998.2014.971159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To demonstrate the health economic impact of OM-85, a bacterial lysates based immunostimulant, for its approved indications in China. METHODS A cost-effectiveness decision tree model was constructed comparing OM-85 with the best supportive care/placebo therapy for managing the acute exacerbation of chronic bronchitis and rhinosinusitis in the Chinese population. Clinical efficacy and adverse events (AE) data were included in the model based on a thorough literature review. All localized direct treatment costs, including drug cost, AE costs, and medical treatment costs for underlining diseases were included from a Chinese third party payer perspective. A Key Opinion Leaders (KOL) survey was conducted with 20 senior physicians specialized in respiratory, ENT, allergy, and immunology fields from tertiary hospitals in Beijing, Shanghai, Guangzhou, Hangzhou, Shenyang, and Wuhan to validate the local treatment costs. Incremental cost-effectiveness ratio (ICER) was calculated based on the above efficacy and cost information. RESULTS OM-85 is a cost-effective therapy when compared with placebo (standard care). OM-85 can treat/prevent one additional full episode exacerbation of chronic bronchitis and one additional full episode exacerbation of rhinosinusitis with only additional costs of RMB 653 and RMB 1182.84, respectively. In comparison, each acute exacerbation of chronic bronchitis will cost RMB 4510.10, and each acute exacerbation of rhinosinuisitis will cost RMB 1807.21 in a Chinese clinical management setting. One-way sensitivity analyses were performed and the ICER result was demonstrated to be consistent. CONCLUSIONS OM 85 reduces acute exacerbations among patients with chronic bronchitis and chronic rhinosinusitis when compared with Placebo (standard care). From a Chinese payer perspective, OM 85 is a cost-effective therapy in the clinical management of both chronic bronchitis and rhinosinusitis in the adult population.
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Onakpoya IJ, Hayward G, Heneghan CJ. The use of antibiotics for preventing lower respiratory tract infections in at risk children less than 12 years old. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd011530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Carlone S, Minenna M, Morlino P, Mosca L, Pasqua F, Pela R, Schino P, Tubaldi A, Tupputi E, De Benedetto F. Clinical efficacy and tolerability of an immune-stimulant(*) constituted by inactivated bacterial bodies in the prophylaxis of infectious episodes of airways: a double blind, placebo-controlled, randomized, multicentre study. Multidiscip Respir Med 2014; 9:58. [PMID: 25699178 PMCID: PMC4334598 DOI: 10.1186/2049-6958-9-58] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/25/2014] [Indexed: 11/27/2022] Open
Abstract
Background (Buccalin ®) is a Bacterial Lysates (BL) that belongs to a family of immune-stimulators, developed more than 30 years ago and it still has a role in the prophylaxis of Recurrent Respiratory Tract Infections (RRTI). However, original studies were conducted with an approach that does not seem to be aligned with the present methodologies. In addition, concomitant therapies substantially improved in the last decades. These two reasons strongly suggested to update our knowledge on the capacity of this bacterial lysate (Buccalin ®) to reduce the number of days with infectious episodes in patients with RRTI. Methods A double blind, placebo-controlled, randomized, multicentre study was programmed (EudraCT code: 2011-005187-25). The reduction of the number of days with infectious episodes (IE) was the primary endpoint. Secondary endpoints were the number of IE, the use of concomitant drugs, the efficacy on signs and symptoms of RRTI and the safety of the drug. Patients were treated according to the registered schedule and were followed up for a period of 6 months. Results From a cohort of 188 patients eligible for the study, 90 were included in the active group and 88 in the placebo group. The study was completed in 170 patients. A significant reduction of the number of days with IE was observed (6.57 days in the active group and 7.47 in the placebo group). Secondary endpoints were only partially achieved. No virtual adverse events related to the treatment were recorded. Conclusion The administration of bacterial lysate (Buccalin ®) in patients with RRTI had the capacity to significantly reduce the number of days with IE in a multicentre, randomized, placebo controlled, clinical study. The treatment was safe. Of note, all patients were free to be treated with the best concomitant therapies. In these conditions, the positive results observed demonstrated that this bacterial lysate has maintained its capacity of reducing the days with infections in patients with RRTI, also in association to the concomitant therapies available nowadays.
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Affiliation(s)
- Stefano Carlone
- Pulmonary Department of San Giovanni-Addolorata General Hospital, Respiratory Diseases I, Via dell'Amba Aradan 9, Rome, 00184 Italy
| | - Michele Minenna
- Pneumology, Civile di Bitonto Hospital, Via Gomes 32, Bitonto, BA 70032 Italy
| | - Paride Morlino
- Respiratory Diseases and Respiratory Rehabilitation, Teresa Masselli Mascia Hospital, Via 2 Giugno, San Severo, FG 71016 Italy
| | - Luigi Mosca
- Pneumology and Respiratory Physiopathology Department, Hospital of Pescara, Via Fonte Romana 8, Pescara, 65124 Italy
| | - Franco Pasqua
- Pneumology Rehabilitation, Villa delle Querce Hospital, Nemi, Rome Italy
| | - Riccardo Pela
- Pneumology Unit, C. e G. Mazzoni Hospital, Via degli Iris 1, Ascoli Piceno, 63100 Italy
| | - Pietro Schino
- Department of Pulmonary Disease, F. Miulli Hospital, Strada Prov. 127 Acquaviva - Santeramo Km. 4,100, Acquaviva delle Fonti, BA 70021 Italy
| | - Alberto Tubaldi
- Pneumology Department, General Hospital of Macerata, Via Santa Lucia 2, Macerata, 62100 Italy
| | - Emmanuele Tupputi
- Local Health Unit, Hospital District 2, BAT, Via Vittore Carpaccio, Andria, BT 70031 Italy
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Martinez FD. The human microbiome. Early life determinant of health outcomes. Ann Am Thorac Soc 2014; 11 Suppl 1:S7-12. [PMID: 24437411 PMCID: PMC3972972 DOI: 10.1513/annalsats.201306-186mg] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 09/16/2013] [Indexed: 01/15/2023] Open
Abstract
The development of new technologies to isolate and identify microbial genomes has markedly increased our understanding of the role of microbiomes in health and disease. The idea, first proposed as part of the hygiene hypothesis, that environmental microbes influence the developmental trajectories of the immune system in early life, has now been considerably extended and refined. The abundant microbiota present in mucosal surfaces, especially the gut, is actively selected by the host through complex receptor systems that respond differentially depending on the molecular patterns presented to mucosal cells. Germ-free mice are more likely to develop allergic airway inflammation and show alterations in normal motor control and anxiety. These effects can be reversed by neonatal microbial recolonization but remain unchanged if recolonization occurs in adults. What emerges from these recent studies is the discovery of a complex, major early environmental determinant of lifetime human phenotypes. To change the natural course of asthma, obesity, and other chronic inflammatory conditions, active manipulation of the extensive bacterial, phage, and fungal metagenomes present in mucosal surfaces may be required, specifically during the developing years. Domesticating the human microbiome and adapting it to our health needs may be a challenge akin to, but far more complex than, the one faced by humanity when a few dozen species of plants and animals were domesticated during the transition between hunter-gatherer and sedentary societies after the end of the Pleistocene era.
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Affiliation(s)
- Fernando D. Martinez
- Arizona Respiratory Center and BIO5 Institute, The University of Arizona, Tucson, Arizona
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