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Guo S, Ouyang J, Hu Z, Cao T, Huang C, Mou J, Gu X, Liu J. Intranasal vaccination with engineered BCG expressing CCL2 induces a stronger immune barrier against Mycobacterium tuberculosis than BCG. Mol Ther 2024:S1525-0016(24)00609-9. [PMID: 39295146 DOI: 10.1016/j.ymthe.2024.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/14/2024] [Accepted: 09/13/2024] [Indexed: 09/21/2024] Open
Abstract
Intradermal Mycobacterium bovis Bacillus Calmette-Guérin (BCG) vaccination is currently the only licensed strategy for preventing tuberculosis (TB). It provides limited protection against pulmonary TB. To enhance the efficacy of BCG, we developed a recombinant BCG expressing exogenous monocyte chemoattractant CC chemokine ligand 2 (CCL2) called rBCG-CCL2. Co-culturing macrophages with rBCG-CCL2 enhances their abilities in migration, phagocytosis, and effector molecule expression. In the mouse model, intranasal vaccination with rBCG-CCL2 induced greater immune cell infiltration and a more extensive innate immune response in lung compared to vaccination with parental BCG, as determined by multiparameter flow cytometry, transcriptomic analysis, and pathological assessments. Moreover, rBCG-CCL2 induced a high frequency of activated macrophages and antigen-specific T helper 1 (Th1) and Th17 T cells in lungs. The enhanced immune microenvironment responded more effectively to intravenous challenge with Mycobacterium tuberculosis (Mtb) H37Ra, leading to significant reductions in H37Ra burden and pathological damage to the lungs and spleen. Intranasal rBCG-CCL2-vaccinated mice rapidly initiated pro-inflammatory Th1 cytokine release and reduced pathological damage to the lungs and spleen during the early stage of H37Ra challenge. The finding that co-expression of CCL2 synergistically enhances the immune barrier induced by BCG provides a model for defining immune correlates and mechanisms of vaccine-elicited protection against TB.
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Affiliation(s)
- Shaohua Guo
- Center for Infectious Disease and Vaccine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Jiangshan Ouyang
- Center for Infectious Disease and Vaccine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Zhiming Hu
- Center for Infectious Disease and Vaccine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Ting Cao
- Center for Infectious Disease and Vaccine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Chunxu Huang
- Center for Infectious Disease and Vaccine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Jun Mou
- Center for Infectious Disease and Vaccine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Xinxia Gu
- Center for Infectious Disease and Vaccine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
| | - Jie Liu
- Center for Infectious Disease and Vaccine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China.
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Elevated Fasting Blood Glucose Levels Are Associated with Worse Clinical Outcomes in COVID-19 Patients Than in Pneumonia Patients with Bacterial Infections. Pathogens 2022; 11:pathogens11080902. [PMID: 36015023 PMCID: PMC9416056 DOI: 10.3390/pathogens11080902] [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: 05/05/2022] [Revised: 07/23/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022] Open
Abstract
Aims: We investigate how fasting blood glucose (FBG) levels affect the clinical severity in coronavirus disease 2019 (COVID-19) patients, pneumonia patients with sole bacterial infection, and pneumonia patients with concurrent bacterial and fungal infections. Methods: We enrolled 2761 COVID-19 patients, 1686 pneumonia patients with bacterial infections, and 2035 pneumonia patients with concurrent infections. We used multivariate logistic regression analysis to assess the associations between FBG levels and clinical severity. Results: FBG levels in COVID-19 patients were significantly higher than in other pneumonia patients during hospitalisation and at discharge (all p < 0.05). Among COVID-19 patients, the odds ratios of acute respiratory distress syndrome (ARDS), respiratory failure (RF), acute hepatitis/liver failure (AH/LF), length of stay, and intensive care unit (ICU) admission were 12.80 (95% CI, 4.80−37.96), 5.72 (2.95−11.06), 2.60 (1.20−5.32), 1.42 (1.26−1.59), and 5.16 (3.26−8.17) times higher in the FBG ≥7.0 mmol/L group than in FBG < 6.1 mmol/L group, respectively. The odds ratios of RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with sole bacterial infection (3.70 [2.21−6.29]; 1.56 [1.17−2.07]; 0.98 [0.88−1.11]; 2.06 [1.26−3.36], respectively). The odds ratios of ARDS, RF, AH/LF, length of stay, and ICU admission were increased to a lesser extent in pneumonia patients with concurrent infections (3.04 [0.36−6.41]; 2.31 [1.76−3.05]; 1.21 [0.97−1.52]; 1.02 [0.93−1.13]; 1.72 [1.19−2.50], respectively). Among COVID-19 patients, the incidence rate of ICU admission on day 21 in the FBG ≥ 7.0 mmol/L group was six times higher than in the FBG < 6.1 mmol/L group (12.30% vs. 2.21%, p < 0.001). Among other pneumonia patients, the incidence rate of ICU admission on day 21 was only two times higher. Conclusions: Elevated FBG levels at admission predict subsequent clinical severity in all pneumonia patients regardless of the underlying pathogens, but COVID-19 patients are more sensitive to FBG levels, and suffer more severe clinical complications than other pneumonia patients.
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Jiang H, Chen X, Wang L, Qian X, Zhang Y, Wu J, Shao S. Subacute thyroiditis complicated with multiple organ failure: A case report. Medicine (Baltimore) 2022; 101:e28710. [PMID: 35119016 PMCID: PMC8812617 DOI: 10.1097/md.0000000000028710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 01/10/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Subacute thyroiditis is an inflammatory disease of the thyroid gland that is often caused by viral infections. Multiple organ failure (MOF) is mainly caused by acute inflammatory reactions resulting from severe infection or trauma. MOF due to subacute thyroiditis is extremely rare. PATIENT CONCERNS A 48-year-old woman with a history of type 2 diabetes mellitus was admitted to our hospital because of subacute thyroiditis. However, the patient developed MOF during hospitalization. DIAGNOSIS The patient was diagnosed with subacute thyroiditis complicated by MOF based on clinical symptoms and laboratory tests. INTERVENTIONS The patient was initially admitted to the endocrinology ward for glucocorticoid and insulin therapies. When the condition deteriorated to MOF, the patient was transferred to the intensive care unit. Ventilator-assisted breathing, blood transfusion, albumin infusion, improved cardiac function, oral glucocorticoids, and insulin were administered to the patient. OUTCOMES The patient was followed-up at 2-weeks intervals for over 2 months. Her thyroid function returned to normal and her blood sugar level was stable. Transaminase, serum creatinine, albumin, and myocardial enzyme levels were normal. LESSONS MOF due to subacute thyroiditis is extremely rare. Especially in patients with elevated blood glucose or other immune dysfunctions, we should be alert to the occurrence of subacute thyroiditis with MOF.
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Affiliation(s)
- Hui Jiang
- Department of Endocrinology, Affiliated People's Hospital of Jiangsu University, 8 Dianli Road, Zhenjiang, Jiangsu Province, China
| | - Xiaoluo Chen
- Department of Endocrinology, Affiliated People's Hospital of Jiangsu University, 8 Dianli Road, Zhenjiang, Jiangsu Province, China
| | - Li Wang
- Department of Endocrinology, Affiliated People's Hospital of Jiangsu University, 8 Dianli Road, Zhenjiang, Jiangsu Province, China
| | - Xiaoqin Qian
- Department of Ultrasound, Affiliated People's Hospital of Jiangsu University, 8 Dianli Road, Zhenjiang, Jiangsu Province, China
| | - Yan Zhang
- Department of Endocrinology, Affiliated People's Hospital of Jiangsu University, 8 Dianli Road, Zhenjiang, Jiangsu Province, China
| | - Jing Wu
- Department of Endocrinology, Affiliated People's Hospital of Jiangsu University, 8 Dianli Road, Zhenjiang, Jiangsu Province, China
| | - Shihe Shao
- School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu Province, China
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Wu J, Zhang J, Sun X, Wang L, Xu Y, Zhang Y, Liu X, Dong C. Influence of diabetes mellitus on the severity and fatality of SARS-CoV-2 (COVID-19) infection. Diabetes Obes Metab 2020; 22:1907-1914. [PMID: 32496012 PMCID: PMC7300679 DOI: 10.1111/dom.14105] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/18/2020] [Accepted: 05/27/2020] [Indexed: 12/22/2022]
Abstract
AIM To evaluate the influence of diabetes on the severity and fatality of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MATERIALS AND METHODS The medical records of 66 hospitalized coronavirus disease 2019 (COVID-19) patients were collected and classified into non-severe (mild/moderate cases) and severe (severe/critical cases) groups. Logistic regression analysis was used to estimate the risk of severe COVID-19 (severe/critical infection). In addition, a meta-analysis including published studies reported the impact of diabetes on the severity and fatality of COVID-19. The current study was conducted using fixed effects models. RESULTS There were 22 diabetes and 44 non-diabetes cases among the 66 hospitalized COVID-19 patients. Seven patients with diabetes (31.82%) were diagnosed as severe COVID-19 cases, which was significantly higher than that in the non-diabetes group (4/44, 9.09%, P = .033). After adjustment for age and gender, diabetes was significantly associated with COVID-19 severity (OR: 5.29, 95% CI: 1.07-26.02). A meta-analysis further confirmed the positive association between diabetes and COVID-19 severity (pooled OR = 2.58, 95% CI: 1.93-3.45). Moreover, the patients with diabetes infected with SARS-CoV-2 had a 2.95-fold higher risk of fatality compared with those patients without diabetes (95% CI: 1.93-4.53). CONCLUSIONS Our findings provide new evidence that diabetes is associated with a higher risk of severity and fatality of COVID-19. Therefore, intensive monitoring and antidiabetic therapy should be considered in patients with diabetes with SARS-CoV-2 infection.
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Affiliation(s)
- Jing Wu
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric DiseaseMedical College of Soochow UniversitySoochowChina
| | - Jingqi Zhang
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric DiseaseMedical College of Soochow UniversitySoochowChina
| | - Xiaohua Sun
- Soochow University HosiptalSoochow UniversitySoochowChina
| | - Lijuan Wang
- Department of Clinical LaboratoryHuai'an Fourth People's HospitalHuai'anChina
| | - Yunfang Xu
- Department of Clinical LaboratoryHuai'an Fourth People's HospitalHuai'anChina
| | - Yuanyuan Zhang
- Department of Clinical LaboratoryHuai'an Fourth People's HospitalHuai'anChina
| | - Xingxiang Liu
- Department of Clinical LaboratoryHuai'an Fourth People's HospitalHuai'anChina
| | - Chen Dong
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric DiseaseMedical College of Soochow UniversitySoochowChina
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Miller LC, Fleming DS, Lager KM. Comparison of the Transcriptome Response within the Swine Tracheobronchial Lymphnode Following Infection with PRRSV, PCV-2 or IAV-S. Pathogens 2020; 9:E99. [PMID: 32033425 PMCID: PMC7168592 DOI: 10.3390/pathogens9020099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/29/2020] [Accepted: 02/04/2020] [Indexed: 12/16/2022] Open
Abstract
Porcine reproductive and respiratory syndrome virus (PRRSV) is a major respiratory pathogen of swine that has become extremely costly to the swine industry worldwide, often causing losses in production and animal life due to their ease of spread. However, the intracellular changes that occur in pigs following viral respiratory infections are still scantily understood for PRRSV, as well as other viral respiratory infections. The aim of this study was to acquire a better understanding of the PRRS disease by comparing gene expression changes that occur in tracheobronchial lymph nodes (TBLN) of pigs infected with either porcine reproductive and respiratory syndrome virus (PRRSV), porcine circovirus type 2 (PCV-2), or swine influenza A virus (IAV-S) infections. The study identified and compared gene expression changes in the TBLN of 80 pigs following infection by PRRSV, PCV-2, IAV-S, or sham inoculation. Total RNA was pooled for each group and time-point (1, 3, 6, and 14 dpi) to make 16 libraries-analyses are by Digital Gene Expression Tag Profiling (DGETP). The data underwent standard filtering to generate a list of sequence tag raw counts that were then analyzed using multidimensional and differential expression statistical tests. The results showed that PRRSV, IAV-S and PCV-2 viral infections followed a clinical course in the pigs typical of experimental infection of young pigs with these viruses. Gene expression results echoed this course, as well as uncovered genes related to intersecting and unique host immune responses to the three viruses. By testing and observing the host response to other respiratory viruses, our study has elucidated similarities and differences that can assist in the development of vaccines and therapeutics that shorten or prevent a chronic PRRSV infection.
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Affiliation(s)
- Laura C. Miller
- Virus and Prion Research Unit, National Animal Disease Center, USDA, Agricultural Research Service, Ames, IA 50161, USA; (D.S.F.); (K.M.L.)
| | - Damarius S. Fleming
- Virus and Prion Research Unit, National Animal Disease Center, USDA, Agricultural Research Service, Ames, IA 50161, USA; (D.S.F.); (K.M.L.)
- Oak Ridge Associated Universities/Oak Ridge Institute for Science and Education, Oakridge, TN 37830, USA
| | - Kelly M. Lager
- Virus and Prion Research Unit, National Animal Disease Center, USDA, Agricultural Research Service, Ames, IA 50161, USA; (D.S.F.); (K.M.L.)
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Jang AY, Ahn KB, Zhi Y, Ji HJ, Zhang J, Han SH, Guo H, Lim S, Song JY, Lim JH, Seo HS. Serotype-Independent Protection Against Invasive Pneumococcal Infections Conferred by Live Vaccine With lgt Deletion. Front Immunol 2019; 10:1212. [PMID: 31191555 PMCID: PMC6549034 DOI: 10.3389/fimmu.2019.01212] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/13/2019] [Indexed: 01/10/2023] Open
Abstract
Streptococcus pneumoniae is the most common respiratory bacterial pathogen among cases of community-acquired infection in young children, older adults, and individuals with underlying medical conditions. Although capsular polysaccharide-based pneumococcal vaccines have contributed to significant decrease in invasive pneumococcal infections, these vaccines have some limitations, including limited serotype coverage, lack of effective mucosal antibody responses, and high costs. In this study, we investigated the safety and immunogenicity of a live, whole-cell pneumococcal vaccine constructed by deleting the gene for prolipoprotein diacylglyceryl transferase (lgt) from the encapsulated pneumococcal strain TIGR4 (TIGR4Δlgt) for protection against heterologous pneumococcal strains. Pneumococcal strain TIGR4 was successfully attenuated by deletion of lgt, resulting in the loss of inflammatory activity and virulence. TIGR4Δlgt colonized the nasopharynx long enough to induce strong mucosal IgA and IgG2b-dominant systemic antibody responses that were cross-reactive to heterologous pneumococcal serotypes. Finally, intranasal immunization with TIGR4Δlgt provided serotype-independent protection against pneumococcal challenge in mice. Taken together, our results suggest that TIGR4Δlgt is an avirulent and attractive broad-spectrum pneumococcal vaccine candidate. More broadly, we assert that modulation of such "master" metabolic genes represents an emerging strategy for developing more effective vaccines against numerous infectious agents.
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Affiliation(s)
- A-Yeung Jang
- Research Division for Biotechnology, Korea Atomic Energy Research Institute, Jeongeup, South Korea.,Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ki Bum Ahn
- Research Division for Biotechnology, Korea Atomic Energy Research Institute, Jeongeup, South Korea
| | - Yong Zhi
- Research Division for Biotechnology, Korea Atomic Energy Research Institute, Jeongeup, South Korea.,Department of Radiation Science and Technology, University of Science and Technology, Daejeon, South Korea
| | - Hyun-Jung Ji
- Research Division for Biotechnology, Korea Atomic Energy Research Institute, Jeongeup, South Korea.,DRI and BK21 Plus Program, Department of Oral Microbiology and Immunology, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Jing Zhang
- Research Division for Biotechnology, Korea Atomic Energy Research Institute, Jeongeup, South Korea
| | - Seung Hyun Han
- DRI and BK21 Plus Program, Department of Oral Microbiology and Immunology, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Huichen Guo
- State Key Laboratory of Veterinary Etiological Biology, National Foot and Mouth Disease Reference Laboratory, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Sangyong Lim
- Research Division for Biotechnology, Korea Atomic Energy Research Institute, Jeongeup, South Korea.,Department of Radiation Science and Technology, University of Science and Technology, Daejeon, South Korea
| | - Joon Yong Song
- Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Jae Hyang Lim
- Department of Microbiology, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Ho Seong Seo
- Research Division for Biotechnology, Korea Atomic Energy Research Institute, Jeongeup, South Korea.,Department of Radiation Science and Technology, University of Science and Technology, Daejeon, South Korea
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