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Cervantes O, Berg MR, Kapnadak SG, Miller E, Fountain C, Curtis B, Thelen S, Ruff S, Huang H, Altemeier W, Adams Waldorf KM. Testing pulmonary physiology in ventilated non-human primates. J Med Primatol 2024; 53:e12694. [PMID: 38454198 PMCID: PMC10994148 DOI: 10.1111/jmp.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/15/2024] [Accepted: 02/19/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Animal models of respiratory viral infections are essential for investigating disease pathogenesis and the efficacy of antivirals and vaccine candidates. A major limitation in the research of respiratory diseases in animal models is correlating clinically relevant changes in pulmonary physiology with cellular and molecular mechanistic studies. Few animal models have captured and correlated physiologic changes in lung function and immune response within same experiment, which is critical given the heterogeneous nature of lung disease due to viral infections. In ventilated human patients, pulmonary physiology testing can be used to not only capture oxygenation, ventilation, but also pulmonary mechanics to yield quantitative measures of lung function and scalar tracings of flow-volume and pressure-volume loops. Application of this protocol during mechanical ventilation in non-human (NHP) models would represent a major advance in respiratory viral disease research. METHODS We have applied and optimized a human pulmonary physiology testing protocol to ventilated pigtail macaques (Macaca nemestrina) at baseline and 5 days after influenza A (IAV) viral inoculation. RESULTS The NHPs manifested clinical disease with hypothermia and loss of body weight. Declines in lung function were striking with a 66%-81% decline in P/F ratio, a measure of oxygenation reflecting the ratio of partial pressure of oxygen in arterial blood (PaO2 ) to the fraction of inspiratory oxygen concentration (FiO2 ). There was also a 16%-45% decline in lung compliance. CONCLUSION We describe a new approach to performing pulmonary physiology testing protocol in non-human primates to better capture quantitative correlates of respiratory disease and demonstrate protection by therapeutics and vaccines.
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Affiliation(s)
- Orlando Cervantes
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Melissa R. Berg
- Washington National Primate Research Center, University of Washington, Seattle, Washington, USA
| | - Siddhartha G. Kapnadak
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA
| | - Elizabeth Miller
- Washington National Primate Research Center, University of Washington, Seattle, Washington, USA
| | - Connie Fountain
- Washington National Primate Research Center, University of Washington, Seattle, Washington, USA
| | - Britni Curtis
- Washington National Primate Research Center, University of Washington, Seattle, Washington, USA
| | - Sandi Thelen
- Washington National Primate Research Center, University of Washington, Seattle, Washington, USA
| | - Shannon Ruff
- Washington National Primate Research Center, University of Washington, Seattle, Washington, USA
| | - Hazel Huang
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
| | - William Altemeier
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA
- Center for Lung Biology, University of Washington, Seattle, Washington, USA
| | - Kristina M. Adams Waldorf
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
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Herron ICT, Laws TR, Nelson M. Marmosets as models of infectious diseases. Front Cell Infect Microbiol 2024; 14:1340017. [PMID: 38465237 PMCID: PMC10921895 DOI: 10.3389/fcimb.2024.1340017] [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: 11/17/2023] [Accepted: 01/29/2024] [Indexed: 03/12/2024] Open
Abstract
Animal models of infectious disease often serve a crucial purpose in obtaining licensure of therapeutics and medical countermeasures, particularly in situations where human trials are not feasible, i.e., for those diseases that occur infrequently in the human population. The common marmoset (Callithrix jacchus), a Neotropical new-world (platyrrhines) non-human primate, has gained increasing attention as an animal model for a number of diseases given its small size, availability and evolutionary proximity to humans. This review aims to (i) discuss the pros and cons of the common marmoset as an animal model by providing a brief snapshot of how marmosets are currently utilized in biomedical research, (ii) summarize and evaluate relevant aspects of the marmoset immune system to the study of infectious diseases, (iii) provide a historical backdrop, outlining the significance of infectious diseases and the importance of developing reliable animal models to test novel therapeutics, and (iv) provide a summary of infectious diseases for which a marmoset model exists, followed by an in-depth discussion of the marmoset models of two studied bacterial infectious diseases (tularemia and melioidosis) and one viral infectious disease (viral hepatitis C).
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Affiliation(s)
- Ian C. T. Herron
- CBR Division, Defence Science and Technology Laboratory (Dstl), Salisbury, United Kingdom
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3
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Jack KM, Kulick NK. Primate field research during a pandemic: Lessons learned from the SARS-CoV-2 outbreak. Am J Primatol 2023; 85:e23551. [PMID: 37706674 DOI: 10.1002/ajp.23551] [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: 02/06/2023] [Revised: 08/22/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023]
Abstract
The COVID-19 pandemic abruptly halted most primate field research in early 2020. While international travel bans and regional travel restrictions made continuing primate field research impossible early on in the pandemic, ethical concerns of transmitting the virus from researchers to primates and surrounding human communities informed decisions regarding the timing of resuming research. Between June and September 2020, we surveyed field primatologists regarding the impacts of the pandemic on their research. We received 90 completed surveys from respondents residing in 21 countries, though most were from the United States and Canada. These data provide a valuable window into the perspectives and actions taken by researchers during the early stages of the pandemic as events were still unfolding. Only 2.4% of projects reported continuing research as usual, 33.7% continued with some decrease in productivity, 42.2% reported postponing research projects, and 21.7% reported canceling projects or postponing research indefinitely. Respondents most severely impacted by the pandemic were those establishing new field sites and graduate students whose projects were postponed or canceled due to pandemic-related shutdowns. Fears about increased poaching, the inability to pay local assistants, frozen research funds, declining habituation, disruptions to data collection, and delays in student projects were among the top concerns of respondents. Nearly all the projects able to continue research in any capacity during the early months of the pandemic were run by or employed primate habitat country primatologists. This finding is a major lesson learned from the pandemic; without habitat country scientists, primate research is not sustainable.
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Affiliation(s)
- Katharine M Jack
- Department of Anthropology, Tulane University, New Orleans, Louisiana, USA
| | - Nelle K Kulick
- Department of Anthropology, Tulane University, New Orleans, Louisiana, USA
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4
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Mei X, Li J, Wang Z, Zhu D, Huang K, Hu S, Popowski KD, Cheng K. An inhaled bioadhesive hydrogel to shield non-human primates from SARS-CoV-2 infection. NATURE MATERIALS 2023; 22:903-912. [PMID: 36759564 PMCID: PMC10615614 DOI: 10.1038/s41563-023-01475-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
The surge of fast-spreading SARS-CoV-2 mutated variants highlights the need for fast, broad-spectrum strategies to counteract viral infections. In this work, we report a physical barrier against SARS-CoV-2 infection based on an inhalable bioadhesive hydrogel, named spherical hydrogel inhalation for enhanced lung defence (SHIELD). Conveniently delivered via a dry powder inhaler, SHIELD particles form a dense hydrogel network that coats the airway, enhancing the diffusional barrier properties and restricting virus penetration. SHIELD's protective effect is first demonstrated in mice against two SARS-CoV-2 pseudo-viruses with different mutated spike proteins. Strikingly, in African green monkeys, a single SHIELD inhalation provides protection for up to 8 hours, efficiently reducing infection by the SARS-CoV-2 WA1 and B.1.617.2 (Delta) variants. Notably, SHIELD is made with food-grade materials and does not affect normal respiratory functions. This approach could offer additional protection to the population against SARS-CoV-2 and other respiratory pathogens.
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Affiliation(s)
- Xuan Mei
- Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill & Raleigh, NC, USA
| | - Junlang Li
- Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill & Raleigh, NC, USA
| | - Zhenzhen Wang
- Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill & Raleigh, NC, USA
| | - Dashuai Zhu
- Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill & Raleigh, NC, USA
| | - Ke Huang
- Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill & Raleigh, NC, USA
| | - Shiqi Hu
- Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill & Raleigh, NC, USA
| | - Kristen D Popowski
- Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - Ke Cheng
- Department of Molecular Biomedical Sciences and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA.
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill & Raleigh, NC, USA.
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Hussain H, Ganesh A, Milane L, Amiji M. Lessons learned from the SARS-CoV-2 pandemic; from nucleic acid nanomedicines, to clinical trials, herd immunity, and the vaccination divide. Expert Opin Drug Deliv 2023; 20:489-506. [PMID: 36890642 DOI: 10.1080/17425247.2023.2189697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
INTRODUCTION In November 2019, the idea of a zoonotic virus crossing over to human transmission in a seafood market in Wuhan, China, and then soaring across the globe to claim over 6.3 million lives and persisting to date, seemed more like wild science fiction than a future reality. As the SARS-CoV-2 pandemic continues, it is important to hallmark the imprints the pandemic has made on science. AREAS COVERED This review covers the biology of SARS-CoV-2, vaccine formulations and trials, the concept of 'herd resistance,' and the vaccination divide. EXPERT OPINION The SARS-CoV-2 pandemic has changed the landscape of medicine. The rapid approval of SARS-CoV-2 vaccines has changed the culture of drug development and clinical approvals. This change is already leading to more accelerated trials. The RNA vaccines have opened the market for nucleic acid therapies and the applications are limitless - from cancer to influenza. A phenomenon that has occurred is that the low efficacy of current vaccines and the rapid mutation rate of the virus is preventing herd immunity from being attained. Instead, herd resistance is being acquired. Even with future, more effective vaccines, anti-vaccination attitudes will continue to challenge the quest for SARS-CoV-2 herd immunity.
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Affiliation(s)
| | - Aishwarya Ganesh
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA, USA
| | - Lara Milane
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA, USA
| | - Mansoor Amiji
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA, USA
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Dillard JA, Martinez SA, Dearing JJ, Montgomery SA, Baxter AK. Animal Models for the Study of SARS-CoV-2-Induced Respiratory Disease and Pathology. Comp Med 2023; 73:72-90. [PMID: 36229170 PMCID: PMC9948904 DOI: 10.30802/aalas-cm-22-000089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Emergence of the betacoronavirus SARS-CoV-2 has resulted in a historic pandemic, with millions of deaths worldwide. An unprecedented effort has been made by the medical, scientific, and public health communities to rapidly develop and implement vaccines and therapeutics to prevent and reduce hospitalizations and deaths. Although SARS-CoV-2 infection can lead to disease in many organ systems, the respiratory system is its main target, with pneumonia and acute respiratory distress syndrome as the hallmark features of severe disease. The large number of patients who have contracted COVID-19 infections since 2019 has permitted a detailed characterization of the clinical and pathologic features of the disease in humans. However, continued progress in the development of effective preventatives and therapies requires a deeper understanding of the pathogenesis of infection. Studies using animal models are necessary to complement in vitro findings and human clinical data. Multiple animal species have been evaluated as potential models for studying the respiratory disease caused by SARSCoV-2 infection. Knowing the similarities and differences between animal and human responses to infection is critical for effective translation of animal data into human medicine. This review provides a detailed summary of the respiratory disease and associated pathology induced by SARS-CoV-2 infection in humans and compares them with the disease that develops in 3 commonly used models: NHP, hamsters, and mice. The effective use of animals to study SARS-CoV-2-induced respiratory disease will enhance our understanding of SARS-CoV-2 pathogenesis, allow the development of novel preventatives and therapeutics, and aid in the preparation for the next emerging virus with pandemic potential.
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Key Words
- ace2, angiotensin-converting enzyme 2
- agm, african green monkey
- ali, acute lung injury
- ards, acute respiratory distress syndrome
- balf, bronchoalveolar lavage fluid
- cards, covid-19-associated acute respiratory distress syndrome
- dad, diffuse alveolar damage
- dpi, days postinfection
- ggo, ground glass opacities
- s, spike glycoprotein
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Affiliation(s)
- Jacob A Dillard
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sabian A Martinez
- Division of Comparative Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Justin J Dearing
- Biological and Biomedical Sciences Program, Office of Graduate Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Stephanie A Montgomery
- Division of Comparative Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Andvictoria K Baxter
- Division of Comparative Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;,
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Brady C, Tipton T, Longet S, Carroll MW. Pre-clinical models to define correlates of protection for SARS-CoV-2. Front Immunol 2023; 14:1166664. [PMID: 37063834 PMCID: PMC10097995 DOI: 10.3389/fimmu.2023.1166664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/22/2023] [Indexed: 04/18/2023] Open
Abstract
A defined immune profile that predicts protection against a pathogen-of-interest, is referred to as a correlate of protection (CoP). A validated SARS-CoV-2 CoP has yet to be defined, however considerable insights have been provided by pre-clinical vaccine and animal rechallenge studies which have fewer associated limitations than equivalent studies in human vaccinees or convalescents, respectively. This literature review focuses on the advantages of the use of animal models for the definition of CoPs, with particular attention on their application in the search for SARS-CoV-2 CoPs. We address the conditions and interventions required for the identification and validation of a CoP, which are often only made possible with the use of appropriate in vivo models.
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Affiliation(s)
- Caolann Brady
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics and Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- *Correspondence: Caolann Brady, ; Miles W. Carroll,
| | - Tom Tipton
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics and Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
| | - Stephanie Longet
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics and Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- International Center for Infectiology Research (CIRI), Team GIMAP, Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR530, Saint-Etienne, France
| | - Miles W. Carroll
- Nuffield Department of Medicine, Wellcome Centre for Human Genetics and Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
- *Correspondence: Caolann Brady, ; Miles W. Carroll,
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8
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Animal Models to Test SARS-CoV-2 Vaccines: Which Ones Are in Use and Future Expectations. Pathogens 2022; 12:pathogens12010020. [PMID: 36678369 PMCID: PMC9861368 DOI: 10.3390/pathogens12010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/04/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Since late 2019 and early 2020, with the emergence of the COVID-19 pandemic, scientists are rushing to develop treatment and prevention methods to combat SARS-CoV-2. Among these are vaccines. In view of this, the use of animals as experimental models, both to investigate the immunopathology of the disease and to evaluate the efficacy and safety of vaccines, is mandatory. This work aims to describe, through recent scientific articles found in reliable databases, the animal models used for the in vivo testing of COVID-19 vaccines, demonstrating some possibilities of more advantageous/gold-standard models for SARS-CoV-2 vaccines. The majority of the studies use rodents and primates. Meanwhile, the most adequate model to be used as the gold standard for in vivo tests of COVID-19 vaccines is not yet conclusive. Promising options are being discussed as new tests are being carried out and new SARS-CoV-2 variants are emerging.
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9
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B.1.351 SARS-CoV-2 Variant Exhibits Higher Virulence but Less Viral Shedding than That of the Ancestral Strain in Young Nonhuman Primates. Microbiol Spectr 2022; 10:e0226322. [PMID: 36069561 PMCID: PMC9603226 DOI: 10.1128/spectrum.02263-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We investigated the distribution, virulence, and pathogenic characteristics of mutated SARS-CoV-2 to clarify the association between virulence and the viral spreading ability of current and future circulating strains. Chinese rhesus macaques were infected with ancestral SARS-CoV-2 strain GD108 and Beta variant B.1.351 (B.1.351) and assessed for clinical signs, viral distribution, pathological changes, and pulmonary inflammation. We found that GD108 replicated more efficiently in the upper respiratory tract, whereas B.1.351 replicated more efficiently in the lower respiratory tract and lung tissue, implying a reduced viral shedding and spreading ability of B.1.351 compared with that of GD108. Importantly, B.1.351 caused more severe lung injury and dramatically elevated the level of inflammatory cytokines compared with those observed after infection with GD108. Moreover, both B.1.351 and GD108 induced spike-specific T-cell responses at an early stage of infection, with higher levels of interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) in the B.1.351 group and higher levels of interleukin 17 (IL-17) in the GD108 group, indicating a divergent pattern in the T-cell-mediated inflammatory "cytokine storm." This study provides a basis for exploring the pathogenesis of SARS-CoV-2 variants of concern (VOCs) and establishes an applicable animal model for evaluating the efficacy and safety of vaccines and drugs. IMPORTANCE One of the priorities of the current SARS-CoV-2 vaccine and drug research strategy is to determine the changes in transmission ability, virulence, and pathogenic characteristics of SARS-CoV-2 variants. In addition, nonhuman primates (NHPs) are suitable animal models for the study of the pathogenic characteristics of SARS-CoV-2 and could contribute to the understanding of pathogenicity and transmission mechanisms. As SARS-CoV-2 variants continually emerge and the viral biological characteristics change frequently, the establishment of NHP infection models for different VOCs is urgently needed. In the study, the virulence and tissue distribution of B.1.351 and GD108 were comprehensively studied in NHPs. We concluded that the B.1.351 strain was more virulent but exhibited less viral shedding than the latter. This study provides a basis for determining the pathogenic characteristics of SARS-CoV-2 and establishes an applicable animal model for evaluating the efficacy and safety of vaccines and drugs.
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Philippens IHCHM, Böszörményi KP, Wubben JAM, Fagrouch ZC, van Driel N, Mayenburg AQ, Lozovagia D, Roos E, Schurink B, Bugiani M, Bontrop RE, Middeldorp J, Bogers WM, de Geus-Oei LF, Langermans JAM, Verschoor EJ, Stammes MA, Verstrepen BE. Brain Inflammation and Intracellular α-Synuclein Aggregates in Macaques after SARS-CoV-2 Infection. Viruses 2022; 14:v14040776. [PMID: 35458506 PMCID: PMC9025893 DOI: 10.3390/v14040776] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
SARS-CoV-2 causes acute respiratory disease, but many patients also experience neurological complications. Neuropathological changes with pronounced neuroinflammation have been described in individuals after lethal COVID-19, as well as in the CSF of hospitalized patients with neurological complications. To assess whether neuropathological changes can occur after a SARS-CoV-2 infection, leading to mild-to-moderate disease, we investigated the brains of four rhesus and four cynomolgus macaques after pulmonary disease and without overt clinical symptoms. Postmortem analysis demonstrated the infiltration of T-cells and activated microglia in the parenchyma of all infected animals, even in the absence of viral antigen or RNA. Moreover, intracellular α-synuclein aggregates were found in the brains of both macaque species. The heterogeneity of these manifestations in the brains indicates the virus’ neuropathological potential and should be considered a warning for long-term health risks, following SARS-CoV-2 infection.
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Affiliation(s)
- Ingrid H. C. H. M. Philippens
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Kinga P. Böszörményi
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Jacqueline A. M. Wubben
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Zahra C. Fagrouch
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Nikki van Driel
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Amber Q. Mayenburg
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Diana Lozovagia
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Eva Roos
- Department of Pathology, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands; (E.R.); (B.S.); (M.B.)
| | - Bernadette Schurink
- Department of Pathology, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands; (E.R.); (B.S.); (M.B.)
| | - Marianna Bugiani
- Department of Pathology, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands; (E.R.); (B.S.); (M.B.)
| | - Ronald E. Bontrop
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
- Department of Biology, Theoretical Biology and Bioinformatics, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Jinte Middeldorp
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Willy M. Bogers
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands;
- Biomedical Photonic Imaging Group, University of Twente, 7522 ND Enschede, The Netherlands
| | - Jan A. M. Langermans
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
- Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CM Utrecht, The Netherlands
| | - Ernst J. Verschoor
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
- Correspondence:
| | - Marieke A. Stammes
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
| | - Babs E. Verstrepen
- Biomedical Primate Research Centre (BPRC), 2288 GJ Rijswijk, The Netherlands; (I.H.C.H.M.P.); (K.P.B.); (J.A.M.W.); (Z.C.F.); (N.v.D.); (A.Q.M.); (D.L.); (R.E.B.); (J.M.); (W.M.B.); (J.A.M.L.); (M.A.S.); (B.E.V.)
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11
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Stamm B, Huang D, Royan R, Lee J, Marquez J, Desai M. Pathomechanisms and Treatment Implications for Stroke in COVID-19: A Review of the Literature. Life (Basel) 2022; 12:life12020207. [PMID: 35207494 PMCID: PMC8877423 DOI: 10.3390/life12020207] [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: 12/19/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 11/25/2022] Open
Abstract
Stroke in patients with COVID-19 has received increasing attention throughout the global COVID-19 pandemic, perhaps due to the substantial disability and mortality that can result when the two conditions co-occur. We reviewed the existing literature and found that the proposed pathomechanism underlying COVID-19-associated ischemic stroke is broadly divided into the following three categories: vasculitis, endothelialitis, and endothelial dysfunction; hypercoagulable state; and cardioembolism secondary to cardiac dysfunction. There has been substantial debate as to whether there is a causal link between stroke and COVID-19. However, the distinct phenotype of COVID-19-associated strokes, with multivessel territory infarcts, higher proportion of large vessel occlusions, and cryptogenic stroke mechanism, that emerged in pooled analytic comparisons with non-COVID-19 strokes is compelling. Further, in this article, we review the various treatment approaches that have emerged as they relate to the proposed pathomechanisms. Finally, we briefly cover the logistical challenges, such as delays in treatment, faced by providers and health systems; the innovative approaches utilized, including the role of tele-stroke; and the future directions in COVID-19-associated stroke research and healthcare delivery.
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Affiliation(s)
- Brian Stamm
- Department of Neurology, School of Medicine, Northwestern University Feinberg, Chicago, IL 60611, USA; (D.H.); (J.L.)
- Correspondence: (B.S.); or (M.D.)
| | - Deborah Huang
- Department of Neurology, School of Medicine, Northwestern University Feinberg, Chicago, IL 60611, USA; (D.H.); (J.L.)
| | - Regina Royan
- Department of Emergency Medicine, School of Medicine, Northwestern University Feinberg, Chicago, IL 60611, USA;
| | - Jessica Lee
- Department of Neurology, School of Medicine, Northwestern University Feinberg, Chicago, IL 60611, USA; (D.H.); (J.L.)
| | - Joshua Marquez
- Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, NM 87144, USA;
| | - Masoom Desai
- Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, NM 87144, USA;
- Correspondence: (B.S.); or (M.D.)
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12
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Weinberger B. Vaccines and Vaccination against SARS-CoV-2: Considerations for the Older Population. Vaccines (Basel) 2021; 9:1435. [PMID: 34960181 PMCID: PMC8704374 DOI: 10.3390/vaccines9121435] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 12/23/2022] Open
Abstract
Age is among the most prominent risk factors for developing severe COVID-19 disease, and therefore older adults are a major target group for vaccination against SARS-CoV-2. This review focusses on age-associated aspects of COVID-19 vaccines and vaccination strategies, and summarizes data on immunogenicity, efficacy and effectiveness of the four COVID-19 vaccines, which are licensed in the US and/or Europe; namely, the two mRNA vaccines by BioNTech/Pfizer (BNT162b2) and Moderna (mRNA-1273), and the adenovector vaccines developed by AstraZeneca/University Oxford (ChAdOx1-nCoV-19, AZD1222) and Janssen/Johnson&Johnson (Ad26.COV2-S), respectively. After very high protection rates in the first months after vaccination even in the older population, effectiveness of the vaccines, particularly against asymptomatic infection and mild disease, declined at later time points and with the emergence of virus variants. Many high-income countries have recently started administration of additional doses to older adults and other high-risk groups, whereas other parts of the world are still struggling to acquire and distribute vaccines for primary vaccination. Other vaccines are available in other countries and clinical development for more vaccine candidates is ongoing, but a complete overview of COVID-19 vaccine development is beyond the scope of this article.
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Affiliation(s)
- Birgit Weinberger
- Institute for Biomedical Aging Research, Universität Innsbruck, 6020 Innsbruck, Austria
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