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Bosch-Nicolau P, Fernández ML, Sulleiro E, Villar JC, Perez-Molina JA, Correa-Oliveira R, Sosa-Estani S, Sánchez-Montalvá A, Del Carmen Bangher M, Moreira OC, Salvador F, Mota Ferreira A, Eloi-Santos SM, Serre-Delcor N, Ramírez JC, Silgado A, Oliveira I, Martín O, Aznar ML, Ribeiro ALP, Almeida PEC, Chamorro-Tojeiro S, Espinosa-Pereiro J, de Paula AMB, Váquiro-Herrera E, Tur C, Molina I. Efficacy of three benznidazole dosing strategies for adults living with chronic Chagas disease (MULTIBENZ): an international, randomised, double-blind, phase 2b trial. Lancet Infect Dis 2024; 24:386-394. [PMID: 38218195 DOI: 10.1016/s1473-3099(23)00629-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Treatment with benznidazole for chronic Chagas disease is associated with low cure rates and substantial toxicity. We aimed to compare the parasitological efficacy and safety of 3 different benznidazole regimens in adult patients with chronic Chagas disease. METHODS The MULTIBENZ trial was an international, randomised, double-blind, phase 2b trial performed in Argentina, Brazil, Colombia, and Spain. We included participants aged 18 years and older diagnosed with Chagas disease with two different serological tests and detectable T cruzi DNA by qPCR in blood. Previously treated people, pregnant women, and people with severe cardiac forms were excluded. Participants were randomly assigned 1:1:1, using a balanced block randomisation scheme stratified by country, to receive benznidazole at three different doses: 300 mg/day for 60 days (control group), 150 mg/day for 60 days (low dose group), or 400 mg/day for 15 days (short treatment group). The primary outcome was the proportion of patients with a sustained parasitological negativity by qPCR during a follow-up period of 12 months. The primary safety outcome was the proportion of people who permanently discontinued the treatment. Both primary efficacy analysis and primary safety analysis were done in the intention-to-treat population. The trial is registered with EudraCT, 2016-003789-21, and ClinicalTrials.gov, NCT03191162, and is completed. FINDINGS From April 20, 2017, to Sept 20, 2020, 245 people were enrolled, and 234 were randomly assigned: 78 to the control group, 77 to the low dose group, and 79 to the short treatment group. Sustained parasitological negativity was observed in 42 (54%) of 78 participants in the control group, 47 (61%) of 77 in the low dose group, and 46 (58%) of 79 in the short treatment group. Odds ratios were 1·41 (95% CI 0·69-2·88; p=0·34) when comparing the low dose and control groups and 1·23 (0·61-2·50; p=0·55) when comparing short treatment and control groups. 177 participants (76%) had an adverse event: 62 (79%) in the control group, 56 (73%) in the low dose group, and 59 (77%) in the short treatment group. However, discontinuations were less frequent in the short treatment group compared with the control group (2 [2%] vs 11 [14%]; OR 0·20, 95% CI 0·04-0·95; p=0·044). INTERPRETATION Participants had a similar parasitological responses. However, reducing the usual treatment from 8 weeks to 2 weeks might maintain the same response while facilitating adherence and increasing treatment coverage. These findings should be confirmed in a phase 3 clinical trial. FUNDING European Community's 7th Framework Programme.
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Affiliation(s)
- Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Marisa L Fernández
- Instituto Nacional de Parasitología Dr M Fatala Chaben, ANLIS Dr C Malbran, Ministerio de Salud, Buenos Aires, Argentina
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Villar
- Departamento de Investigaciones, Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia
| | - José A Perez-Molina
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; National Referral Centre for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal IRYCIS, Madrid, Spain
| | | | - Sergio Sosa-Estani
- Instituto Nacional de Parasitología Dr M Fatala Chaben, ANLIS Dr C Malbran, Ministerio de Salud, Buenos Aires, Argentina; Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-EICS), Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Del Carmen Bangher
- Instituto de Cardiología de Corrientes Juana Francisca Cabral (Argentina), Corrientes, Argentina
| | - Otacilio C Moreira
- Laboratory of Molecular Virology and Parasitology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ariela Mota Ferreira
- Graduate Program in Health Sciences, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, Brazil
| | | | - Núria Serre-Delcor
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Ramírez
- Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas, CONICET-GCBA, Buenos Aires, Argentina
| | - Aroa Silgado
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Oliveira
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Oihane Martín
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; National Referral Centre for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal IRYCIS, Madrid, Spain
| | - Maria Luisa Aznar
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Antonio Luiz P Ribeiro
- Hospital das Clínicas and Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Sandra Chamorro-Tojeiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; National Referral Centre for Tropical Diseases, Infectious Diseases Department, Hospital Universitario Ramón y Cajal IRYCIS, Madrid, Spain
| | - Juan Espinosa-Pereiro
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Eliana Váquiro-Herrera
- Departamento de Investigaciones, Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia
| | - Carmen Tur
- Multiple Sclerosis Centre of Catalonia (Cemcat), Neurology Department. Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain; Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Medicine Department Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
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Tamarozzi F, Mazzi C, Antinori S, Arsuaga M, Becker SL, Bottieau E, Camprubi-Ferrer D, Caumes E, Duvignaud A, Grobusch MP, Jaureguiberry S, Jordan S, Mueller A, Neumayr A, Perez-Molina JA, Salas-Coronas J, Salvador F, Tomasoni LR, van Hellemond JJ, Vaughan SD, Wammes LJ, Zammarchi L, Buonfrate D, Huits R, van Lieshout L, Gobbi F. Consensus definitions in imported human schistosomiasis: a GeoSentinel and TropNet Delphi study. Lancet Infect Dis 2024:S1473-3099(24)00080-X. [PMID: 38467128 DOI: 10.1016/s1473-3099(24)00080-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 03/13/2024]
Abstract
Terminology in schistosomiasis is not harmonised, generating misunderstanding in data interpretation and clinical descriptions. This study aimed to achieve consensus on definitions of clinical aspects of schistosomiasis in migrants and returning travellers. We applied the Delphi method. Experts from institutions affiliated with GeoSentinel and TropNet, identified through clinical and scientific criteria, were invited to participate. Five external reviewers revised and pilot-tested the statements. Statements focusing on the definitions of acute or chronic; possible, probable, or confirmed; active; and complicated schistosomiasis were managed through REDCap and replies managed in a blinded manner. Round 1 mapped the definitions used by experts; subsequent rounds were done to reach consensus, or quantify disagreement, on the proposed statements. Data were analysed with percentages, medians, and IQRs of a 5-point Likert scale. The study was terminated on the basis of consensus or stability-related and time-related criteria. 28 clinicians and scientists met the criteria for experts. 25 (89%) of 28 experts replied to Round 1, 18 (64%) of 28 to Round 2, 19 (68%) of 28 to Round 3, and 21 (75%) of 28 to at least two rounds. High-level consensus (79-100% agreement and IQRs ≤1) was reached for all definitions. Consensus definitions will foster harmonised scientific and clinical communication and support future research and development of management guidelines for schistosomiasis.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
| | - Cristina Mazzi
- Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Marta Arsuaga
- National Referral for Imported Diseases Unit, Hospital La Paz-Carlos III, Madrid, Spain
| | - Sören L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Eric Caumes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Alexandre Duvignaud
- Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; University of Bordeaux, INSERM UMR 1219, IRD EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Stephane Jaureguiberry
- Université de Paris Saclay, AP-HP, INSERM, Centre de Recherche en Epidémiologie et Santé des Populations, Service des Maladies Infectieuses et Tropicales, Hôpital de Bicêtre, Paris, France
| | - Sabine Jordan
- Division of Infectious Diseases, Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Mueller
- Department of Tropical Medicine, Klinikum Würzburg Mitte (Medical Mission Hospital), Würzburg, Germany
| | - Andreas Neumayr
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Jose A Perez-Molina
- National Referral Centre for Tropical Diseases, Infectious Diseases Department, University Hospital Ramón y Cajal (IRYCIS), Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Joaquin Salas-Coronas
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain; Tropical Medicine Unit, Hospital Universitario Poniente, El Ejido, Almería, Spain; Department of Nursing, Physiotherapy and Medicine, Faculty of Health Sciences, Universidad de Almería, Almería, Spain
| | - Fernando Salvador
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Lina R Tomasoni
- Department of Infectious and Tropical Diseases, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Jaap J van Hellemond
- Department of Medical Microbiology & Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Stephen D Vaughan
- Division of Infectious Diseases, Department of Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada
| | - Linda J Wammes
- Department of Medical Microbiology, Leiden University Center for Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Ralph Huits
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Lisette van Lieshout
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Salvador F, Treviño B, Sulleiro E, Bosch-Nicolau P, Aznar ML, Goterris L, Espinosa-Pereiro J, Pou D, Sánchez-Montalvá A, Oliveira I, Martínez-Campreciós J, Serre-Delcor N, Sao-Avilés A, Molina I. Epidemiological and clinical trends of imported strongyloidiasis in a referral international health unit, Barcelona, Spain: A 12-year period experience. Travel Med Infect Dis 2024; 58:102690. [PMID: 38246513 DOI: 10.1016/j.tmaid.2024.102690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/20/2023] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Imported strongyloidiasis in non-endemic countries has increasingly been diagnosed. The aim of the present study is to describe the main epidemiological and clinical characteristics of patients with imported strongyloidiasis attended in a referral International Health Unit and to detect trend changes over a 12-year period. METHODS This is an observational retrospective study including all imported strongyloidiasis cases seen at the International Health Unit Vall d'Hebron-Drassanes (Barcelona, Spain) from January 2009 to December 2020. Epidemiological and clinical characteristics from included patients were collected. RESULTS Overall, 865 cases of imported strongyloidiasis were diagnosed, of whom 472 (54.6 %) were men and mean age was 38.7 (SD 13.4) years. Most cases were diagnosed in migrants (830, 96 %). The distribution of the geographic origin was: Latin America (561, 67.6 %), Sub-Saharan Africa (148, 17.8 %), Asia (113, 13.6 %), North Africa (5, 0.6 %), Eastern Europe (2, 0.2 %), and North America (1, 0.1 %). The main reasons for consultation at the Unit were screening of health status (371, 42.9 %), laboratory test alteration (367, 42.4 %), gastrointestinal symptoms (56, 6.5 %), cutaneous symptoms (26, 3 %), and other clinical symptoms (45, 5.2 %). An increase in the number of cases was observed in the last years of the study period. CONCLUSIONS Imported strongyloidiasis has increasingly been diagnosed in our referral unit, mostly due to screening strategies implementation. Most of the patients were young migrants coming from Latin America, with no symptoms at the time of diagnosis. The optimization of screening strategies will increase the detection and treatment of cases, reducing potential complications.
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Affiliation(s)
- Fernando Salvador
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - Begoña Treviño
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ma Luisa Aznar
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Goterris
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Juan Espinosa-Pereiro
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Diana Pou
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Oliveira
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Joan Martínez-Campreciós
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Serre-Delcor
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Augusto Sao-Avilés
- Information Systems Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Martínez-Campreciós J, Moreno M, Salvador F, Barrio-Tofiño ED, Nindia A, Aznar ML, Molina I. Impact of traditional cutaneous scarification on anthrax lesions: A series of cases from Cubal, Angola. Int J Infect Dis 2024; 140:104-109. [PMID: 38195038 DOI: 10.1016/j.ijid.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES Bacillus anthracis infection is a worldwide zoonosis that affects the most vulnerable population and has a high mortality rate without treatment, especially in non-cutaneous presentations. Cutaneous scarification is still common in some regions of the world for the treatment of certain diseases as part of traditional medicine. We describe a series of cutaneus anthrax from a rural setting in Angola where cutaneus scarification is common. CASE PRESENTATION This is a retrospective observational study describing a series of cutaneous anthrax cases from Cubal (Angola), many of whom were treated with skin scarification before admission. A total of 26 cases were diagnosed from January 2010 to December 2018. None of the cases were confirmed and eight (30.8%) were probable cases according to the Centers for the Disease Control and Prevention anthrax case definition. The median age was 11 (4.7-30.5) years, 17 (65.4%) had lesions on the head, face, or neck and 15 (57.7%) were treated with cutaneous scarification. Nine (34.6%) patients died. Traditional cutaneous scarification was significantly associated with cutaneous superinfection, respiratory, systemic involvement, and death. CONCLUSION Our case series points to increased complications and worse outcome of cutaneous anthrax disease if treated with skin scarification.
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Affiliation(s)
- Joan Martínez-Campreciós
- International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Fernando Salvador
- International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Maria Luisa Aznar
- International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - Israel Molina
- International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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5
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Freitas VLTD, Novaes CTG, Sartori AMC, Carvalho NB, Silva SCVD, Nakanishi ÉS, Salvador F, Castro CND, Bezerra RC, Westphalen EVN, Oliveira CMRD, Busser FD, Ho YL, Buccheri R, Bonilla C, Shikanai-Yasuda MA. Quantitative PCR as a marker for preemptive therapy and its role in therapeutic control in Trypanosoma cruzi/HIV coinfection. PLoS Negl Trop Dis 2024; 18:e0011961. [PMID: 38408095 PMCID: PMC10896531 DOI: 10.1371/journal.pntd.0011961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 02/01/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Trypanosoma cruzi and HIV coinfection can evolve with depression of cellular immunity and increased parasitemia. We applied quantitative PCR (qPCR) as a marker for preemptive antiparasitic treatment to avoid fatal Chagas disease reactivation and analyzed the outcome of treated cases. METHODOLOGY This mixed cross-sectional and longitudinal study included 171 Chagas disease patients, 60 coinfected with HIV. Of these 60 patients, ten showed Chagas disease reactivation, confirmed by parasites identified in the blood, cerebrospinal fluid, or tissues, 12 exhibited high parasitemia without reactivation, and 38 had low parasitemia and no reactivation. RESULTS We showed, for the first time, the success of the timely introduction of benznidazole in the non-reactivated group with high levels of parasitemia detected by qPCR and the absence of parasites in reactivated cases with at least 58 days of benznidazole. All HIV+ patients with or without reactivation had a 4.0-5.1 higher chance of having parasitemia than HIV seronegative cases. A positive correlation was found between parasites and viral loads. Remarkably, treated T. cruzi/HIV-coinfected patients had 77.3% conversion from positive to negative parasitemia compared to 19.1% of untreated patients. Additionally, untreated patients showed ~13.6 times higher Odds Ratio of having positive parasitemia in the follow-up period compared with treated patients. Treated and untreated patients showed no differences regarding the evolution of Chagas disease. The main factors associated with all-cause mortality were higher parasitemia, lower CD4 counts/μL, higher viral load, and absence of antiretroviral therapy. CONCLUSION We recommend qPCR prospective monitoring of T. cruzi parasitemia in HIV+ coinfected patients and point out the value of pre-emptive therapy for those with high parasitemia. In parallel, early antiretroviral therapy introduction is advisable, aiming at viral load control, immune response restoration, and increasing survival. We also suggest an early antiparasitic treatment for all coinfected patients, followed by effectiveness analysis alongside antiretroviral therapy.
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Affiliation(s)
- Vera Lúcia Teixeira de Freitas
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, São Paulo, Brazil
- Laboratorio de Investigacao Medica em Imunologia (LIM 48), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Christina Terra Gallafrio Novaes
- Divisao de Molestias Infecciosas e Parasitarias, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Ana Marli Christovam Sartori
- Divisao de Molestias Infecciosas e Parasitarias, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Noemia Barbosa Carvalho
- Divisao de Molestias Infecciosas e Parasitarias, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Sheila Cristina Vicente da Silva
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, São Paulo, Brazil
- Laboratorio de Investigacao Medica em Imunologia (LIM 48), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Érika Shimoda Nakanishi
- Laboratorio de Investigacao Medica em Imunologia (LIM 48), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Fernando Salvador
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Cleudson Nery de Castro
- Centre for Tropical Medicine, School of Medicine, University of Brasilia, Brasília, Distrito Federal, Brazil
| | - Rita Cristina Bezerra
- Laboratorio de Investigacao Medica em Parasitologia (LIM 46), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | | | - Caroline Medeji Ramos de Oliveira
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, São Paulo, Brazil
- Laboratorio de Investigacao Medica em Imunologia (LIM 48), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Felipe Delatorre Busser
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, São Paulo, Brazil
- Laboratorio de Investigacao Medica em Imunologia (LIM 48), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Yeh-Li Ho
- Divisao de Molestias Infecciosas e Parasitarias, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Renata Buccheri
- Instituto de Infectologia Emilio Ribas, São Paulo, Brasil
- Vitalant Research Institute, San Francisco, California, United States of America
| | - Carolina Bonilla
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Maria Aparecida Shikanai-Yasuda
- Departamento de Molestias Infecciosas e Parasitarias, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, São Paulo, Brazil
- Laboratorio de Investigacao Medica em Imunologia (LIM 48), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
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6
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Weitzel T, Brown A, Libman M, Perret C, Huits R, Chen L, Leung D, Leder K, Connor BA, Menéndez MD, Asgeirsson H, Schwartz E, Salvador F, Malvy D, Saio M, Norman FF, Amatya B, Duvingnaud A, Vaughan S, Glynn M, Angelo KM. Intestinal protozoa in returning travellers: a GeoSentinel analysis from 2007 to 2019. J Travel Med 2024:taae010. [PMID: 38245913 DOI: 10.1093/jtm/taae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/08/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Prolonged diarrhoea is common among returning travellers and is often caused by intestinal protozoa. However, the epidemiology of travel-associated illness caused by protozoal pathogens is not well described. METHODS We analysed records of returning international travellers with illness caused by Giardia duodenalis, Cryptosporidium spp., Cyclospora cayetanensis, or Cystoisospora belli, reported to the GeoSentinel Network during January 2007-December 2019. We excluded records of travellers migrating, with an unascertainable exposure country, or from GeoSentinel sites that were not located in high-income countries. RESULTS There were 2517 cases, 82.3% giardiasis (n = 2072), 11.4% cryptosporidiosis (n = 287), 6.0% cyclosporiasis (n = 150), and 0.3% cystoisosporiasis (n = 8). Overall, most travellers were tourists (64.4%) on long trips (median durations: 18-30 days). Cryptosporidiosis more frequently affected people < 18 years (13.9%) and cyclosporiasis affected people ≥40 years (59.4%). Giardiasis was most frequently acquired in South-Central Asia (45.8%) and Sub-Saharan Africa (22.6%), cryptosporidiosis in Sub-Saharan Africa (24.7%) and South-Central Asia (19.5%), and cyclosporiasis in South East Asia (31.3%) and Central America (27.3%). and cystoisosporiasis in Sub-Saharan Africa (62.5%). Cyclosporiasis cases were reported from countries of uncertain endemicity (e.g. Cambodia) or in countries with no previous evidence of this parasite (e.g. French Guiana). The time from symptom onset to presentation at a GeoSentinel site was the longest among travellers with giardiasis (median: 30 days). Over 14% of travellers with cryptosporidiosis were hospitalized. CONCLUSIONS This analysis provides new insights into the epidemiology and clinical significance of 4 intestinal protozoa that can cause morbidity in international travellers. These data might help optimize pretravel advice and post-travel management of patients with travel-associated prolonged gastrointestinal illnesses. This analysis reinforces the importance of international travel-related surveillance to identify sentinel cases and areas where protozoal infections might be undetected or underreported.
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Affiliation(s)
- Thomas Weitzel
- Travel Medicine Program, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Ashley Brown
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Michael Libman
- J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, Montreal, Quebec, Canada
| | - Cecilia Perret
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Ralph Huits
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
| | - Lin Chen
- Division of Infectious Diseases, Mount Auburn Hospital, Cambridge, Massachusetts, United States of America
| | - Daniel Leung
- International Travel Clinic, University of Utah Hospital and Clinics, Salt Lake City, Utah, United States of America
| | - Karin Leder
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia
| | - Bradley A Connor
- New York Center for Travel and Tropical Medicine, New York, United States of America
| | - Marta Diaz Menéndez
- Tropical Medicine Department, Hospital Universitario La Paz Carlos III, CIBERINFECT, Madrid, Spain
| | - Hilmir Asgeirsson
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
- Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Eli Schwartz
- The Center of Geographical Medicine and Tropical Diseases, Sheba Medical Center, Tel HaShomer, Israel
- Ramat Gan & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Fernando Salvador
- Tropical Medicine Unit, Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Denis Malvy
- Department of Infectious Diseases and Tropical Medicine, Hôpital Pellegrin, Bordeaux, France
| | | | - Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, CIBERINFEC, IRYCIS, Madrid, Spain
- Universidad de Alcalá, Madrid, Spain
| | - Bhawana Amatya
- CIWEC Hospital and Travel Medicine Center, Kathmandu, Nepal
| | - Alexandre Duvingnaud
- Department of Infectious Diseases and Tropical Medicine, Hôpital Pellegrin, Bordeaux, France
| | - Stephen Vaughan
- Division of Infectious Diseases, University of Calgary, South Health Campus, Calgary, Alberta, Canada
| | - Marielle Glynn
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kristina M Angelo
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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7
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Llorente A, Blasco MT, Espuny I, Guiu M, Ballaré C, Blanco E, Caballé A, Bellmunt A, Salvador F, Morales A, Nuñez M, Loren G, Imbastari F, Fidalgo M, Figueras-Puig C, Gibler P, Graupera M, Monteiro F, Riera A, Holen I, Avgustinova A, Di Croce L, Gomis RR. MAF amplification licenses ERα through epigenetic remodelling to drive breast cancer metastasis. Nat Cell Biol 2023; 25:1833-1847. [PMID: 37945904 PMCID: PMC10709142 DOI: 10.1038/s41556-023-01281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/09/2023] [Indexed: 11/12/2023]
Abstract
MAF amplification increases the risk of breast cancer (BCa) metastasis through mechanisms that are still poorly understood yet have important clinical implications. Oestrogen-receptor-positive (ER+) BCa requires oestrogen for both growth and metastasis, albeit by ill-known mechanisms. Here we integrate proteomics, transcriptomics, epigenomics, chromatin accessibility and functional assays from human and syngeneic mouse BCa models to show that MAF directly interacts with oestrogen receptor alpha (ERα), thereby promoting a unique chromatin landscape that favours metastatic spread. We identify metastasis-promoting genes that are de novo licensed following oestrogen exposure in a MAF-dependent manner. The histone demethylase KDM1A is key to the epigenomic remodelling that facilitates the expression of the pro-metastatic MAF/oestrogen-driven gene expression program, and loss of KDM1A activity prevents this metastasis. We have thus determined that the molecular basis underlying MAF/oestrogen-mediated metastasis requires genetic, epigenetic and hormone signals from the systemic environment, which influence the ability of BCa cells to metastasize.
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Affiliation(s)
- Alicia Llorente
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - María Teresa Blasco
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.
| | - Irene Espuny
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Marc Guiu
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Cecilia Ballaré
- Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Enrique Blanco
- Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Adrià Caballé
- Biostatistics and Bioinformatics Unit, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Anna Bellmunt
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Fernando Salvador
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Andrea Morales
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Marc Nuñez
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Guillem Loren
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Francesca Imbastari
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Marta Fidalgo
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
- Endothelial Pathobiology and Microenvironment Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Barcelona, Spain
| | - Cristina Figueras-Puig
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Patrizia Gibler
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Mariona Graupera
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Endothelial Pathobiology and Microenvironment Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Freddy Monteiro
- Functional Genomics Core Facility, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Antoni Riera
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Ingunn Holen
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | | | - Luciano Di Croce
- Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Roger R Gomis
- Cancer Science Program, Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
- Universitat de Barcelona, Barcelona, Spain.
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8
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Molina-Morant D, Fernández ML, Bosch-Nicolau P, Sulleiro E, Bangher M, Salvador F, Sanchez-Montalva A, Ribeiro ALP, de Paula AMB, Eloi S, Correa-Oliveira R, Villar JC, Sosa-Estani S, Molina I. Correction: Efficacy and safety assessment of different dosage of benznidazol for the treatment of Chagas disease in chronic phase in adults (MULTIBENZ study): study protocol for a multicenter randomized Phase II non-inferiority clinical trial. Trials 2023; 24:726. [PMID: 37964376 PMCID: PMC10644612 DOI: 10.1186/s13063-023-07659-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Affiliation(s)
- D Molina-Morant
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain
| | - M L Fernández
- Departamento de Clínica, Patología y Tratamiento, Instituto Nacional de Parasitología Dr. Mario Fatala Chaben, Ministerio de Salud y Desarrollo Social, Buenos Aires, Argentina
| | - P Bosch-Nicolau
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain
| | - E Sulleiro
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Bangher
- Instituto de Cardiología de Corrientes Juana Francisca Cabral (Argentina), Corrientes, Argentina
| | - F Salvador
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain
| | - A Sanchez-Montalva
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain
| | - A L P Ribeiro
- Programa de Pós-Graduação Infectologia E Medicina Tropical, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - A M B de Paula
- Laboratory of Health Science, Postgraduate Program in Health Sciences, Universidade Estadual de Montes Claros (Unimontes), Montes Claros, MG, Brazil
| | - S Eloi
- Programa de Pós-Graduação Em Patologia, Departamento de Propedêutica Complementar, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculdade de Medicina da Universidade José Do Rosário Vellano, Belo Horizonte, Brazil
| | - R Correa-Oliveira
- René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - J C Villar
- Faculty of Health Sciences, Universidad Autónoma de Bucaramanga and Research Department, Bucaramanga, Colombia
- Fundación Cardioinfantil - Instituto de Cardiología, Bogotá, Colombia
| | - S Sosa-Estani
- Chagas Clinical Program, Drugs for Neglected Disease Initiative (DNDi), Geneva, Switzerland
- Epidemiology and Public Health Research Center, CONICET, Buenos Aires, Argentina
| | - I Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, P° Vall d'Hebron 119, Edifici Mediterrània, VHIR, 08035, Barcelona, Spain.
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9
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Sánchez-Marqués R, Bocanegra C, Salvador F, Nindia A, Pintar Z, Martínez-Campreciós J, Aixut S, Mossalilo P, Sulleiro E, Espiau M, Mas-Coma S, Bargues MD, Molina I. Prevalence and morbidity of urogenital schistosomiasis among pre-school age children in Cubal, Angola. PLoS Negl Trop Dis 2023; 17:e0011751. [PMID: 37939154 PMCID: PMC10659159 DOI: 10.1371/journal.pntd.0011751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/20/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Schistosomiasis is one of the most important neglected tropical diseases, with a great impact on public health and more than 200,000 deaths annually. Schistosoma haematobium causes urinary tract (UT) morbidity. Since schistosomiasis morbidity control programs focus on children older than 5 years, pre-school age children (PSAC) morbidity is not well known. METHODS We conducted a cross-sectional study in Cubal (Angola) among 245 PSAC with the objective of evaluating the prevalence of S. haematobium infection, the intensity of infection, and associated morbidity. For this purpose, urine filtration test followed by microscopic visualization and ultrasound examinations were performed. RESULTS The estimated overall prevalence of urogenital schistosomiasis was 30.2% (CI 95%; 24.5-35.9), with 20.3% (CI 95%; 15.3-25.3) of the samples analysed showing a high intensity of infection. A total of 54.5% (CI 95%; 47.6-61.8) of infected children presented UT lesions, showing a significant association between schistosomiasis infection and UT morbidity (p-value < 0.001). Bladder wall thickening was the most common lesion, being present in 100% of abnormal ultrasounds. We found that anaemia and severe malnutrition were not significantly associated with the development of UT lesions. CONCLUSIONS S. haematobium infection in PSAC causes great UT detectable morbidities. Therefore, there is an evident need of including them in mass drug administration (MDA) campaigns and consequently the development of an adapted praziquantel treatment dosage for children under 2 years of age.
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Affiliation(s)
- Raquel Sánchez-Marqués
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Bocanegra
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Fernando Salvador
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | | | | | - Joan Martínez-Campreciós
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Nossa Senhora da Paz, Cubal, Angola
| | - Sandra Aixut
- Department of Infectious Diseases, Vall Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | | | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - María Espiau
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Department of Pediatrics, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ma. Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Israel Molina
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
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10
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España-Cueto S, Oliveira-Souto I, Salvador F, Goterris L, Treviño B, Sánchez-Montalvá A, Serre-Delcor N, Sulleiro E, Rodríguez V, Aznar ML, Bosch-Nicolau P, Espinosa-Pereiro J, Pou D, Molina I. Post-infectious irritable bowel syndrome following a diagnosis of traveller's diarrhoea: a comprehensive characterization of clinical and laboratory parameters. J Travel Med 2023; 30:taad030. [PMID: 36881659 DOI: 10.1093/jtm/taad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Prolonged or recurrent gastrointestinal symptoms may persist after acute traveller's diarrhoea (TD), even after adequate treatment of the primary cause. This study aims to describe the epidemiological, clinical and microbiological characteristics of patients with post-infectious irritable bowel syndrome (PI-IBS) after returning from tropical or subtropical areas. METHODS We conducted a retrospective study of patients presenting between 2009 and 2018 at the International Health referral centre in Barcelona with persistent gastrointestinal symptoms following a diagnosis of TD. PI-IBS was defined as the presence of persistent or recurrent gastrointestinal manifestations for at least 6 months after the diagnosis of TD, a negative stool culture for bacterial pathogens and a negative ova and parasite exam after targeted treatment. Epidemiological, clinical and microbiological variables were collected. RESULTS We identified 669 travellers with a diagnosis of TD. Sixty-eight (10.2%) of these travellers, mean age 33 years and 36 (52.9%) women, developed PI-IBS. The most frequently visited geographical areas were Latin America (29.4%) and the Middle East (17.6%), with a median trip duration of 30 days (IQR 14-96). A microbiological diagnosis of TD was made in 32 of these 68 (47%) patients, 24 (75%) of whom had a parasitic infection, Giardia duodenalis being the most commonly detected parasite (n = 20, 83.3%). The symptoms persisted for a mean of 15 months after diagnosis and treatment of TD. The multivariate analysis revealed that parasitic infections were independent risk factors for PI-IBS (OR 3.0, 95%CI 1.2-7.8). Pre-travel counselling reduced the risk of PI-IBS (OR 0.4, 95%CI 0.2-0.9). CONCLUSIONS In our cohort, almost 10% of patients with travellers' diarrhoea developed persistent symptoms compatible with PI-IBS. Parasitic infections, mainly giardiasis, seem to be associated with PI-IBS.
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Affiliation(s)
- Sergio España-Cueto
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Infectious Diseases Department, Germans Trias i Pujol University Hospital, Badalona, Spain
- The Fight Infections Foundation, Badalona, Spain
| | - Inés Oliveira-Souto
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Salvador
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Goterris
- Department of Microbiology, Vall d'Hebron University Hospital and PROSICS, Barcelona, Spain
| | - Begoña Treviño
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Serre-Delcor
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Microbiology, Vall d'Hebron University Hospital and PROSICS, Barcelona, Spain
| | - Virginia Rodríguez
- Department of Microbiology, Vall d'Hebron University Hospital and PROSICS, Barcelona, Spain
| | - Maria Luisa Aznar
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Pau Bosch-Nicolau
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Espinosa-Pereiro
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Diana Pou
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Crego-Vicente B, Febrer-Sendra B, Nindia A, Pessela A, Aixut S, Martínez-Campreciós J, Mediavilla A, Silgado A, Sulleiro E, Treviño B, Molina I, Muro A, Salvador F, Fernández-Soto P. First field study using Strong-LAMP for diagnosis of strongyloidiasis in Cubal, Angola. Parasit Vectors 2023; 16:393. [PMID: 37907997 PMCID: PMC10619288 DOI: 10.1186/s13071-023-06009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Strongyloides stercoralis infection is a common neglected tropical disease distributed worldwide, mainly in tropical and subtropical climates. The impact of S. stercoralis infections on human health ranges from mild asymptomatic infections to chronic strongyloidiasis unnoticeable until the host is immunosuppressed. In severe strongyloidiasis, a syndrome of hyperinfection and larval dissemination to various organs can occur with high mortality rates. The diagnosis of strongyloidiasis is challenging because of the absence of a single standard reference test with high sensitivity and specificity, which also makes it difficult to estimate the accuracy of other diagnostic tests. This study aimed to evaluate, for the first time, the use of an easy-to-perform loop-mediated isothermal amplification (LAMP) colorimetric assay (named Strong-LAMP) for the molecular screening of strongyloidiasis in stool samples from patients in a low-resource endemic area in Cubal, Angola. To compare different LAMP application scenarios, the performance of the Strong-LAMP under field conditions in Angola was reassessed in a well-equipped reference laboratory in Spain and compared with a quantitative polymerase chain reaction (qPCR) method. METHODS A total of 192 stool samples were collected from adult population in Cubal, Angola, and examined by parasitological methods (direct saline microscopy and Baermann's technique). DNA was extracted from each stool sample using a commercial kit and tested by the colorimetric Strong-LAMP assay for the detection of Strongyloides spp. under field conditions. Furthermore, all samples were shipped to a well-equipped laboratory in Spain, reanalysed by the same procedure and compared with a qPCR method. The overall results after testing were compared. RESULTS Strongyloides stercoralis larvae were identified by direct saline microscopy and Baermann in a total of 10/192 (5.2%) and 18/192 (9.4%) stool samples, respectively. Other helminth and protozoan species were also identified. The Strong-LAMP-positive results were visually detected in 69/192 (35.9%) stool samples. The comparison of Strong-LAMP results in field conditions and at a reference laboratory matched in a total of 146/192 (76.0%) samples. A total of 24/192 (12.5%) stool samples tested positive by qPCR. CONCLUSIONS This is the first study in which colorimetric Strong-LAMP has been clinically evaluated in a resource-poor strongyloidiasis endemic area. Strong-LAMP has been shown to be more effective in screening for strongyloidiasis than parasitological methods under field conditions and qPCR in the laboratory. Our Strong-LAMP has proven to be a field-friendly and highly accurate molecular test for the diagnosis of strongyloidiasis.
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Affiliation(s)
- Beatriz Crego-Vicente
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Begoña Febrer-Sendra
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | | | | | | | - Joan Martínez-Campreciós
- Hospital Nossa Senhora da Paz, Cubal, Angola
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Alejandro Mediavilla
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain
| | - Aroa Silgado
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain
| | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain
| | - Begoña Treviño
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain
| | - Israel Molina
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Fernando Salvador
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS, Barcelona, Spain.
| | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain.
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Febrer-Sendra B, Crego-Vicente B, Nindia A, Martínez-Campreciós J, Aixut S, Mediavilla A, Silgado A, Oliveira-Souto I, Salvador F, Molina I, Muro A, Sulleiro E, Fernández-Soto P. First field and laboratory evaluation of LAMP assay for malaria diagnosis in Cubal, Angola. Parasit Vectors 2023; 16:343. [PMID: 37789462 PMCID: PMC10548721 DOI: 10.1186/s13071-023-05942-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/22/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Malaria is a globally distributed infectious disease. According to the World Health Organization, Angola is one of the six countries that account for over half the global malaria burden in terms of both malaria cases and deaths. Diagnosis of malaria still depends on microscopic examination of thin and thick blood smears and rapid diagnostic tests (RDTs), which often lack analytical and clinical sensitivity. Molecular methods could overcome these disadvantages. The aim of this study was to evaluate, for the first time to our knowledge, the performance of a loop-mediated isothermal amplification (LAMP) for the diagnosis of malaria in an endemic area in Cubal, Angola, and to assess the reproducibility at a reference laboratory. METHODS A total of 200 blood samples from patients attended at Hospital Nossa Senhora da Paz, Cubal, Angola, were analysed for Plasmodium spp. detection by microscopy, RDTs, and LAMP. LAMP assay was easily performed in a portable heating block, and the results were visualized by a simple colour change. Subsequently, the samples were sent to a reference laboratory in Spain to be reanalysed by the same colorimetric LAMP assay and also in real-time LAMP format. RESULTS In field tests, a total of 67/200 (33.5%) blood samples were microscopy-positive for Plasmodium spp., 98/200 RDT positive, and 112/200 (56%) LAMP positive. Using microscopy as reference standard, field LAMP detected more microscopy-positive samples than RDTs (66/67; 98% vs. 62/67; 92.5%). When samples were reanalysed at a reference laboratory in Spain using both colorimetric and real-time assays, the overall reproducibility achieved 84.5%. CONCLUSIONS This is the first study to our knowledge in which LAMP has been clinically evaluated on blood samples in a resource-poor malaria-endemic area. The colorimetric LAMP proved to be more sensitive than microscopy and RDTs for malaria diagnosis in field conditions. Furthermore, LAMP showed an acceptable level of reproducibility in a reference laboratory. The possibility to use LAMP in a real-time format in a portable device reinforces the reliability of the assay for molecular diagnosis of malaria in resource-poor laboratories in endemic areas.
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Affiliation(s)
- Begoña Febrer-Sendra
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | - Beatriz Crego-Vicente
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | | | - Joan Martínez-Campreciós
- Hospital Nossa Senhora da Paz, Cubal, Angola
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Alejandro Mediavilla
- Microbiology Department Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Aroa Silgado
- Microbiology Department Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Inés Oliveira-Souto
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Fernando Salvador
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain
| | - Elena Sulleiro
- Microbiology Department Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.
| | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Salamanca, Spain.
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Bocanegra C, Álvarez-Martínez MJ, Arsuaga Vicente M, Belhassen-García M, Chamorro Tojeiro S, Camprubí-Ferrer D, Fernández Soto P, García Vázquez E, Herrador Ortiz Z, Martín O, Muro A, Pérez Arellano JL, Reguera Gómez M, Salas-Coronas J, Salvador F, Sotillo Gallego J, Sulleiro E, Torrús Tendero D, Velasco Arribas M, Rodríguez Guardado A. Executive summary consensus statement of imported diseases group (GEPI) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Tropical Medicine and International Health (SETMSI), on the diagnostic and treatment of imported schistosomiasis. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:505-512. [PMID: 37230838 DOI: 10.1016/j.eimce.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/08/2023] [Indexed: 05/27/2023]
Abstract
Schistosomiasis is a highly prevalent disease, especially in immigrant populations, and is associated with significant morbidity and diagnostic delays outside endemic areas. For these reasons, the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Tropical Medicine and International Health (SEMTSI) have developed a joint consensus document to serve as a guide for the screening, diagnosis and treatment of this disease outside endemic areas. A panel of experts from both societies identified the main questions to be answered and developed recommendations based on the scientific evidence available at the time. The document was reviewed by the members from both societies for final approval.
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Affiliation(s)
- Cristina Bocanegra
- Unidad de Medicina Tropical y Salud Internacional Vall d'Hebron-Drassanes, PROSICS Barcelona, Servicio de Enfermedades Infecciosas Hospital Universitario Vall d'Hebron, Spain
| | - Miriam J Álvarez-Martínez
- Servicio de Microbiología, Hospital Clínic de Barcelona, Departamento de Fundamentos Clínicos, Facultad de Medicina y Ciencias de la Salud, Universidad de Barcelona, ISGlobal, Spain
| | - Marta Arsuaga Vicente
- Unidad de Patología Importada y Salud Internacional (CSUR), Unidad de Alto Aislamiento, CIBERINFEC, Hospital La Paz-Carlos III, Madrid, Spain
| | - Moncef Belhassen-García
- Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Hospital Universitario de Salamanca, Centro de Investigación en Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Sandra Chamorro Tojeiro
- Unidad de Referencia Nacional para Enfermedades Tropicales, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, IRYCIS, CIBERINFEC, Spain
| | | | - Pedro Fernández Soto
- Grupo Enfermedades Infecciosas y Tropicales (e-INTRO), Instituto de Investigación Biomédica de Salamanca-Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (IBSAL-CIETUS), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Elisa García Vázquez
- Unidad de Enfermedades Infecciosas, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, Facultad de Medicina, Universidad de Murcia, Spain
| | | | - Oihane Martín
- Servicio de Microbiología y Parasitología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Antonio Muro
- Grupo de Investigación Enfermedades Infecciosas y Tropicales (e-INTRO), IBSAL, CIETUS, Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - José Luis Pérez Arellano
- Universidad de las Palmas de Gran Canaria, Unidad de Enfermedades Infecciosas y Medicina Tropical, Hospital Insular de Gran Canaria, Spain
| | - Marta Reguera Gómez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
| | - Joaquín Salas-Coronas
- Unidad de Medicina Tropical, Hospital Universitario Poniente El Ejido, Almería, Spain
| | - Fernando Salvador
- Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Sotillo Gallego
- Laboratorio de Referencia e Investigación en Parasitología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Spain
| | - Elena Sulleiro
- Servicio de Microbiología, Hospital Vall d́Hebron, Barcelona, CIBERINFEC, ISCIII, Universitat Autònoma de Barcelona, Spain
| | - Diego Torrús Tendero
- Unidad de Referencia de Enfermedades Importadas y Salud Internacional, Unidad de Enfermedades Infecciosas, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Área de Parasitología, Universidad Miguel Hernández, Spain
| | - María Velasco Arribas
- Sección Infecciosas y Medicina Tropical, Medicina Interna, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Azucena Rodríguez Guardado
- Área de Gestión Clínica Medicina Interna, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain.
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Sánchez-Marqués R, Salvador F, Bocanegra C, Nindia A, Pintar Z, Martínez J, Aixut S, Pessela A, Ramírez-Arroyo S, Farrés A, Chopo M, Izquierdo S, Mas-Coma S, Bargues MD, Molina I. Schistosoma haematobium infection and morbidity risk factors for pre-school age children in western Angola: A knowledge, attitudes and practices survey. PLoS Negl Trop Dis 2023; 17:e0011650. [PMID: 37844022 PMCID: PMC10578572 DOI: 10.1371/journal.pntd.0011650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/05/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Urogenital schistosomiasis is one of the most prevalent parasitic diseases in sub-Saharan Africa. It is a poverty-related disease conditioned by behavioural practices. METHODS Our objective is to evaluate the awareness, mindset and habits about urogenital schistosomiasis in the community of Cubal (Angola), as well as its association with infection and urinary tract morbidity in pre-school age children. A cross-sectional study of knowledge, attitudes and practices at home was conducted between February and May 2022 with 250 participants. RESULTS Overall, 93.6% of those surveyed had some prior knowledge about schistosomiasis and, among all the symptoms associated with this disease, blood in the urine was the best known (54.4%). Nevertheless, 57.6% obtained a medium knowledge score. Regarding attitude, the majority of respondents had a high attitude score (79.2%) with 96.0% willing to participate in mass drug administration campaigns. Laundry in the river was the most common risk practice (61.2%) and 55.2% out of the total were classified with a low practice score. CONCLUSION Low knowledge about symptoms and transmission by caregivers was the outstanding risk factor for infection in pre-school age children (OR = 16.93, 95%CI: 3.93-72.82), and lack of knowledge that avoiding entering the river prevents schistosomiasis was the main risk factor for morbidity in PSAC (OR = 8.14, 95%CI: 1.14-58.25).
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Affiliation(s)
- Raquel Sánchez-Marqués
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Salvador
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Cristina Bocanegra
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | | | | | - Joan Martínez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
- Hospital Nossa Senhora da Paz, Cubal, Angola
| | - Sandra Aixut
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
- Hospital Nossa Senhora da Paz, Cubal, Angola
| | | | | | - Aina Farrés
- Hospital Nossa Senhora da Paz, Cubal, Angola
| | - María Chopo
- Hospital Nossa Senhora da Paz, Cubal, Angola
| | | | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - María Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Israel Molina
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Tropical Medicine Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
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15
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Miranda S, Clara P, Rua J, Cimbron M, Salvador F. Deep Vein Thrombosis Revealing A "Silent" Coeliac Disease. Eur J Case Rep Intern Med 2023; 10:003977. [PMID: 37680785 PMCID: PMC10482128 DOI: 10.12890/2023_003977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/04/2023] [Indexed: 09/09/2023] Open
Abstract
Introduction We present a clinical case of a 45-year-old man with recurrent deep vein thrombosis (DVT) and multiple hospital admissions due to severe infectious conditions. A newfound hypoalbuminemia raised the suspicion of a protein-losing condition, with an upper endoscopy revealing lesions at the D2 level compatible with coeliac sprue and HLA typing positive for both DQ-2 and DQ-8. Methods A gluten free diet was started and apixaban was suspended. Results No new complications were reported. Discussion Multiple mechanisms are believed to be behind the association between DVT and coeliac disease. However, to this date, no consensus exists regarding the ideal duration of anticoagulation. LEARNING POINTS Coeliac disease should always be considered a systemic disease.Thromboembolism is a possible extraintestinal manifestation of coeliac disease.Coeliac disease should be considered as a possible cause of thromboembolism even in the absence of gastrointestinal symptoms, which it can precede by several years.
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Affiliation(s)
- Sofia Miranda
- Internal Medicine Department, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal
| | - Patrícia Clara
- Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Joana Rua
- Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Miriam Cimbron
- Internal Medicine Department, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal
| | - Fernando Salvador
- Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Barber Caselles C, Rivera Esteban JM, Maynard AA, Salvador F, Alonso Cotoner C. Weil syndrome coincident with upper gastrointestinal bleeding. Rev Esp Enferm Dig 2023; 115:458-459. [PMID: 36263834 DOI: 10.17235/reed.2022.9086/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 48 year old male was referred to our center due to a gastrointestinal bleeding with melena secondary to a Forrest IIb gastric ulcer treated endoscopically. Physical examination revealed bilateral conjunctival suffusion, bradypsychia, and asterixis. Epidemiological history included a trip to Dominican Republic two weeks before, presenting later a flu-like syndrome. He had no history of NSAID use. Laboratory tests showed a normocytic anemia, leukocytosis with neutrophilia, acute renal failure, severe hyponatremia, a predominant direct hyperbilirubinemia, hyperamylasemia, and mild coagulopathy (Table 1). An abdominal ultrasound was performed, with no pathological findings, and a chest-abdominal computed tomography (CT), bilateral diffuse ground glass pulmonary opacities and pleural effusion, mild hepatomegaly, and peritoneal and gastrohepatic ligament lymphadenopathy, with no signs of acute pancreatitis. A second look upper endoscopy revealed a Forrest III gastric ulcer. Gastric biopsies results ruled out malignancy and Helicobacter pylori infection. Due to his recent travel history combined with his characteristic signs and symptoms a clinical diagnosis of leptospirosis was made and empirical antibiotic therapy with meropenem was started. The serology for Leptospira was positive (IgG 1/1600) and antibiotic therapy was de-escalated to ceftriaxone with clinical and analytical remission on day five of his hospital stay with complete radiological resolution at 6 months.
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Puyana Ortiz JD, Garcés Rodríguez AC, Aznar ML, Espinosa Pereiro J, Sánchez-Montalvá A, Martínez-Campreciós J, Saborit N, Rodrigo-Pendás JÁ, García Salgado G, Broto Cortes C, Delcor NS, Oliveira I, Treviño Maruri B, Ciruelo DP, Salvador F, Bosch-Nicolau P, Torrecilla-Martínez I, Zules-Oña R, Tórtola Fernández MT, Molina I. Adherence and Toxicity during the Treatment of Latent Tuberculous Infection in a Referral Center in Spain. Trop Med Infect Dis 2023; 8:373. [PMID: 37505669 PMCID: PMC10383852 DOI: 10.3390/tropicalmed8070373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
The screening and treatment of latent tuberculosis infection (LTBI) in countries with a low incidence of TB is a key strategy for the elimination of tuberculosis (TB). However, treatment can result in adverse events (AEs) and have poor adherence. This study aimed to describe treatment outcomes and AEs for LTBI patients at two departments in Vall d'Hebron University Hospital in Barcelona, Spain. A retrospective study was conducted on all persons treated for LTBI between January 2018 and December 2020. Variables collected included demographics, the reason for LTBI screening and treatment initiation, AEs related to treatment, and treatment outcome. Out of 261 persons who initiated LTBI treatment, 145 (55.6%) were men, with a median age of 42.1 years. The indications for LTBI screening were household contact of a TB case in 96 (36.8%) persons, immunosuppressive treatment in 84 (32.2%), and recently arrived migrants from a country with high TB incidence in 81 (31.0%). Sixty-three (24.1%) persons presented at least one AE during treatment, and seven (2.7%) required definitive discontinuation of treatment. In the multivariate analysis, AE development was more frequent in those who started LTBI treatment due to immunosuppression. Overall, 226 (86.6%) completed treatment successfully. We concluded that LTBI screening and treatment groups had different risks for adverse events and treatment outcomes. Persons receiving immunosuppressive treatment were at higher risk of developing AEs, and recently arrived immigrants from countries with a high incidence of TB had greater LTFU. A person-centered adherence and AE management plan is recommended.
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Affiliation(s)
| | | | - María Luisa Aznar
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Grupo de Estudio de Micobacterias (GEIM), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), 28003 Madrid, Spain
| | - Juan Espinosa Pereiro
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Grupo de Estudio de Micobacterias (GEIM), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), 28003 Madrid, Spain
| | - Adrián Sánchez-Montalvá
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Grupo de Estudio de Micobacterias (GEIM), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), 28003 Madrid, Spain
| | - Joan Martínez-Campreciós
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Nuria Saborit
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
| | - José Ángel Rodrigo-Pendás
- Preventive Medicine and Epidemiology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain
| | - Guadalupe García Salgado
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
| | - Claudia Broto Cortes
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
| | - Nuria Serre Delcor
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Inés Oliveira
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Begoña Treviño Maruri
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Diana Pou Ciruelo
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Fernando Salvador
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pau Bosch-Nicolau
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Irene Torrecilla-Martínez
- Preventive Medicine and Epidemiology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain
| | - Ricardo Zules-Oña
- Preventive Medicine and Epidemiology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain
| | - María Teresa Tórtola Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Microbiology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain
| | - Israel Molina
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08001 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Treviño B, Zarzuela F, Oliveira-Souto I, Maturana CR, Serre-Delcor N, Aznar ML, Pou D, Goterris L, Salvador F, Bosch-Nicolau P, Rubio JM, Ruiz E, Molina I, Sulleiro E. Unexpected Loa loa Finding in an Asymptomatic Patient From The Gambia: A Case Report. Open Forum Infect Dis 2023; 10:ofad338. [PMID: 37484898 PMCID: PMC10358219 DOI: 10.1093/ofid/ofad338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
A 17-year-old asymptomatic male from The Gambia presented for a routine health examination after migration to Spain. Laboratory diagnosis confirmed the presence of Loa loa microfilariae. This unusual finding emphasizes the importance of screening in newly arrived migrants and the need of an extended anamnesis including migratory route and previous travels.
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Affiliation(s)
- Begoña Treviño
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Francesc Zarzuela
- Vall d’Hebron-Drassanes International Health Unit, Microbiology Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
| | - Inés Oliveira-Souto
- Correspondence: Inés Oliveira-Souto, MD, PhD, Unidad de Salud Internacional Vall d’Hebron-Drassanes, Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d’Hebron, Passeig de la Vall d’Hebron 119-129, 08035 Barcelona, Spain ()
| | - Carles Rubio Maturana
- Vall d’Hebron-Drassanes International Health Unit, Microbiology Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
| | - Núria Serre-Delcor
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Maria L Aznar
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Diana Pou
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Lidia Goterris
- Vall d’Hebron-Drassanes International Health Unit, Microbiology Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
| | - Fernando Salvador
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - Pau Bosch-Nicolau
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
| | - José M Rubio
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
- Microbiology National Centre, Carlos III Health Institute, Madrid, Spain
| | - Edurne Ruiz
- Vall d’Hebron-Drassanes International Health Unit, Microbiology Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
| | - Israel Molina
- Vall d’Hebron-Drassanes International Health Unit, Infectious Diseases Department, Vall d’Hebron University Hospital, International Health Programme of Catalan Health Institute (PROSICS) Barcelona, Centres, Services and Reference Units (CSUR) Imported Tropical Diseases, Barcelona, Spain
- Centre for Biomedical Research Network on Infectious Diseases, Madrid, Spain
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España-Cueto S, Salvador F, Oliveira I, Goterris L, Treviño B, Sánchez-Montalvá A, Serre-Delcor N, Sulleiro E, Rodríguez V, Aznar ML, Bosch-Nicolau P, Espinosa-Pereiro J, Pou D, Molina I. Corrigendum to "Epidemiological and clinical profile of adult patients with diarrhoea after international travel attended in an International Health referral center" [Trav Med Infect Dis 45 (2022) 102216]. Travel Med Infect Dis 2023; 54:102611. [PMID: 37507309 DOI: 10.1016/j.tmaid.2023.102611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Affiliation(s)
- Sergio España-Cueto
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Departamento de Medicina, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Departamento de Medicina, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain.
| | - Inés Oliveira
- Tropical Medicine and International Health Unit Drassanes-Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | - Lidia Goterris
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Begoña Treviño
- Tropical Medicine and International Health Unit Drassanes-Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Departamento de Medicina, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Núria Serre-Delcor
- Tropical Medicine and International Health Unit Drassanes-Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Virginia Rodríguez
- Department of Microbiology, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - María Luisa Aznar
- Tropical Medicine and International Health Unit Drassanes-Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Departamento de Medicina, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Juan Espinosa-Pereiro
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Departamento de Medicina, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
| | - Diana Pou
- Tropical Medicine and International Health Unit Drassanes-Vall d'Hebron, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, Departamento de Medicina, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain
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Schnyder JL, Gobbi F, Schunk M, Lindner A, Salvador F, Duvignaud A, Arsuaga Vicente M, Dejon Agobé JC, Cattaneo P, Bertoli G, Rothe C, Wintel M, Pou D, Malvy D, Adegnika AA, De Jong HK, Grobusch MP. Can haematological changes constitute a surrogate diagnostic parameter to detect schistosomiasis in migrants and travellers? - A retrospective analysis. New Microbes New Infect 2023; 53:101136. [PMID: 37187799 PMCID: PMC10176249 DOI: 10.1016/j.nmni.2023.101136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/17/2023] Open
Abstract
Background Earlier studies found characteristic haematological changes in African patients with active schistosomiasis. If consistently present, full blood counts (FBC) may be helpful to diagnose schistosomiasis also in migrants and returning travellers. Methods A retrospective patient record review was conducted on data from seven European travel clinics, comparing FBC of Schistosoma egg-positive travellers and migrants to reference values. Sub-analyses were performed for children, returned travellers, migrants and different Schistosoma species. Results Data analysis included 382 subjects (median age 21.0 years [range 2-73]). In returned travellers, decreases in means of haemoglobin particularly in females (β = -0.82 g/dL, p = 0.005), MCV (β = -1.6 fL, p = 0.009), basophils, neutrophils, lymphocytes and monocytes (β = -0.07, p < 0.001; -0.57, p = 0.012; -0.57, p < 0.001 and -0.13 103/μL, p < 0.001, respectively) were observed. As expected, eosinophils were increased (β = +0.45 103/μL, p < 0.001). In migrants, a similar FBC profile was observed, yet thrombocytes and leukocytes were significantly lower in migrants (β = -48 103/μL p < 0.001 and β = -2.35 103/μL, p < 0.001, respectively). Conclusions Active egg-producing Schistosoma infections are associated with haematological alterations in returned travellers and migrants. However, these differences are discrete and seem to vary among disease stage and Schistosoma species. Therefore, the FBC is unsuitable as a surrogate diagnostic parameter to detect schistosomiasis.
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Affiliation(s)
- Jenny L. Schnyder
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Federico Gobbi
- Department of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Mirjam Schunk
- Division of Infectious Diseases and Tropical Medicine, LMU Hospital Centre, Munich, Germany
| | - Andreas Lindner
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Fernando Salvador
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Alexandre Duvignaud
- Department of Infectious Diseases and Tropical Medicine, Hôpital Pellegrin - CHU de Bordeaux, Bordeaux, France
| | - Marta Arsuaga Vicente
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Imported Diseases and International Health Referral Unit, Hospital Universitario La Paz- Carlos III, Madrid, Spain
| | | | - Paolo Cattaneo
- Department of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Giulia Bertoli
- Department of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore-Don Calabria, Negrar di Valpolicella, Verona, Italy
| | - Camilla Rothe
- Division of Infectious Diseases and Tropical Medicine, LMU Hospital Centre, Munich, Germany
| | - Mia Wintel
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Diana Pou
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Denis Malvy
- Department of Infectious Diseases and Tropical Medicine, Hôpital Pellegrin - CHU de Bordeaux, Bordeaux, France
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales en Lambaréné (CERMEL), Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, German Centre for Infection Research, Tübingen, Germany
| | - Hanna K. De Jong
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Martin P. Grobusch
- Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, the Netherlands
- Centre de Recherches Médicales en Lambaréné (CERMEL), Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, German Centre for Infection Research, Tübingen, Germany
- Masanga Medical Research Unit (MMRU), Masanga, Sierra Leone
- Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- Corresponding author. Centre for Tropical Medicine and Travel Medicine, Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
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21
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Correia JA, Crespo J, Alves G, Salvador F, Matos-Costa J, Alves JD, Fortuna J, Almeida I, Campar A, Brandão M, Faria R, Marado D, Oliveira S, Santos L, Silva F, Vasconcelos C, Fernandes M, Marinho A. Biologic therapy in large and small vessels vasculitis, and Behçet's disease: Evidence- and practice-based guidance. Autoimmun Rev 2023:103362. [PMID: 37230310 DOI: 10.1016/j.autrev.2023.103362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/21/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Vasculitis are a very heterogenous group of systemic autoimmune diseases, affecting large vessels (LVV), small vessels or presenting as a multisystemic variable vessel vasculitis. We aimed to define evidence and practice-based recommendations for the use of biologics in large and small vessels vasculitis, and Behçet's disease (BD). METHODS Recommendations were made by an independent expert panel, following a comprehensive literature review and two consensus rounds. The panel included 17 internal medicine experts with recognized practice on autoimmune diseases management. The literature review was systematic from 2014 until 2019 and later updated by cross-reference checking and experts' input until 2022. Preliminary recommendations were drafted by working groups for each disease and voted in two rounds, in June and September 2021. Recommendations with at least 75% agreement were approved. RESULTS A total of 32 final recommendations (10 for LVV treatment, 7 for small vessels vasculitis and 15 for BD) were approved by the experts and several biologic drugs were considered with different supporting evidence. Among LVV treatment options, tocilizumab presents the higher level of supporting evidence. Rituximab is recommended for treatment of severe/refractory cryoglobulinemic vasculitis. Infliximab and adalimumab are most recommended in treatment of severe/refractory BD manifestations. Other biologic drugs can be considered is specific presentations. CONCLUSION These evidence and practice-based recommendations are a contribute to treatment decision and may, ultimately, improve the outcome of patients living with these conditions.
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Affiliation(s)
- João Araújo Correia
- Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal; Unidade de Imunologia Clínica, Departamento de Medicina, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Jorge Crespo
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Glória Alves
- Serviço de Medicina Interna, Hospital da Senhora da Oliveira, Centro Hospitalar Alto Ave, Rua dos Cutileiros 4810-055, Guimarães, Portugal
| | - Fernando Salvador
- Unidade de Doenças Autoimunes, Serviço de Medicina Interna, Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega, 5000-508 Vila Real, Portugal
| | - João Matos-Costa
- Serviço de Medicina Interna, Hospital Distrital de Santarém, Avenida Bernardo Santareno, 2005-177 Santarém,Portugal
| | - José Delgado Alves
- Systemic Autoimmune Diseases Unit, Hospital Prof. Doutor Fernando Fonseca, IC19 - 2720-276, Amadora, Portugal; 4Immune Response and Vascular Disease Unit - iNOVA4Health, NOVA Medical School; R. Câmara Pestana 6, 1150-082 Lisboa, Portugal
| | - Jorge Fortuna
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Isabel Almeida
- Unidade de Imunologia Clínica, Departamento de Medicina, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Ana Campar
- Unidade de Imunologia Clínica, Departamento de Medicina, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Mariana Brandão
- Unidade de Imunologia Clínica, Departamento de Medicina, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Raquel Faria
- Unidade de Imunologia Clínica, Departamento de Medicina, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Daniela Marado
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Susana Oliveira
- Systemic Autoimmune Diseases Unit, Hospital Prof. Doutor Fernando Fonseca, IC19 - 2720-276, Amadora, Portugal
| | - Lelita Santos
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra, R. Larga 2, 3000-370 Coimbra, Portugal; CIMAGO, Faculdade de Medicina da Universidade de Coimbra, R. Larga 2, 3000-370 Coimbra, Portugal
| | - Fátima Silva
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Carlos Vasconcelos
- Unidade de Imunologia Clínica, Departamento de Medicina, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - Milene Fernandes
- RWE & Late Phase, CTI Clinical Trial & Consulting Services Unipessoal Lda, R. Tierno Galvan, 1250-096 Lisboa, Portugal
| | - António Marinho
- Unidade de Imunologia Clínica, Departamento de Medicina, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal.
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22
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Salvador F, Martin A, López-Menéndez C, Moreno-Bueno G, Santos V, Vázquez-Naharro A, Santamaría PG, Morales S, Dubus PR, Muinelo-Romay L, López-López R, Tung JC, Weaver VM, Portillo F, Cano A. Correction: Lysyl Oxidase-like Protein LOXL2 Promotes Lung Metastasis of Breast Cancer. Cancer Res 2023; 83:974. [PMID: 36919424 DOI: 10.1158/0008-5472.can-23-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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23
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Orgiani P, Chaluvadi SK, Chalil SP, Mazzola F, Jana A, Dolabella S, Rajak P, Ferrara M, Benedetti D, Fondacaro A, Salvador F, Ciancio R, Fujii J, Panaccione G, Vobornik I, Rossi G. Dual pulsed laser deposition system for the growth of complex materials and heterostructures. Rev Sci Instrum 2023; 94:033903. [PMID: 37012774 DOI: 10.1063/5.0138889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/12/2023] [Indexed: 06/19/2023]
Abstract
Here, we present an integrated ultra-high-vacuum (UHV) apparatus for the growth of complex materials and heterostructures. The specific growth technique is the Pulsed Laser Deposition (PLD) by means of a dual-laser source based on an excimer KrF ultraviolet and solid-state Nd:YAG infra-red lasers. By taking advantage of the two laser sources-both lasers can be independently used within the deposition chambers-a large number of different materials-ranging from oxides to metals, to selenides, and others-can be successfully grown in the form of thin films and heterostructures. All of the samples can be in situ transferred between the deposition chambers and the analysis chambers by using vessels and holders' manipulators. The apparatus also offers the possibility to transfer samples to remote instrumentation under UHV conditions by means of commercially available UHV-suitcases. The dual-PLD operates for in-house research as well as user facility in combination with the Advanced Photo-electric Effect beamline at the Elettra synchrotron radiation facility in Trieste and allows synchrotron-based photo-emission as well as x-ray absorption experiments on pristine films and heterostructures.
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Affiliation(s)
- P Orgiani
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - S K Chaluvadi
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - S Punathum Chalil
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - F Mazzola
- Department of Molecular Sciences and Nanosystems, Ca' Foscari University of Venice, 30172 Venice, Italy
| | - A Jana
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - S Dolabella
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - P Rajak
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - M Ferrara
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - D Benedetti
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - A Fondacaro
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - F Salvador
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - R Ciancio
- AREA Science Park, Padriciano 99, I-34149 Trieste, Italy
| | - J Fujii
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - G Panaccione
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - I Vobornik
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
| | - G Rossi
- CNR-IOM Istituto Officina dei Materiali, TASC Laboratory, Area Science Park, S.S. 14, km 163.5, I-34149 Trieste, Italy
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24
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Salvador F, Galvis D, Treviño B, Sulleiro E, Sánchez-Montalvá A, Serre-Delcor N, Goterris L, Aznar ML, Bosch-Nicolau P, Oliveira I, Espinosa-Pereiro J, Pou D, Molina I. Imported Strongyloides stercoralis infection and diabetes mellitus and other metabolic diseases: Is there any association? Trop Med Int Health 2023; 28:232-236. [PMID: 36651761 DOI: 10.1111/tmi.13853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Strongyloidiasis is a nematode infection caused by Strongyloides stercoralis. Previous studies have addressed the possibility of the parasite to establish a complex relationship with the host that could affect the risk of developing diabetes mellitus or modify its presentation. This study aims to evaluate the potential impact of strongyloidiasis in diabetes mellitus and other metabolic diseases. METHODS Case-control observational retrospective study that included 95 S. stercoralis-infected patients and 83 non-infected individuals. Epidemiological and clinical variables were retrieved from medical records, and a statistical analysis was carried out to explore any association between strongyloidiasis and diabetes mellitus and other metabolic diseases. RESULTS Most of the patients were men (99, 55.60%) with a mean age of 42.53 ± SD 14 years. Twelve (6.70%) patients were diabetic; 30 (16.90%) presented arterial hypertension; 28 (15.70%) had dyslipidaemia; and 10 (5.60%) had thyroid pathology. When comparing patients with strongyloidiasis and uninfected patients, no differences were found regarding diabetes mellitus or other metabolic diseases. CONCLUSIONS The results obtained in the present study do not confirm any type of association between strongyloidiasis and diabetes mellitus or other metabolic diseases.
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Affiliation(s)
- Fernando Salvador
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Galvis
- Autonomous University of Barcelona, Bellaterra, Spain
| | - Begoña Treviño
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Sulleiro
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.,Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Serre-Delcor
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Goterris
- Microbiology Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Mª Luisa Aznar
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Pau Bosch-Nicolau
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Oliveira
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Espinosa-Pereiro
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Diana Pou
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Israel Molina
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Tolosa P, Pascual T, Hernando C, Servitja S, Fernández A, Brasó-Maristany F, Benitez J, Lema L, Ruano Y, Parrilla L, Roncero AM, Sánchez-Bayona R, Alva M, Villacampa G, Moreno-Villa MR, Canes J, Salvador F, Prat A, Ciruelos E. Abstract P5-02-44: Efficacy analysis of CDK4/6 inhibitors in combination with endocrine therapy treatment in HR+/HER2- breast cancer according to PAM50 intrinsic subtype: primary results of SOLTI-1801_CDK-PREDICT study. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-02-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: First-line treatment with cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) plus endocrine therapy (ET) has demonstrated efficacy in improving progression-free survival (PFS), overall response rate (ORR) and, more recently, ribociclib was also improve overall survival (OS) in hormone receptor-positive/HER2-negative (HR+/HER2-) advanced breast cancer (aBC). Unfortunately, most patients eventually progress and develop secondary or primary endocrine resistance. To date, no clinical or molecular markers have shown clinical utility in this setting. However, data from retrospective analysis suggest that intrinsic subtypes (IS) are prognostic and predict benefit from CDK4/6i+ET (Finn SABCS 2017, Prat. JCO 2021). Here, we have evaluated the impact of IS in PFS and ORR.
Methods: This study prospectively evaluated patients with HR+/HER2- aBC treated in the first-line setting with CDK4/6i + ET from February 2015 to January 2022 across 5 hospitals in Spain. Tumor biopsies had been performed within 90 days prior the patient started the CDK4/6i + ET. RNA from FFPE tumors was analyzed at the nCounter® (Nanostring Technologies) using a 72 custom gene panel including the PAM50 genes. The primary objective is to correlate the baseline PAM50 IS with PFS. The Kaplan-Meier method and multivariable cox model PFS analyses were performed adjusting for previous endocrine sensitivity, visceral disease, and metastatic onset disease. Secondary objectives were to estimate the ORR based on RECIST1.1 and its association with IS and the development of a prognostic algorithm that includes clinical and genomic data.
Results: From May 2020 to May 2022, 113 patients with PAM50 results who met all eligibility criteria, including sample quality, were included. IS distribution was 42.5% Luminal A, 46.9% luminal B, 7.1% HER2-enriched, 0.9% basal-like and 2.6% Normal-like (89.4% luminal vs 10.6% non-luminal). Baseline patient characteristics are shown in table 1. The median follow-up for PFS was 18.5 m (interquartile range 10.0 – 31.7m). Median PFS for Luminal vs no-luminal subtypes was 26.8 m (95% CI: 18.9 - 43.8 m) and 10.0 m (95% CI: 5.8 - 26.0 m) (adjusted hazard ratio [aHR]= 2.44 95% IC: 1.17 - 5.07). Median PFS by all IS was not reached (NR) for Luminal A (95% CI: 23.0 – NR); 19.5 m luminal B (95% CI: 15.7 - 27.3 m, aHR vs Luminal A= 1.98 95% IC: 1.09 - 3.62), 10.0 m HER2-E (95% CI: 4.4 - NR, aHR vs Luminal A= 2.75 95% IC: 1.05 - 7.18), 12.4 m Normal-like (95% CI: 5.8 - NR, aHR vs Luminal A= 19.35 95% IC: 2.32 - 160.89) and not estimable for basal-like (aHR vs Luminal A= 5.44 95% IC: 1.44 - 20.60). ORR was not significantly higher in Luminal B (55.1%) and HER2-E (57.1%) subtype versus luminal A (46.3%) (p=0.677). OS follow-up is still immature.
Conclusions: We confirmed the independent prognostic value of the PAM50 IS in first-line HR+/HER2- breast cancer treated with CDK4/6i+ET. Further gene expression analysis and development of a prognostic composite score is ongoing and will be presented at the conference.
This project has received a research grant from “Instituto de Salud Carlos III (ISCIII), Ministerio de Economía y Competitividad” (Spain) awarded within the National Research Program with reference PI 18/01408, co-funded with European Union ERDF funds.
Baseline patient characteristics
Citation Format: Pablo Tolosa, Tomás Pascual, Cristina Hernando, Sonia Servitja, Adela Fernández, Fara Brasó-Maristany, Javier Benitez, Laura Lema, Yolanda Ruano, Lucia Parrilla, Ana María Roncero, Rodrigo Sánchez-Bayona, Manuel Alva, Guillermo Villacampa, María Rocío Moreno-Villa, Jordi Canes, Fernando Salvador, Aleix Prat, Eva Ciruelos. Efficacy analysis of CDK4/6 inhibitors in combination with endocrine therapy treatment in HR+/HER2- breast cancer according to PAM50 intrinsic subtype: primary results of SOLTI-1801_CDK-PREDICT study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-02-44.
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Affiliation(s)
- Pablo Tolosa
- 1SOLTI Cancer Research Group, Barcelona, Spain/Medical Oncology Department, Hospital 12 de Octubre, Madrid., Madrid, Madrid, Spain
| | - Tomás Pascual
- 2Medical Oncology Department, Hospital Clínic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute, Barcelona, Spain; SOLTI Breast Cancer Research Group, Barcelona, Spain, Catalonia, Spain
| | | | | | - Adela Fernández
- 5Medical Oncology Department, Hospital Ramon y Cajal, Madrid, Spain; Alcalá de Henares University, Faculty of Medicine, Madrid, Spain, Spain
| | - Fara Brasó-Maristany
- 6Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
| | - Javier Benitez
- 7Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Laura Lema
- 8Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Yolanda Ruano
- 9Molecular Pathology Unit, Hospital Universitario 12 de Octubre Research Institute, Madrid, Spain
| | - Lucia Parrilla
- 10Pathology department, Hospital Universitario 12 de Octubre, Madrid Spain
| | - Ana María Roncero
- 11Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Rodrigo Sánchez-Bayona
- 12Medical Oncology Department, Hospital 12 de Octubre, Madrid. SOLTI Cancer Research Group, Barcelona, Spain
| | - Manuel Alva
- 13Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - Guillermo Villacampa
- 14SOLTI Cancer Research Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain/The Institute of Cancer Research. Oncology Data Science, London, United Kingdom
| | | | - Jordi Canes
- 16SOLTI Cancer Research Group, Barcelona, Spain
| | | | | | - Eva Ciruelos
- 19SOLTI Breast Cancer Research Group, Barcelona, Spain/Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain, Madrid, Spain
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Vidal M, Pascual T, Falato C, Sanchez-Bayona R, Muñoz M, Cerbrecos I, Gonzalez-Farré X, Cortadellas T, Margelí M, Luna MA, Siso C, Amillano K, Galván P, Salvador F, Espinosa A, Paré L, Sanfeliu E, Prat A, Ezquerra MB. Abstract PD13-01: PD13-01 Elacestrant in postmenopausal women with estrogen receptor positive and HER2-negative early breast cancer: primary efficacy and safety analysis of the preoperative, window of opportunity SOLTI-1905-ELIPSE trial. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-pd13-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Introduction Elacestrant is the first oral, non-steroidal, selective estrogen receptor degrader (SERD) to demonstrate improved efficacy compared to standard of care endocrine treatment, with greater relative benefit in ESR1-mutated tumors, and manageable safety profile in pretreated patients with metastatic breast cancer (BC) (Bidard F.C., JCO 2022). SOLTI ELIPSE trial (NCT04797728) is a prospective, multicenter, window of opportunity trial designed to assess whether a short-course of preoperative elacestrant may suppress tumor proliferation in postmenopausal women with estrogen receptor positive (ER+)/HER2-negative early BC (Vidal M., SABCS 2021). Here, we present the results of the primary efficacy and safety study analysis. Methods Eligible patients with operable, untreated ER+/HER2-negative BC that were T1c (≥1.5 cm)-T3 by ultrasound, clinically or radiologically N0 and had a locally assessed Ki67 ≥10%, received elacestrant 400 mg once a day continuously for a total of 4 weeks. At the study treatment completion, patients were treated according to local practice. Centralized assessment of post-treatment (D28) Ki67 from surgical specimen or tumor biopsy was required for the primary endpoint evaluation. Primary efficacy endpoint was complete cell cycle arrest (CCCA), defined as Ki67≤2.7%, at D28. Ki67 geometric relative change, variation in tumor infiltrating lymphocytes (TILs), switch in PAM50 subtypes and differential expression of 192 genes from baseline (D1) to D28 was also explored. Adverse events (AEs) were graded according to CTCAE v5.0. Results Between April 2021 and February 2022, 24 patients were enrolled and 22 were evaluable for the primary endpoint. Baseline characteristics were: mean age 69 years (range 50-81); ductal histology 74%; T1c 61%; T2 39%; grade 1-2 83%; median local Ki67 20% (10-70). Baseline PAM50 subtypes distribution was: Luminal A (n=12), Luminal B (n=8), Basal-like (n=1), Normal-like (n=1). At D28, CCCA was achieved in the 27% (n=6) of the patients. Fourteen patients (64%) had D28 Ki67 ≤10%. Paired centralized Ki67 was available in 19 patients. A statistically significant 41% (95% CI, -24 to -58) Ki67 relative reduction (rr) from D1 was observed (p=0.007). CCCA rate was 31% and 17% in patients with D1 Ki67 < 20% (n=13) and D1 Ki67 ≥20% (n=6), respectively. Ki67 varied consistently in both Ki67 < 20% (rr=-38%; 95% CI, -16 to -60) and Ki67 ≥20% (rr=-46%; 95% CI, -20 to -72) groups. Overall, elacestrant was associated with a shift towards a more endocrine sensitive and less proliferative phenotype based on PAM50 gene signatures. CCCA occurred in 45% of Luminal A tumors, whereas no CCCA was observed among Luminal B tumors. Levels of TILs were significantly higher at D28 (mean difference, +3.73; p=0.004). Elacestrant induced high expression of immune-response genes including IGJ, GZMB, CD4, CD8a and suppressed proliferation (e.g., UBE2T, MYBL2, BIRC5, MK67) and estrogen-signaling (e.g., ESR1, PGR, CCND1, BRCA2) genes (false discovery rate 5%). These changes in gene expression were observed both in tumors with D28 Ki67≤2.7% and in those with D28 Ki67 >10%. Overall, 87% of the patients reported any grade AEs. Treatment-related AE occurred in 1 patient (grade 3 cutaneous rash) and led to treatment discontinuation. Most frequently reported AEs (all grade 1) were hot flush (n=6), dyspepsia (n=2), anemia (n=2) and constipation (n=2). No serious AEs were reported. Conclusions In untreated ER+/HER2-negative early BC a short-course preoperative treatment with elacestrant was associated with relevant biological and molecular response and with manageable safety profile. Globally, these findings support further exploration of this highly potent, novel oral SERD in early BC.
Citation Format: Maria Vidal, Tomás Pascual, Claudette Falato, Rodrigo Sanchez-Bayona, Montserrat Muñoz, Isaac Cerbrecos, Xavier Gonzalez-Farré, Tomás Cortadellas, Mireia Margelí, Miguel Angel Luna, Christian Siso, Kepa Amillano, Patricia Galván, Fernando Salvador, Alejandra Espinosa, Laia Paré, Esther Sanfeliu, Aleix Prat, Meritxell Bellet Ezquerra. PD13-01 Elacestrant in postmenopausal women with estrogen receptor positive and HER2-negative early breast cancer: primary efficacy and safety analysis of the preoperative, window of opportunity SOLTI-1905-ELIPSE trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD13-01.
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Affiliation(s)
- Maria Vidal
- 1Medical Oncology Department, Hospital Clínic of Barcelona ; Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute, Barcelona, Spain ; SOLTI Breast Cancer Research Group ; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Tomás Pascual
- 2Medical Oncology Department, Hospital Clínic of Barcelona, Barcelona, Spain ; Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute, Barcelona, Spain ; SOLTI Breast Cancer Research Group, Barcelona, Spain, Catalonia, Spain
| | - Claudette Falato
- 3SOLTI Cancer Research Group. Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Department of Oncology and Pathology, Karolinska Institute, Catalonia, Spain
| | | | - Montserrat Muñoz
- 5SOLTI Breast Cancer Research Group, Hospital Clínic of Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute, Barcelona, Spain ; Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain, Catalonia, Spain
| | - Isaac Cerbrecos
- 6Medical Oncology Department, Hospital Clinic de Barcelona, Catalonia, Spain
| | | | - Tomás Cortadellas
- 8Breast Unit, Obs&Gyne department, Hospital Universitari General de Catalunya, Catalonia, Spain
| | - Mireia Margelí
- 9SOLTI Cancer Research Group. Medical Oncology Department, ICO Badalona, B-ARGO Group. GEICAM Spasnish Breast Cancer Group., Catalonia, Spain
| | - Miguel Angel Luna
- 10Medical Oncology Department, ICO Badalona, B-ARGO Group, Catalonia, Spain
| | | | - Kepa Amillano
- 12Hospital Universitari Sant Joan de Reus, Catalonia, Spain
| | - Patricia Galván
- 13Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute, Barcelona, Spain, Catalonia, Spain
| | | | | | - Laia Paré
- 16Reveal Genomics, Barcelona, Spain, Catalonia, Spain
| | - Esther Sanfeliu
- 17SOLTI Breast Cancer Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Faculty of Medicine and Pathology Department, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain., Catalonia, Spain
| | | | - Meritxell Bellet Ezquerra
- 19Vall d’Hebron Institute of Oncology (VHIO) and Vall d’Hebron University Hospital, and SOLTI Group, Barcelona, Spain
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Oliveira E Costa A, Barreira A, Cunha M, Salvador F. Polycythemia and JAK2 variant N1108S: cause-and-effect or coincidence? Hematol Transfus Cell Ther 2023:S2531-1379(23)00035-4. [PMID: 36870884 DOI: 10.1016/j.htct.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/17/2022] [Accepted: 01/16/2023] [Indexed: 02/25/2023] Open
Affiliation(s)
| | - Ana Barreira
- Centro Hospitalar de Trás os Montes e Alto Douro EPE, Portugal
| | - Manuel Cunha
- Centro Hospitalar de Trás os Montes e Alto Douro EPE, Portugal
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Basile G, Tamarozzi F, Salas-Coronas J, Soriano-Pérez MJ, Luzón-García P, Moro L, Antinori S, Arsuaga M, Bartoloni A, Tomasoni LR, Gobbi FG, Köhler C, Salvador F, Bocanegra C, Zammarchi L. Management of imported complicated urogenital schistosomiasis in Europe: a TropNet retrospective study. J Travel Med 2023; 30:6956960. [PMID: 36547229 DOI: 10.1093/jtm/taac150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Schistosomiasis is a neglected tropical disease caused by trematodes of the genus Schistosoma. Schistosoma haematobium causes urogenital schistosomiasis (UGS), a chronic disease characterized by pathology of the urogenital tract leading to potentially severe morbidity for which the treatment is poorly standardized. We conducted a survey in TropNet centres on the clinical presentations and management strategies of complicated urogenital schistosomiasis (cUGS). METHODS We reviewed the clinical records of patients seen at TropNet centres over a 20-year timespan (January 2001-December 2020). Case definition for cUGS included the presence of urogenital cancer, obstructive uropathy, kidney insufficiency of all grades and female or male genital involvement leading to infertility. Collected data included demographic information, patient category (traveller or migrant), imaging data, microbiological data (serology results and presence/absence of eggs in urine), histological features and outcome at last visit recorded. RESULTS Eight centres contributed with at least one case. Overall, 31 patients matched the inclusion criteria. Sub-Saharan Africa was the most likely place of infection for included patients. Median age was 30.6 years (range 21-46, interquartile ranges, IQR 27-33). Most patients (28/31, 90.3%) were males. Hydronephrosis was the most frequent complication, being present in 18 (58.1%) patients, followed by cancer, present in 5 patients (16.1%); 27 patients (87.1%) required surgical management of some sort. Use of praziquantel varied across centres, with six different regimens employed. DISCUSSION Very few cases of cUGSs were found in our survey, possibly indicating underdiagnosis of this condition. Hydronephrosis was the most frequently observed urogenital complication, and most patients required invasive procedures. Infection by S. haematobium can result in considerable morbidity, resulting in clinically challenging presentations requiring a multidisciplinary approach. As such, development of common protocols for early diagnosis and treatment is urgently needed.
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Affiliation(s)
- Gregorio Basile
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134 Italy
| | - Francesca Tamarozzi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024, Italy
| | | | | | - Pilar Luzón-García
- Tropical Medicine Unit, Hospital Universitario Poniente, Almería, 04700, Spain
| | - Lucia Moro
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024, Italy
| | - Spinello Antinori
- Luigi Sacco Department of Biomedical and Clinical Sciences, Università di Milano, Milan, 20157, Italy
| | - Marta Arsuaga
- Imported Diseases and International Health Referral Unit, High Level Isolation Unit, La Paz-Carlos III University Hospital, Madrid, 28029, Spain
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134 Italy
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, 50134, Italy
| | - Lina Rachele Tomasoni
- University Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili, Brescia, 25125, Italy
| | - Federico Giovanni Gobbi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, 37024, Italy
| | - Carsten Köhler
- Institute of Tropical Medicine, Travel Medicine and Human parasitology, Center of Competence, Baden-Württtemberg, Universität und Universitätsklinikum Tübingen, Tübingen, 72074, Germany
| | - Fernando Salvador
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, 08035, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Cristina Bocanegra
- International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, 08035, Spain
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134 Italy
- Infectious and Tropical Diseases Unit, Careggi University and Hospital, Florence, 50134, Italy
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Alonso-Nocelo M, Ruiz-Cañas L, Sancho P, Görgülü K, Alcalá S, Pedrero C, Vallespinos M, López-Gil JC, Ochando M, García-García E, David Trabulo SM, Martinelli P, Sánchez-Tomero P, Sánchez-Palomo C, Gonzalez-Santamaría P, Yuste L, Wörmann SM, Kabacaoğlu D, Earl J, Martin A, Salvador F, Valle S, Martin-Hijano L, Carrato A, Erkan M, García-Bermejo L, Hermann PC, Algül H, Moreno-Bueno G, Heeschen C, Portillo F, Cano A, Sainz B. Macrophages direct cancer cells through a LOXL2-mediated metastatic cascade in pancreatic ductal adenocarcinoma. Gut 2023; 72:345-359. [PMID: 35428659 PMCID: PMC9872246 DOI: 10.1136/gutjnl-2021-325564] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/21/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The lysyl oxidase-like protein 2 (LOXL2) contributes to tumour progression and metastasis in different tumour entities, but its role in pancreatic ductal adenocarcinoma (PDAC) has not been evaluated in immunocompetent in vivo PDAC models. DESIGN Towards this end, we used PDAC patient data sets, patient-derived xenograft in vivo and in vitro models, and four conditional genetically-engineered mouse models (GEMMS) to dissect the role of LOXL2 in PDAC. For GEMM-based studies, K-Ras +/LSL-G12D;Trp53 LSL-R172H;Pdx1-Cre mice (KPC) and the K-Ras +/LSL-G12D;Pdx1-Cre mice (KC) were crossed with Loxl2 allele floxed mice (Loxl2Exon2 fl/fl) or conditional Loxl2 overexpressing mice (R26Loxl2 KI/KI) to generate KPCL2KO or KCL2KO and KPCL2KI or KCL2KI mice, which were used to study overall survival; tumour incidence, burden and differentiation; metastases; epithelial to mesenchymal transition (EMT); stemness and extracellular collagen matrix (ECM) organisation. RESULTS Using these PDAC mouse models, we show that while Loxl2 ablation had little effect on primary tumour development and growth, its loss significantly decreased metastasis and increased overall survival. We attribute this effect to non-cell autonomous factors, primarily ECM remodelling. Loxl2 overexpression, on the other hand, promoted primary and metastatic tumour growth and decreased overall survival, which could be linked to increased EMT and stemness. We also identified tumour-associated macrophage-secreted oncostatin M (OSM) as an inducer of LOXL2 expression, and show that targeting macrophages in vivo affects Osm and Loxl2 expression and collagen fibre alignment. CONCLUSION Taken together, our findings establish novel pathophysiological roles and functions for LOXL2 in PDAC, which could be potentially exploited to treat metastatic disease.
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Affiliation(s)
- Marta Alonso-Nocelo
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Laura Ruiz-Cañas
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Patricia Sancho
- Translational Research Unit, Hospital Miguel Servet, Instituto de Investigacion Sanitaria Aragon, Zaragoza, Spain
| | - Kıvanç Görgülü
- Comprehensive Cancer Center München, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Sonia Alcalá
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Coral Pedrero
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Mireia Vallespinos
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Juan Carlos López-Gil
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Marina Ochando
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Elena García-García
- Departamento de Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - Sara Maria David Trabulo
- Stem Cells and Cancer Group, Molecular Pathology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Paola Martinelli
- Institute for Cancer Research, Comprehensive Cancer Center, Medizinische Universitat Wien, Wien, Austria
| | - Patricia Sánchez-Tomero
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Carmen Sánchez-Palomo
- Departamento de Anatomía, Histologia y Neurociencia, Universidad Autónoma de Madrid, Madrid, Spain
| | - Patricia Gonzalez-Santamaría
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer and Human Molecular Genetics, Instituto de Investigación Sanitaria IdiPAZ, Madrid, Spain
| | - Lourdes Yuste
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Cancer and Human Molecular Genetics, Instituto de Investigación Sanitaria IdiPAZ, Madrid, Spain
| | - Sonja Maria Wörmann
- Ahmed Cancer Center for Pancreatic Cancer Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Derya Kabacaoğlu
- Comprehensive Cancer Center München, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Julie Earl
- Molecular Epidemiology and Predictive Tumor Markers Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain, Madrid, Spain
- Gastrointestinal Tumours Research Programme, Biomedical Research Network in Cancer (CIBERONC), Madrid, Spain
| | - Alberto Martin
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
| | - Fernando Salvador
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
| | - Sandra Valle
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Laura Martin-Hijano
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Alfredo Carrato
- Molecular Epidemiology and Predictive Tumor Markers Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain, Madrid, Spain
- Gastrointestinal Tumours Research Programme, Biomedical Research Network in Cancer (CIBERONC), Madrid, Spain
- Alcala University, Madrid, Spain
| | - Mert Erkan
- University Research Center for Translational Medicine - KUTTAM, Istanbul, Turkey
| | - Laura García-Bermejo
- Biomarkers and Therapeutic Targets Group, Area 4, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | - Hana Algül
- Comprehensive Cancer Center München, Klinikum rechts der Isar der Technischen Universität München, München, Germany
| | - Gema Moreno-Bueno
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer and Human Molecular Genetics, Instituto de Investigación Sanitaria IdiPAZ, Madrid, Spain
- Breast Cancer Research Programme, Biomedical Research Network in Cancer (CIBERONC), Madrid, Spain
- Fundación MD Anderson Internacional, Madrid, Spain
| | - Christopher Heeschen
- Stem Cells and Cancer Group, Molecular Pathology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Center for Single-Cell Omics and Key Laboratory of Oncogenes and Related Genes, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Francisco Portillo
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Breast Cancer Research Programme, Biomedical Research Network in Cancer (CIBERONC), Madrid, Spain
| | - Amparo Cano
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer and Human Molecular Genetics, Instituto de Investigación Sanitaria IdiPAZ, Madrid, Spain
- Breast Cancer Research Programme, Biomedical Research Network in Cancer (CIBERONC), Madrid, Spain
| | - Bruno Sainz
- Departament of Biochemistry, Universidad Autónoma de Madrid (UAM), Departament of Cancer Biology, Instituto de Investigaciones Biomédicas Alberto Sols CSIC-UAM, Madrid, Spain
- Cancer Stem Cells and Fibroinflammatory Microenvironment Group, Chronic Diseases and Cancer, Area 3, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Gastrointestinal Tumours Research Programme, Biomedical Research Network in Cancer (CIBERONC), Madrid, Spain
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Gil Olivas E, Bruguera A, Eugenio ANE, Nunda JJ, Tchiyanga A, Ekavo FG, Cambali A, Moreno M, Bocanegra García C, Aznar ML, Salvador F, Sánchez-Montalvá A, Molina I. Civil Engineering and Malaria Risk: A Descriptive Study in a Rural Area of Cubal, Angola. Trop Med Infect Dis 2023; 8:tropicalmed8020096. [PMID: 36828512 PMCID: PMC9961019 DOI: 10.3390/tropicalmed8020096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Angola is among the high-burden countries with malaria cases globally. After 2013, we suspected an increase in the number of malaria cases in Cubal (Angola), previously in decline. Our objective was to evaluate the incidence rate in Cubal, overall and by neighborhood, for 2014, 2015, and 2016. (2) Methods: A retrospective, observational study was performed in Cubal (Angola) from January 2014 to December 2016, including all patients with a microbiologically confirmed diagnosis, treated at Cubal's Hospitals for this period of time. The principal variables calculated were the incidence rates of 2014, 2015, and 2016 in Cubal (overall and by neighborhood). (3) Results: There were 3249 malaria cases. The incidence rates were 2.27, 10.73, and 12.40 cases per 1000 inhabitants in 2014, 2015, and 2016, respectively. In the neighborhood, Hamavoko-Kasseke, there was a 10.73-fold increase in incidence during this period. Additionally, Hamavoko-Kasseke presents an anomalous distribution of malaria cases. (4) Conclusions: We observed an increase in the incidence of malaria in Cubal during the three-year study period. The case distribution was highly heterogeneous with hyperendemic areas, and we found a chronobiological association between the construction of a civil engineering project. This information could be useful for deciding which malaria control strategies must be implemented in this area.
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Affiliation(s)
- Eva Gil Olivas
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Hospital Nossa Senhora da Paz, Cubal 690, Angola
- Emergency Department, Hospital de la Santa Creu I Sant Pau, 08041 Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), 08041 Barcelona, Spain
- Correspondence: ; Tel.: +34-935537568
| | - Andreu Bruguera
- Preventive Medicine and Epidemiology Department, Vall d’Hebron University Hospital, 08035 Barcelona, Spain
| | | | | | | | | | | | | | - Cristina Bocanegra García
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Hospital Nossa Senhora da Paz, Cubal 690, Angola
| | - Maria Luísa Aznar
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 08029 Madrid, Spain
| | - Fernando Salvador
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 08029 Madrid, Spain
| | - Adrián Sánchez-Montalvá
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 08029 Madrid, Spain
| | - Israel Molina
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 08029 Madrid, Spain
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Marinho A, Delgado Alves J, Fortuna J, Faria R, Almeida I, Alves G, Araújo Correia J, Campar A, Brandão M, Crespo J, Marado D, Matos-Costa J, Oliveira S, Salvador F, Santos L, Silva F, Fernandes M, Vasconcelos C. Biological therapy in systemic lupus erythematosus, antiphospholipid syndrome, and Sjögren's syndrome: evidence- and practice-based guidance. Front Immunol 2023; 14:1117699. [PMID: 37138867 PMCID: PMC10150407 DOI: 10.3389/fimmu.2023.1117699] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/13/2023] [Indexed: 05/05/2023] Open
Abstract
Systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), and Sjögren's syndrome (SS) are heterogeneous autoimmune diseases. Severe manifestations and refractory/intolerance to conventional immunosuppressants demand other options, namely biological drugs, and small molecules. We aimed to define evidence and practice-based guidance for the off-label use of biologics in SLE, APS, and SS. Recommendations were made by an independent expert panel, following a comprehensive literature review and two consensus rounds. The panel included 17 internal medicine experts with recognized practice in autoimmune disease management. The literature review was systematic from 2014 until 2019 and later updated by cross-reference checking and experts' input until 2021. Preliminary recommendations were drafted by working groups for each disease. A revision meeting with all experts anticipated the consensus meeting held in June 2021. All experts voted (agree, disagree, neither agree nor disagree) during two rounds, and recommendations with at least 75% agreement were approved. A total of 32 final recommendations (20 for SLE treatment, 5 for APS, and 7 for SS) were approved by the experts. These recommendations consider organ involvement, manifestations, severity, and response to previous treatments. In these three autoimmune diseases, most recommendations refer to rituximab, which aligns with the higher number of studies and clinical experience with this biological agent. Belimumab sequential treatment after rituximab may also be used in severe cases of SLE and SS. Second-line therapy with baricitinib, bortezomib, eculizumab, secukinumab, or tocilizumab can be considered in SLE-specific manifestations. These evidence and practice-based recommendations may support treatment decision and, ultimately, improve the outcome of patients living with SLE, APS, or SS.
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Affiliation(s)
- António Marinho
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- *Correspondence: António Marinho,
| | - José Delgado Alves
- Systemic Autoimmune Diseases Unit, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
- Immune Response and Vascular Disease Unit - iNOVA4Health, NOVA Medical School, Lisboa, Portugal
| | - Jorge Fortuna
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Raquel Faria
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Isabel Almeida
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Glória Alves
- Serviço de Medicina Interna, Hospital da Senhora da Oliveira - Centro Hospitalar Alto Ave, Guimarães, Portugal
| | - João Araújo Correia
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Campar
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Mariana Brandão
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Jorge Crespo
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Daniela Marado
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - João Matos-Costa
- Serviço de Medicina Interna, Hospital Distrital de Santarém, Santarém, Portugal
| | - Susana Oliveira
- Systemic Autoimmune Diseases Unit, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - Fernando Salvador
- Unidade de Doenças Autoimunes, Serviço de Medicina Interna, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Lelita Santos
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Linha de Investigação Clínica e Interdisciplinar em Meio Ambiente, Genética e Oncobiologia (CIMAGO), Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - Fátima Silva
- Serviço de Medicina Interna, Departamento de Medicina, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Milene Fernandes
- Real-World Evidence & Late Phase, CTI Clinical Trial & Consulting Services Unipessoal Lda, Lisboa, Portugal
| | - Carlos Vasconcelos
- Unidade de Imunologia Clínica, Centro Hospitalar Universitário do Porto, Porto, Portugal
- UMIB - Unidade Multidisciplinar de Investigação Biomédica, ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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Silgado A, Bosch-Nicolau P, Sánchez-Montalvá A, Cervià A, Gomez-i-Prat J, Bagaria G, Rodriguez C, Goterris L, Serre-Delcor N, Oliveira-Souto I, Salvador F, Molina I, Sulleiro E. Opportunistic Community Screening of Chronic Chagas Disease Using a Rapid Diagnosis Test in Pharmacies in Barcelona (Catalonia, Spain): Study Protocol and Pilot Phase Results. Int J Public Health 2022; 67:1605386. [DOI: 10.3389/ijph.2022.1605386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives: This study aimed to report the protocol and results from the pilot phase of an opportunistic CP-based CD screening program in Barcelona, Spain.Methods: Three strategies according to recruitment approach were designed: passive, active and active-community. The study process consisted of signing the informed consent form, recording the patient’s data in a web-based database system, and performing the rapid test and blood collection on dry paper.Results: Nineteen pharmacies participated and 64 patients were included during the pilot phase of the study. The rapid diagnostic test (RDT) was positive in 2/64 (3.13%) cases. Of the 49 DBS samples that arrived at the laboratory, 22 (45%) were collected incorrectly. After quantitative and qualitative assessment of the program, the dry paper sample and passive strategy were ruled out.Conclusion: DBS sampling and the passive strategy are not suitable for CD screening in community pharmacies. There is a need to expand the number of participating pharmacies and individuals to determine whether conducting a RDT in community pharmacies is an effective screening method to increase access to CD diagnosis in a non-endemic area.
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De Salazar PM, Sosa-Estani S, Salvador F, Sulleiro E, Sánchez-Montalvá A, Ribeiro I, Molina I, Buckee CO. Human Trypanosoma cruzi chronic infection leads to individual level steady-state parasitemia: Implications for drug-trial optimization in Chagas disease. PLoS Negl Trop Dis 2022; 16:e0010828. [PMID: 36409773 PMCID: PMC9721471 DOI: 10.1371/journal.pntd.0010828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/05/2022] [Accepted: 09/19/2022] [Indexed: 11/22/2022] Open
Abstract
Currently available drugs against Trypanosoma cruzi infection, which causes 12000 deaths annually, have limitations in their efficacy, safety and tolerability. The evaluation of therapeutic responses to available and new compounds is based on parasite detection in the bloodstream but remains challenging because a substantial proportion of infected individuals have undetectable parasitemia even when using diagnostic tools with the highest accuracy. We characterize parasite dynamics which might impact drug efficacy assessments in chronic Chagas by analyzing pre- and post-treatment quantitative-PCR data obtained from blood samples collected regularly over a year. We show that parasitemia remains at a steady-state independently of the diagnostic sensitivity. This steady-state can be probabilistically quantified and robustly predicted at an individual level. Furthermore, individuals can be assigned to categories with distinct parasitological status, allowing a more detailed evaluation of the efficacy outcomes and adjustment for potential biases. Our analysis improves understanding of parasite dynamics and provides a novel background for optimizing future drug efficacy trials in Chagas disease. Trial Registration: original trial registered with ClinicalTrials.gov, number NCT01489228.
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Affiliation(s)
- Pablo M. De Salazar
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
| | - Sergio Sosa-Estani
- Drugs for Neglected Diseases Initiative. Rio de Janeiro, Brazil
- Epidemiology and Public Health Research Centre, CONICET, Buenos Aires, Argentina
| | - Fernando Salvador
- Department of Infectious Diseases, Vall d’Hebron University Hospital, International Health Program of the Catalan Institute of Health (PROSICS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Sulleiro
- Department of Microbiology, Vall d’Hebron University Hospital, International Health Program of the Catalan Institute of Health (PROSICS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d’Hebron University Hospital, International Health Program of the Catalan Institute of Health (PROSICS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabela Ribeiro
- Drugs for Neglected Diseases Initiative, Geneve, Switzerland
| | - Israel Molina
- Department of Infectious Diseases, Vall d’Hebron University Hospital, International Health Program of the Catalan Institute of Health (PROSICS), Barcelona, Spain
- Instituto René Rachou-FIOCRUZ Minas, Laboratório de Triatomíneos e Epidemiologia da Doença de Chagas, Belo Horizonte, Brazil
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Caroline O. Buckee
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Tamarozzi F, Rodari P, Salas-Coronas J, Bottieau E, Salvador F, Soriano-Pérez MJ, Cabeza-Barrera MI, Van Esbroeck M, Treviño B, Buonfrate D, Gobbi FG. A large case series of travel-related Mansonella perstans (vector-borne filarial nematode): a TropNet study in Europe. J Travel Med 2022; 29:6567953. [PMID: 35417002 PMCID: PMC9635058 DOI: 10.1093/jtm/taac048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/25/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Infection with Mansonella perstans is a neglected filariasis, widely distributed in sub-Saharan Africa, characterized by an elusive clinical picture; treatment for mansonellosis is not standardized. This retrospective study aimed to describe the clinical features, treatment schemes and evolution, of a large cohort of imported cases of M. perstans infection seen in four European centres for tropical diseases. METHODS Mansonella perstans infections, diagnosed by identification of blood microfilariae in migrants, expatriates and travellers, collected between 1994 and 2018, were retrospectively analysed. Data concerning demographics, clinical history and laboratory examinations at diagnosis and at follow-up time points were retrieved. RESULTS A total of 392 patients were included in the study. Of the 281 patients for whom information on symptoms could be retrieved, 150 (53.4%) reported symptoms, abdominal pain and itching being the most frequent. Positive serology and eosinophilia were present in 84.4% and 66.1%, respectively, of those patients for whom these data were available. Concomitant parasitic infections were reported in 23.5% of patients. Treatment, administered to 325 patients (82.9%), was extremely heterogeneous between and within centres; the most commonly used regimen was mebendazole 100 mg twice a day for 1 month. A total of 256 (65.3%) patients attended a first follow-up, median 3 months (interquartile range 2-12) after the first visit; 83.1% of patients having received treatment based on mebendazole and/or doxycycline, targeting Wolbachia, became amicrofilaremic, 41.1-78.4% of whom within 12 months from single treatment. CONCLUSIONS Lack of specific symptoms, together with the inconstant positivity of parasitological and antibody-based assays in the infected population, makes the clinical suspicion and screening for mansonellosis particularly difficult. Prospective studies evaluating prevalence of infection in migrants from endemic areas, infection-specific morbidity, presence of Wolbachia endosymbionts in M. perstans populations from different geographical areas and efficacy of treatment regimens are absolutely needed to optimize the clinical management of infection.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Paola Rodari
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | | | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Fernando Salvador
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | | | | | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Begoña Treviño
- Tropical Medicine Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Federico G Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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Norman FF, Salvador F, Gullón B, Díaz-Menéndez M, Pérez-Ayala A, Rodriguez-Guardado A, García-Rodriguez M, Henriquez-Camacho C, Goikoetxea J, Bosch-Nicolau P, de la Calle F, Ramos-Rincon JM, Aznar ML, Peñaranda M, Calabuig E, Suarez-Garcia I, Pérez-Molina JA, López-Vélez R. Frequency and characteristics of HTLV in migrants: results from the +Redivi collaborative network in Spain. J Travel Med 2022; 29:6528728. [PMID: 35166822 DOI: 10.1093/jtm/taac019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/21/2022] [Accepted: 02/09/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The objective of this study was to describe the main characteristics of migrants diagnosed with human T-lymphotropic virus (HTLV) infection within the +Redivi Spanish network. METHODS Patients with a diagnosis of HTLV type 1 or 2 in +Redivi from October 2009 to December 2020 were included. Diagnosis was based on positive HTLV serology (enzyme-linked immunosorbent assay (ELISA)/chemiluminescent immunoassay (CLIA)) with line immunoassay (LIA)/Western blot with/without polymerase chain reaction (PCR). RESULTS A total of 107/17 007 cases (0.6%) had a final diagnosis of HTLV infection: 83 (77.67%) HTLV-1 infections, 6 (5.6%) HTLV-2 infections and 18 (16.8%) non-specified. The majority (76, 71%) were female, median age was 42 years and median time from arrival to Spain until consultation was 10 years. The group included 100 (93.5%) immigrants and 7 (6.6%) visiting friends and relatives (VFR)-immigrants. Most patients were from South America (71, 66.4%), followed by Sub-Saharan Africa (15, 14%) and Central America-Caribbean (13, 12.1%). Around 90% of patients were asymptomatic at presentation and diagnosed as part of screening programs. Median duration of follow-up was 5 years (IQR 2-7). Regarding HTLV-associated conditions, 90 patients (84.2%) had none, 7 (6.5%) had tropical spastic paraparesis , 5 (4.7%) had other associated conditions (dermatitis, uveitis, pulmonary disease), 3 (2.8%) had other neurological symptoms and 2 (1.9%) had adult T-cell leukaemia/lymphoma. No patients with HTLV-2 had HTLV-associated conditions. Four patients (3.7%) died. Concomitant diagnoses were found in 41 (38.3%) patients, including strongyloidiasis in 15 (14%) and HIV co-infection in 4 (3.7%). In 70% of patients, screening of potential contacts was not performed/recorded. CONCLUSIONS HTLV infections (the majority due to HTLV-1) were mainly diagnosed in asymptomatic migrants from Latin America (generally long-settled immigrants and the majority female with the consequent implications for screening/prevention). A high rate of association with strongyloidiasis was found. In the majority, screening of potential contacts was not performed, representing a missed opportunity for decreasing the under diagnosis of this infection.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Fernando Salvador
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain
| | - Beatriz Gullón
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Marta Díaz-Menéndez
- National Referral Centre for Imported Tropical diseases, Hospital Universitario La Paz-Carlos III, Madrid, Spain
| | | | | | | | | | | | - Pau Bosch-Nicolau
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain
| | - Fernando de la Calle
- National Referral Centre for Imported Tropical diseases, Hospital Universitario La Paz-Carlos III, Madrid, Spain
| | | | - Maria-Luisa Aznar
- Unitat de Medicina Tropical y Salut Internacional Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain
| | | | - Eva Calabuig
- Unidad de Enfermedades Infecciosas, La Fe University and Polytechnic Hospital, Medicine Department, University of Valencia, Valencia, Spain
| | | | - Jose A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, CIBER de Enfermedades Infecciosas, Madrid, Spain
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Prat A, Paz-Ares L, Juan M, Felip E, Garralda E, González B, Arance A, Martín-Liberal J, Gavilá J, López-González A, Cejalvo JM, Izarzugaza Y, Amillano K, Corbacho JG, Saura C, Racca F, Hierro C, Sanfeliu E, Gonzalez X, Canes J, Villacampa G, Salvador F, Pascual T, Mesía R, Cervantes A, Tabernero J. SOLTI-1904 ACROPOLI TRIAL: efficacy of spartalizumab monotherapy across tumor-types expressing high levels of PD1 mRNA. Future Oncol 2022; 18:3791-3800. [PMID: 36200668 DOI: 10.2217/fon-2022-0660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Improved selection of cancer patients who are most likely to respond to immune checkpoint inhibitors remains an unmet clinical need. Recently, a positive correlation between levels of PD1 mRNA and clinical outcome in response to PD1 blockade across diverse tumor histologies has been confirmed in several datasets. ACROPOLI is a parallel cohort, non-randomized, phase II study that aims to evaluate the efficacy of the anti-PD1 immune checkpoint inhibitor spartalizumab as monotherapy in metastatic patients with solid tumors that express high levels of PD1 (cohort 1; n = 111). An additional cohort of 30 patients with tumors expressing low levels of PD1, where PD1/PD-L1 antibodies in monotherapy are standard treatment, will also be included (cohort 2). Primary end point is overall response rate in cohort 1. Trial registration number: NCT04802876 (ClinicalTrials.gov).
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Affiliation(s)
- Aleix Prat
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Medicine Department, University of Barcelona, Barcelona, Spain
| | - Luis Paz-Ares
- Hospital Universitario 12 de Octubre, Madrid, Spain
- CIBERONC (Centro de Investigación Biomédica en Red de Cáncer), Instituto de Salud Carlos III, Madrid (Spain)
| | - Manel Juan
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Immunology Department, Immunotherapy Platforms, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Enriqueta Felip
- Vall d'Hebron Hospital Campus, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Elena Garralda
- Vall d'Hebron Hospital Campus, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Blanca González
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Pathology department Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ana Arance
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Joaquín Gavilá
- SOLTI Cancer Research Group, Barcelona, Spain
- Instituto Valenciano de Oncología (IVO), Valencia, Spain
| | | | - Juan Miguel Cejalvo
- Hospital Clínico Universitario de Valencia, INCLIVA (Instituto de investigación sanitaria), Universidad Valencia, Spain
| | - Yann Izarzugaza
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | - Javier García Corbacho
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
- August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Cristina Saura
- SOLTI Cancer Research Group, Barcelona, Spain
- Vall d'Hebron Hospital Campus, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Cinta Hierro
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias I Pujol Research Institute (IGTP); Badalona, Barcelona, Spain
| | - Esther Sanfeliu
- SOLTI Cancer Research Group, Barcelona, Spain
- Pathology department Hospital Clinic de Barcelona, Barcelona, Spain
| | - Xavier Gonzalez
- SOLTI Cancer Research Group, Barcelona, Spain
- Institut Oncològic Dr. Rosell. Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Jordi Canes
- SOLTI Cancer Research Group, Barcelona, Spain
| | - Guillermo Villacampa
- SOLTI Cancer Research Group, Barcelona, Spain
- Oncology Data Science, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Tomás Pascual
- SOLTI Cancer Research Group, Barcelona, Spain
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ricard Mesía
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Badalona-Applied Research Group in Oncology (B-ARGO), Germans Trias I Pujol Research Institute (IGTP); Badalona, Barcelona, Spain
| | - Andrés Cervantes
- CIBERONC (Centro de Investigación Biomédica en Red de Cáncer), Instituto de Salud Carlos III, Madrid (Spain)
- Hospital Clínico Universitario de Valencia, INCLIVA (Instituto de investigación sanitaria), Universidad Valencia, Spain
| | - Josep Tabernero
- CIBERONC (Centro de Investigación Biomédica en Red de Cáncer), Instituto de Salud Carlos III, Madrid (Spain)
- Vall d'Hebron Hospital Campus, Barcelona, Spain
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
- IOB-Hospital Quironsalud Barcelona, Spain
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Queirós R, Salvador F. Assessment of cardiovascular risk with C-reactive protein in rheumatoid arthritis patients. Eur J Intern Med 2022; 104:39-40. [PMID: 35973882 DOI: 10.1016/j.ejim.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Rita Queirós
- Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega, Vila Real 5000-508, Portugal.
| | - Fernando Salvador
- Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega, Vila Real 5000-508, Portugal
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Norman FF, Treviño-Maruri B, Ruiz Giardín JM, Gullón-Peña B, Salvador F, Serre N, Díaz-Menéndez M, Calabuig E, Rodriguez-Guardado A, Lombide I, Pérez-Ayala A, Torrús D, Goikoetxea J, García-Rodriguez M, Pérez-Molina JA. Trends in imported malaria during the COVID-19 pandemic, Spain (+Redivi Collaborative Network). J Travel Med 2022; 29:6649393. [PMID: 35876259 DOI: 10.1093/jtm/taac083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has caused disruptions in prevention and management strategies for malaria globally. Currently, data analysing trends in travel-related infections during the pandemic years are scarce. The objective of this analysis was to describe the epidemiological and clinical characteristics of patients with imported malaria within the +Redivi network in Spain, focusing on yearly trends from pre-pandemic years to date. METHODS Cases recorded in +Redivi from October 2009 to December 2021 were analysed and patients with a diagnosis of malaria (standard diagnostic methods using thick/thin peripheral blood smears, with/without a malaria rapid diagnostic test and/or Plasmodium spp. polymerase chain reaction) were identified. The total number of malaria cases, cases according to type of patient and severe cases, per year, were analysed. RESULTS In total, 1751 cases of malaria (1751/26 601, 6.6%) were identified. The majority occurred in males (1041, 59.5%), median age was 36.3 (interquartile range: 27-44.7) years and most occurred in visiting friends and relatives (VFR)-immigrants (872, 49.8%). Most infections were acquired in sub-Saharan Africa (1.660, 94.8%) and were due to Plasmodium falciparum (81.3%). There were 64 cases of severe malaria (3.7%) and 4 patients died (0.2% mortality, all in pre-pandemic years). A significant increase in cases of severe malaria was observed during the study period (P < 0.001) (attributable to the increase in 2021). There were 16/93 severe cases in 2021 (17.2%), all due to Plasmodium falciparum, (compared with ≤ 5% in previous years), which mainly occurred in travellers and VFR-immigrants (10/16, 62.5% and 5/16, 31.3%, respectively). CONCLUSIONS After an initial decline associated with travel restrictions due to the ongoing COVID-19 pandemic, an increase in imported malaria and a significant increase in cases of severe malaria was observed. Patients with imported malaria may present and/or be diagnosed late during this public health crisis and health care professionals should be alerted to the recent increase in severe cases.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department. Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Begoña Treviño-Maruri
- Unitat de Medicina Tropical y Salut Internacional Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Beatriz Gullón-Peña
- National Referral Unit for Tropical Diseases, Infectious Diseases Department. Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Salvador
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Nuria Serre
- Unitat de Medicina Tropical y Salut Internacional Vall d'Hebron-Drassanes, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Díaz-Menéndez
- National Referral Centre for Imported Tropical Diseases, Hospital Universitario La Paz-Carlos III, Madrid, Spain
| | - Eva Calabuig
- La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain
| | | | | | | | - Diego Torrús
- Alicante General University Hospital, Alicante, Spain
| | | | | | - Jose A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department. Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
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Piron M, Salvador F, Caballero E, Sánchez-Montalvá A, Bes M, Casamitjana N, Puig L, Molina I, Sauleda S. HTLV-1/2 Infection in Blood Donors from a Non-Endemic Area (Catalonia, Spain) between 2008 and 2017: A 10-Year Experience. Viruses 2022; 14:v14091975. [PMID: 36146780 PMCID: PMC9504911 DOI: 10.3390/v14091975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 01/19/2023] Open
Abstract
Human T-cell lymphotropic virus type 1 and 2 (HTLV-1/2) screening is not mandatory in Spanish blood banks. In Catalonia, selective screening was introduced in 2008, followed by universal screening in 2011. We present herein a 10-year experience of HTLV testing in blood donors. HTLV-1/2 selective screening was performed using Ortho-Clinical Diagnostics HTLV-I/HTLV-II Ab-Capture ELISA between February 2008 and May 2009, then Abbott Prism HTLV-I/ HTLV-II assay until December 2010. Abbott Architect rHTLV-I/II assay was then used for HTLV-1/2 universal screening in pooled samples. INNO-LIA HTLV I/II Score (Fujirebio) and in-house HTLV-1/2 proviral DNA real-time PCR were used in reactive samples. Follow-up was offered to confirm HTLV-1/2 donors in Vall d’Hebron Hospital. Between 2008 and 2017, 51 blood donors were confirmed HTLV positive (46 HTLV-1, 4 HTLV-2 and 1 HTLV) out of 2,114,891 blood donations (1 in 41,468). Sixty-nine percent were female, median age was 40 years and most were born in Latin America (69%), followed by Europe (25%), Africa (4%) and Asia (2%). Screening of relatives and partners identified 12 additional HTLV-1 cases. Lookback studies did not show any HTLV-1/2 transmission. HTLV infections found in blood donors mirror epidemiological changes in the population of Spain. Consequently, HTLV should be considered a potential risk for recipients and calls for the design of optimal strategies to ensure transfusion safety.
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Affiliation(s)
- Maria Piron
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Vall d’Hebron Research Institute (VHIR), Vall d’Hebron University Hospital, 08035 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-557-35-00 (ext. 6631)
| | - Fernando Salvador
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Estrella Caballero
- Laboratory of Microbiology, Vall d’Hebron University Hospital, 08035 Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marta Bes
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Vall d’Hebron Research Institute (VHIR), Vall d’Hebron University Hospital, 08035 Barcelona, Spain
| | - Natàlia Casamitjana
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
| | - Lluís Puig
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Israel Molina
- International Health Unit Vall d’Hebron-Drassanes, Infectious Diseases Department, Vall d’Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Silvia Sauleda
- Banc de Sang i Teixits de Catalunya (Blood and Tissue Bank of Catalonia, BST), Transfusion Safety Laboratory, 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREhd), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Vall d’Hebron Research Institute (VHIR), Vall d’Hebron University Hospital, 08035 Barcelona, Spain
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Alves AS, Perdigão S, Morais S, Sousa C, Salvador F. Androgenic-Anabolic Steroids: From the Gym to Drug-Induced Liver Injury. Cureus 2022; 14:e28798. [PMID: 36105900 PMCID: PMC9444045 DOI: 10.7759/cureus.28798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/05/2022] Open
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Barkauskas C, Mylonakis E, Poulakou G, Young BE, Vock DM, Siegel L, Engen N, Grandits G, Mosaly NR, Vekstein AM, Rogers R, Shehadeh F, Kaczynski M, Mylona EK, Syrigos KN, Rapti V, Lye DC, Hui DS, Leither L, Knowlton KU, Jain MK, Marines-Price R, Osuji A, Overcash JS, Kalomenidis I, Barmparessou Z, Waters M, Zepeda K, Chen P, Torbati S, Kiweewa F, Sebudde N, Almasri E, Hughes A, Bhagani SR, Rodger A, Sandkovsky U, Gottlieb RL, Nnakelu E, Trautner B, Menon V, Lutaakome J, Matthay M, Robinson P, Protopapas K, Koulouris N, Kimuli I, Baduashvili A, Braun DL, Günthard HF, Ramachandruni S, Kidega R, Kim K, Hatlen TJ, Phillips AN, Murray DD, Jensen TO, Padilla ML, Accardi EX, Shaw-Saliba K, Dewar RL, Teitelbaum M, Natarajan V, Laverdure S, Highbarger HC, Rehman MT, Vogel S, Vallée D, Crew P, Atri N, Schechner AJ, Pett S, Hudson F, Badrock J, Touloumi G, Brown SM, Self WH, North CM, Ginde AA, Chang CC, Kelleher A, Nagy-Agren S, Vasudeva S, Looney D, Nguyen HH, Sánchez A, Weintrob AC, Grund B, Sharma S, Reilly CS, Paredes R, Bednarska A, Gerry NP, Babiker AG, Davey VJ, Gelijns AC, Higgs ES, Kan V, Matthews G, Argyraki K, Lourida P, Bakakos P, Vlachakos V, Balis E, Zakynthinos S, Sigala I, Gianniou N, Dima E, Magkouta S, Thompson BT, Synolaki E, Konstanta S, Vlachou M, Stathopoulou P, Panagopoulos P, Petrakis V, Papazoglou D, Tompaidou E, Isaakidou E, Leontis K, Legenne P, Nitsotolis T, Athanasiou K, Myrodia M, Kyriakoulis K, Trontzas I, Arfara-Melanini M, Kolonia V, Kityo C, Mugerwa H, Lukaakome J, Chandra R, Nsereko C, Lubega G, Kibirige M, Nakahima W, Wangi D, Aguti E, Generous L, Massa R, Nalaki M, Magala F, Lane HC, Nabaggala PK, Kityo C, Mugerwa H, Faith OD, Florence A, Emmanuel O, Beacham MP, Geoffrey A, Nakiboneka D, Apiyo P, Neaton JD, Kiweewa F, Kirenga B, Kimuli I, Atukunda A, Muttamba W, Remmy K, Segawa I, Pheona N, Kigere D, Mbabazi QL, Lundgren JD, Boersalino L, Nyakoolo G, Kiweewa F, Fred A, Alupo A, Ebong D, Monday E, Nalubwama RN, Kainja M, Ambrose M, Barkauskas C, Kwehayo V, Nalubega MG, Ongoli A, Obbo S, Alaba J, Magombe G, Tino H, Obonya E, Lutaakome J, Kitonsa J, Mylonakis E, Onyango M, Naboth T, Naluyinda H, Nanyunja R, Irene M, Jane B, Wimfred K, Leonar S, Deus T, Babra N, Poulakou G, Taire P, Lutaakone J, Nabankema E, Ogavu J, Mugerwa O, Okoth I, Mwebaze R, Mugabi T, Makhoba A, Arikiriza P, Young BE, Theresa N, Nakayima H, Frank K, Ramgi P, Pereira K, Osinusi A, Cao H, Stumpp M, Goncalves S, Ramanathan K, Vock DM, Baseler B, Holley HP, Jankelevich S, Adams A, Becker N, Dolney S, Hissey D, Simpson S, Kim MH, Beeler J, Siegel L, Harmon L, Asomah M, Jato Y, Stottlemyer A, Tang O, Vanderpuye S, Yeon L, Buehn M, Eccard-Koons V, Frary S, Engen N, MacDonald L, Cash J, Hoopengardner L, Linton J, Schaffhauser M, Nelson M, Spinelli-Nadzam M, Proffitt C, Lee C, Engel T, Grandits G, Fontaine L, Osborne C, Hohn M, Galcik M, Thompson D, Chang W, Sherman BT, Rupert AW, Baseler M, Lallemand P, Mosaly NR, Imamichi T, Paudel S, Cook K, Haupt K, Highbarger J, Hazen A, Badralmaa Y, Smith K, Patel B, Kubernac R, Vekstein AM, Hoover ML, Brown C, DuChateau N, Ellis S, Flosi A, Fox L, Johnson L, Nelson R, Stojanovic J, Treagus A, Rogers R, Wenner C, Williams R, Shehadeh F, Kaczynski M, Mylona EK, Syrigos KN, Rapti V, Lye DC, Hui DS, Leither L, Knowlton KU, Jain MK, Marines-Price R, Osuji A, Overcash JS, Kalomenidis I, Barmparessou Z, Waters M, Zepeda K, Chen P, Torbati S, Kiweewa F, Sebudde N, Almasri E, Hughes A, Bhagani SR, Rodger A, Sandkovsky U, Gottlieb RL, Nnakelu E, Trautner B, Menon V, Lutaakome J, Matthay M, Robinson P, Protopapas K, Koulouris N, Kimuli I, Baduashvili A, Braun DL, Günthard HF, Ramachandruni S, Kidega R, Kim K, Hatlen TJ, Phillips AN, Murray DD, Jensen TO, Padilla ML, Accardi EX, Shaw-Saliba K, Dewar RL, Teitelbaum M, Natarajan V, Laverdure S, Highbarger HC, Rehman MT, Vogel S, Vallée D, Crew P, Atri N, Schechner AJ, Pett S, Hudson F, Badrock J, Touloumi G, Brown SM, Self WH, North CM, Ginde AA, Chang CC, Kelleher A, Nagy-Agren S, Vasudeva S, Looney D, Nguyen HH, Sánchez A, Weintrob AC, Grund B, Sharma S, Reilly CS, Paredes R, Bednarska A, Gerry NP, Babiker AG, Davey VJ, Gelijns AC, Higgs ES, Kan V, Matthews G, Thompson BT, Legenne P, Chandra R, Lane HC, Neaton JD, Lundgren JD, Sahner D, Tierney J, Herpin BR, Smolskis MC, McKay LA, Cahill K, Sardana R, Raim SS, Hensely L, Lorenzo J, Mock R, Zuckerman J, Miller M, Chung L, Kang N, Adam SJ, Read S, Draghia-Akli R, Carlsen A, Carter A, Denning E, DuChene A, Eckroth K, Frase A, Gandits G, Harrison M, Kaiser P, Koopmeiners J, Meger S, Murray T, Quan K, Quan SF, Thompson G, Walski J, Wentworth D, Moskowitz AJ, Bagiella E, Moquete E, O’Sullivan K, Marks ME, Kinzel E, Burris S, Bedoya G, Gupta L, Overbey JR, Padillia ML, Santos M, Gillinov MA, Miller MA, Taddei-Peters WC, Fenton K, Mack M, Berhe M, Haley C, Dishner E, Bettacchi C, Golden K, Duhaime E, Ryan M, Burris S, Tallmadge C, Estrada L, Jones F, Villa S, Wang S, Robert R, Coleman T, Clariday L, Baker R, Hurutado-Rodriguez M, Iram N, Fresnedo M, Davis A, Leonard K, Ramierez N, Thammavong J, Duque K, Turner E, Fisher T, Robinson D, Ransom D, Maldonado N, Lusk E, Killian A, Palacious A, Solis E, Jerrow J, Watts M, Whitacre H, Cothran E, Smith PK, Ko ER, Dreyer GR, Stafford N, Brooks M, Der T, Witte M, Gamarallage R, Franzone J, Ivey N, Lumsden RH, Mourad A, Holland TL, Motta M, Lane K, McGowan LM, Stout J, Aloor H, Bragg KM, Toledo B, McLendon-Arvik B, Bussadori B, Hollister BA, Griffin M, Giangiacomo DM, Rodriguez V, Parrino PE, Spindel S, Bansal A, Baumgarten K, Hand J, Vonderhaar D, Nossaman B, Laudun S, Ames D, Broussard S, Hernandez N, Isaac G, Dinh H, Zheng Y, Tran S, McDaniel H, Crovetto N, Perin E, Costello B, Manian P, Sohail MR, Postalian A, Hinsu P, Watson C, Chen J, Fink M, Sturgis L, Kim W, Mahon K, Parenti J, Kappenman C, Knight A, Sturek JM, Barros A, Enfield KB, Kadl A, Green CJ, Simon RM, Fox A, Thornton K, Adams A, Traverse JH, Rhame F, Huelster J, Kethireddy R, Salamanca J, Majeski C, Skelton P, Zarambo M, Sarafolean A, Oldmixon C, Ringwood N, Muzikansky A, Morse R, Brower RG, Reineck LA, Aggarwal NR, Bienstock K, Steingrub JH, Hou PK, Steingrub JS, Tidswell MA, Kozikowski LA, Kardos C, DeSouza L, Romain S, Talmor D, Shapiro N, Andromidas K, Banner-Goodspeed V, Bolstad M, Boyle KL, Cabrera P, deVilla A, Ellis JC, Grafals A, Hayes S, Higgins C, Kurt L, Kurtzman N, Redman K, Rosseto E, Scaffidi D, Shapiro N, Talmor D, Filbin MR, Hibbert KA, Parry B, Margolin J, Hillis B, Hamer R, Jones AE, Galbraith J, Nandi U, Hendey G, Matthay MA, Kangelaris K, Ashktorab K, Gropper R, Agrawal A, Almasri E, Fayed M, Hubel KA, Garcia RL, Lim GW, Chang SY, Hendey G, Lin MY, Vargas J, Sihota H, Beutler R, Rogers AJ, Wilson JG, Vojnik R, Perez C, McDowell JH, Albertson T, Hardy E, Harper R, Moss MA, Ginde AA, Chauhan L, Douin DJ, Martinez F, Finck LL, Bastman J, Hyzy RC, Park PK, Hyzy RC, Park PK, Nelson K, McSparron JI, Co IN, Wang BR, Jimenez J, Sullins B, Olbrich N, Gong MN, Richardson LD, Gong MN, Nair R, Lopez B, Amosu O, Tzehaie H, Nkemdirim W, Boujid S, Mosier JM, Hypes C, Campbell ES, Bixby B, Gilson B, Lopez A, Hite RD, Terndrup TE, Wiedemann HP, Hudock K, Tanzeem H, More H, Martinkovic J, Sellers S, Houston J, Burns M, Hough CL, Robinson BH, Hough CL, Khan A, Krol OF, Mills E, Kinjal M, Briceno G, Reddy R, Hubel K, Parimon T, Caudill A, Mattison B, Jackman SE, Chen PE, Bayoumi E, Ojukwu C, Fine D, Weissberg G, Isip K, Choi-Kuaea Y, Mehdikhani S, Dar TB, Augustin NBF, Tran D, Dukov JE, O’Mahony DS, Wilson DM, Wallick JA, Duven AM, Fletcher DD, Files DC, Miller C, Gibbs KW, Flores LS, LaRose ME, Landreth LD, Palacios DR, Parks L, Hicks M, Goodwin AJ, Kilb EF, Lematty CT, Patti K, Bledsoe J, Brown S, Lanspa M, Pelton I, Armbruster BP, Montgomery Q, Kumar N, Fergus M, Imel K, Palmer G, Webb B, Klippel C, Jensen H, Duckworth S, Gray A, Burke T, Knox D, Lumpkin J, Aston VT, Rice TW, Self WH, Rice TW, Casey JD, Johnson J, Hays M, Kasubhai M, Pillai A, Daniel J, Sittler D, Kanna B, Jilani N, Amaro F, Santana J, Lyakovestsky A, Madhoun I, Desroches LM, Amadon N, Bahr A, Ezzat I, Guerrero M, Padilla J, Fullmer J, Singh I, Ali Shah SH, Narang R, Mock P, Shadle M, Hernandez B, Welch K, Payne A, Ertl G, Canario D, Barrientos I, Goss D, DeVries M, Folowosele I, Garner D, Gomez M, Price J, Bansal E, Wong J, Faulhaber J, Fazili T, Yeary B, Ndolo R, Bryant C, Smigeil B, Najjar R, Jones P, Nguyen J, Chin C, Taha H, Najm S, Smith C, Moore J, Nassar T, Gallinger N, Christian A, Mauer D, Phipps A, Coslet J, Landazuri R, Pineda J, Uribe N, Garcia JR, Barbabosa C, Sandler K, Marquez A, Chu H, Lee K, Quillin K, Garcia A, Lew P, Tran QL, Benitez G, Mishra B, Felix LO, Vafea MT, Atalla E, Davies R, Hedili S, Monkeberg MA, Tabler S, Mylonakis E, Rogers R, Shehadeh F, Mylona EK, Kaczynski M, Tran QL, Benitez G, Mishra B, Felix LO, Vafea MT, Atalla E, Davies R, Hedili S, Harrington B, Popielski L, Kambo A, Viens K, Turner M, Vjecha MJ, Osuji A, Agbor BTA, Petersen T, Kamel D, Hansen L, Garcia A, Cha C, Mozaffari A, Hernandez R, Jain MK, Agbor BTA, Petersen T, Kamel D, Hansen L, Garcia A, Kim M, DellaValle N, Gonzales S, Somboonwit C, Oxner A, Guerra L, Tran T, Pinto A, Anderson B, Zepeda-Gutierrez A, Martin D, Temblador C, Cuenca A, Guerrero M, Daar E, Correa R, Hartnell G, Wortmann G, Doshi S, Moriarty T, Gonzales M, Garman K, Baker JV, Frosch A, Goldsmith R, Jibrell H, Lo M, Klaphake J, Mackedanz S, Ngo L, Garcia-Myers K, Kunisaki KM, Hassler M, Walquist M, Augenbraun M, Dehovitz J, Abassi M, Leuck AM, Rao V, Biswas K, Harrington C, Garcia A, Bremer T, Burke T, Koker B, Davis-Karim A, Pittman D, Vasudeva SS, Pandit L, Hines-Munson C, Van J, Dillon L, Wang Y, Ochalek T, Caldwell E, Humerickhouse E, Boone D, McGraw W, Mehta SR, Johns ST, John MS, Raceles J, Sear E, Funk S, Cesarini R, Fang M, Nicalo K, Drake W, Jones B, Holtman T, Maniar A, Johnson EA, Nguyen L, Tran MT, Barrett TW, Johnston T, Huggins JT, Beiko TY, Hughes HY, McManigle WC, Tanner NT, Washburn RG, Ardelt M, Tuohy PA, Mixson JL, Hinton CG, Thornley N, Allen H, Elam S, Boatman B, Baber BJ, Ryant R, Roller B, Nguyen C, Mikail AM, Hansen M, Lichtenberger P, Baracco G, Ramos C, Bjork L, Sueiro M, Tien P, Freasier H, Buck T, Nekach H, Holodniy M, Chary A, Lu K, Peters T, Lopez J, Tan SY, Lee RH, Asghar A, Isip TKK, Le K, Nguyen T, Wong S, Raben D, Aagaard B, Nielsen CB, Krapp K, Nykjær BR, Olsson C, Kanne KL, Grevsen AL, Joensen ZM, Bruun T, Bojesen A, Woldbye F, Normand NE, Benfield T, Clausen CL, Hovmand N, Israelsen SB, Iversen K, Leding C, Pedersen KB, Thorlacius-Ussing L, Tinggaard M, Tingsgard S, Jensen JUS, Overgaard R, Rastoder E, Heerfordt C, Hedsund C, Ronn CP, Kamstrup PT, Hogsberg DS, Bergsoe C, Ostergaard L, Staerke NB, Yehdego Y, Sondergaard A, Johansen IS, Holden IK, Lindvig SO, Helleberg M, Gerstoft J, Kirk O, Bruun T, Jensen TO, Madsen BL, Pedersen TI, Harboe ZB, Roge BT, Hansen TM, Glesner MK, Lofberg SV, Nielsen AD, Nielsen H, Thisted RK, Petersen KT, Juhl MR, Podlekareva D, Johnsen S, Wiese L, Knudsen LS, Expósito M, Badillo J, Martínez A, Abad E, Chamorro A, Mateu L, España S, Lucero MC, Santos JR, Lladós G, Lopez C, Carabias L, Fernández-Cruz E, Di Natale M, Padure S, Gomez J, Ausin C, Cervilla E, Balastegui H, Sainz CR, Lopez P, Escobar M, Balerdi L, Legarda A, Roldan M, Letona L, Muñoz J, Arribas JR, Sánchez RM, Díaz-Pollán B, Stewart SM, Garcia I, Borobia A, Estrada V, Cabello N, Nuñez-Orantos M, Sagastagoitia I, Homen J, Orviz E, Montalvá AS, Espinosa-Pereiro J, Bosch-Nicolau P, Salvador F, Morales-Rull JL, Pena AMM, Acosta C, Solé-Felip C, West E, M’Rabeth-Bensalah K, Eichinger ML, Grüttner-Durmaz M, Grube C, Zink V, Goes J, Tsertsvadze T, Abutidze A, Chkhartishvili N, Metchurtchlishvili R, Endeladze M, Paciorek M, Bursa D, Krogulec D, Pulik P, Ignatowska A, Fishchuk R, Kobrynska O, Levandovska K, Kirieieva I, Kuziuk M, Polizzotto M, Carey C, Dharan NJ, Hough S, Virachit S, Davidson S, Bice DJ, Ognenovska K, Cabrera G, Flynn R, Chia PY, Lee TH, Lin RJ, Ong SW, Puah SH, Yeo TW, Ongko J, Yeo HP, Kwaghe V, Zaiyad H, Idoko G, Uche B, Selvamuthu P, Kumarasamy N, Beulah FE, Govindarajan N, Mariyappan K, Losso MH, Abela C, Moretto R, Belloc CG, Ludueña J, Amar J, Losso MH, Toibaro J, Macias LM, Fernandez L, Frare PS, Chaio SR, Pachioli V, Timpano SM, Sanchez MDL, Sierra MDP, Stanek V, Belloso W, Cilenti FL, Valentini RN, Stryjewski ME, Locatelli N, Riera MCS, Salgado C, Baeck IM, Di Castelnuovo V, Zarza SM, Parmar MK, Goodman AL, Gregory A, Goodall K, Harris N, Wyncoll J, Luntiel A, Patterson C, Morales J, Witele E, Preston A, Nandani A, Price D, Nell J, Patel B, Hays C, Jones G, Davidson J, Pantazis N, Gioukari V, Souliou T, Antoniadou A, Kavatha D, Grigoropoulou S, Tziolos R, Oikonomopoulo C, Moschopoulos C, Tzimopoulos K, Koromilias A. Efficacy and Safety of Ensovibep for Adults Hospitalized With COVID-19 : A Randomized Controlled Trial. Ann Intern Med 2022; 175:1266-1274. [PMID: 35939810 PMCID: PMC9384272 DOI: 10.7326/m22-1503] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Ensovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection. OBJECTIVE To investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone. DESIGN Double-blind, randomized, placebo-controlled, clinical trial. (ClinicalTrials.gov: NCT04501978). SETTING Multinational, multicenter trial. PARTICIPANTS Adults hospitalized with COVID-19. INTERVENTION Intravenous ensovibep, 600 mg, or placebo. MEASUREMENTS Ensovibep was assessed for early futility on the basis of pulmonary ordinal scores at day 5. The primary outcome was time to sustained recovery through day 90, defined as 14 consecutive days at home or place of usual residence after hospital discharge. A composite safety outcome that included death, serious adverse events, end-organ disease, and serious infections was assessed through day 90. RESULTS An independent data and safety monitoring board recommended that enrollment be halted for early futility after 485 patients were randomly assigned and received an infusion of ensovibep (n = 247) or placebo (n = 238). The odds ratio (OR) for a more favorable pulmonary outcome in the ensovibep (vs. placebo) group at day 5 was 0.93 (95% CI, 0.67 to 1.30; P = 0.68; OR > 1 would favor ensovibep). The 90-day cumulative incidence of sustained recovery was 82% for ensovibep and 80% for placebo (subhazard ratio [sHR], 1.06 [CI, 0.88 to 1.28]; sHR > 1 would favor ensovibep). The primary composite safety outcome at day 90 occurred in 78 ensovibep participants (32%) and 70 placebo participants (29%) (HR, 1.07 [CI, 0.77 to 1.47]; HR < 1 would favor ensovibep). LIMITATION The trial was prematurely stopped because of futility, limiting power for the primary outcome. CONCLUSION Compared with placebo, ensovibep did not improve clinical outcomes for hospitalized participants with COVID-19 receiving standard care, including remdesivir; no safety concerns were identified. PRIMARY FUNDING SOURCE National Institutes of Health.
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Affiliation(s)
| | - Christina Barkauskas
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Duke Health, Durham, North Carolina
| | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Garyfallia Poulakou
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | | | - David M Vock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Lianne Siegel
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Nicole Engen
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Greg Grandits
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | - Ralph Rogers
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fadi Shehadeh
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Matthew Kaczynski
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Evangelia K Mylona
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Konstantinos N Syrigos
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Vasiliki Rapti
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - David C Lye
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Lee Kong Chian School of Medicine, Singapore
| | - Diong Shiau Hui
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Lindsay Leither
- Division of Pulmonary and Critical Care, Department of Medicine, Intermountain Medical Center, Salt Lake City, Utah
| | - Kirk U Knowlton
- Cardiovascular Department, Intermountain Medical Center, Salt Lake City, Utah
| | - Mamta K Jain
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | - Rubria Marines-Price
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | - Alice Osuji
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | | | - Ioannis Kalomenidis
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evaggelismos General Hospital, Athens, Greece
| | - Zafeiria Barmparessou
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evaggelismos General Hospital, Athens, Greece
| | | | | | - Peter Chen
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Sam Torbati
- Cedars-Sinai Medical Center, Los Angeles, California
| | | | | | - Eyad Almasri
- University of California, San Francisco-Fresno, Fresno, California
| | - Alyssa Hughes
- University of California, San Francisco-Fresno, Fresno, California
| | | | | | | | | | | | - Barbara Trautner
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
| | - Vidya Menon
- NYC Health + Hospitals/Lincoln, Bronx, New York
| | - Joseph Lutaakome
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Michael Matthay
- University of California, San Francisco, Medical Center, Fresno, California
| | - Philip Robinson
- Hoag Memorial Hospital Presbyterian, Newport Beach, California
| | - Konstantinos Protopapas
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Nikolaos Koulouris
- 1st Respiratory Medicine Department, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Ivan Kimuli
- Makerere University Lung Institute, Kampala, Uganda
| | - Amiran Baduashvili
- Division of Hospital Medicine, University of Colorado Hospital - Anschutz Medical Campus, Aurora, Colorado
| | - Dominique L Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Huldrych F Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | | | - Kami Kim
- Division of Infectious Diseases, University of South Florida and Global Emerging Diseases Institute, Tampa General Hospital, Tampa, Florida
| | - Timothy J Hatlen
- Lundquist Institute for Biomedical Innovation, Torrance, California
| | | | - Daniel D Murray
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Tomas O Jensen
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, and Department of Pulmonary and Infectious Diseases, North Zealand University Hospital, Hillerod, Denmark
| | | | - Evan X Accardi
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Katy Shaw-Saliba
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Robin L Dewar
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | | | - Ven Natarajan
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Sylvain Laverdure
- Laboratory of Human Retrovirology and Immunoinformatics, National Institutes of Health, Frederick, Maryland
| | | | - M Tauseef Rehman
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Susan Vogel
- Office of Clinical Research Policy and Regulatory Operations, National Institutes of Health, Bethesda, Maryland
| | - David Vallée
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Page Crew
- Collaborative Clinical Research Branch, National Institutes of Health, Bethesda, Maryland
| | - Negin Atri
- Office of Clinical Research Policy and Regulatory Operations, National Institutes of Health, Bethesda, Maryland
| | | | - Sarah Pett
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Fleur Hudson
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Jonathan Badrock
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Samuel M Brown
- Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, and Department of Internal Medicine, University of Utah, Murray, Utah
| | - Wesley H Self
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Crystal M North
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Adit A Ginde
- University of Colorado School of Medicine, Aurora, Colorado
| | - Christina C Chang
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony Kelleher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - David Looney
- The Veterans Medical Research Foundation, San Diego, California
| | - Hien H Nguyen
- Veterans Affairs Northern California Health Care System, Sacramento, California
| | | | - Amy C Weintrob
- Infectious Diseases Section, Washington Veterans Affairs Medical Center, Washington, DC
| | - Birgit Grund
- School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Shweta Sharma
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Cavan S Reilly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Roger Paredes
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Agnieszka Bednarska
- Wojewódzki Szpital Zakaźny w Warszawie, Medical University of Warsaw, Warsaw, Poland
| | - Norman P Gerry
- Advanced Biomedical Laboratories, Cinnaminson, New Jersey
| | - Abdel G Babiker
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | | | - Annetine C Gelijns
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Elizabeth S Higgs
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Virginia Kan
- Infectious Diseases Section, Veterans Affairs Medical Center, Washington, DC
| | - Gail Matthews
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - K. Argyraki
- Sotiria General, Medical School, National & Kapodistrian University of Athens
| | - P. Lourida
- Sotiria General Hospital, Medical School, National & Kapodistrian University of Athens
| | - P. Bakakos
- Sotiria General Hospital, Medical School, National & Kapodistrian University of Athens
| | - V. Vlachakos
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - E. Balis
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - S. Zakynthinos
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - I. Sigala
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - N. Gianniou
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - E. Dima
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - S. Magkouta
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - B Taylor Thompson
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - E. Synolaki
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - S. Konstanta
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - M. Vlachou
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - P. Stathopoulou
- Evangelismos General Hospital, Medical School, National & Kapodistrian University of Athens
| | - P. Panagopoulos
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - V. Petrakis
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - D. Papazoglou
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - E. Tompaidou
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - E. Isaakidou
- Alexandroupolis General Hospital, Medical School, Democritus University of Thrace
| | - K. Leontis
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | | | - T. Nitsotolis
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - K. Athanasiou
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - M.D. Myrodia
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - K. Kyriakoulis
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - I. Trontzas
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - M. Arfara-Melanini
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - V. Kolonia
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Cissy Kityo
- Uganda SCC, JCRC/MRC/UVRI Uganda Research Unit
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - H Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | | | | | | | | | | | | | | | | | | | | | - James D Neaton
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | | | | | | | | | | | | | | | - Jens D Lundgren
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | | | | | | | | | | | | | - Christina Barkauskas
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Duke Health, Durham, North Carolina
| | | | | | | | | | | | | | | | | | | | | | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | | | | | | | | | | | | | | | | | - Garyfallia Poulakou
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Patrícia Ramgi
- CISPOC: Centro de Investigaçäo e Treino em Saúde da Polana Caniço, Maputo, Mozambique
| | - Kássia Pereira
- CISPOC: Centro de Investigaçäo e Treino em Saúde da Polana Caniço, Maputo, Mozambique
| | | | - Huyen Cao
- Gilead Sciences, Foster City, California
| | | | | | | | - David M. Vock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | - Amy Adams
- Leidos Biomedical Research, Frederick, Maryland
| | | | | | | | | | - Mi Ha Kim
- Leidos Biomedical Research, Frederick, Maryland
| | - Joy Beeler
- Leidos Biomedical Research, Frederick, Maryland
| | - Lianne Siegel
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Liam Harmon
- Leidos Biomedical Research, Frederick, Maryland
| | | | - Yvonne Jato
- Leidos Biomedical Research, Frederick, Maryland
| | | | - Olivia Tang
- Leidos Biomedical Research, Frederick, Maryland
| | | | | | - Molly Buehn
- Leidos Biomedical Research, Frederick, Maryland
| | | | - Sadie Frary
- Leidos Biomedical Research, Frederick, Maryland
| | - Nicole Engen
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | | | | | | | | | | | | | | | - Greg Grandits
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | | | | | - Matt Hohn
- Leidos Biomedical Research, Frederick, Maryland
| | | | | | - Weizhong Chang
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Brad T. Sherman
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Adam W. Rupert
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Michael Baseler
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Perrine Lallemand
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | | | - Tom Imamichi
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Sharada Paudel
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Kyndal Cook
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Kendra Haupt
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Jeroen Highbarger
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Allison Hazen
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Yunden Badralmaa
- Frederick National Laboratory for Cancer Research/Leidos Biomedical Research, Frederick, Maryland
| | - Kenneth Smith
- Advanced Biomedical Laboratories, Cinnaminson, New Jersey
| | - Bhakti Patel
- Advanced Biomedical Laboratories, Cinnaminson, New Jersey
| | | | | | | | | | | | | | | | | | | | | | | | | | - Ralph Rogers
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | | | - Fadi Shehadeh
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Matthew Kaczynski
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Evangelia K. Mylona
- Division of Infectious Diseases, Rhode Island Hospital and The Miriam Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Konstantinos N. Syrigos
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Vasiliki Rapti
- 3rd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - David C. Lye
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Lee Kong Chian School of Medicine, Singapore
| | - Diong Shiau Hui
- National Centre for Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Lindsay Leither
- Division of Pulmonary and Critical Care, Department of Medicine, Intermountain Medical Center, Salt Lake City, Utah
| | - Kirk U. Knowlton
- Cardiovascular Department, Intermountain Medical Center, Salt Lake City, Utah
| | - Mamta K. Jain
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | - Rubria Marines-Price
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | - Alice Osuji
- UT Southwestern Medical Center and Parkland Health and Hospital Systems, Dallas, Texas
| | | | - Ioannis Kalomenidis
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evaggelismos General Hospital, Athens, Greece
| | - Zafeiria Barmparessou
- 1st Department of Critical Care and Pulmonary Medicine, Medical School, National and Kapodistrian University of Athens, Evaggelismos General Hospital, Athens, Greece
| | | | | | - Peter Chen
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Sam Torbati
- Cedars-Sinai Medical Center, Los Angeles, California
| | | | | | - Eyad Almasri
- University of California, San Francisco–Fresno, Fresno, California
| | - Alyssa Hughes
- University of California, San Francisco–Fresno, Fresno, California
| | | | | | | | | | | | - Barbara Trautner
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
| | - Vidya Menon
- NYC Health + Hospitals/Lincoln, Bronx, New York
| | - Joseph Lutaakome
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Michael Matthay
- University of California, San Francisco, Medical Center, Fresno, California
| | - Philip Robinson
- Hoag Memorial Hospital Presbyterian, Newport Beach, California
| | - Konstantinos Protopapas
- 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - Nikolaos Koulouris
- 1st Respiratory Medicine Department, Medical School, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Ivan Kimuli
- Makerere University Lung Institute, Kampala, Uganda
| | - Amiran Baduashvili
- Division of Hospital Medicine, University of Colorado Hospital - Anschutz Medical Campus, Aurora, Colorado
| | - Dominique L. Braun
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Huldrych F. Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | | | | | - Kami Kim
- Division of Infectious Diseases, University of South Florida and Global Emerging Diseases Institute, Tampa General Hospital, Tampa, Florida
| | | | | | - Daniel D. Murray
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Tomas O. Jensen
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, and Department of Pulmonary and Infectious Diseases, North Zealand University Hospital, Hillerod, Denmark
| | | | | | - Katy Shaw-Saliba
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Robin L. Dewar
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | | | - Ven Natarajan
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Sylvain Laverdure
- Laboratory of Human Retrovirology and Immunoinformatics, National Institutes of Health, Frederick, Maryland
| | | | - M. Tauseef Rehman
- Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Susan Vogel
- Office of Clinical Research Policy and Regulatory Operations, National Institutes of Health, Bethesda, Maryland
| | - David Vallée
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Page Crew
- Collaborative Clinical Research Branch, National Institutes of Health, Bethesda, Maryland
| | - Negin Atri
- Office of Clinical Research Policy and Regulatory Operations, National Institutes of Health, Bethesda, Maryland
| | | | - Sarah Pett
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Fleur Hudson
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Jonathan Badrock
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Samuel M. Brown
- Division of Pulmonary and Critical Care Medicine, Intermountain Medical Center, and Department of Internal Medicine, University of Utah, Murray, Utah
| | - Wesley H. Self
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Crystal M. North
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Adit A. Ginde
- University of Colorado School of Medicine, Aurora, Colorado
| | - Christina C. Chang
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony Kelleher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - David Looney
- The Veterans Medical Research Foundation, San Diego, California
| | - Hien H. Nguyen
- Veterans Affairs Northern California Health Care System, Sacramento, California
| | | | - Amy C. Weintrob
- Infectious Diseases Section, Washington Veterans Affairs Medical Center, Washington, DC
| | - Birgit Grund
- School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Shweta Sharma
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Cavan S. Reilly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Roger Paredes
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Agnieszka Bednarska
- Wojewódzki Szpital Zakaźny w Warszawie, Medical University of Warsaw, Warsaw, Poland
| | | | - Abdel G. Babiker
- The Medical Research Council Clinical Trials Unit at University College London, London, England
| | | | - Annetine C. Gelijns
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Elizabeth S. Higgs
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - Virginia Kan
- Infectious Diseases Section, Veterans Affairs Medical Center, Washington, DC
| | - Gail Matthews
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - B. Taylor Thompson
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - H. Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland
| | - James D. Neaton
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Jens D. Lundgren
- CHIP Center of Excellence for Health, Immunity, and Infections and Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - David Sahner
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - John Tierney
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Betsey R. Herpin
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Mary C. Smolskis
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Laura A. McKay
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Kelly Cahill
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Ratna Sardana
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Sharon Segal Raim
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Lisa Hensely
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Joshua Lorenzo
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Rebecca Mock
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Judith Zuckerman
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Mark Miller
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Lucy Chung
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Nayon Kang
- Department of Clinical Research, National Institute of Allergy and Infectious Diseases
| | - Stacey J. Adam
- Foundation for the National Institutes of Health, The Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) and Operation Warp Speed
| | - Sarah Read
- Foundation for the National Institutes of Health, The Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) and Operation Warp Speed
| | - Ruxandra Draghia-Akli
- Foundation for the National Institutes of Health, The Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) and Operation Warp Speed
| | - Amy Carlsen
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Anita Carter
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Eileen Denning
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Alain DuChene
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Kate Eckroth
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Alex Frase
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Greg Gandits
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Merrie Harrison
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Payton Kaiser
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Joseph Koopmeiners
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Sue Meger
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Thomas Murray
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Kien Quan
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Siu Fun Quan
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Greg Thompson
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Jamie Walski
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Deborah Wentworth
- INSIGHT SDMC, Division of Biostatistics, School of Public Health and School of Statistics, University of Minnesota, Minneapolis, Minnesota
| | - Alan J. Moskowitz
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Emilia Bagiella
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Ellen Moquete
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Karen O’Sullivan
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Mary E. Marks
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Emily Kinzel
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Sarah Burris
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Gabriela Bedoya
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Lola Gupta
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Jessica R. Overbey
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Maria L. Padillia
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | - Milerva Santos
- Cardiothoracic Surgical Trials Network (CTSN) International Coordinating Center (ICC), Icahn School of Medicine at Mount Sinai, New York
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Amy Adams
- University of Virginia Health Systems
| | | | | | | | | | | | | | | | | | | | - Cathryn Oldmixon
- Prevention and Early Treatment of Acute Lung Injury (PETAL) ICC, Massachusetts General Hospital, Boston, Massachusetts
| | - Nancy Ringwood
- Prevention and Early Treatment of Acute Lung Injury (PETAL) ICC, Massachusetts General Hospital, Boston, Massachusetts
| | - Ariela Muzikansky
- Prevention and Early Treatment of Acute Lung Injury (PETAL) ICC, Massachusetts General Hospital, Boston, Massachusetts
| | - Richard Morse
- Prevention and Early Treatment of Acute Lung Injury (PETAL) ICC, Massachusetts General Hospital, Boston, Massachusetts
| | - Roy G. Brower
- PETAL Steering Committee Chair, Johns Hopkins University
| | | | | | | | - Jay H. Steingrub
- ALIGNE Site Coordinating Center (SCC) Lead Investigators, Baystate Medical Center
| | - Peter K. Hou
- ALIGNE Site Coordinating Center (SCC) Lead Investigators, Brigham and Women's Hospital
| | | | | | | | | | | | | | - Daniel Talmor
- Boston SCC Lead Investigators, Beth Israel Deaconess Medical Center
| | - Nathan Shapiro
- Boston SCC Lead Investigators, Beth Israel Deaconess Medical Center
| | | | | | | | | | | | | | | | | | | | | | - Lisa Kurt
- Beth Israel Deaconess Medical Center
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Gregory Hendey
- California SCC Lead Investigators, David Geffen School of Medicine at UCLA
| | - Michael A. Matthay
- University of California San Francisco, University of San Francisco Mount Zion
| | - Kirsten Kangelaris
- University of California San Francisco, University of San Francisco Mount Zion
| | - Kimia Ashktorab
- University of California San Francisco, University of San Francisco Mount Zion
| | - Rachel Gropper
- University of California San Francisco, University of San Francisco Mount Zion
| | - Anika Agrawal
- University of California San Francisco, University of San Francisco Mount Zion
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marc A. Moss
- Colorado SCC Lead Investigators, University of Colorado Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Michelle N. Gong
- Montefiore-Sinai SCC Lead Investigators: Montefiore Medical Center
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Catherine L. Hough
- Pacific Northwest SCC Lead Investigators, Oregon Health & Science University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Todd W. Rice
- Vanderbilt SCC Lead Investigators, Vanderbilt University Medical Center
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jim Wong
- Carilion Roanoke Memorial Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Laura Popielski
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | - Amy Kambo
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | - Kimberley Viens
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | - Melissa Turner
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | - Michael J. Vjecha
- INSIGHT Washington ICC, Veterans Affairs (VA) Medical Center, Washington, DC
| | | | | | | | | | | | | | | | | | | | - Mamta K. Jain
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Tianna Petersen
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dena Kamel
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Laura Hansen
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Angie Garcia
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mina Kim
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Sonia Gonzales
- University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Asa Oxner
- University of South Florida, Tampa General Hospital
| | - Lucy Guerra
- University of South Florida, Tampa General Hospital
| | - Thanh Tran
- University of South Florida, Tampa General Hospital
| | | | | | | | | | | | - Avon Cuenca
- Lundquist Institute for Biomedical Innovation
| | | | - Eric Daar
- Lundquist Institute for Biomedical Innovation
| | | | | | | | | | | | | | | | - Jason V. Baker
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - Anne Frosch
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | | | - Hodan Jibrell
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - Melanie Lo
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | | | - Shari Mackedanz
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - Linh Ngo
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | | | | | | | | | | | | | | | | | | | | | | | | | - Tammy Bremer
- INSIGHT US Department of Veterans Affairs (VA) ICC
| | - Tara Burke
- INSIGHT US Department of Veterans Affairs (VA) ICC
| | | | | | | | | | | | | | - John Van
- Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Laura Dillon
- Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Yiqun Wang
- Michael E. DeBakey VA Medical Center, Houston, Texas
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Kan Lu
- Veterans Affairs Palo Alto Health Care System
| | | | | | | | | | | | | | | | | | | | - Dorthe Raben
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bitten Aagaard
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte B. Nielsen
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Katharina Krapp
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bente Rosdahl Nykjær
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christina Olsson
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Katja Lisa Kanne
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne Louise Grevsen
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Zillah Maria Joensen
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tina Bruun
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ane Bojesen
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Frederik Woldbye
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Nick E. Normand
- INSIGHT Copenhagen ICC, CHIP (Centre of Excellence for Health, Immunity and Infections), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Benfield
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Clara Lundetoft Clausen
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Nichlas Hovmand
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Simone Bastrup Israelsen
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Katrine Iversen
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Caecilie Leding
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Karen Brorup Pedersen
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Louise Thorlacius-Ussing
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Michaela Tinggaard
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | - Sandra Tingsgard
- Denmark Copenhagen University Hospital - Amager and Hvidovre, Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases
| | | | - Rikke Overgaard
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | - Ema Rastoder
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | - Christian Heerfordt
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | - Caroline Hedsund
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | | | | | | | - Christina Bergsoe
- Herlev-Gentofte Hospital, Respiratory Medicine Section, Department of Internal Medicine
| | | | | | | | | | | | - Inge K. Holden
- Odense University Hospital, Department of Infectious Diseases
| | | | - Marie Helleberg
- Dept. of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital
| | - Jan Gerstoft
- Dept. of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital
| | - Ole Kirk
- Dept. of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital
| | - Tina Bruun
- Dept. of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital
| | | | | | | | | | | | | | | | | | | | - Henrik Nielsen
- Aalborg University Hospital, Department of Infectious Diseases
| | | | | | | | - Daria Podlekareva
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Stine Johnsen
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Lothar Wiese
- Department of Infectious Diseases, Zealand University Hospital Roskilde and Department of Internal Medicine, Zealand University Hospital Koge
| | - Lene Surland Knudsen
- Department of Infectious Diseases, Zealand University Hospital Roskilde and Department of Internal Medicine, Zealand University Hospital Koge
| | - Maria Expósito
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - José Badillo
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Ana Martínez
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Elena Abad
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Ana Chamorro
- Spain INSIGHT SCC Spain, Hospital Universitari Germans Trias i Pujol, Badalona
| | - Lourdes Mateu
- Hospital Universitari Germans Trias i Pujol, Badalona
| | - Sergio España
- Hospital Universitari Germans Trias i Pujol, Badalona
| | | | | | - Gemma Lladós
- Hospital Universitari Germans Trias i Pujol, Badalona
| | | | | | | | | | - Sergiu Padure
- Hospital General Universitario Gregorio Marañón, Madrid
| | - Jimena Gomez
- Hospital General Universitario Gregorio Marañón, Madrid
| | | | - Eva Cervilla
- Hospital General Universitario Gregorio Marañón, Madrid
| | | | | | - Paco Lopez
- Hospital General Universitario Gregorio Marañón, Madrid
| | | | - Leire Balerdi
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | - Almudena Legarda
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | - Montserrat Roldan
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | - Laura Letona
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | - José Muñoz
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona
| | | | | | | | | | | | | | | | | | | | | | | | - E. Orviz
- Hospital Clínico San Carlos, Madrid
| | | | | | | | | | | | | | - Cristina Acosta
- Internal Medicine Department, University Hospital Arnau de Vilanova, Lleida
| | | | - Emily West
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Khadija M’Rabeth-Bensalah
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Mareile L. Eichinger
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Manuela Grüttner-Durmaz
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Christina Grube
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Veronika Zink
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Josefine Goes
- Switzerland Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Tengiz Tsertsvadze
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Akaki Abutidze
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Nikoloz Chkhartishvili
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Revaz Metchurtchlishvili
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Marina Endeladze
- Georgia SCC, Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | | | | | | | - Piotr Pulik
- Poland SCC, Wojewodzki Szpital Zakazny Warsaw
| | | | - Roman Fishchuk
- Ukraine Central City Clinical Hospital of Ivano-Frankivsk City, Ukraine
| | - Olena Kobrynska
- Ukraine Central City Clinical Hospital of Ivano-Frankivsk City, Ukraine
| | | | - Ivanna Kirieieva
- Ukraine Central City Clinical Hospital of Ivano-Frankivsk City, Ukraine
| | - Mykhailo Kuziuk
- Ukraine Central City Clinical Hospital of Ivano-Frankivsk City, Ukraine
| | - Mark Polizzotto
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Catherine Carey
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Nila J. Dharan
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sally Hough
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sophie Virachit
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Sarah Davidson
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Daniel J. Bice
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Katherine Ognenovska
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Gesalit Cabrera
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Ruth Flynn
- INSIGHT Sydney ICC, The Kirby Institute, University of New South Wales, Sydney, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcelo H. Losso
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Cecilia Abela
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Renzo Moretto
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Carlos G. Belloc
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Jael Ludueña
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | - Josefina Amar
- INSIGHT SCC Argentina, Coordinación en Investigación Clínica Académica en Latinoamérica
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Clara Salgado
- Centro de Educacion Medica e Investigaciones Clinicas, Buenos Aires
| | - Ines M. Baeck
- Centro de Educacion Medica e Investigaciones Clinicas, Buenos Aires
| | | | - Stella M. Zarza
- Centro de Educacion Medica e Investigaciones Clinicas, Buenos Aires
| | - Mahesh K.B. Parmar
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - Anna L. Goodman
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - Adam Gregory
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - Katharine Goodall
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - Nicola Harris
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | - James Wyncoll
- INSIGHT London ICC, MRC Clinical Trials Unit at UC, London, United Kingdom
| | | | | | | | - E. Witele
- United Kingdom SCC: Royal Free Hospital
| | | | | | | | | | | | | | | | | | - Nikos Pantazis
- Greece SCC, Medical School, National & Kapodistrian University of Athens
| | - Vicky Gioukari
- Greece SCC, Medical School, National & Kapodistrian University of Athens
| | - Tania Souliou
- Greece SCC, Medical School, National & Kapodistrian University of Athens
| | - A. Antoniadou
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - D. Kavatha
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - S. Grigoropoulou
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - R.N. Tziolos
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - C. Oikonomopoulo
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - C. Moschopoulos
- Attikon University General Hospital, Medical School, National & Kapodistrian University of Athens
| | - K. Tzimopoulos
- Sotiria General Hospital, Medical School, National & Kapodistrian University of Athens
| | - A. Koromilias
- Sotiria General Hospital, Medical School, National & Kapodistrian University of Athens
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Arias-Alpízar K, Sánchez-Cano A, Prat-Trunas J, Sulleiro E, Bosch-Nicolau P, Salvador F, Oliveira I, Molina I, Sánchez-Montalvá A, Baldrich E. Magnetic Bead Handling Using a Paper-Based Device for Quantitative Point-of-Care Testing. Biosensors (Basel) 2022; 12:680. [PMID: 36140066 PMCID: PMC9496280 DOI: 10.3390/bios12090680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 06/16/2023]
Abstract
Microfluidic paper-based analytical devices (μPADs) have been extensively proposed as ideal tools for point-of-care (POC) testing with minimal user training and technical requirements. However, most μPADs use dried bioreagents, which complicate production, reduce device reproducibility and stability, and require transport and storage under temperature and humidity-controlled conditions. In this work, we propose a μPAD produced using an affordable craft-cutter and stored at room temperature, which is used to partially automate a single-step colorimetric magneto-immunoassay. As a proof-of-concept, the μPAD has been applied to the quantitative detection of Plasmodium falciparum lactate dehydrogenase (Pf-LDH), a biomarker of malaria infection. In this system, detection is based on a single-step magneto-immunoassay that consists of a single 5-min incubation of the lysed blood sample with immuno-modified magnetic beads (MB), detection antibody, and an enzymatic signal amplifier (Poly-HRP). This mixture is then transferred to a single-piece paper device where, after on-chip MB magnetic concentration and washing, signal generation is achieved by adding a chromogenic enzyme substrate. The colorimetric readout is achieved by the naked eye or using a smartphone camera and free software for image analysis. This μPAD afforded quantitative Pf-LDH detection in <15 min, with a detection limit of 6.25 ng mL−1 when the result was interpreted by the naked eye and 1.4 ng mL−1 when analysed using the smartphone imaging system. Moreover, the study of a battery of clinical samples revealed concentrations of Pf-LDH that correlated with those provided by the reference ELISA and with better sensitivity than a commercial rapid diagnostic test (RDT). These results demonstrate that magneto-immunoassays can be partly automated by employing a μPAD, achieving a level of handling that approaches the requirements of POC testing.
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Affiliation(s)
- Kevin Arias-Alpízar
- Diagnostic Nanotools Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Ana Sánchez-Cano
- Diagnostic Nanotools Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
| | - Judit Prat-Trunas
- Diagnostic Nanotools Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
| | - Elena Sulleiro
- Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Pau Bosch-Nicolau
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Fernando Salvador
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Inés Oliveira
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Israel Molina
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Adrián Sánchez-Montalvá
- Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- International Health Unit Vall d’Hebron-Drassanes, Vall d’Hebron Hospital Universitari, PROSICS Barcelona, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
| | - Eva Baldrich
- Diagnostic Nanotools Group, Vall d’Hebron Institut de Recerca (VHIR), 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28028 Madrid, Spain
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43
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Guerra-Amor A, Lopez-Gonzalez A, Bosch-Nicolau P, Rodriguez-Acevedo B, Zabalza A, Sulleiro E, Espinosa-Pereiro J, Aznar ML, Salvador F, Sánchez-Montalvá A, Molina I. Case Report: Leishmaniasis in a 33-Year-Old Man with Multiple Sclerosis. Am J Trop Med Hyg 2022; 107:339-341. [PMID: 35895413 PMCID: PMC9393455 DOI: 10.4269/ajtmh.22-0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/31/2022] [Indexed: 08/03/2023] Open
Abstract
Leishmaniasis is a protozoan disease caused by species of genus Leishmania. Immunosuppression increases the risk of severe clinical forms and impairs response to treatment. The expansion of the use of immunomodulatory drugs for different conditions has raised the number of these cases. In this report, we present a case of visceral leishmaniasis in a patient with multiple sclerosis (MS) under fingolimod treatment. He presented with the triad of fever, visceromegaly, and pancytopenia and was diagnosed by the presence of amastigotes in a bone marrow sample. Furthermore, we discuss the previous published cases of MS patients under different immunosuppressant therapies to highlight its risk in endemic areas and suggest a therapeutic approach.
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Affiliation(s)
- Alvaro Guerra-Amor
- Dermatology Department, Hospital Universitari Vall d’Hebrón, Barcelona, Spain
| | - Ane Lopez-Gonzalez
- Pneumology Department, Hospital Universitari Vall d’Hebrón, Barcelona, Spain
| | - Pau Bosch-Nicolau
- Tropical Medicine & International Health Unit Vall d’Hebrón—Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Breogan Rodriguez-Acevedo
- Neurology-Neuroimmunology Service, Multiple Sclerosis Center of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Ana Zabalza
- Neurology-Neuroimmunology Service, Multiple Sclerosis Center of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Elena Sulleiro
- Microbiology Department, University Hospital Vall d’Hebrón, Barcelona, Spain
| | - Juan Espinosa-Pereiro
- Tropical Medicine & International Health Unit Vall d’Hebrón—Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Maria Luisa Aznar
- Tropical Medicine & International Health Unit Vall d’Hebrón—Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Fernando Salvador
- Tropical Medicine & International Health Unit Vall d’Hebrón—Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Adrián Sánchez-Montalvá
- Tropical Medicine & International Health Unit Vall d’Hebrón—Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain
| | - Israel Molina
- Tropical Medicine & International Health Unit Vall d’Hebrón—Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall d’Hebron, Barcelona, Spain
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Sánchez-Montalvá A, Sellarés-Nadal J, Espinosa-Pereiro J, Fernández-Hidalgo N, Pérez-Hoyos S, Salvador F, Durà X, Miarons M, Antón A, Eremiev-Eremiev S, Sempere-González A, Monforte-Pallarés A, Bosch-Nicolau P, Augustin S, Sampol J, Guillén-del-Castillo A, Almirante B. Early outcomes in adults hospitalized with severe SARS-CoV-2 infection receiving tocilizumab. Med Clin (Barc) 2022; 158:509-518. [PMID: 34544604 PMCID: PMC8448395 DOI: 10.1016/j.medcli.2021.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Modulation of the immune system to prevent lung injury is being widely used against the new coronavirus disease (COVID-19). The primary endpoint was mortality at 7 days after tocilizumab administration. Secondary endpoints were admission to the intensive care unit, development of ARDS and respiratory insufficiency among others. METHODS We report the preliminary results from the Vall d'Hebron cohort study at Vall d'Hebron University Hospital, in Barcelona (Spain), including all consecutive patients who had a confirmed SARS-CoV-2 infection and who were treated with tocilizumab until March 25th. RESULTS 82 patients with COVID-19 received at least one dose of tocilizumab. The mean (± SD) age was 59.1 (19.8) years, 63% were male, 22% were of non-Spanish ancestry, and the median (IQR) age-adjusted Charlson index at baseline was 3 (1-4) points. Respiratory failure and ARDS developed in 62 (75.6%) and 45 (54.9%) patients, respectively. Median time from symptom onset to ARDS development was 8 (5-11) days. Mortality at 7 days was 26.8%. Hazard ratio for mortality was 3.3; 95% CI, 1.3-8.5 (age-adjusted hazard ratio for mortality 2.1; 95% CI, 0.8-5.8) if tocilizumab was administered after the onset of ARDS. CONCLUSION Early administration of tocilizumab in patients needing oxygen supplementation may be critical to patient recovery. Our preliminary data could inform bedside decisions until more data regarding the precise timing in of initiation of the treatment with tocilizumab.
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Affiliation(s)
- Adrián Sánchez-Montalvá
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain,International Health Program of the Catalan Institut of Health (PROSICS), Barcelona, Spain,Tropical Medicine Spanish Research Network (RICET), Madrid, Spain,Corresponding author
| | - Júlia Sellarés-Nadal
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan Espinosa-Pereiro
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain,International Health Program of the Catalan Institut of Health (PROSICS), Barcelona, Spain
| | - Nuria Fernández-Hidalgo
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain,Infectous Diseases Spanish Research Network (REIPI), Madrid, Spain
| | | | - Fernando Salvador
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain,International Health Program of the Catalan Institut of Health (PROSICS), Barcelona, Spain,Tropical Medicine Spanish Research Network (RICET), Madrid, Spain
| | - Xavier Durà
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Miarons
- Pharmacy Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrés Antón
- Infectous Diseases Spanish Research Network (REIPI), Madrid, Spain,Microbiology Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Simeón Eremiev-Eremiev
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Abiu Sempere-González
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Arnau Monforte-Pallarés
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pau Bosch-Nicolau
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Salvador Augustin
- Hepatology Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Júlia Sampol
- Pneumology Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alfredo Guillén-del-Castillo
- Internal Medicine Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Benito Almirante
- Infectious Diseases Department, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain,Infectous Diseases Spanish Research Network (REIPI), Madrid, Spain
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Sánchez-Montalvá A, Sellarés-Nadal J, Espinosa-Pereiro J, Fernández-Hidalgo N, Pérez-Hoyos S, Salvador F, Durà X, Miarons M, Antón A, Eremiev-Eremiev S, Sempere-González A, Monforte-Pallarés A, Bosch-Nicolau P, Augustin S, Sampol J, Guillén-del-Castillo A, Almirante B. Early outcomes in adults hospitalized with severe SARS-CoV-2 infection receiving tocilizumab. Medicina Clínica (English Edition) 2022; 158:509-518. [PMID: 35755602 PMCID: PMC9213005 DOI: 10.1016/j.medcle.2021.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/10/2021] [Indexed: 11/26/2022]
Abstract
Background Methods Results Conclusion
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Palomar AM, Molina I, Bocanegra C, Portillo A, Salvador F, Moreno M, Oteo JA. Old zoonotic agents and novel variants of tick-borne microorganisms from Benguela (Angola), July 2017. Parasit Vectors 2022; 15:140. [PMID: 35449022 PMCID: PMC9022410 DOI: 10.1186/s13071-022-05238-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Ticks and tick-borne diseases constitute a real threat for the livestock industry, which is increasing in Angola. In addition, ticks are vectors of zoonoses of public health concern, and scarce information is available from this country. In an effort to contribute to the prevention of zoonotic infectious diseases affecting humans and animals, the molecular screening of certain tick-related microorganisms collected on cattle in Angola was performed under a ‘One Health’ scope. Methods Ticks collected from cattle in Cubal (Benguela Province, Angola) in July 2017 were analysed in pools using specific PCR assays for bacteria (Rickettsia, Anaplasmataceae, Borrelia, Coxiella and Spiroplasma) and protozoa (Theileria and Babesia) detection. Results A total of 124 tick specimens were grouped in 25 pools (two Amblyomma variegatum, three Hyalomma truncatum, 16 Rhipicephalus decoloratus, two Rhipicephalus duttoni, one Rhipicephalus evertsi mimeticus and one Rhipicephalus sp.). The amplified microorganisms were (pools): Rickettsia africae (two A. variegatum and one R. decoloratus), Rickettsia aeschlimannii (three H. truncatum), Ehrlichia spp. (six R. decoloratus), Coxiella spp. (all but H. truncatum), Francisella sp. (one H. truncatum), Spiroplasma sp. closely related to Spiroplasma ixodetis (three R. decoloratus), Babesia bigemina (two R. decoloratus) and Babesia spp. (two A. variegatum). The obtained nucleotide sequences from Ehrlichia spp., two Coxiella genotypes (from R. duttoni and Rhipicephalus sp.), Francisella sp. and Babesia spp. (from A. variegatum) reached low identities with known genetically characterized species. Conclusions This study demonstrates the circulation in Angola of the pathogen R. aeschlimannii and potential novel tick-related microorganisms belonging to Ehrlichia, Coxiella, Francisella, Spiroplasma and Babesia spp. and corroborates the presence of R. africae and B. bigemina. Our results should be considered in developing protocols for the management of fever of unknown origin and for veterinary practices. Further studies are required to evaluate the risk of tick-borne diseases in Angola. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05238-2.
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Affiliation(s)
- Ana M Palomar
- Infectious Diseases Department, Center of Rickettsiosis and Arthropod-Borne Diseases (CRETAV), San Pedro University Hospital-Center of Biomedical Research From La Rioja (CIBIR), Piqueras, 98, 26006, Logroño, La Rioja, Spain
| | - Israel Molina
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08035, Barcelona, Spain
| | - Cristina Bocanegra
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08035, Barcelona, Spain
| | - Aránzazu Portillo
- Infectious Diseases Department, Center of Rickettsiosis and Arthropod-Borne Diseases (CRETAV), San Pedro University Hospital-Center of Biomedical Research From La Rioja (CIBIR), Piqueras, 98, 26006, Logroño, La Rioja, Spain
| | - Fernando Salvador
- Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, 08035, Barcelona, Spain
| | | | - José A Oteo
- Infectious Diseases Department, Center of Rickettsiosis and Arthropod-Borne Diseases (CRETAV), San Pedro University Hospital-Center of Biomedical Research From La Rioja (CIBIR), Piqueras, 98, 26006, Logroño, La Rioja, Spain.
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Miguel Cejalvo J, Falato C, Villanueva L, Tolosa P, González X, Pascal M, Canes J, Gavilá J, Manso L, Pascual T, Prat A, Salvador F. Oncolytic Viruses: a new immunotherapeutic approach for breast cancer treatment? Cancer Treat Rev 2022; 106:102392. [DOI: 10.1016/j.ctrv.2022.102392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 12/22/2022]
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Balogun O, Brown A, Angelo KM, Hochberg NS, Barnett ED, Nicolini LA, Asgeirsson H, Grobusch MP, Leder K, Salvador F, Chen L, Odolini S, Díaz-Menéndez M, Gobbi F, Connor BA, Libman M, Hamer DH. Acute hepatitis A in international travellers: a GeoSentinel analysis, 2008-2020. J Travel Med 2022; 29:6520887. [PMID: 35134210 PMCID: PMC9383360 DOI: 10.1093/jtm/taac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Non-immune international travellers are at risk of acquiring hepatitis A. Although hepatitis A vaccination is recommended for unvaccinated travellers to high or intermediate hepatitis A virus endemicity, compliance with this recommendation is not universal.The main objective was to describe the demographic and travel characteristics of international travellers infected with hepatitis A during travel. METHODS Available data on travellers with confirmed (positive molecular test) or probable (symptomatic individuals with a single positive IgM test) hepatitis A diagnosed during and after travel from January 2008 to December 2020 were obtained from the GeoSentinel Surveillance Network database. We analysed demographic and travel characteristics of infected travellers. RESULTS Among 254 travellers with hepatitis A (185 confirmed and 69 probable), the median age was 28 years (interquartile range: 19-40), 150 (59%) were male, and among 54 travellers with information available, 53 (98%) were unvaccinated. The most common reasons for travel included tourism (n = 120; 47%) and visiting friends or relatives (VFR; n = 72; 28%). About two-thirds of VFR travellers with hepatitis A (n = 50; 69%) were younger than 20 years old. Hepatitis A was acquired most frequently in South-Central Asia (n = 63; 25%) and sub-Saharan Africa (n = 61; 24%), but 16 travellers (6%) acquired hepatitis A in regions with low endemicity including Western Europe (n = 7; 3%), the Caribbean (n = 6; 2%) and North America (n = 3; 1%). Median duration from illness onset to GeoSentinel site presentation was ~7 days (interquartile range : 4-14 days). Among 88 travellers with information available, 59% were hospitalized. CONCLUSIONS Despite availability of highly effective vaccines, travellers still acquire hepatitis A, even when traveling to low-endemicity destinations. Providing pre-departure hepatitis A vaccine to susceptible travellers is crucial to reducing travel-associated hepatitis A and should be offered to all travellers as part of the pre-travel consultation, regardless of destination.
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Affiliation(s)
- Oluwafemi Balogun
- Bureau of Infectious Disease and Laboratory Services, Massachusetts Department of Public Health, Boston, MA, USA.,Department of Medicine, Massachusetts General Hospital and Harvard Medical School
| | - Ashley Brown
- Travelers' Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristina M Angelo
- Travelers' Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Natasha S Hochberg
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Elizabeth D Barnett
- Section of Pediatric Infectious Diseases, Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
| | | | - Hilmir Asgeirsson
- Department of Infectious Diseases, Karolinska University Hospital and Karolinska Institutet
| | - Martin P Grobusch
- Department of Infectious Diseases, Division of Internal Medicine, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, PO Box 22660, Amsterdam, The Netherlands 1100DD
| | - Karin Leder
- Victorian Infectious Diseases Service (VIDS), Royal Melbourne Hospital, Melbourne, Australia Infectious Disease Epidemiology Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Spain
| | - Lin Chen
- Mount Auburn Hospital, Cambridge, MA, and Harvard Medical School, Boston, 02115, MA, USA
| | - Silvia Odolini
- University Division of Infectious and Tropical Diseases, University of Brescia and Spedali Civili General Hospital, Brescia, Italy
| | - Marta Díaz-Menéndez
- National Referral Unit for Imported Tropical Diseases, Tropical & Travel medicine Unit, Infectious Diseases Department, La Paz- Carlos III University Hospital-IdiPAZ, Paseo de la Castellana, 261 28046 Madrid, Spain
| | - Federico Gobbi
- Department of Infectious-Tropical Diseases and Microbiology (DITM), IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Bradley A Connor
- Weill Cornell Medical College and the New York Center for Travel and Tropical Medicine
| | - Michael Libman
- J.D. MacLean Centre for Tropical Diseases, McGill University Health Centre, 1001 Decarie Blvd, Montreal, H4A 3J1, Canada
| | - Davidson H Hamer
- Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.,Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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Salvador F, Escolà-Vergé L, Barios M, Belhassen-Garcia M, Tamayo-Alonso P, Sánchez-Montalvá A, Romero-Alegría Á, Simó M, Garcia-Talavera P, Bosch-Nicolau P, Espinosa-Pereiro J, Molina I. Usefulness of the FDG PET/CT in the management of cystic echinococcosis: A pilot study. Acta Trop 2022; 227:106295. [PMID: 34954257 DOI: 10.1016/j.actatropica.2021.106295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Cystic echinococcosis is a zoonotic disease caused by the cestode Echinococcus granulosus. The activity of the cysts is assessed through the WHO-IWGE standardized classification based on ultrasound features. However, viability of the cysts is not always concordant with the activity assessed by ultrasound. The aim of the present study is to describe the metabolic activity of cysts in patients with cystic echinococcosis through FDG-PET. METHODS Prospective observational study where adult patients diagnosed of cystic echinococcosis were offered to undergo FDG PET/CT before treatment onset. Demographic, clinical, radiological, and histopathological information was collected from all patients. RESULTS Sixteen patients were included, 50% were male, and age ranged from 18 to 85 years. Most of the patients had liver involvement, and all patients had CE3, CE4 or CE5 stage of the WHO-IWGE classification. Only one patient (CE5) had an increased 18F-FDG uptake of the cyst in the FDG PET/CT. From the 5 patients who underwent surgical treatment, only one showed signs of viability of the cyst: a patient with CE5 with no increased 18F-FDG uptake of the cyst. CONCLUSION In our pilot study, we did not find the correlation between the FDG PET/CT imaging and the cystic echinococcosis cyst bioactivity.
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Affiliation(s)
- Fernando Salvador
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.
| | - Laura Escolà-Vergé
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Marta Barios
- Nuclear Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Moncef Belhassen-Garcia
- Infectious Diseases Unit, Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain
| | - Pilar Tamayo-Alonso
- Nuclear Medicine Department, University Hospital of Salamanca, Salamanca, Spain
| | - Adrián Sánchez-Montalvá
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Ángela Romero-Alegría
- Infectious Diseases Unit, Internal Medicine Department, University Hospital of Salamanca, Salamanca, Spain
| | - Marc Simó
- Nuclear Medicine Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - Pau Bosch-Nicolau
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Juan Espinosa-Pereiro
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
| | - Israel Molina
- Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain
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Ciruelos E, Muñoz M, Oliveira M, Chic N, Hernando C, Viruzuela JA, Vázquez S, Blanch S, Paré L, Salvador F, Villagrasa P, Pascual T, Prat A. Abstract OT1-17-01: Solti-1716. Targeting with pembrolizumab + paclitaxel non-luminal by PAM50 hormone receptor-positive/HER2-negative advanced/metastatic breast cancer patients who have progressed on or after CDK4/6 inhibitor treatment (TATEN trial). Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-ot1-17-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background.Patients with metastatic hormone receptor-positive/HER2-negative (HR+/HER2-) breast cancer (BC) are usually treated with CDK4/6 inhibitors combined with endocrine therapy (ET) as first line treatment. The addition of CDK4/6 inhibitors to endocrine therapy has demonstrated improved progression free survival (PFS), overall response rate (ORR) and, more recently, overall survival (OS). However, there is a 20% of patients who do not benefit from these drugs and those who respond eventually progress to the treatment, for whom no standard treatment exists. The information provided by the intrinsic subtypes (PAM50) highlight the potential value of BC molecular classification as a prognosis and predictive marker. Within HR+/HER2- disease, patients with non-luminal subtypes (HER2-enriched and Basal-like) present poorer prognosis than those with luminal subtypes, may be more sensitive to chemotherapy, and have higher expression of immune-related genes and tumor infiltrating lymphocytes (TILs). Recently, immunotherapy has been approved for treating metastatic triple negative (TN) BC and several trials evaluating the action of immune checkpoint inhibitors are ongoing both in TN and in HR+/HER2- BC. TATEN study aims to evaluate the combination of pembrolizumab and chemotherapy in metastatic HR+/HER2-negative, PAM50 non-luminal BC.Study design. TATEN is an open-label, single arm, multicenter phase II study evaluating pembrolizumab in combination with paclitaxel in patients with locally advanced or metastatic PAM50 non-luminal HR+/HER2- BC who had recurrence or progression after therapy with a CDK4/6 inhibitor plus endocrine therapy. Tumor samples collected during advanced/metastatic disease are mandatory. No prior chemotherapy for inoperable locally advanced or metastatic BC is permitted. Eligible patients will receive pembrolizumab 200 mg every 3 weeks (on day 1 of each 21-day cycle, beginning in Cycle 1) in combination with paclitaxel 80 mg/m2 administered at days 1, 8, 15 of each 21-day cycle beginning at cycle 2. The primary endpoint of the study is to evaluate ORR according to RECIST V1.1. The study will use a Simon’s 2-stage design and will include up to 46 evaluable patients. If 6 or more responses are observed in up to 15 patients in the first stage, the trial will continue to the second stage and 31 additional patients may be evaluated for a total of 46 evaluable patients. The null hypothesis will be rejected if 19 or more responses are observed. Tumor assessments will be performed every 9 weeks. Secondary endpoints include clinical benefit rate (CBR), PFS, duration of response (DoR), time to response (TtR), OS, as well as the correlation of clinical benefit (ORR, PFS) with PD1 mRNA expression and early dynamic changes in ctDNA after 1 cycle of pembrolizumab (collection of blood samples at Cycle 1 Day 1, Cycle 2 Day 1 and end of treatment are mandatory). Safety and tolerability of the combination will also be assessed. Exploratory objectives include to determine ORR, PFS, DoR and TtR based on iRECIST and to identify predictive biomarkers of response to pembrolizumab plus paclitaxel. As of July 2021, 10 patients have been enrolled in 7 sites in Spain. Clinical trial identification: NCT04251169. Acknowledgements:This study is financially supported by MSD
Citation Format: Eva Ciruelos, Montserrat Muñoz, Mafalda Oliveira, Nuria Chic, Cristina Hernando, Juan Antonio Viruzuela, Silvia Vázquez, Salvador Blanch, Laia Paré, Fernando Salvador, Patricia Villagrasa, Tomás Pascual, Aleix Prat. Solti-1716. Targeting with pembrolizumab + paclitaxel non-luminal by PAM50 hormone receptor-positive/HER2-negative advanced/metastatic breast cancer patients who have progressed on or after CDK4/6 inhibitor treatment (TATEN trial) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr OT1-17-01.
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Affiliation(s)
- Eva Ciruelos
- SOLTI Breast Cancer Research Group/Hospital 12 de Octubre, Barcelona/Madrid, Spain
| | - Montserrat Muñoz
- SOLTI Breast Cancer Research Group/Hospital Clinic de Barcelona/August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Mafalda Oliveira
- Vall d'Hebron University Hospital/SOLTI Breast Cancer Research Group/Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nuria Chic
- Hospital Clinic de Barcelona, Barcelona, Spain
| | | | | | - Silvia Vázquez
- Hospital Duran i Reynals-Institut Català d’Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Laia Paré
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | | | | | - Tomás Pascual
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - Aleix Prat
- Hospital Clinic de Barcelona/SOLTI Breast Cancer Research Group/August Pi i Sunyer Biomedical Research Institute (IDIBAPS)/Medicine Department, University of Barcelona, Barcelona, Spain
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