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Short CES, Byrne L, Hagan-Bezgin A, Quinlan RA, Anderson J, Brook G, De Alwis O, de Ruiter A, Farrugia P, Fidler S, Hamlyn E, Hartley A, Murphy S, Noble H, Oomeer S, Roedling S, Rosenvinge M, Rubinstein L, Shah R, Singh S, Thorne E, Toby M, Wait B, Sarner L, Taylor GP. Pregnancy Management in HIV Viral Controllers: Twenty Years of Experience. Pathogens 2024; 13:308. [PMID: 38668263 PMCID: PMC11054990 DOI: 10.3390/pathogens13040308] [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: 02/16/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/29/2024] Open
Abstract
(1) Background: The evidence base for the management of spontaneous viral controllers in pregnancy is lacking. We describe the management outcomes of pregnancies in a series of UK women with spontaneous HIV viral control (<100 copies/mL 2 occasions before or after pregnancy off ART). (2) Methods: A multi-centre, retrospective case series (1999-2021) comparing pre- and post-2012 when guidelines departed from zidovudine-monotherapy (ZDVm) as a first-line option. Demographic, virologic, obstetric and neonatal information were anonymised, collated and analysed in SPSS. (3) Results: A total of 49 live births were recorded in 29 women, 35 pre-2012 and 14 post. HIV infection was more commonly diagnosed in first reported pregnancy pre-2012 (15/35) compared to post (2/14), p = 0.10. Pre-2012 pregnancies were predominantly managed with ZDVm (28/35) with pre-labour caesarean section (PLCS) (24/35). Post-2012 4/14 received ZDVm and 10/14 triple ART, p = 0.002. Post-2012 mode of delivery was varied (5 vaginal, 6 PLCS and 3 emergency CS). No intrapartum ZDV infusions were given post-2012 compared to 11/35 deliveries pre-2012. During pregnancy, HIV was detected (> 50 copies/mL) in 14/49 pregnancies (29%) (median 92, range 51-6084). Neonatal ZDV post-exposure prophylaxis was recorded for 45/49 infants. No transmissions were reported. (4) Conclusion: UK practice has been influenced by the change in guidelines, but this has had little impact on CS rates.
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Affiliation(s)
- Charlotte-Eve S. Short
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Imperial College NIHR BRC, Imperial College London, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, London W2 1NY, UK
| | - Laura Byrne
- School of Medicine, St Georges, University of London, London SW17 0RE, UK
- St. George’s University Hospitals NHS Trust, London SW17 0RE, UK
| | - Aishah Hagan-Bezgin
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- School of Medicine, University of Liverpool, Liverpool L69 3GE, UK
| | - Rachael A. Quinlan
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Imperial College NIHR BRC, Imperial College London, London W2 1NY, UK
| | - Jane Anderson
- Homerton Healthcare NHS Foundation Trust, London E9 6SR, UK
- London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK
| | - Gary Brook
- London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK
| | | | - Annemiek de Ruiter
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
- ViiV Healthcare, Brentford TW8 9GS, UK
| | - Pippa Farrugia
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
| | - Sarah Fidler
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Imperial College NIHR BRC, Imperial College London, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, London W2 1NY, UK
| | - Eleanor Hamlyn
- Royal Free London NHS Foundation Trust, London NW3 2QG, UK
| | - Anna Hartley
- Barts Health NHS Trust, London E1 1BB, UK
- Leeds University Teaching Hospital NHS Trust, Leeds LS1 3EX, UK
| | - Siobhan Murphy
- London North West University Healthcare NHS Trust, Harrow HA1 3UJ, UK
| | | | - Soonita Oomeer
- Imperial College Healthcare NHS Trust, London W2 1NY, UK
- Central and North West London NHS Foundation Trust, London NW1 3AX, UK
| | - Sherie Roedling
- Central and North West London NHS Foundation Trust, London NW1 3AX, UK
| | | | | | - Rimi Shah
- Royal Free London NHS Foundation Trust, London NW3 2QG, UK
| | | | - Elizabeth Thorne
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Imperial College Healthcare NHS Trust, London W2 1NY, UK
| | | | - Brenton Wait
- Homerton Healthcare NHS Foundation Trust, London E9 6SR, UK
| | | | - Graham P. Taylor
- Department of Infectious Disease, Imperial College London, London W2 1PG, UK
- Imperial College NIHR BRC, Imperial College London, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, London W2 1NY, UK
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Crone MA, Hakki S, Fenn J, Zhou J, Oliveira CRD, Madon KJ, Koycheva A, Badhan A, Jonnerby J, Nevin S, Conibear E, Derelle R, Varro R, Luca C, Ahmad S, Zambon M, Barclay WS, Dunning J, Freemont PS, Taylor GP, Lalvani A. Rapid emergence of transmissible SARS-CoV-2 variants in mild community cases. Microbiol Spectr 2024; 12:e0363423. [PMID: 38483161 DOI: 10.1128/spectrum.03634-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/06/2024] [Indexed: 04/06/2024] Open
Affiliation(s)
- Michael A Crone
- Section of Structural and Synthetic Biology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, United Kingdom
- London Biofoundry, Imperial College Translation and Innovation Hub, London, United Kingdom
| | - Seran Hakki
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Joe Fenn
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Jie Zhou
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | | | - Kieran J Madon
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Aleksandra Koycheva
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Anjna Badhan
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Jakob Jonnerby
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Sean Nevin
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Emily Conibear
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Romain Derelle
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Robert Varro
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Constanta Luca
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Shazaad Ahmad
- Department of Virology, Manchester Medical Microbiology Partnership, Manchester Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Maria Zambon
- UK Health Security Agency, London, United Kingdom
| | - Wendy S Barclay
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Jake Dunning
- UK Health Security Agency, London, United Kingdom
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Oxford, Oxford, United Kingdom
| | - Paul S Freemont
- Section of Structural and Synthetic Biology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, United Kingdom
- London Biofoundry, Imperial College Translation and Innovation Hub, London, United Kingdom
| | - Graham P Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Ajit Lalvani
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, United Kingdom
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Mahdifar M, Boostani R, Taylor GP, Rezaee SA, Rafatpanah H. Comprehensive Insight into the Functional Roles of NK and NKT Cells in HTLV-1-Associated Diseases and Asymptomatic Carriers. Mol Neurobiol 2024:10.1007/s12035-024-03999-8. [PMID: 38436833 DOI: 10.1007/s12035-024-03999-8] [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: 06/13/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Abstract
Human T cell leukemia virus type 1 (HTLV-1) is the first human oncogenic retrovirus to be discovered and causes two major diseases: a progressive neuro-inflammatory disease, termed HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP), and an aggressive malignancy of T lymphocytes known as adult T cell leukemia (ATL). Innate and acquired immune responses play pivotal roles in controlling the status of HTLV-1-infected cells and such, the outcome of HTLV-1 infection. Natural killer cells (NKCs) are the effector cells of the innate immune system and are involved in controlling viral infections and several types of cancers. The ability of NKCs to trigger cytotoxicity to provide surveillance against viruses and cancer depends on the balance between the inhibitory and activating signals. In this review, we will discuss NKC function and the alterations in the frequency of these cells in HTLV-1 infection.
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Affiliation(s)
- Maryam Mahdifar
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Boostani
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Graham P Taylor
- Section of Infectious Diseases, Department of Medicine, Imperial College London, London, UK
| | - Seyed Abdolrahim Rezaee
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Houshang Rafatpanah
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ramesh N, Cockbain B, Taylor GP, Rosadas C. How do socioeconomic determinants of health affect the likelihood of living with HTLV-1 globally? A systematic review with meta-analysis. Front Public Health 2024; 12:1298308. [PMID: 38327581 PMCID: PMC10848500 DOI: 10.3389/fpubh.2024.1298308] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Human T Lymphotropic Virus type 1 (HTLV-1) is a neglected retrovirus associated with many clinical disorders, most notably Adult T-cell Leukemia/Lymphoma and HTLV-1-Associated Myelopathy (HAM). Found in endemic clusters across the world, high prevalence has been reported in minoritized groups who suffer from health inequities. This study investigates the association between HTLV-1 prevalence and the following socioeconomic determinants of health: education, income, and employment, which are markers of health inequity. Methods A systematic review was conducted by searching the following databases: Ovid/Medline, Embase, Global Health Database, Web of Science, LILACS and SciELO. Primary studies in English, Spanish and Portuguese mentioning HTLV-1 and one of education, income and/or employment were included. A random-effects meta-analysis was performed, and odds ratios (OR) were calculated to determine the association between these socioeconomic determinants of health and HTLV-1 prevalence. Results 42 studies were included. The likelihood of having HTLV-1 was higher in individuals with less than completed primary education compared to those who completed primary education (OR 1.86 [95% CI 1.34-2.57]; p < 0.01). This may be because individuals with low education have reduced access to and understanding of health information, thus increasing the prevalence of risk factors associated with HTLV-1 infection. No other determinants were found to be statistically significant. Conclusion Fewer years of schooling are associated with increased likelihood of contracting HTLV-1. Therefore, health promotion materials and public health policies regarding HTLV-1 must consider those with lower educational levels to effectively reduce disease transmission. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335004, identifier (CRD42022335004).
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Affiliation(s)
- Nydile Ramesh
- School of Public Health, Imperial College London, London, United Kingdom
| | - Beatrice Cockbain
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
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5
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Maher AK, Aristodemou A, Giang N, Tanaka Y, Bangham CR, Taylor GP, Dominguez-Villar M. HTLV-1 induces an inflammatory CD4+CD8+ T cell population in HTLV-1-associated myelopathy. JCI Insight 2024; 9:e173738. [PMID: 38193535 PMCID: PMC10906466 DOI: 10.1172/jci.insight.173738] [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: 07/06/2023] [Accepted: 11/15/2023] [Indexed: 01/10/2024] Open
Abstract
Human T cell leukemia virus type 1 (HTLV-1) is a retrovirus with preferential CD4+ T cell tropism that causes a range of conditions spanning from asymptomatic infection to adult T cell leukemia and HTLV-1-associated myelopathy (HAM), an inflammatory disease of the CNS. The mechanisms by which HTLV-1 induces HAM are poorly understood. By directly examining the ex vivo phenotype and function of T cells from asymptomatic carriers and patients with HAM, we show that patients with HAM have a higher frequency of CD4+CD8+ double-positive (DP) T cells, which are infected with HTLV-1 at higher rates than CD4+ T cells. Displaying both helper and cytotoxic phenotypes, these DP T cells are highly proinflammatory and contain high frequencies of HTLV-1-specific cells. Mechanistically, we demonstrate that DP T cells arise by direct HTLV-1 infection of CD4+ and CD8+ T cells. High levels of CD49d and CXCR3 expression suggest that DP T cells possess the ability to migrate to the CNS, and when cocultured with astrocytes, DP T cells induce proinflammatory astrocytes that express high levels of CXCL10, IFN-γ, and IL-6. These results demonstrate the potential of DP T cells to directly contribute to CNS pathology.
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Affiliation(s)
- Allison K. Maher
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Aris Aristodemou
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Nicolas Giang
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Yuetsu Tanaka
- Laboratory of Hematoimmunology, Graduate School of Health Sciences, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Charles R.M. Bangham
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
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Adonis A, Russell A, Taylor GP, Preston M, Shields A, Strachan S, Young S, Diallo H, Ashford S, Cassidy E. Patient research priority setting partnership in human T-cell lymphotropic virus type I. Health Expect 2023; 26:2418-2427. [PMID: 37578191 PMCID: PMC10632630 DOI: 10.1111/hex.13848] [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: 11/08/2022] [Revised: 07/27/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023] Open
Abstract
INTRODUCTION Human T-cell lymphotropic virus type 1 (HTLV-1) is a chronic infection affecting 5-10 million people worldwide. Ten percent develop HTLV-1-associated diseases, and 3%-5% develop HTLV-1-associated myelopathy (HAM)/tropical spastic paraparesis. Low health-related quality of life (HRQoL) is a significant concern for those with HTLV-1, and little is known about how it impacts daily life or what patients need from healthcare services. To address this, we report on patient involvement workshops aimed at identifying research priorities for HTLV-1 health service provision. METHODS Participants recruited through HTLV-1 clinics in England attended six 90-min virtual workshops over 10 months, and two 60-min consolidation workshops. Content developed iteratively from topic focussed group discussions. All workshops were video-recorded with consent, transcribed verbatim and thematically analysed. Using consensus voting rounds, participants individually ranked their top six and then collectively their top three research priorities from the themes inferred from the analysis. A final feedback session explored the experiences of participating in the workshops. FINDINGS Twenty-seven people with HTLV-1 engaged with the workshops with up to 22 participants attending each meeting. The majority were diagnosed with HAM (n = 22). The top three research priorities were identified as understanding disease progression, psychosocial wellbeing, and information and knowledge. Participants valued being asked to set research priorities that directly addressed their needs and enjoyed the workshops. They stressed the importance of patient advocates for promoting research that positively impacts everyday life. CONCLUSION This is the first of this type of research engagement with people with HTLV-1 in the United Kingdom. Participants identified several avenues of investigation that could lead to improvements in healthcare services and HRQoL. Participants believed the workshops signified the start of a conversation to progress person-centred and meaningful research in HTLV-1. PATIENT OR PUBLIC CONTRIBUTION People living with HTLV-1 were involved in the iterative design, conduct, analysis, writing and dissemination of this project through the patient involvement workshops. As a result of this engagement, a patient led advisory group has been set up to assist with the dissemination of the findings.
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Affiliation(s)
- Adine Adonis
- National Centre for Human Retrovirology, Imperial College Healthcare NHS TrustLondonUK
| | | | - Graham P. Taylor
- National Centre for Human Retrovirology, Imperial College Healthcare NHS TrustLondonUK
- Imperial College London, Faculty of MedicineLondonUK
| | | | | | | | | | | | - Stephen Ashford
- The Regional Hyper‑Acute Rehabilitation UnitNorthwick Park Hospital, London North West University Healthcare NHS TrustLondonUK
- Department of Palliative Care, Policy and RehabilitationThe Cicely Saunders Institute, King's College LondonLondonUK
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Ren R, Cai S, Fang X, Wang X, Zhang Z, Damiani M, Hudlerova C, Rosa A, Hope J, Cook NJ, Gorelkin P, Erofeev A, Novak P, Badhan A, Crone M, Freemont P, Taylor GP, Tang L, Edwards C, Shevchuk A, Cherepanov P, Luo Z, Tan W, Korchev Y, Ivanov AP, Edel JB. Multiplexed detection of viral antigen and RNA using nanopore sensing and encoded molecular probes. Nat Commun 2023; 14:7362. [PMID: 37963924 PMCID: PMC10646045 DOI: 10.1038/s41467-023-43004-9] [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: 02/21/2023] [Accepted: 10/27/2023] [Indexed: 11/16/2023] Open
Abstract
We report on single-molecule nanopore sensing combined with position-encoded DNA molecular probes, with chemistry tuned to simultaneously identify various antigen proteins and multiple RNA gene fragments of SARS-CoV-2 with high sensitivity and selectivity. We show that this sensing strategy can directly detect spike (S) and nucleocapsid (N) proteins in unprocessed human saliva. Moreover, our approach enables the identification of RNA fragments from patient samples using nasal/throat swabs, enabling the identification of critical mutations such as D614G, G446S, or Y144del among viral variants. In particular, it can detect and discriminate between SARS-CoV-2 lineages of wild-type B.1.1.7 (Alpha), B.1.617.2 (Delta), and B.1.1.539 (Omicron) within a single measurement without the need for nucleic acid sequencing. The sensing strategy of the molecular probes is easily adaptable to other viral targets and diseases and can be expanded depending on the application required.
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Affiliation(s)
- Ren Ren
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, 82 Wood Lane, London, W12 0BZ, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - Shenglin Cai
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, 82 Wood Lane, London, W12 0BZ, UK.
- Yusuf Hamied Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge, CB2 1EW, UK.
| | - Xiaona Fang
- The Key Laboratory of Zhejiang Province for Aptamers and Theranostics, Aptamer Selection Center, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, 310022, Hangzhou, Zhejiang, China
| | - Xiaoyi Wang
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, 82 Wood Lane, London, W12 0BZ, UK
| | - Zheng Zhang
- The Key Laboratory of Zhejiang Province for Aptamers and Theranostics, Aptamer Selection Center, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, 310022, Hangzhou, Zhejiang, China
| | - Micol Damiani
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, 82 Wood Lane, London, W12 0BZ, UK
| | - Charlotte Hudlerova
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, 82 Wood Lane, London, W12 0BZ, UK
| | - Annachiara Rosa
- The Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
- Wolfson Education Centre, Faculty of Medicine, Imperial College London, London, UK
| | - Joshua Hope
- The Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Nicola J Cook
- The Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Peter Gorelkin
- National University of Science and Technology "MISIS", Leninskiy Prospect 4, 119991, Moscow, Russian Federation
| | - Alexander Erofeev
- National University of Science and Technology "MISIS", Leninskiy Prospect 4, 119991, Moscow, Russian Federation
| | - Pavel Novak
- ICAPPIC Limited, The Fisheries, Mentmore Terrace, London, E8 3PN, UK
| | - Anjna Badhan
- Molecular Diagnostic Unit, Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Michael Crone
- Section of Structural and Synthetic Biology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Paul Freemont
- Section of Structural and Synthetic Biology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Graham P Taylor
- Molecular Diagnostic Unit, Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Longhua Tang
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, International Research Center for Advanced Photonics, Zhejiang University, 310027, Hangzhou, China
| | - Christopher Edwards
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
- ICAPPIC Limited, The Fisheries, Mentmore Terrace, London, E8 3PN, UK
| | - Andrew Shevchuk
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
| | - Peter Cherepanov
- The Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
- Molecular Diagnostic Unit, Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Zhaofeng Luo
- The Key Laboratory of Zhejiang Province for Aptamers and Theranostics, Aptamer Selection Center, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, 310022, Hangzhou, Zhejiang, China
| | - Weihong Tan
- The Key Laboratory of Zhejiang Province for Aptamers and Theranostics, Aptamer Selection Center, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, 310022, Hangzhou, Zhejiang, China.
| | - Yuri Korchev
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK
- Nano Life Science Institute (WPI-NanoLSI), Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Aleksandar P Ivanov
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, 82 Wood Lane, London, W12 0BZ, UK.
| | - Joshua B Edel
- Department of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, 82 Wood Lane, London, W12 0BZ, UK.
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Cockbain B, Rosadas C, Taylor GP. HTLV-1 as a contributing factor towards scabies and its systemic sequelae. J Glob Health 2023; 13:03057. [PMID: 37921043 PMCID: PMC10623376 DOI: 10.7189/jogh.13.03057] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Affiliation(s)
- Beatrice Cockbain
- Department of Infectious Disease, Imperial College London, London, England, UK
- Chelsea and Westminster NHS Foundation Trust, London, England, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Imperial College London, London, England, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, London, England, UK
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, England, UK
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Rosadas C, Harvala H, Davison K, Taylor GP. HTLV-1 screening of blood donations: We are systematically missing opportunities. Br J Haematol 2023; 202:1220-1223. [PMID: 37487701 DOI: 10.1111/bjh.18988] [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] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Heli Harvala
- National Health Service Blood and Transplant, London, UK
| | - Katy Davison
- NHS Blood and Transplant (NHSBT) and UK Health Security Agency (UKHSA) Epidemiology Unit, UKHSA, London, UK
| | - Graham P Taylor
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
- National Centre for Human Retrovirology, Imperial College NHS Trust, St Mary's Hospital, London, UK
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Davies NWS, Taylor GP. Targeted immunotherapy for HTLV-1-associated myelopathy: a step in the right direction. Brain 2023; 146:3114-3116. [PMID: 37459435 DOI: 10.1093/brain/awad229] [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] [Received: 07/04/2023] [Accepted: 07/04/2023] [Indexed: 08/03/2023] Open
Abstract
This scientific commentary refers to ‘Long-term safety and efficacy of mogamulizumab (anti-CCR4) for treating virus-associated myelopathy’ by Sato et al. (https://doi.org/10.1093/brain/awad139).
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Affiliation(s)
- Nicholas W S Davies
- National Centre for Human Retrovirology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Graham P Taylor
- National Centre for Human Retrovirology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, W2 1NY, UK
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
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11
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Aristodemou AEN, Rueda DS, Taylor GP, Bangham CRM. The transcriptome of HTLV-1-infected primary cells following reactivation reveals changes to host gene expression central to the proviral life cycle. PLoS Pathog 2023; 19:e1011494. [PMID: 37523412 PMCID: PMC10431621 DOI: 10.1371/journal.ppat.1011494] [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: 01/16/2023] [Revised: 08/16/2023] [Accepted: 06/19/2023] [Indexed: 08/02/2023] Open
Abstract
Infections by Human T cell Leukaemia Virus type 1 (HTLV-1) persist for the lifetime of the host by integrating into the genome of CD4+ T cells. Proviral gene expression is essential for proviral survival and the maintenance of the proviral load, through the pro-proliferative changes it induces in infected cells. Despite their role in HTLV-1 infection and a persistent cytotoxic T lymphocyte response raised against the virus, proviral transcripts from the sense-strand are rarely detected in fresh cells extracted from the peripheral blood, and have recently been found to be expressed intermittently by a small subset of cells at a given time. Ex vivo culture of infected cells prompts synchronised proviral expression in infected cells from peripheral blood, allowing the study of factors involved in reactivation in primary cells. Here, we used bulk RNA-seq to examine the host transcriptome over six days in vitro, following proviral reactivation in primary peripheral CD4+ T cells isolated from subjects with non-malignant HTLV-1 infection. Infected cells displayed a conserved response to reactivation, characterised by discrete stages of gene expression, cell division and subsequently horizontal transmission of the virus. We observed widespread changes in Polycomb gene expression following reactivation, including an increase in PRC2 transcript levels and diverse changes in the expression of PRC1 components. We hypothesize that these transcriptional changes constitute a negative feedback loop that maintains proviral latency by re-deposition of H2AK119ub1 following the end of proviral expression. Using RNAi, we found that certain deubiquitinases, BAP1, USP14 and OTUD5 each promote proviral transcription. These data demonstrate the detailed trajectory of HTLV-1 proviral reactivation in primary HTLV-1-carrier lymphocytes and the impact on the host cell.
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Affiliation(s)
- Aris E. N. Aristodemou
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - David S. Rueda
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
- Single Molecule Imaging Group, MRC-London Institute of Medical Sciences, London, United Kingdom
| | - Graham P. Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Charles R. M. Bangham
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
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12
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Rosadas C, Taylor GP. Pre-analytical long-term stability of neopterin and neurofilament light in stored cerebrospinal fluid samples. Clin Chem Lab Med 2023; 61:1230-1234. [PMID: 36692943 DOI: 10.1515/cclm-2022-0904] [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: 09/13/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of long-term sample storage on the concentrations of neopterin and neurofilament light (Nfl) in cerebrospinal fluid (CSF) samples. These are useful markers of neuroinflammation and neuronal damage and have been applied as biomarkers for several neurological diseases. However, different pre-analytical variables have potential to influence results. METHODS Twenty-one CSF samples donated by patients with HTLV-1-associated myelopathy (HAM) and stored for up to 11 years at -80 °C were retested after three-years for neopterin (n=10) and Nfl (n=11) by ELISA. RESULTS There was a strong correlation between the paired results (r>0.98, p<0.0001). Neopterin concentrations (nmol/L) ranged from 12.4 to 64 initially and from 11.5 to 64.4 when retested, with means (SD) of 30 (18.4) 1st test and 33 (19.1) 2nd test. Nfl concentrations (pg/mL) ranged from 79.9 to 3,733 initially and from 86.3 to 3,332, when retested with means (SD) of 1,138 (1,272) 1st test and 1,009 (1,114) at re-test. CONCLUSIONS Storing CSF samples at -80 °C appears not to impact the quantification of neopterin and Nfl allowing confidence in the reporting of archived samples.
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Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, UK
| | - Graham P Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, UK
- National Centre for Human Retrovirology, St Mary's Hospital, London, UK
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13
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Zhang Y, Yan AW, Boelen L, Hadcocks L, Salam A, Gispert DP, Spanos L, Bitria LM, Nemat-Gorgani N, Traherne JA, Roberts C, Koftori D, Taylor GP, Forton D, Norman PJ, Marsh SG, Busch R, Macallan DC, Asquith B. KIR-HLA interactions extend human CD8+ T cell lifespan in vivo. J Clin Invest 2023; 133:e169496. [PMID: 37071474 PMCID: PMC10266773 DOI: 10.1172/jci169496] [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: 02/06/2023] [Accepted: 04/05/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUNDThere is increasing evidence, in transgenic mice and in vitro, that inhibitory killer cell immunoglobulin-like receptors (iKIRs) can modulate T cell responses. Furthermore, we have previously shown that iKIRs are an important determinant of T cell-mediated control of chronic viral infection and that these results are consistent with an increase in the CD8+ T cell lifespan due to iKIR-ligand interactions. Here, we tested this prediction and investigated whether iKIRs affect T cell lifespan in humans in vivo.METHODSWe used stable isotope labeling with deuterated water to quantify memory CD8+ T cell survival in healthy individuals and patients with chronic viral infections.RESULTSWe showed that an individual's iKIR-ligand genotype was a significant determinant of CD8+ T cell lifespan: in individuals with 2 iKIR-ligand gene pairs, memory CD8+ T cells survived, on average, for 125 days; in individuals with 4 iKIR-ligand gene pairs, the memory CD8+ T cell lifespan doubled to 250 days. Additionally, we showed that this survival advantage was independent of iKIR expression by the T cell of interest and, further, that the iKIR-ligand genotype altered the CD8+ and CD4+ T cell immune aging phenotype.CONCLUSIONSTogether, these data reveal an unexpectedly large effect of iKIR genotype on T cell survival.FUNDINGWellcome Trust; Medical Research Council; EU Horizon 2020; EU FP7; Leukemia and Lymphoma Research; National Institute of Health Research (NIHR) Imperial Biomedical Research Centre; Imperial College Research Fellowship; National Institutes of Health; Jefferiss Trust.
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Affiliation(s)
- Yan Zhang
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Ada W.C. Yan
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Lies Boelen
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Linda Hadcocks
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Arafa Salam
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
| | | | - Loiza Spanos
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
- School of Life and Health Sciences, University of Roehampton, London, United Kingdom
| | - Laura Mora Bitria
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Neda Nemat-Gorgani
- Department of Structural Biology and Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California, USA
| | - James A. Traherne
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Chrissy Roberts
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Danai Koftori
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Department of Infectious Disease, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Daniel Forton
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
- Department of Gastroenterology and Hepatology, St George’s University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Paul J. Norman
- Department of Structural Biology and Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California, USA
- Department of Biomedical Informatics and Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Steven G.E. Marsh
- Anthony Nolan Research Institute, Royal Free Hospital, London, United Kingdom
- UCL Cancer Institute, UCL, London, United Kingdom
| | - Robert Busch
- School of Life and Health Sciences, University of Roehampton, London, United Kingdom
| | - Derek C. Macallan
- Institute for Infection and Immunity, St George’s, University of London, London, United Kingdom
| | - Becca Asquith
- Department of Infectious Disease, Imperial College London, London, United Kingdom
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14
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Dixon L, McNamara C, Dhasmana D, Taylor GP, Davies N. Imaging Spectrum of HTLV-1–Related Neurologic Disease. Neurol Clin Pract 2023; 13:e200147. [PMID: 37066106 PMCID: PMC10092304 DOI: 10.1212/cpj.0000000000200147] [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] [Received: 08/09/2022] [Accepted: 01/23/2023] [Indexed: 03/29/2023]
Abstract
Purpose of ReviewHuman T-cell lymphotropic virus type 1 (HTLV-1)–associated myelopathy (HAM) is a well-recognized neurologic complication of HTLV-1. Beyond HAM, several other neurologic manifestations are increasingly recognized, including acute myelopathy, encephalopathy, and myositis. The clinical and imaging features of these presentations are less well understood and potentially underdiagnosed. In this study, we summarize the imaging features of HTLV-1–related neurologic disease, providing both a pictorial review and pooled series of the less well-recognized presentations.Recent Findings35 cases of acute/subacute HAM and 12 cases of HTLV-1–related encephalopathy were found. In subacute HAM, cervical and upper thoracic longitudinally extensive tranverse myelitis was noted, while in HTLV-1–related encephalopathy, confluent lesions in the frontoparietal white matter and along the corticospinal tracts were the most prevalent finding.SummaryThere are varied clinical and imaging presentations of HTLV-1–related neurologic disease. Recognition of these features aids early diagnosis where therapy may have the greatest benefit.
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Affiliation(s)
- Luke Dixon
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
| | - Cillian McNamara
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
| | - Divya Dhasmana
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
| | - Graham P Taylor
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
| | - Nicholas Davies
- Department of Neuroradiology (LD, CM), Imperial College Healthcare NHS Trust, London, UK; National Centre for Human Retrovirology (DD, GPT, ND), Imperial College Healthcare NHS Trust, London, UK; Section of Virology, Department of Infectious Disease (GPT), Imperial College London, UK; Department of Neurology (GPT), Imperial College Healthcare NHS Trust, London, UK; Department of Neurology (GPT), Chelsea and Westminster Hospital NHS Trust, London, UK
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15
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Short CES, Quinlan R, Lee YS, Preda VG, Smith A, Marchesi JR, Shattock R, Bennett PR, MacIntyre DA, Taylor GP. Comparative analysis of vaginal microbiota sampling using menstrual cups and high vaginal swabs in pregnant women living with HIV-1 infection. Front Cell Infect Microbiol 2023; 13:1190160. [PMID: 37228662 PMCID: PMC10204588 DOI: 10.3389/fcimb.2023.1190160] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
Background Menstrual cups (MCs) are increasingly used to collect cervicovaginal secretions to characterise vaginal mucosal immunology, in conjunction with high vaginal swabs (HVS) for metataxonomics, particularly in HIV transmission studies. We hypothesised that both methods of collecting bacterial biomass are equivalent for 16S rRNA gene sequencing. Material and Methods Cervicovaginal fluid (CVF) samples from 16 pregnant women with HIV-1 (PWWH) were included to represent the major vaginal bacterial community state types (CST I-V). Women underwent sampling during the second trimester by liquid amies HVS followed by a MC (Soft disc™) and samples were stored at -80°C. Bacterial cell pellets obtained from swab elution and MC (500 µL, 1 in 10 dilution) were resuspended in 120 µL PBS for DNA extraction. Bacterial 16S rRNA gene sequencing was performed using V1-V2 primers and were analysed using MOTHUR. Paired total DNA, bacterial load, amplicon read counts, diversity matrices and bacterial taxa were compared by sampling method using MicrobiomeAnalyst, SPSS and R. Results The total DNA eluted from one aliquot of diluted CVF from an MC was similar to that of a HVS (993ng and 609ng, p=0.18); the mean bacterial loads were also comparable for both methods (MC: 8.0 log10 16S rRNA gene copies versus HVS: 7.9 log10 16S rRNA gene copies, p=0.27). The mean number of sequence reads generated from MC samples was lower than from HVS (MC: 12730; HVS:14830, p=0.05). The α-diversity metrices were similar for both techniques; MC Species Observed: 41 (range 12-96) versus HVS: 47 (range 16-96), p=0.15; MC Inverse Simpson Index: 1.98 (range 1.0-4.0) versus HVS: 0.48 (range 1.0-4.4), p=0.22). The three most abundant species observed were: Lactobacillus iners, Lactobacillus crispatus and Gardnerella vaginalis. Hierarchical clustering of relative abundance data showed that samples obtained using different techniques in an individual clustered in the same CST group. Conclusion These data demonstrate that despite sampling slightly different areas of the lower genital tract, there was no difference in bacterial load or composition between methods. Both are suitable for characterisation of vaginal microbiota in PWWH. The MC offers advantages, including a higher volume of sample available for DNA extraction and complimentary assays.
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Affiliation(s)
- Charlotte-Eve S. Short
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- March of Dimes Prematurity Research Centre, Division of the Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, United Kingdom
| | - Rachael Quinlan
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- March of Dimes Prematurity Research Centre, Division of the Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, United Kingdom
| | - Yun S. Lee
- March of Dimes Prematurity Research Centre, Division of the Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, United Kingdom
| | - Veronica G. Preda
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Ann Smith
- Faculty of Health and Applied Sciences, University West of England, Bristol, United Kingdom
| | - Julian R. Marchesi
- March of Dimes Prematurity Research Centre, Division of the Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, United Kingdom
- Marchesi Laboratory, Department of Metabolism, Digestion, and Reproduction, Division of Digestive Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Robin Shattock
- Section of Immunology of Infection, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Phillip R. Bennett
- St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- March of Dimes Prematurity Research Centre, Division of the Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, United Kingdom
| | - David A. MacIntyre
- March of Dimes Prematurity Research Centre, Division of the Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- March of Dimes Prematurity Research Centre, Division of the Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, United Kingdom
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16
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Derqui N, Koycheva A, Zhou J, Pillay TD, Crone MA, Hakki S, Fenn J, Kundu R, Varro R, Conibear E, Madon KJ, Barnett JL, Houston H, Singanayagam A, Narean JS, Tolosa-Wright MR, Mosscrop L, Rosadas C, Watber P, Anderson C, Parker E, Freemont PS, Ferguson NM, Zambon M, McClure MO, Tedder R, Barclay WS, Dunning J, Taylor GP, Lalvani A, Cutajar J, Quinn V, Hammett S, McDermott E, Luca C, Timcang K, Samuel J, Bremang S, Evetts S, Wang L, Nevin S, Davies M, Tejpal C, Essoussi M, Ketkar AV, Miserocchi G, Catchpole H, Badhan A, Dustan S, Day Weber IJ, Marchesin F, Whitfield MG, Poh J, Kondratiuk A. Risk factors and vectors for SARS-CoV-2 household transmission: a prospective, longitudinal cohort study. The Lancet Microbe 2023:S2666-5247(23)00069-1. [PMID: 37031689 PMCID: PMC10132910 DOI: 10.1016/s2666-5247(23)00069-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Despite circumstantial evidence for aerosol and fomite spread of SARS-CoV-2, empirical data linking either pathway with transmission are scarce. Here we aimed to assess whether the presence of SARS-CoV-2 on frequently-touched surfaces and residents' hands was a predictor of SARS-CoV-2 household transmission. METHODS In this longitudinal cohort study, during the pre-alpha (September to December, 2020) and alpha (B.1.1.7; December, 2020, to April, 2021) SARS-CoV-2 variant waves, we prospectively recruited contacts from households exposed to newly diagnosed COVID-19 primary cases, in London, UK. To maximally capture transmission events, contacts were recruited regardless of symptom status and serially tested for SARS-CoV-2 infection by RT-PCR on upper respiratory tract (URT) samples and, in a subcohort, by serial serology. Contacts' hands, primary cases' hands, and frequently-touched surface-samples from communal areas were tested for SARS-CoV-2 RNA. SARS-CoV-2 URT isolates from 25 primary case-contact pairs underwent whole-genome sequencing (WGS). FINDINGS From Aug 1, 2020, until March 31, 2021, 620 contacts of PCR-confirmed SARS-CoV-2-infected primary cases were recruited. 414 household contacts (from 279 households) with available serial URT PCR results were analysed in the full household contacts' cohort, and of those, 134 contacts with available longitudinal serology data and not vaccinated pre-enrolment were analysed in the serology subcohort. Household infection rate was 28·4% (95% CI 20·8-37·5) for pre-alpha-exposed contacts and 51·8% (42·5-61·0) for alpha-exposed contacts (p=0·0047). Primary cases' URT RNA viral load did not correlate with transmission, but was associated with detection of SARS-CoV-2 RNA on their hands (p=0·031). SARS-CoV-2 detected on primary cases' hands, in turn, predicted contacts' risk of infection (adjusted relative risk [aRR]=1·70 [95% CI 1·24-2·31]), as did SARS-CoV-2 RNA presence on household surfaces (aRR=1·66 [1·09-2·55]) and contacts' hands (aRR=2·06 [1·57-2·69]). In six contacts with an initial negative URT PCR result, hand-swab (n=3) and household surface-swab (n=3) PCR positivity preceded URT PCR positivity. WGS corroborated household transmission. INTERPRETATION Presence of SARS-CoV-2 RNA on primary cases' and contacts' hands and on frequently-touched household surfaces associates with transmission, identifying these as potential vectors for spread in households. FUNDING National Institute for Health Research Health Protection Research Unit in Respiratory Infections, Medical Research Council.
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17
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Bukasa LL, Cortina-Borja M, Peters H, Taylor GP, Thorne C. Gestational diabetes in women living with HIV in the UK and Ireland: insights from population-based surveillance data. J Int AIDS Soc 2023; 26:e26078. [PMID: 37012900 PMCID: PMC10071091 DOI: 10.1002/jia2.26078] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
INTRODUCTION The prevalence of gestational diabetes (GD) is increasing globally. While universal risk factors for GD are reasonably well understood, questions remain regarding risks for women living with HIV (WLWH). We aimed to describe GD prevalence, evaluate associated maternal risk factors and assess specific birth outcomes in WLWH in the UK and Ireland. METHODS We analysed all pregnancies (≥24 weeks' gestation) in women diagnosed with HIV before delivery, reported to the UK-based Integrated Screening Outcomes Surveillance Service between 2010 and 2020. Every report of GD was considered as a case. A multivariable logistic regression model, adjusted for women with more than one pregnancy fitted with generalized estimating equations (GEE) assessed the effect of independent risk factors. RESULTS There were 10,553 pregnancies in 7916 women, of which 460 (4.72%) pregnancies had reported GD. Overall, the median maternal age was 33 years (Q1:29-Q3:37), and 73% of pregnancies were in Black African women. WLWH with GD (WLWH-GD) were older (61% vs. 41% aged ≥35 years, p < 0.001) and more likely to be on treatment at conception (74% vs. 64%, p < 0.001) than women without GD. WLWH-GD were more likely to have a stillbirth (odds ratio [OR]: 5.38, 95% CI: 2.14-13.5), preterm delivery (OR: 2.54, 95% CI: 1.95-3.32) and fetal macrosomia (OR: 1.14, 95% CI: 1.04-1.24). Independent risk factors for GD included estimated year of delivery (GEE-adjusted odds ratio [GEE-aOR]: 1.14, 95% CI: 1.10-1.18), advanced maternal age (≥35 years) (GEE-aOR: 2.87, 95% CI: 1.54-5.34), Asian (GEE-aOR: 2.63, 95% CI: 1.40-4.63) and Black African (GEE-aOR: 1.55, 95% CI: 1.13-2.12) ethnicity. Timing and type of antiretroviral therapy showed no evidence of a relationship with GD in multivariable analyses; however, women with a CD4 count ≤350 cells/μl were 27% less likely to have GD than women with CD4 counts >350 cells/μl (GEE-aOR: 0.73, 95% CI: 0.50-0.96). CONCLUSIONS GD prevalence increased over time among WLWH but was not significantly different from the general population. Maternal age, ethnicity and CD4 count were risk factors based on available data. Stillbirth and preterm delivery were more common in WLWH-GD than other WLWH over the study period. Further studies are required to build upon these results.
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Affiliation(s)
- Laurette L Bukasa
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Helen Peters
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Graham P Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, UK
| | - Claire Thorne
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
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18
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Khan M, Bradshaw D, Brown CS, Haddow J, Patel P, Tosswill JHC, Pollock K, Elliott T, Wang X, Alagaratnam J, Mora-Peris B, Kaye S, McClure MO, Muir D, Randell P, Taylor GP, Fidler SJ. Characterisation of rare spontaneous HIV viral controllers attending a national UK clinical service using a combination of serology and molecular diagnostic assays. Open Forum Infect Dis 2023; 10:ofad108. [PMID: 37152187 PMCID: PMC10155812 DOI: 10.1093/ofid/ofad108] [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] [Received: 11/10/2022] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Abstract
We report outcomes and novel characterisation of a unique cohort of 42 individuals with persistently indeterminate HIV status, the majority of whom are HIV viral controllers.
Eligible individuals had indeterminate or positive HIV serology, but persistently undetectable HIV RNA by commercial assays and were not taking ART. Routine investigations included: HIV Western blot; HIV viral load; qualitative HIV-1 DNA; co-infection screen and T-cell quantification. Research assays included T-cell activation; ART measurement; single copy assays detecting HIV-1 RNA and DNA and plasma cytokine quantification. HIV seropositivity was defined as ≥3 bands on Western blot; molecular positivity as detection of HIV RNA or DNA.
HIV infection was excluded in 10/42 referrals, remains unconfirmed in 2/42 and was confirmed in 30/42, who were identified as HIV elite controllers (EC), normal CD4 T-cell counts (median 820/ml, range 805-1336) and normal CD4:CD8 ratio (median 1.8, range 1.2-1.9). ECs had a median duration of elite control of 6 years (IQR=4-14). ART was undetected in all 23 tested. Two distinct categories of EC were identified: molecular-positive (n=20) and molecular-negative (n=10).
HIV status was resolved for 95% of referrals with the majority diagnosed as EC. The clinical significance of the two molecular categories amongst EC requires further investigation.
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Affiliation(s)
- Maryam Khan
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
- Imperial College National Institute of Health Research Biomedical Research Centre , St Mary’s campus, London, W2 1NY , United Kingdom
| | - Daniel Bradshaw
- Virus Reference Department, UK Health Security Agency , London, NW9 5EQ , United Kingdom
| | - Colin S Brown
- Virus Reference Department, UK Health Security Agency , London, NW9 5EQ , United Kingdom
| | - Jana Haddow
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, St Mary’s Hospital , London, W2 1NY , United Kingdom
| | - Poorvi Patel
- Virus Reference Department, UK Health Security Agency , London, NW9 5EQ , United Kingdom
| | - Jennifer H C Tosswill
- Virus Reference Department, UK Health Security Agency , London, NW9 5EQ , United Kingdom
| | - Katrina Pollock
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, St Mary’s Hospital , London, W2 1NY , United Kingdom
- Imperial College National Institute of Health Research Biomedical Research Centre , St Mary’s campus, London, W2 1NY , United Kingdom
| | - Tamara Elliott
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
- Imperial College National Institute of Health Research Biomedical Research Centre , St Mary’s campus, London, W2 1NY , United Kingdom
| | - Xinzhu Wang
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
- Imperial College National Institute of Health Research Biomedical Research Centre , St Mary’s campus, London, W2 1NY , United Kingdom
| | - Jasmini Alagaratnam
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, St Mary’s Hospital , London, W2 1NY , United Kingdom
- Imperial College National Institute of Health Research Biomedical Research Centre , St Mary’s campus, London, W2 1NY , United Kingdom
| | - Borja Mora-Peris
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
- Imperial College National Institute of Health Research Biomedical Research Centre , St Mary’s campus, London, W2 1NY , United Kingdom
| | - Steve Kaye
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
| | - Myra O McClure
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
| | - David Muir
- Department of Infection and Immunity, Imperial College Healthcare NHS Trust, Charing Cross Hospital , London, W6 8RF , United Kingdom
| | - Paul Randell
- Department of Infection and Immunity, Imperial College Healthcare NHS Trust, Charing Cross Hospital , London, W6 8RF , United Kingdom
| | - Graham P Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, St Mary’s Hospital , London, W2 1NY , United Kingdom
- Imperial College National Institute of Health Research Biomedical Research Centre , St Mary’s campus, London, W2 1NY , United Kingdom
| | - Sarah J Fidler
- Section of Virology, Department of Infectious Disease, Imperial College London , St Mary’s Campus, London, W2 1PG , United Kingdom
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, St Mary’s Hospital , London, W2 1NY , United Kingdom
- Imperial College National Institute of Health Research Biomedical Research Centre , St Mary’s campus, London, W2 1NY , United Kingdom
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Bradshaw D, Khawar A, Patel P, Tosswill J, Brown C, Ogaz D, Mason E, Osman R, Mitchell H, Dosekun O, Peris BM, Pickard G, Rayment M, Jones R, Hopkins M, Williams A, Kingston M, Machin N, Taha Y, Duncan S, Turner N, Gill N, Andrews N, Raza M, Tazzyman S, Nori A, Cunningham E, Taylor GP. HTLV seroprevalence in people using HIV pre-exposure prophylaxis in England. J Infect 2023; 86:245-247. [PMID: 36773896 DOI: 10.1016/j.jinf.2023.01.033] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/05/2023] [Accepted: 01/20/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES HTLV-1 is predominantly a sexually-transmitted infection but testing is not mentioned in HIV-PrEP guidelines. We ascertained HTLV-1/HTLV-2 seroprevalence amongst HIV-PrEP users in England. METHODS An unlinked anonymous seroprevalence study. RESULTS Amongst 2015 HIV-PrEP users, 95% were men, 76% of white ethnicity and 83% had been born in Europe. There were no HTLV-1/HTLV-2 seropositive cases (95% confidence interval 0% - 0.18%). CONCLUSIONS There were no HTLV positive cases, likely reflecting the demographic of mostly white and European-born individuals. Similar studies are needed worldwide to inform public health recommendations for HIV-PrEP using populations, particularly in HTLV-endemic settings.
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Affiliation(s)
- Daniel Bradshaw
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK; National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London W2 1NY, UK.
| | - Arham Khawar
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Poorvi Patel
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | | | - Colin Brown
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Dana Ogaz
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Emily Mason
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Roeann Osman
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Holly Mitchell
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Olamide Dosekun
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London W2 1NY, UK
| | - Borja Mora Peris
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London W2 1NY, UK
| | - Graham Pickard
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London W2 1NY, UK
| | - Michael Rayment
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK
| | - Rachael Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK
| | - Mark Hopkins
- Barts Health NHS Trust, St Bartholomew's Hospital, London EC1A 7BE, UK
| | - Andy Williams
- Barts Health NHS Trust, St Bartholomew's Hospital, London EC1A 7BE, UK
| | - Margaret Kingston
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - Nicholas Machin
- Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - Yusri Taha
- Newcastle Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle NE1 4LP, UK
| | - Sarah Duncan
- Newcastle Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle NE1 4LP, UK
| | - Neil Turner
- Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London SW10 9NH, UK
| | - Noel Gill
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Nick Andrews
- UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, UK
| | - Mohammad Raza
- Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield S10 2JF, UK
| | - Simon Tazzyman
- Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Sheffield S10 2JF, UK
| | - Achyuta Nori
- Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK
| | - Emma Cunningham
- Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK
| | - Graham P Taylor
- Imperial College London, London W2 1PG, UK; National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London W2 1NY, UK
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20
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Joris T, Haddow J, Taylor GP, Cook LBM, Rowan AG. Detection of HTLV-1 proviral DNA in cell-free DNA: Potential for non-invasive monitoring of Adult T cell leukaemia/lymphoma using liquid biopsy? Front Immunol 2023; 14:1150285. [PMID: 37114063 PMCID: PMC10126272 DOI: 10.3389/fimmu.2023.1150285] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/24/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Fragmented genomic DNA is constitutively released from dying cells into interstitial fluid in healthy tissue. In cancer, this so-called 'cell-free' DNA (cfDNA) released from dying malignant cells encodes cancer-associated mutations. Thus, minimally invasive sampling of cfDNA in blood plasma can be used to diagnose, characterise and longitudinally monitor solid tumours at remote sites in the body. ~5% of carriers of Human T cell leukaemia virus type 1 (HTLV-1) develop Adult T cell leukaemia/lymphoma (ATL), and a similar percentage develop an inflammatory CNS disease, HTLV-1 associated myelopathy (HAM). In both ATL and HAM, high frequencies of HTLV-1 infected cells are present in the affected tissue: each carrying an integrated DNA copy of the provirus. We hypothesised that turnover of infected cells results in the release of HTLV-1 proviruses in cfDNA, and that analysis of cfDNA from infected cells in HTLV-1 carriers might contain clinically useful information pertaining to inaccessible sites in the body- e.g. for early detection of primary or relapsing localised lymphoma type ATL. To evaluate the feasibility of this approach, we tested for HTLV-1 proviruses in blood plasma cfDNA. Methods CfDNA (from blood plasma) and genomic DNA (gDNA, from peripheral blood mononuclear cells, PBMC) was isolated from blood from 6 uninfected controls, 24 asymptomatic carriers (AC), 21 patients with HAM and 25 patients with ATL. Proviral (HTLV-1 Tax) and human genomic DNA (the beta globin gene, HBB) targets were quantified by qPCR using primer pairs optimised for fragmented DNA. Results Pure, high quality cfDNA was successfully extracted from blood plasma of all study participants. When compared with uninfected controls, HTLV-1 carriers had higher concentrations of cfDNA circulating in their blood plasma. Patients with ATL who were not in remission had the highest levels of blood plasma cfDNA in any group studied. HTLV-1 proviral DNA was detected in 60/70 samples obtained from HTLV-1 carriers. The proviral load (percentage of cells carrying proviruses) was approximately tenfold lower in plasma cfDNA than in PBMC genomic DNA, and there was a strong correlation between the proviral load in cfDNA and PBMC genomic DNA in HTLV-1 carriers that did not have ATL. cfDNA samples in which proviruses were undetectable also had very low proviral load in PBMC genomic DNA. Finally, detection of proviruses in cfDNA of patients with ATL was predictive of clinical status: patients with evolving disease had higher than expected total amount of proviruses detectable in plasma cfDNA. Discussion We demonstrated that (1) HTLV-1 infection is associated with increased levels of blood plasma cfDNA, (2) proviral DNA is released into blood plasma cfDNA in HTLV-1 carriers and (3) proviral burden in cfDNA correlates with clinical status, raising the possibility of developing assays of cfDNA for clinical use in HTLV-1 carriers.
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Affiliation(s)
- Thomas Joris
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- Gembloux Agro-Biotech, University of Liege, Gembloux, Belgium
| | - Jana Haddow
- National Centre for Human Retrovirology, Imperial College Healthcare National Health Service Trust, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- Gembloux Agro-Biotech, University of Liege, Gembloux, Belgium
| | - Lucy B. M. Cook
- Gembloux Agro-Biotech, University of Liege, Gembloux, Belgium
- National Centre for Human Retrovirology, Imperial College Healthcare National Health Service Trust, London, United Kingdom
- Department of Haematology, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom
- Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | - Aileen G. Rowan
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- *Correspondence: Aileen G. Rowan,
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21
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Rowan AG, Ponnusamy K, Ren H, Taylor GP, Cook LBM, Karadimitris A. CAR-iNKT cells targeting clonal TCRVβ chains as a precise strategy to treat T cell lymphoma. Front Immunol 2023; 14:1118681. [PMID: 36936927 PMCID: PMC10019783 DOI: 10.3389/fimmu.2023.1118681] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 12/07/2022] [Accepted: 02/09/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Most T cell receptor (TCR)Vβ chain-expressing T cell lymphomas (TCL) including those caused by Human T cell leukaemia virus type-1 (HTLV-1) have poor prognosis. We hypothesised that chimeric antigen receptor (CAR)-mediated targeting of the clonal, lymphoma-associated TCRβ chains would comprise an effective cell therapy for TCL that would minimally impact the physiological TCR repertoire. Methods As proof of concept, we generated CAR constructs to target four TCRVβ subunits. Efficacy of the CAR constructs was tested using conventional T cells as effectors (CAR-T). Since invariant NKT (iNKT) cell do not incite acute graft-versus-host disease and are suitable for 'off-the-shelf' immunotherapy, we generated anti-TCRVβ CAR-iNKT cells. Results We show that anti-TCRVβ CAR-T cells selectively kill their cognate tumour targets while leaving >90% of the physiological TCR repertoire intact. CAR-iNKT cells inhibited the growth of TCL in vivo, and were also selectively active against malignant cells from Adult T cell leukaemia/lymphoma patients without activating expression of HTLV-1. Discussion Thus we provide proof-of-concept for effective and selective anti-TCRVβ CAR-T and -iNKT cell-based therapy of TCL with the latter providing the option for 'off-the-shelf' immunotherapy.
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Affiliation(s)
- Aileen G. Rowan
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- Hugh and Josseline Langmuir Centre for Myeloma Research, Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | - Kanagaraju Ponnusamy
- Hugh and Josseline Langmuir Centre for Myeloma Research, Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | - Hongwei Ren
- Hugh and Josseline Langmuir Centre for Myeloma Research, Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom
| | - Lucy B. M. Cook
- Hugh and Josseline Langmuir Centre for Myeloma Research, Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom
- Department of Haematology, Hammersmith Hospital, Imperial College Healthcare National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Anastasios Karadimitris
- Hugh and Josseline Langmuir Centre for Myeloma Research, Centre for Haematology, Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
- Department of Haematology, Hammersmith Hospital, Imperial College Healthcare National Health Service (NHS) Foundation Trust, London, United Kingdom
- *Correspondence: Anastasios Karadimitris,
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Maher AK, Burnham KL, Jones EM, Tan MMH, Saputil RC, Baillon L, Selck C, Giang N, Argüello R, Pillay C, Thorley E, Short CE, Quinlan R, Barclay WS, Cooper N, Taylor GP, Davenport EE, Dominguez-Villar M. Transcriptional reprogramming from innate immune functions to a pro-thrombotic signature by monocytes in COVID-19. Nat Commun 2022; 13:7947. [PMID: 36572683 PMCID: PMC9791976 DOI: 10.1038/s41467-022-35638-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 12/14/2022] [Indexed: 12/27/2022] Open
Abstract
Although alterations in myeloid cells have been observed in COVID-19, the specific underlying mechanisms are not completely understood. Here, we examine the function of classical CD14+ monocytes in patients with mild and moderate COVID-19 during the acute phase of infection and in healthy individuals. Monocytes from COVID-19 patients display altered expression of cell surface receptors and a dysfunctional metabolic profile that distinguish them from healthy monocytes. Secondary pathogen sensing ex vivo leads to defects in pro-inflammatory cytokine and type-I IFN production in moderate COVID-19 cases, together with defects in glycolysis. COVID-19 monocytes switch their gene expression profile from canonical innate immune to pro-thrombotic signatures and are functionally pro-thrombotic, both at baseline and following ex vivo stimulation with SARS-CoV-2. Transcriptionally, COVID-19 monocytes are characterized by enrichment of pathways involved in hemostasis, immunothrombosis, platelet aggregation and other accessory pathways to platelet activation and clot formation. These results identify a potential mechanism by which monocyte dysfunction may contribute to COVID-19 pathology.
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Affiliation(s)
- Allison K Maher
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Katie L Burnham
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Emma M Jones
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Michelle M H Tan
- Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK
| | - Rocel C Saputil
- Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK
| | - Laury Baillon
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Claudia Selck
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Nicolas Giang
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Rafael Argüello
- Aix Marseille Université, CNRS, INSERM, Centre d'Immunologie de Marseille-Luminy, Marseille, France
| | - Clio Pillay
- Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK
| | - Emma Thorley
- Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK
| | - Charlotte-Eve Short
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Rachael Quinlan
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Wendy S Barclay
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Nichola Cooper
- Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK
| | - Graham P Taylor
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Emma E Davenport
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
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Mosscrop L, Watber P, Elliot P, Cooke G, Barclay W, Freemont PS, Rosadas C, Taylor GP. Evaluation of the impact of pre-analytical conditions on sample stability for the detection of SARS-CoV-2 RNA. J Virol Methods 2022; 309:114607. [PMID: 35973468 PMCID: PMC9374597 DOI: 10.1016/j.jviromet.2022.114607] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/24/2022]
Abstract
Demand for accurate SARS-CoV-2 diagnostics is high. Most samples in the UK are collected in the community and rely on the postal service for delivery to the laboratories. The current recommendation remains that swabs should be collected in Viral Transport Media (VTM) and transported with a cold chain to the laboratory for RNA extraction and RT-qPCR. This is not always possible. We aimed to test the stability of SARS-CoV-2 RNA subjected to different pre-analytical conditions. Swabs were dipped into PBS containing cultured SARS-CoV-2 and placed in either a dry tube or a tube containing either normal saline or VTM. The tubes were then stored at different temperatures (20-50 °C) for variable periods (8 h to 5 days). Samples were tested by RT-qPCR targeting SARS-CoV-2 E gene. VTM outperformed swabs in saline and dry swabs in all conditions. Samples in VTM were stable, independent of a cold chain, for 5 days, with a maximum increase in cycle threshold (Ct) of 1.34 when held at 40 °C. Using normal saline as the transport media resulted in a loss of sensitivity (increased Ct) over time and with increasing temperature (up to 7.8 cycles compared to VTM). SARS-CoV-2 was not detected in 3/9 samples in normal saline when tested after 120 h incubation. Transportation of samples in VTM provides a high level of confidence in the results despite the potential for considerable, uncontrolled variation in temperature and longer transportation periods. False negative results may be seen after 96 h in saline and viral loads will appear lower.
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Affiliation(s)
- Lucy Mosscrop
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Patricia Watber
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Paul Elliot
- School of Public Health, Imperial College London, London, United Kingdom
| | - Graham Cooke
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Wendy Barclay
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Paul S Freemont
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Carolina Rosadas
- Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, London, United Kingdom.
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Schnell AP, Kohrt S, Aristodemou A, Taylor GP, Bangham CRM, Thoma-Kress AK. HDAC inhibitors Panobinostat and Romidepsin enhance tax transcription in HTLV-1-infected cell lines and freshly isolated patients’ T-cells. Front Immunol 2022; 13:978800. [PMID: 36052071 PMCID: PMC9424546 DOI: 10.3389/fimmu.2022.978800] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
The viral transactivator Tax plays a key role in HTLV-1 reactivation and de novo infection. Previous approaches focused on the histone deacetylase inhibitor (HDACi) Valproate as a latency-reversing agent to boost Tax expression and expose infected cells to the host’s immune response. However, following treatment with Valproate proviral load decreases in patients with HAM/TSP were only transient. Here, we hypothesize that other compounds, including more potent and selective HDACi, might prove superior to Valproate in manipulating Tax expression. Thus, a panel of HDACi (Vorinostat/SAHA/Zolinza, Panobinostat/LBH589/Farydak, Belinostat/PXD101/Beleodaq, Valproate, Entinostat/MS-275, Romidepsin/FK228/Istodax, and MC1568) was selected and tested for toxicity and potency in enhancing Tax expression. The impact of the compounds was evaluated in different model systems, including transiently transfected T-cells, chronically HTLV-1-infected T-cell lines, and freshly isolated PBMCs from HTLV-1 carriers ex vivo. We identified the pan-HDACi Panobinostat and class I HDACi Romidepsin as particularly potent agents at raising Tax expression. qRT-PCR analysis revealed that these inhibitors considerably boost tax and Tax-target gene transcription. However, despite this significant increase in tax transcription and histone acetylation, protein levels of Tax were only moderately enhanced. In conclusion, these data demonstrate the ability of Panobinostat and Romidepsin to manipulate Tax expression and provide a foundation for further research into eliminating latently infected cells. These findings also contribute to a better understanding of conditions limiting transcription and translation of viral gene products.
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Affiliation(s)
- Annika P. Schnell
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephan Kohrt
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Aris Aristodemou
- Section of Immunology of Infection, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Charles R. M. Bangham
- Section of Immunology of Infection, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Andrea K. Thoma-Kress
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- *Correspondence: Andrea K. Thoma-Kress,
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Hakki S, Zhou J, Jonnerby J, Singanayagam A, Barnett JL, Madon KJ, Koycheva A, Kelly C, Houston H, Nevin S, Fenn J, Kundu R, Crone MA, Pillay TD, Ahmad S, Derqui-Fernandez N, Conibear E, Freemont PS, Taylor GP, Ferguson N, Zambon M, Barclay WS, Dunning J, Lalvani A, Badhan A, Varro R, Luca C, Quinn V, Cutajar J, Nichols N, Russell J, Grey H, Ketkar A, Miserocchi G, Tejpal C, Catchpole H, Nixon K, Di Biase B, Hopewell T, Narean JS, Samuel J, Timcang K, McDermott E, Bremang S, Hammett S, Evetts S, Kondratiuk A. Onset and window of SARS-CoV-2 infectiousness and temporal correlation with symptom onset: a prospective, longitudinal, community cohort study. The Lancet Respiratory Medicine 2022; 10:1061-1073. [PMID: 35988572 PMCID: PMC9388060 DOI: 10.1016/s2213-2600(22)00226-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 12/05/2022]
Abstract
Background Knowledge of the window of SARS-CoV-2 infectiousness is crucial in developing policies to curb transmission. Mathematical modelling based on scarce empirical evidence and key assumptions has driven isolation and testing policy, but real-world data are needed. We aimed to characterise infectiousness across the full course of infection in a real-world community setting. Methods The Assessment of Transmission and Contagiousness of COVID-19 in Contacts (ATACCC) study was a UK prospective, longitudinal, community cohort of contacts of newly diagnosed, PCR-confirmed SARS-CoV-2 index cases. Household and non-household exposed contacts aged 5 years or older were eligible for recruitment if they could provide informed consent and agree to self-swabbing of the upper respiratory tract. The primary objective was to define the window of SARS-CoV-2 infectiousness and its temporal correlation with symptom onset. We quantified viral RNA load by RT-PCR and infectious viral shedding by enumerating cultivable virus daily across the course of infection. Participants completed a daily diary to track the emergence of symptoms. Outcomes were assessed with empirical data and a phenomenological Bayesian hierarchical model. Findings Between Sept 13, 2020, and March 31, 2021, we enrolled 393 contacts from 327 households (the SARS-CoV-2 pre-alpha and alpha variant waves); and between May 24, 2021, and Oct 28, 2021, we enrolled 345 contacts from 215 households (the delta variant wave). 173 of these 738 contacts were PCR positive for more than one timepoint, 57 of which were at the start of infection and comprised the final study population. The onset and end of infectious viral shedding were captured in 42 cases and the median duration of infectiousness was 5 (IQR 3–7) days. Although 24 (63%) of 38 cases had PCR-detectable virus before symptom onset, only seven (20%) of 35 shed infectious virus presymptomatically. Symptom onset was a median of 3 days before both peak viral RNA and peak infectious viral load (viral RNA IQR 3–5 days, n=38; plaque-forming units IQR 3–6 days, n=35). Notably, 22 (65%) of 34 cases and eight (24%) of 34 cases continued to shed infectious virus 5 days and 7 days post-symptom onset, respectively (survival probabilities 67% and 35%). Correlation of lateral flow device (LFD) results with infectious viral shedding was poor during the viral growth phase (sensitivity 67% [95% CI 59–75]), but high during the decline phase (92% [86–96]). Infectious virus kinetic modelling suggested that the initial rate of viral replication determines the course of infection and infectiousness. Interpretation Less than a quarter of COVID-19 cases shed infectious virus before symptom onset; under a crude 5-day self-isolation period from symptom onset, two-thirds of cases released into the community would still be infectious, but with reduced infectious viral shedding. Our findings support a role for LFDs to safely accelerate deisolation but not for early diagnosis, unless used daily. These high-resolution, community-based data provide evidence to inform infection control guidance. Funding National Institute for Health and Care Research.
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Taylor GP, Cook LB. A new paradigm for the management of ATL. Br J Haematol 2022; 198:941-942. [PMID: 35839073 PMCID: PMC9546003 DOI: 10.1111/bjh.18363] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Graham P Taylor
- Section of Virology, Department on Infectious Disease, Imperial College London, London, UK.,National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, UK
| | - Lucy B Cook
- Section of Virology, Department on Infectious Disease, Imperial College London, London, UK.,National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, UK
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Barr RS, Drysdale SB, Boullier M, Lyall H, Cook L, Collins GP, Kelly DF, Phelan L, Taylor GP. A Review of the Prevention of Mother-to-Child Transmission of Human T-Cell Lymphotrophic Virus Type 1 (HTLV-1) With a Proposed Management Algorithm. Front Med (Lausanne) 2022; 9:941647. [PMID: 35872787 PMCID: PMC9304803 DOI: 10.3389/fmed.2022.941647] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/10/2022] [Indexed: 01/06/2023] Open
Abstract
Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that is endemic in a number of regions across the world. There are an estimated 5–10 million people infected worldwide. Japan is currently the only country with a national antenatal screening programme in place. HTLV-1 is primarily transmitted sexually in adulthood, however it can be transmitted from mother-to-child perinatally. This can occur transplacentally, during the birth process or via breastmilk. If HTLV-1 is transmitted perinatally then the lifetime risk of adult T cell leukemia/lymphoma rises from 5 to 20%, therefore prevention of mother-to-child transmission of HTLV-1 is a public health priority. There are reliable immunological and molecular tests available for HTLV-1 diagnosis during pregnancy and screening should be considered on a country by country basis. Further research on best management is needed particularly for pregnancies in women with high HTLV-1 viral load. A first step would be to establish an international registry of cases and to monitor outcomes for neonates and mothers. We have summarized key risk factors for mother-to-child transmission of HTLV-1 and subsequently propose a pragmatic guideline for management of mothers and infants in pregnancy and the perinatal period to reduce the risk of transmission. This is clinically relevant in order to reduce mother-to-child transmission of HTLV-1 and it's complications.
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Affiliation(s)
- Rachael S. Barr
- Department of Paediatrics, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- *Correspondence: Rachael S. Barr
| | - Simon B. Drysdale
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George's, University of London, London, United Kingdom
- Oxford Vaccine Group and NIHR Oxford Biomedical Research Centre, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Mary Boullier
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George's, University of London, London, United Kingdom
| | - Hermione Lyall
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Lucy Cook
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, United Kingdom
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P. Collins
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Dominic F. Kelly
- Oxford Vaccine Group and NIHR Oxford Biomedical Research Centre, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Level 2, Children's Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Lorna Phelan
- Department of Obstetrics and Gynaecology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
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King-Robson J, Taylor GP. HTLV-1 encephalomyelitis; a case report of a treatable manifestation of HTLV-1 infection. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.37] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
IntroductionHuman T-cell lymphotropic virus type-1 (HTLV-1) infection remains asymptomatic in >90% of the 20-million people infected worldwide. However in 3%, chronic inflammation within the thoracic spinal cord leads to progressive spastic paraparesis; HTLV-1 associated myelopathy (HAM). This pathological process is not limited to the thoracic cord. We present a case of HTLV-1 encephalomyelitis.CaseA 53-year-old woman with HAM of 9 years duration presented with subacute cerebellar dysfunc- tion, being unable to feed herself, 3-months after cessation of methotrexate. Investigations demonstrated extensive T2-hyperintensity within the brainstem, cortical and subcortical white matter with punctate contrast enhancement; lymphocytic CSF; and high blood (36%) and CSF (72%) HTLV-1 proviral load (DNA copies per 100 lymphocytes). We diagnosed HTLV-1 encephalomyelitis and commenced high dose methylprednisolone with slow steroid taper following which functional independence in the upper limbs was regained.DiscussionRisk of HAM rises exponentially once HTLV-1 proviral load exceeds 1%, while CSF:blood proviral load ratio ≥2:1 indicates CNS infiltration of HTLV-1 infected lymphocytes. This patient’s high HTLV-1 proviral load and widespread MRI changes indicated HTLV-1 associated inflammation of the brain and spine. Prompt immunosuppression resulted in significant recovery and highlights the importance of early rec- ognition and management of extraspinal manifestations of HTLV-1 infection.j.king-robson@nhs.net
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Rosadas C, Assone T, Sereno L, Miranda AE, Mayorga-Sagastume R, Freitas MA, Taylor GP, Ishak R. "We Need to Translate Research Into Meaningful HTLV Health Policies and Programs": Webinar HTLV World Day 2021. Front Public Health 2022; 10:883080. [PMID: 35619801 PMCID: PMC9127409 DOI: 10.3389/fpubh.2022.883080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/17/2022] [Indexed: 01/13/2023] Open
Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom,HTLV Channel, Brazilia, Brazil,*Correspondence: Carolina Rosadas
| | - Tatiane Assone
- HTLV Channel, Brazilia, Brazil,Faculty of Medicine, São Paulo University (USP), São Paulo, Brazil
| | - Leandro Sereno
- Pan American Health Organization/World Health Organization, Washington, DC, United States
| | - Angelica Espinosa Miranda
- Departamento de Condições Crônicas e Infecções Sexualmente Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil,Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | | | - Marcelo A. Freitas
- Pan American Health Organization/World Health Organization, Washington, DC, United States
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom,National Centre for Human Retrovirology, St Mary's Hospital, London, United Kingdom
| | - Ricardo Ishak
- Laboratório de Virologia, Universidade Federal do Pará, Pará, Brazil
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Vallinoto ACR, Rosadas C, Machado LFA, Taylor GP, Ishak R. HTLV: It Is Time to Reach a Consensus on Its Nomenclature. Front Microbiol 2022; 13:896224. [PMID: 35531274 PMCID: PMC9072825 DOI: 10.3389/fmicb.2022.896224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia do Instituto de Ciências Biológicas da Universidade Federal do Pará, Belém, Brazil
- *Correspondence: Antonio Carlos Rosário Vallinoto
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | | | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Ricardo Ishak
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
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Rosadas C, Khan M, Parker E, Marchesin F, Katsanovskaja K, Sureda-Vives M, Fernandez N, Randell P, Harvey R, Lilley A, Harris BHL, Zuhair M, Fertleman M, Ijaz S, Dicks S, Short CE, Quinlan R, Taylor GP, Hu K, McKay P, Rosa A, Roustan C, Zuckerman M, El Bouzidi K, Cooke G, Flower B, Moshe M, Elliott P, Spencer AJ, Lambe T, Gilbert SC, Kingston H, Baillie JK, Openshaw PJM, Semple MG, Cherepanov P, McClure MO, Tedder RS. Detection and quantification of antibody to SARS CoV 2 receptor binding domain provides enhanced sensitivity, specificity and utility. J Virol Methods 2022; 302:114475. [PMID: 35077719 PMCID: PMC8782753 DOI: 10.1016/j.jviromet.2022.114475] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 01/10/2023]
Abstract
Accurate and sensitive detection of antibody to SARS-CoV-2 remains an essential component of the pandemic response. Measuring antibody that predicts neutralising activity and the vaccine response is an absolute requirement for laboratory-based confirmatory and reference activity. The viral receptor binding domain (RBD) constitutes the prime target antigen for neutralising antibody. A double antigen binding assay (DABA), providing the most sensitive format has been exploited in a novel hybrid manner employing a solid-phase S1 preferentially presenting RBD, coupled with a labelled RBD conjugate, used in a two-step sequential assay for detection and measurement of antibody to RBD (anti-RBD). This class and species neutral assay showed a specificity of 100 % on 825 pre COVID-19 samples and a potential sensitivity of 99.6 % on 276 recovery samples, predicting quantitatively the presence of neutralising antibody determined by pseudo-type neutralization and by plaque reduction. Anti-RBD is also measurable in ferrets immunised with ChadOx1 nCoV-19 vaccine and in humans immunised with both AstraZeneca and Pfizer vaccines. This assay detects anti-RBD at presentation with illness, demonstrates its elevation with disease severity, its sequel to asymptomatic infection and its persistence after the loss of antibody to the nucleoprotein (anti-NP). It also provides serological confirmation of prior infection and offers a secure measure for seroprevalence and studies of vaccine immunisation in human and animal populations. The hybrid DABA also displays the attributes necessary for the detection and quantification of anti-RBD to be used in clinical practice. An absence of detectable anti-RBD by this assay predicates the need for passive immune prophylaxis in at-risk patients.
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Affiliation(s)
- Carolina Rosadas
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Maryam Khan
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Eleanor Parker
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Federica Marchesin
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Macià Sureda-Vives
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Natalia Fernandez
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Paul Randell
- Department of Infection and Immunity, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF, UK
| | - Ruth Harvey
- Worldwide Influenza Centre, Francis Crick Institute, London, NW1 1AT, UK
| | - Alice Lilley
- Worldwide Influenza Centre, Francis Crick Institute, London, NW1 1AT, UK
| | - Benjamin H L Harris
- The Wellington Hospital, Circus Road, St John's Wood, London, NW8 6PD, UK; Computational Biology and Integrative Genomics, Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - Mohamed Zuhair
- The Wellington Hospital, Circus Road, St John's Wood, London, NW8 6PD, UK
| | - Michael Fertleman
- The Wellington Hospital, Circus Road, St John's Wood, London, NW8 6PD, UK
| | - Samreen Ijaz
- Blood Borne Virus Unit, National Infection Service, Colindale Public Health England, London, NW9 5EQ, UK
| | - Steve Dicks
- Blood Borne Virus Unit, National Infection Service, Colindale Public Health England, London, NW9 5EQ, UK; Transfusion Microbiology, NHS Blood and Transplant, Lingard Avenue, London, NW9 5BG, UK
| | - Charlotte-Eve Short
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Rachael Quinlan
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Kai Hu
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Paul McKay
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Annachiara Rosa
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, NW1 1AT, UK; Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Chloe Roustan
- Structural Biology Science Technology Platform, Francis Crick Institute, London, NW1 1AT, UK; Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Mark Zuckerman
- Department of Virology, King's College Hospital, London, SE5 9RS, UK
| | - Kate El Bouzidi
- Department of Virology, King's College Hospital, London, SE5 9RS, UK
| | - Graham Cooke
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Barnaby Flower
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Maya Moshe
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | | | - Teresa Lambe
- Jenner Institute, University of Oxford, ORCRB, Oxford, OX3 7DQ, UK
| | - Sarah C Gilbert
- Jenner Institute, University of Oxford, ORCRB, Oxford, OX3 7DQ, UK
| | - Hugh Kingston
- Department of Infection and Immunity, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, W6 8RF, UK
| | | | - Peter J M Openshaw
- National Heart and Lung Institute, Imperial College London, Chelsea, London, SW3 6LY, UK
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, L69 7BE, UK
| | - Peter Cherepanov
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK; Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, NW1 1AT, UK; Crick COVID19 Consortium, Francis Crick Institute, London, NW1 1AT, UK
| | - Myra O McClure
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Richard S Tedder
- Department of Infectious Disease, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
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Ye L, Taylor GP, Rosadas C. Human T-Cell Lymphotropic Virus Type 1 and Strongyloides stercoralis Co-infection: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:832430. [PMID: 35237633 PMCID: PMC8882768 DOI: 10.3389/fmed.2022.832430] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe distribution of human T cell lymphotropic virus type 1 (HTLV-1) overlaps with that of Strongyloides stercoralis. Strongyloides stercoralis infection has been reported to be impacted by co-infection with HTLV-1. Disseminated strongyloidiasis and hyperinfection syndrome, which are commonly fatal, are observed in HTLV-1 co-infected patients. Reduced efficacy of anti-strongyloidiasis treatment in HTLV-1 carriers has been reported. The aim of this meta-analysis and systematic review is to better understand the association between HTLV-1 and S. stercoralis infection.MethodsPubMed, Embase, MEDLINE, Global Health, Healthcare Management Information Consortium databases were searched. Studies regarding the prevalence of S. stercoralis, those evaluating the frequency of mild or severe strongyloidiasis, and treatment response in people living with and without HTLV-1 infection were included. Data were extracted and odds ratios were calculated. Random-effect meta-analysis was used to assess the pooled OR and 95% confidence intervals.ResultsFourteen studies were included after full-text reviewing of which seven described the prevalence of S. stercoralis and HTLV-1. The odds of S. stercoralis infection were higher in HTLV-1 carriers when compared with HTLV-1 seronegative subjects (OR 3.2 95%CI 1.7–6.2). A strong association was found between severe strongyloidiasis and HTLV-1 infection (OR 59.9, 95%CI 18.1–198). Co-infection with HTLV-1 was associated with a higher rate of strongyloidiasis treatment failure (OR 5.05, 95%CI 2.5–10.1).ConclusionStrongyloides stercoralis infection is more prevalent in people living with HTLV-1. Co-infected patients are more likely to develop severe presentation and to fail treatment. Screening for HTLV-1 and Strongyloides sp. should be routine when either is diagnosed.
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Affiliation(s)
- Lingqing Ye
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- *Correspondence: Graham P. Taylor
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
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Khan M, Rosadas C, Katsanovskaja K, Weber ID, Shute J, Ijaz S, Marchesin F, McClure E, Elias S, Flower B, Gao H, Quinlan R, Short C, Rosa A, Roustan C, Moshe M, Taylor GP, Elliott P, Cooke GS, Cherepanov P, Parker E, McClure MO, Tedder RS. Simple, sensitive, specific self-sampling assay secures SARS-CoV-2 antibody signals in sero-prevalence and post-vaccine studies. Sci Rep 2022; 12:1885. [PMID: 35115570 PMCID: PMC8814240 DOI: 10.1038/s41598-022-05640-x] [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: 06/17/2021] [Accepted: 01/10/2022] [Indexed: 12/20/2022] Open
Abstract
At-home sampling is key to large scale seroprevalence studies. Dried blood spot (DBS) self-sampling removes the need for medical personnel for specimen collection but facilitates specimen referral to an appropriately accredited laboratory for accurate sample analysis. To establish a highly sensitive and specific antibody assay that would facilitate self-sampling for prevalence and vaccine-response studies. Paired sera and DBS eluates collected from 439 sero-positive, 382 sero-negative individuals and DBS from 34 vaccine recipients were assayed by capture ELISAs for IgG and IgM antibody to SARS-CoV-2. IgG and IgM combined on DBS eluates achieved a diagnostic sensitivity of 97.9% (95%CI 96.6 to 99.3) and a specificity of 99.2% (95% CI 98.4 to 100) compared to serum, displaying limits of detection equivalent to 23 and 10 WHO IU/ml, respectively. A strong correlation (r = 0.81) was observed between serum and DBS reactivities. Reactivity remained stable with samples deliberately rendered inadequate, (p = 0.234) and when samples were accidentally damaged or 'invalid'. All vaccine recipients were sero-positive. This assay provides a secure method for self-sampling by DBS with a sensitivity comparable to serum. The feasibility of DBS testing in sero-prevalence studies and in monitoring post-vaccine responses was confirmed, offering a robust and reliable tool for serological monitoring at a population level.
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Affiliation(s)
- Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Isaac D Weber
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Justin Shute
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Samreen Ijaz
- Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK
| | - Federica Marchesin
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Eleanor McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Salem Elias
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Barnaby Flower
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - He Gao
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Rachael Quinlan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Charlotte Short
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Annachiara Rosa
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Chloe Roustan
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Maya Moshe
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Graham P Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.,Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK
| | - Paul Elliott
- Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK.,Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, London, UK.,NIHR Imperial Biomedical Research Centre, Imperial College London, Exhibition Rd, London, SW7 2AZ, UK
| | - Graham S Cooke
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.,Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed St, Paddington, London, W2 1NY, UK
| | - Peter Cherepanov
- Francis Crick Institute, 1 Midland Rd, Somers Town, London, NW1 1AT, UK
| | - Eleanor Parker
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK
| | - Richard S Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, St Mary's Campus, Praed Street, London, W2 1NY, UK.
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Abstract
Human T lymphotropic virus type 1 (HTLV-1) is a retrovirus that causes lifelong T-cell infection in humans, impacting the host immune response. This virus causes a range of clinical manifestations, from inflammatory conditions, including neuronal damage (HTLV-1 associated myelopathy, HAM) to life-threatening leukemia (adult T-cell leukemia, ATL). Human T lymphotropic virus type 1 is also associated with increased risk of all-cause mortality, but the mechanisms remain unclear. As a blood-borne and sexually transmitted infection (STI), HTLV-1 shares transmission routes to many other pathogens and although it has worldwide distribution, it affects mainly those in low- and middle-income tropical areas, where the prevalence of other infectious agents is high. These factors contribute to a high incidence of co-infections in people living with HTLV-1 (PLHTLV). This comprehensive review addresses the impact of HTLV-1 on several co-infections and vice-versa. There is evidence of higher rates of HTLV-1 infection in association with other blood borne (HCV, HBV) and sexually transmitted (Syphilis, Chlamydia, HPV, HSV) infections but whether this represents increased susceptibility or opportunity is unclear. Higher frequency of Mycobacterium tuberculosis (MTb) and Mycobacterium leprae (M. leprae) is observed in PLHTLV. Reports of opportunistic infections and high frequency of crusted scabies in patients with HTLV-1 points to immune impairment in those individuals. Human T lymphotropic virus type 1 may influence the persistence of pathogens, exemplified by the higher rates of Schistosoma mansoni and Strongyloides stercoralis (St. stercoralis) treatment failure observed in PLHTLV. This retrovirus is also associated with increased tuberculosis (TB) severity with some evidence pointing to a deleterious impact on leprosy outcome as well. These findings are supported by immune alterations observed in those co-infected individuals. Although the role of HTLV-1 in HCV outcome is debatable, most data indicate that HTLV may negatively impact the clinical course of hepatitis C. Co-infections may also influence the risk of developing HTLV-1 associated disease, but data are still limited. The impact of HTLV-1 on the response to more common infections, might contribute to the increased mortality rate of HTLV-1. Large scale prospective controlled studies on the prevalence and impact of HTLV-1 in co-infections and vice-versa are needed. Human T lymphotropic virus type 1 impact in public health is broad. Measures to increase awareness and to prevent new infections are needed.
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Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, Division of Medicine and Integrated Care, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- *Correspondence: Graham P. Taylor
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Singanayagam A, Hakki S, Dunning J, Madon KJ, Crone MA, Koycheva A, Derqui-Fernandez N, Barnett JL, Whitfield MG, Varro R, Charlett A, Kundu R, Fenn J, Cutajar J, Quinn V, Conibear E, Barclay W, Freemont PS, Taylor GP, Ahmad S, Zambon M, Ferguson NM, Lalvani A. Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study. Lancet Infect Dis 2022; 22:183-195. [PMID: 34756186 PMCID: PMC8554486 DOI: 10.1016/s1473-3099(21)00648-4] [Citation(s) in RCA: 414] [Impact Index Per Article: 207.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/27/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND The SARS-CoV-2 delta (B.1.617.2) variant is highly transmissible and spreading globally, including in populations with high vaccination rates. We aimed to investigate transmission and viral load kinetics in vaccinated and unvaccinated individuals with mild delta variant infection in the community. METHODS Between Sept 13, 2020, and Sept 15, 2021, 602 community contacts (identified via the UK contract-tracing system) of 471 UK COVID-19 index cases were recruited to the Assessment of Transmission and Contagiousness of COVID-19 in Contacts cohort study and contributed 8145 upper respiratory tract samples from daily sampling for up to 20 days. Household and non-household exposed contacts aged 5 years or older were eligible for recruitment if they could provide informed consent and agree to self-swabbing of the upper respiratory tract. We analysed transmission risk by vaccination status for 231 contacts exposed to 162 epidemiologically linked delta variant-infected index cases. We compared viral load trajectories from fully vaccinated individuals with delta infection (n=29) with unvaccinated individuals with delta (n=16), alpha (B.1.1.7; n=39), and pre-alpha (n=49) infections. Primary outcomes for the epidemiological analysis were to assess the secondary attack rate (SAR) in household contacts stratified by contact vaccination status and the index cases' vaccination status. Primary outcomes for the viral load kinetics analysis were to detect differences in the peak viral load, viral growth rate, and viral decline rate between participants according to SARS-CoV-2 variant and vaccination status. FINDINGS The SAR in household contacts exposed to the delta variant was 25% (95% CI 18-33) for fully vaccinated individuals compared with 38% (24-53) in unvaccinated individuals. The median time between second vaccine dose and study recruitment in fully vaccinated contacts was longer for infected individuals (median 101 days [IQR 74-120]) than for uninfected individuals (64 days [32-97], p=0·001). SAR among household contacts exposed to fully vaccinated index cases was similar to household contacts exposed to unvaccinated index cases (25% [95% CI 15-35] for vaccinated vs 23% [15-31] for unvaccinated). 12 (39%) of 31 infections in fully vaccinated household contacts arose from fully vaccinated epidemiologically linked index cases, further confirmed by genomic and virological analysis in three index case-contact pairs. Although peak viral load did not differ by vaccination status or variant type, it increased modestly with age (difference of 0·39 [95% credible interval -0·03 to 0·79] in peak log10 viral load per mL between those aged 10 years and 50 years). Fully vaccinated individuals with delta variant infection had a faster (posterior probability >0·84) mean rate of viral load decline (0·95 log10 copies per mL per day) than did unvaccinated individuals with pre-alpha (0·69), alpha (0·82), or delta (0·79) variant infections. Within individuals, faster viral load growth was correlated with higher peak viral load (correlation 0·42 [95% credible interval 0·13 to 0·65]) and slower decline (-0·44 [-0·67 to -0·18]). INTERPRETATION Vaccination reduces the risk of delta variant infection and accelerates viral clearance. Nonetheless, fully vaccinated individuals with breakthrough infections have peak viral load similar to unvaccinated cases and can efficiently transmit infection in household settings, including to fully vaccinated contacts. Host-virus interactions early in infection may shape the entire viral trajectory. FUNDING National Institute for Health Research.
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Affiliation(s)
- Anika Singanayagam
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK; Department of Infectious Disease, Imperial College London, London, UK; National Infection Service, Public Health England, London, UK
| | - Seran Hakki
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jake Dunning
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Oxford, Oxford, UK; National Infection Service, Public Health England, London, UK
| | - Kieran J Madon
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael A Crone
- Department of Infectious Disease, Imperial College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK; London Biofoundry, Imperial College Translation and Innovation Hub, London, UK
| | - Aleksandra Koycheva
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Nieves Derqui-Fernandez
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jack L Barnett
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael G Whitfield
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Robert Varro
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Andre Charlett
- Data and Analytical Services, Public Health England, London, UK
| | - Rhia Kundu
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Joe Fenn
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jessica Cutajar
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Valerie Quinn
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Emily Conibear
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - Wendy Barclay
- Department of Infectious Disease, Imperial College London, London, UK
| | - Paul S Freemont
- Department of Infectious Disease, Imperial College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, London, UK; London Biofoundry, Imperial College Translation and Innovation Hub, London, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, London, UK
| | - Shazaad Ahmad
- Department of Virology, Manchester Medical Microbiology Partnership, Manchester Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Maria Zambon
- National Infection Service, Public Health England, London, UK
| | - Neil M Ferguson
- NIHR Health Protection Research Unit in Modelling and Health Economics, MRC Centre for Global Infectious Disease Analysis, Jameel Institute, Imperial College London, London, UK
| | - Ajit Lalvani
- NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK.
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Katsuya H, Cook LBM, Rowan AG, Melamed A, Turpin J, Ito J, Islam S, Miyazato P, Jek Yang Tan B, Matsuo M, Miyakawa T, Nakata H, Matsushita S, Taylor GP, Bangham CRM, Kimura S, Satou Y. Erratum to: Clonality of HIV-1- and HTLV-1-Infected Cells in Naturally Coinfected Individuals. J Infect Dis 2022; 225:359. [PMID: 34865054 DOI: 10.1093/infdis/jiab493] [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: 11/14/2022] Open
Affiliation(s)
- Hiroo Katsuya
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.,Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Lucy B M Cook
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Aileen G Rowan
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Anat Melamed
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Jocelyn Turpin
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Jumpei Ito
- Division of Systems Virology, Department of Infectious Disease Control, International Research Center for Infectious Diseases, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Saiful Islam
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Paola Miyazato
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Benjy Jek Yang Tan
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Misaki Matsuo
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshikazu Miyakawa
- Department of Hematology, Rheumatology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto, Japan
| | - Hirotomo Nakata
- Department of Hematology, Rheumatology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto, Japan
| | - Shuzo Matsushita
- Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Graham P Taylor
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Charles R M Bangham
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yorifumi Satou
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
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Katsuya H, Cook LBM, Rowan AG, Melamed A, Turpin J, Ito J, Islam S, Miyazato P, Jek Yang Tan B, Matsuo M, Miyakawa T, Nakata H, Matsushita S, Taylor GP, Bangham CRM, Kimura S, Satou Y. Clonality of HIV-1- and HTLV-1-Infected Cells in Naturally Coinfected Individuals. J Infect Dis 2022; 225:317-326. [PMID: 33844021 DOI: 10.1093/infdis/jiab202] [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: 12/22/2020] [Accepted: 04/11/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Coinfection with human immunodeficiency virus type 1 (HIV-1) and human T-cell leukemia virus type 1 (HTLV-1) diminishes the value of the CD4+ T-cell count in diagnosing AIDS, and increases the rate of HTLV-1-associated myelopathy. It remains elusive how HIV-1/HTLV-1 coinfection is related to such characteristics. We investigated the mutual effect of HIV-1/HTLV-1 coinfection on their integration sites (ISs) and clonal expansion. METHODS We extracted DNA from longitudinal peripheral blood samples from 7 HIV-1/HTLV-1 coinfected, and 12 HIV-1 and 13 HTLV-1 monoinfected individuals. Proviral loads (PVL) were quantified using real-time polymerase chain reaction (PCR). Viral ISs and clonality were quantified by ligation-mediated PCR followed by high-throughput sequencing. RESULTS PVL of both HIV-1 and HTLV-1 in coinfected individuals was significantly higher than that of the respective virus in monoinfected individuals. The degree of oligoclonality of both HIV-1- and HTLV-1-infected cells in coinfected individuals was also greater than in monoinfected subjects. ISs of HIV-1 in cases of coinfection were more frequently located in intergenic regions and transcriptionally silent regions, compared with HIV-1 monoinfected individuals. CONCLUSIONS HIV-1/HTLV-1 coinfection makes an impact on the distribution of viral ISs and clonality of virus-infected cells and thus may alter the risks of both HTLV-1- and HIV-1-associated disease.
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Affiliation(s)
- Hiroo Katsuya
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.,Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Lucy B M Cook
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Aileen G Rowan
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Anat Melamed
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Jocelyn Turpin
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Jumpei Ito
- Division of Systems Virology, Department of Infectious Disease Control, International Research Center for Infectious Diseases, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Saiful Islam
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Paola Miyazato
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Benjy Jek Yang Tan
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Misaki Matsuo
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshikazu Miyakawa
- Department of Hematology, Rheumatology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto, Japan
| | - Hirotomo Nakata
- Department of Hematology, Rheumatology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto, Japan
| | - Shuzo Matsushita
- Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Graham P Taylor
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Charles R M Bangham
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yorifumi Satou
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
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Kundu R, Narean JS, Wang L, Fenn J, Pillay T, Fernandez ND, Conibear E, Koycheva A, Davies M, Tolosa-Wright M, Hakki S, Varro R, McDermott E, Hammett S, Cutajar J, Thwaites RS, Parker E, Rosadas C, McClure M, Tedder R, Taylor GP, Dunning J, Lalvani A. Cross-reactive memory T cells associate with protection against SARS-CoV-2 infection in COVID-19 contacts. Nat Commun 2022; 13:80. [PMID: 35013199 PMCID: PMC8748880 DOI: 10.1038/s41467-021-27674-x] [Citation(s) in RCA: 169] [Impact Index Per Article: 84.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
Cross-reactive immune responses to SARS-CoV-2 have been observed in pre-pandemic cohorts and proposed to contribute to host protection. Here we assess 52 COVID-19 household contacts to capture immune responses at the earliest timepoints after SARS-CoV-2 exposure. Using a dual cytokine FLISpot assay on peripheral blood mononuclear cells, we enumerate the frequency of T cells specific for spike, nucleocapsid, membrane, envelope and ORF1 SARS-CoV-2 epitopes that cross-react with human endemic coronaviruses. We observe higher frequencies of cross-reactive (p = 0.0139), and nucleocapsid-specific (p = 0.0355) IL-2-secreting memory T cells in contacts who remained PCR-negative despite exposure (n = 26), when compared with those who convert to PCR-positive (n = 26); no significant difference in the frequency of responses to spike is observed, hinting at a limited protective function of spike-cross-reactive T cells. Our results are thus consistent with pre-existing non-spike cross-reactive memory T cells protecting SARS-CoV-2-naïve contacts from infection, thereby supporting the inclusion of non-spike antigens in second-generation vaccines.
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Affiliation(s)
- Rhia Kundu
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England.
- National Heart and Lung Institute, Imperial College London, London, England.
| | - Janakan Sam Narean
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Lulu Wang
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Joseph Fenn
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Timesh Pillay
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Nieves Derqui Fernandez
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Emily Conibear
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Aleksandra Koycheva
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Megan Davies
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Mica Tolosa-Wright
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Seran Hakki
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Robert Varro
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Eimear McDermott
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Sarah Hammett
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Jessica Cutajar
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
| | - Ryan S Thwaites
- National Heart and Lung Institute, Imperial College London, London, England
| | - Eleanor Parker
- Section of Virology, Department of Infectious Disease, Imperial College London, London, England
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, England
| | - Myra McClure
- Section of Virology, Department of Infectious Disease, Imperial College London, London, England
| | - Richard Tedder
- Section of Virology, Department of Infectious Disease, Imperial College London, London, England
| | - Graham P Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, England
| | - Jake Dunning
- National Infection Service, Public Health England, London, England
- NIHR HPRU in Emerging and Zoonotic Infections, London, England
| | - Ajit Lalvani
- NIHR HPRU in Respiratory Infections, Imperial College London, London, England
- National Heart and Lung Institute, Imperial College London, London, England
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Harding D, Rosadas C, Tsoti SM, Heslegrave A, Stewart M, Kelleher P, Zetterberg H, Taylor GP, Dhasmana D. Refining the risk of HTLV-1-associated myelopathy in people living with HTLV-1: identification of a HAM-like phenotype in a proportion of asymptomatic carriers. J Neurovirol 2022; 28:473-482. [PMID: 35908019 PMCID: PMC9797460 DOI: 10.1007/s13365-022-01088-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/16/2021] [Revised: 03/22/2022] [Accepted: 07/07/2022] [Indexed: 01/13/2023]
Abstract
Up to 3.8% of human T-lymphotropic virus type-1 (HTLV-1)-infected asymptomatic carriers (AC) eventually develop HTLV-1-associated myelopathy (HAM). HAM occurs in patients with high (> 1%) HTLV proviral load (PVL). However, this cut-off includes more than 50% of ACs and therefore the risk needs to be refined. As HAM is additionally characterised by an inflammatory response to HTLV-1, markers of T cell activation (TCA), β2-microglobulin (β2M) and neuronal damage were accessed for the identification of ACs at high risk of HAM. Retrospective analysis of cross-sectional and longitudinal routine clinical data examining differences in TCA (CD4/CD25, CD4/HLA-DR, CD8/CD25 & CD8/HLA-DR), β2M and neurofilament light (NfL) in plasma in ACs with high or low PVL and patients with HAM. Comparison between 74 low PVL ACs, 84 high PVL ACs and 58 patients with HAM revealed a significant, stepwise, increase in TCA and β2M. Construction of receiver operating characteristic (ROC) curves for each of these blood tests generated a profile that correctly identifies 88% of patients with HAM along with 6% of ACs. The 10 ACs with this 'HAM-like' profile had increased levels of NfL in plasma and two developed myelopathy during follow-up, compared to none of the 148 without this viral-immune-phenotype. A viral-immuno-phenotype resembling that seen in patients with HAM identifies asymptomatic carriers who are at increased risk of developing HAM and have markers of subclinical neuronal damage.
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Affiliation(s)
- Daniel Harding
- Section of Virology, Department of Infectious Disease, Imperial College London, London, W2 1PG UK
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, W2 1PG UK
| | - Sandra Maria Tsoti
- Section of Virology, Department of Infectious Disease, Imperial College London, London, W2 1PG UK
| | - Amanda Heslegrave
- UK Dementia Research Institute at UCL, London, UK ,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Molly Stewart
- Section of Virology, Department of Infectious Disease, Imperial College London, London, W2 1PG UK
| | - Peter Kelleher
- Department of Infection and Immunity Sciences, North West London Pathology, Charing Cross Hospital, London, UK ,Section of Immunology of Infection, Department of Infectious Disease, Imperial College London, London, UK
| | - Henrik Zetterberg
- UK Dementia Research Institute at UCL, London, UK ,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK ,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden ,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden ,Hong Kong Centre for Neurodegenerative Diseases, Hong Kong, China
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, W2 1PG UK ,National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, W2 1NY UK
| | - Divya Dhasmana
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, W2 1NY UK
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Short CES, Quinlan RA, Wang X, Preda VG, Smith A, Marchesi JR, Lee YS, MacIntyre DA, Bennett PR, Taylor GP. Vaginal Microbiota, Genital Inflammation and Extracellular Matrix Remodelling Collagenase: MMP-9 in Pregnant Women With HIV, a Potential Preterm Birth Mechanism Warranting Further Exploration. Front Cell Infect Microbiol 2021; 11:750103. [PMID: 34912728 PMCID: PMC8667959 DOI: 10.3389/fcimb.2021.750103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/03/2021] [Indexed: 01/24/2023] Open
Abstract
Background Pregnant women living with HIV infection (PWLWH) have elevated rates of preterm birth (PTB) in which HIV and cART are implicated. PWLWH also have a high prevalence of adverse vaginal microbiota, which associate with genital tract inflammation. The mechanism underlying PTB in PWLWH is unknown. We present the first data in PWLWH on genital-tract matrix-metalloproteinase-9(MMP-9), an important collagenase implicated in labour onset, and tissue inhibitor of metalloproteinases-1(TIMP-1) and explore correlations with local inflammation and vaginal bacteria. Material and Methods Cervical vaginal fluid (CVF) collected by a soft cup and high vaginal swabs (HVS) were obtained from PWLWH and HIV uninfected pregnant women (HUPW) at three antenatal time points. Maternal characteristics, combination antiretroviral therapy (cART) exposure, and pregnancy outcome were recorded. Concentrations of MMP-9, TIMP-1 and ten cytokines were measured by immunoassays. Vaginal microbiota composition was determined through 16S rRNA amplicon sequencing. MMP-9, TIMP-1 and cytokine concentrations were compared by HIV status, cART, and prematurity and in PWLWH correlations with polymorphonuclear leucocytes, cytokines and bacterial genera were explored. Results CVF was available for 50 PWLWH (108 samples) and 12 HUPW (20 samples) between gestation weeks 14-38. Thirty-six PWLWH conceived on cART and 14 initiated post-conception. There were five and one PTB outcomes in PWLWH and HUPW respectively. PWLWH had higher mean CVF concentrations of MMP-9 (p<0.001) and TIMP-1 (p=0.035) in the second trimester compared with HUPW with a similar trend in the third trimester. PWLWH also had higher CVF values of cytokines: IL-1β, IL-8, IL-12 and TNF-α in both trimesters compared to HUPW (p ≤ 0.003). In PWLWH, MMP-9 positively correlated with TIMP-1 (r=0.31, p=0.002) and CVF polymorphonuclear leucocytes (r=0.57, p=0.02). Correlations were observed between MMP-9 and three cytokines: IL-1β (r=0.61), IL-8 (r=0.57) and TNF-α (r=0.64), p<0.001, similarly for TIMP-1. Abundance of anaerobic pathobionts correlated with MMP-9: Gardnerella (r=0.44, p<0.001), Atopobium (r=0.33, p=0.005), and Prevotella genera (r=0.39, p<0.001). Conversely proportion of Lactobacillus genera negatively correlated with MMP-9 (rho=-0.46, p<0.001). MMP-9/TIMP-1 ratio increased with gestational age at sampling in PWLWH, but this was no longer significant after adjusting for confounders and no difference by prematurity was observed in this sub-study. Conclusions Here we show strong correlations of MMP-9 to genital tract inflammation and sub-optimal bacterial genera in PWLWH indicating the ascending genital tract infection pathway may be a contributory mechanism to the high risk of PTB.
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Affiliation(s)
- Charlotte-Eve S. Short
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rachael A. Quinlan
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Xuan Wang
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Veronica Georgiana Preda
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ann Smith
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Faculty of Health and Applied Sciences, University West of England, Bristol, United Kingdom
| | - Julian R. Marchesi
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Yooni S. Lee
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - David A. MacIntyre
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Phillip R. Bennett
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
- March of Dimes Prematurity Research Centre, Division of Development and Reproductive Biology, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom
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Rosadas C, Zetterberg H, Heslegrave A, Haddow J, Borisova M, Taylor GP. Neurofilament Light in CSF and Plasma Is a Marker of Neuronal Damage in HTLV-1-Associated Myelopathy and Correlates With Neuroinflammation. Neurol Neuroimmunol Neuroinflamm 2021; 8:8/6/e1090. [PMID: 34611039 PMCID: PMC8495502 DOI: 10.1212/nxi.0000000000001090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 08/10/2021] [Indexed: 11/15/2022]
Abstract
Background and Objectives To evaluate the usefulness of CSF and plasma neurofilament light (Nf-L) as a biomarker for human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM). Methods Nf-L, CXCL10, and neopterin were measured by ELISA in 83 CSF samples obtained from 49 individuals living with HTLV-1/2. Plasma Nf-L was also measured by single molecule array. Results were correlated with duration of disease, age, mobility, CSF cell counts, CSF protein, and HTLV-1 proviral load. Results Nf-L was detected in all CSF samples (median [range] = 575 [791.8–2,349] pg/mL) and positively correlated with markers of inflammation (CXCL10 (r = 0.733), neopterin (r = 0.499), cell count (r = 0.403), and protein levels (r = 0.693) in CSF; p < 0.0015). There was an inverse correlation between Nf-L and duration of disease (r = −0.584, p < 0.0001). Wheelchair-dependent patients had high concentrations of markers of inflammation and neuronal damage. Concentrations of CXCL10, neopterin, and Nf-L remained elevated in follow-up samples (mean follow-up 5.2 years). Nf-L in plasma correlated with concentration of Nf-L, neopterin, CXCL10, and protein in CSF. Conclusions Nf-L in plasma and CSF has potential to be used as a biomarker of disease activity in HAM. Neuronal damage seems to be more intense early in disease but persists long term. Wheelchair-dependent patients have ongoing neuroinflammation.
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Affiliation(s)
- Carolina Rosadas
- From the Section of Virology (C.R., G.P.T.), Department of Infectious Disease, Imperial College London; UK Dementia Research Institute at UCL (H.Z., A.H., M.B.); Department of Neurodegenerative Disease (H.Z., A.H., M.B.) at UCL Institute of Neurology, London, UK; Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital; Department of Psychiatry and Neurochemistry (H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and National Centre for Human Retrovirology (J.H., G.P.T.), St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
| | - Henrik Zetterberg
- From the Section of Virology (C.R., G.P.T.), Department of Infectious Disease, Imperial College London; UK Dementia Research Institute at UCL (H.Z., A.H., M.B.); Department of Neurodegenerative Disease (H.Z., A.H., M.B.) at UCL Institute of Neurology, London, UK; Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital; Department of Psychiatry and Neurochemistry (H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and National Centre for Human Retrovirology (J.H., G.P.T.), St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Amanda Heslegrave
- From the Section of Virology (C.R., G.P.T.), Department of Infectious Disease, Imperial College London; UK Dementia Research Institute at UCL (H.Z., A.H., M.B.); Department of Neurodegenerative Disease (H.Z., A.H., M.B.) at UCL Institute of Neurology, London, UK; Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital; Department of Psychiatry and Neurochemistry (H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and National Centre for Human Retrovirology (J.H., G.P.T.), St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Jana Haddow
- From the Section of Virology (C.R., G.P.T.), Department of Infectious Disease, Imperial College London; UK Dementia Research Institute at UCL (H.Z., A.H., M.B.); Department of Neurodegenerative Disease (H.Z., A.H., M.B.) at UCL Institute of Neurology, London, UK; Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital; Department of Psychiatry and Neurochemistry (H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and National Centre for Human Retrovirology (J.H., G.P.T.), St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Mina Borisova
- From the Section of Virology (C.R., G.P.T.), Department of Infectious Disease, Imperial College London; UK Dementia Research Institute at UCL (H.Z., A.H., M.B.); Department of Neurodegenerative Disease (H.Z., A.H., M.B.) at UCL Institute of Neurology, London, UK; Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital; Department of Psychiatry and Neurochemistry (H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and National Centre for Human Retrovirology (J.H., G.P.T.), St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Graham P Taylor
- From the Section of Virology (C.R., G.P.T.), Department of Infectious Disease, Imperial College London; UK Dementia Research Institute at UCL (H.Z., A.H., M.B.); Department of Neurodegenerative Disease (H.Z., A.H., M.B.) at UCL Institute of Neurology, London, UK; Clinical Neurochemistry Laboratory (H.Z.), Sahlgrenska University Hospital; Department of Psychiatry and Neurochemistry (H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; and National Centre for Human Retrovirology (J.H., G.P.T.), St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
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Rosadas C, Menezes MLB, Galvão-Castro B, Assone T, Miranda AE, Aragón MG, Caterino-de-Araujo A, Taylor GP, Ishak R. Blocking HTLV-1/2 silent transmission in Brazil: Current public health policies and proposal for additional strategies. PLoS Negl Trop Dis 2021; 15:e0009717. [PMID: 34555019 PMCID: PMC8460035 DOI: 10.1371/journal.pntd.0009717] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human T-cell lymphotropic viruses 1 and 2 (HTLV-1/2) are relatively common in Brazil but remain silent and neglected infections. HTLV-1 is associated with a range of diseases with high morbidity and mortality. There is no curative treatment for this lifelong infection, so measures to prevent transmission are essential. This narrative review discusses HTLV-1/2 transmission routes and measures to prevent its continuous dissemination. The public health policies that are currently implemented in Brazil to avoid HTLV-1/2 transmission are addressed, and further strategies are proposed.
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Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Maria Luiza B. Menezes
- Departamento Materno-Infantil, Faculdade de Ciências Médicas, Universidade de Pernambuco, Pernambuco, Brazil
| | - Bernardo Galvão-Castro
- Centro Integrativo e Muldisciplinar de Atendimento ao Portador de HTLV (CHTLV), Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Tatiane Assone
- Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Angélica E. Miranda
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | - Mayra G. Aragón
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | | | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Pará, Brazil
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Abstract
A 53-year-old woman developed subacute onset of upper limb weakness, sensory loss and cerebellar dysfunction. She was known to have human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy. MR scan of the brain showed extensive T2 hyperintensity within the deep and subcortical white matter, with punctate contrast enhancement. Cerebrospinal fluid (CSF) was lymphocytic with very high levels of HTLV-1 provirus in both CSF and peripheral blood lymphocytes. We diagnosed HTLV-1 encephalomyelitis and started high-dose methylprednisolone followed by a slow corticosteroid taper. She recovered well and regained functional independence in the upper limbs. Neurological manifestations of HTLV-1 infection extend beyond classical 'tropical spastic paraparesis' and are under-recognised. We review the literature on HTLV-1 encephalitis and discuss its diagnosis and management.
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Affiliation(s)
| | - Timothy Hampton
- Neuroradiology Department, King's College Hospital, London, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Imperial College London, London, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, London, UK
| | - Biba Stanton
- Neurology Department, King's College Hospital, London, UK
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Pereira C, Harris BHL, Di Giovannantonio M, Rosadas C, Short CE, Quinlan R, Sureda-Vives M, Fernandez N, Day-Weber I, Khan M, Marchesin F, Katsanovskaja K, Parker E, Taylor GP, Tedder RS, McClure MO, Dani M, Fertleman M. The Association Between Antibody Response to Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Post-COVID-19 Syndrome in Healthcare Workers. J Infect Dis 2021; 223:1671-1676. [PMID: 33675366 PMCID: PMC7989400 DOI: 10.1093/infdis/jiab120] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 12/27/2020] [Accepted: 02/26/2021] [Indexed: 12/19/2022] Open
Abstract
It is currently unknown how post-COVID-19 syndrome (PCS) may affect those infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This longitudinal study includes healthcare staff who tested positive for SARS-CoV-2 between March and April 2020, with follow-up of their antibody titers and symptoms. More than half (21 of 38) had PCS after 7–8 months. There was no statistically significant difference between initial reverse-transcription polymerase chain reaction titers or serial antibody levels between those who did and those who did not develop PCS. This study highlights the relative commonality of PCS in healthcare workers and this should be considered in vaccination scheduling and workforce planning to allow adequate frontline staffing numbers.
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Affiliation(s)
- Christopher Pereira
- Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, United Kingdom.,The Wellington Hospital, Circus Road, St John's Wood, London, United Kingdom
| | - Benjamin H L Harris
- Computational Biology and Integrative Genomics, Department of Oncology, University of Oxford, Oxford, United Kingdom.,The Wellington Hospital, Circus Road, St John's Wood, London, United Kingdom
| | - Matteo Di Giovannantonio
- Computational Biology and Integrative Genomics, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Carolina Rosadas
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Charlotte-Eve Short
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Rachael Quinlan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Macià Sureda-Vives
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Natalia Fernandez
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Isaac Day-Weber
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Maryam Khan
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Federica Marchesin
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ksenia Katsanovskaja
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Eleanor Parker
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Graham P Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Richard S Tedder
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Myra O McClure
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Melanie Dani
- Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, United Kingdom.,Department of Geriatric Medicine, Hammersmith Hospital, London, United Kingdom
| | - Michael Fertleman
- Cutrale Perioperative and Ageing Group, Department of Bioengineering, Imperial College London, London, United Kingdom
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Rowan AG, May P, Badhan A, Herrera C, Watber P, Penn R, Crone MA, Storch M, Garson JA, McClure M, Freemont PS, Madona P, Randell P, Taylor GP. Optimized protocol for a quantitative SARS-CoV-2 duplex RT-qPCR assay with internal human sample sufficiency control. J Virol Methods 2021; 294:114174. [PMID: 33984396 PMCID: PMC8108476 DOI: 10.1016/j.jviromet.2021.114174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 01/21/2023]
Abstract
There is growing evidence that measurement of SARS-CoV-2 viral copy number can inform clinical and public health management of SARS-CoV-2 carriers and COVID-19 patients. Here we show that quantification of SARS-CoV-2 is feasible in a clinical setting, using a duplex RT-qPCR assay which targets both the E gene (Charité assay) and a human RNA transcript, RNase P (CDC assay) as an internal sample sufficiency control. Samples in which RNase P is not amplified indicate that sample degradation has occurred, PCR inhibitors are present, RNA extraction has failed or swabbing technique was insufficient. This important internal control reveals that 2.4 % of nasopharyngeal swabs (15/618 samples) are inadequate for SARS-CoV-2 testing which, if not identified, could result in false negative results. We show that our assay is linear across at least 7 logs and is highly reproducible, enabling the conversion of Cq values to viral copy numbers using a standard curve. Furthermore, the SARS-CoV-2 copy number was independent of the RNase P copy number indicating that the per-swab viral copy number is not dependent on sampling- further allowing comparisons between samples. The ability to quantify SARS-CoV-2 viral copy number will provide an important opportunity for viral burden-guided public health and clinical decision making.
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Affiliation(s)
- Aileen G Rowan
- Section of Virology, Department of Infectious Disease, Imperial College London, United Kingdom; Centre for Haematology, Department of Infection and Inflammation, Imperial College London, United Kingdom.
| | - Philippa May
- Centre for Haematology, Department of Infection and Inflammation, Imperial College London, United Kingdom; Developmental Disorders, South East Genomics Laboratory Hub, Guy's and St Thomas' NHS Trust, United Kingdom
| | - Anjna Badhan
- Section of Virology, Department of Infectious Disease, Imperial College London, United Kingdom
| | - Carolina Herrera
- Section of Immunology of Infection, Department of Infectious Disease, Imperial College London, United Kingdom
| | - Patricia Watber
- Section of Virology, Department of Infectious Disease, Imperial College London, United Kingdom
| | - Rebecca Penn
- Section of Virology, Department of Infectious Disease, Imperial College London, United Kingdom
| | - Michael A Crone
- London Biofoundry, Imperial College Translation and Innovation Hub, Imperial College London, United Kingdom; Section of Structural and Synthetic Biology, Department of Infectious Disease, Imperial College London, United Kingdom; UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, United Kingdom
| | - Marko Storch
- London Biofoundry, Imperial College Translation and Innovation Hub, Imperial College London, United Kingdom; Section of Structural and Synthetic Biology, Department of Infectious Disease, Imperial College London, United Kingdom
| | - Jeremy A Garson
- Division of Infection and Immunity, University College London, United Kingdom
| | - Myra McClure
- Section of Virology, Department of Infectious Disease, Imperial College London, United Kingdom
| | - Paul S Freemont
- London Biofoundry, Imperial College Translation and Innovation Hub, Imperial College London, United Kingdom; Section of Structural and Synthetic Biology, Department of Infectious Disease, Imperial College London, United Kingdom; UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, United Kingdom
| | - Pinglawathee Madona
- North West London Pathology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom
| | - Paul Randell
- North West London Pathology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, United Kingdom
| | - Graham P Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, United Kingdom.
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Rosa A, Pye VE, Graham C, Muir L, Seow J, Ng KW, Cook NJ, Rees-Spear C, Parker E, Dos Santos MS, Rosadas C, Susana A, Rhys H, Nans A, Masino L, Roustan C, Christodoulou E, Ulferts R, Wrobel AG, Short CE, Fertleman M, Sanders RW, Heaney J, Spyer M, Kjær S, Riddell A, Malim MH, Beale R, MacRae JI, Taylor GP, Nastouli E, van Gils MJ, Rosenthal PB, Pizzato M, McClure MO, Tedder RS, Kassiotis G, McCoy LE, Doores KJ, Cherepanov P. SARS-CoV-2 can recruit a heme metabolite to evade antibody immunity. Sci Adv 2021; 7:eabg7607. [PMID: 33888467 PMCID: PMC8163077 DOI: 10.1126/sciadv.abg7607] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/02/2021] [Indexed: 05/11/2023]
Abstract
The coronaviral spike is the dominant viral antigen and the target of neutralizing antibodies. We show that SARS-CoV-2 spike binds biliverdin and bilirubin, the tetrapyrrole products of heme metabolism, with nanomolar affinity. Using cryo-electron microscopy and x-ray crystallography, we mapped the tetrapyrrole interaction pocket to a deep cleft on the spike N-terminal domain (NTD). At physiological concentrations, biliverdin significantly dampened the reactivity of SARS-CoV-2 spike with immune sera and inhibited a subset of neutralizing antibodies. Access to the tetrapyrrole-sensitive epitope is gated by a flexible loop on the distal face of the NTD. Accompanied by profound conformational changes in the NTD, antibody binding requires relocation of the gating loop, which folds into the cleft vacated by the metabolite. Our results indicate that SARS-CoV-2 spike NTD harbors a dominant epitope, access to which can be controlled by an allosteric mechanism that is regulated through recruitment of a metabolite.
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Affiliation(s)
- Annachiara Rosa
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Valerie E Pye
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Luke Muir
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK
| | - Jeffrey Seow
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Kevin W Ng
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK
| | - Nicola J Cook
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK
| | - Chloe Rees-Spear
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK
| | - Eleanor Parker
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | | | - Carolina Rosadas
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Alberto Susana
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Hefin Rhys
- Flow Cytometry Science and Technology Platform, The Francis Crick Institute, London, UK
| | - Andrea Nans
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Laura Masino
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Chloe Roustan
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | | | - Rachel Ulferts
- Cell Biology of Infection Laboratory, The Francis Crick Institute, London, UK
| | - Antoni G Wrobel
- Structural Biology of Disease Processes Laboratory, The Francis Crick Institute, London, UK
| | - Charlotte-Eve Short
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Michael Fertleman
- Cutrale Perioperative and Ageing Group, Imperial College London, London, UK
| | - Rogier W Sanders
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, Netherlands
- Weill Medical College of Cornell University, New York, NY, USA
| | - Judith Heaney
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
| | - Moira Spyer
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health
| | - Svend Kjær
- Structural Biology Science Technology Platform, The Francis Crick Institute, London, UK
| | - Andy Riddell
- Flow Cytometry Science and Technology Platform, The Francis Crick Institute, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Rupert Beale
- Cell Biology of Infection Laboratory, The Francis Crick Institute, London, UK
| | - James I MacRae
- Metabolomics Science Technology Platform, The Francis Crick Institute, London, UK
| | - Graham P Taylor
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Eleni Nastouli
- Advanced Pathogen Diagnostic Unit, University College London Hospitals NHS Foundation Trust, London, UK
- Crick COVID-19 Consortium, The Francis Crick Institute, London, UK
- Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health
| | - Marit J van Gils
- Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, Netherlands
| | - Peter B Rosenthal
- Structural Biology of Cells and Viruses Laboratory, The Francis Crick Institute, London, UK
| | - Massimo Pizzato
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Myra O McClure
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Richard S Tedder
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - George Kassiotis
- Retroviral Immunology Laboratory, The Francis Crick Institute, London, UK.
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
| | - Laura E McCoy
- Institute of Immunity and Transplantation, Division of Infection and Immunity, University College London, London, UK.
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK.
| | - Peter Cherepanov
- Chromatin Structure and Mobile DNA Laboratory, The Francis Crick Institute, London, UK.
- Department of Infectious Disease, St. Mary's Campus, Imperial College London, London, UK
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Edhom KA, Lidman C, Granberg T, Taylor GP, Paucar M. Expanding the etiologic spectrum of spastic ataxia syndrome: chronic infection with human T lymphotropic virus type 1. J Neurovirol 2021; 27:345-347. [PMID: 33751488 PMCID: PMC8192349 DOI: 10.1007/s13365-020-00932-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/08/2020] [Accepted: 12/02/2020] [Indexed: 11/26/2022]
Abstract
Human T-lymphotropic virus type-1 (HTLV-1) is a neglected infection most often associated with an indolent process. However, a subset of HTLV-1 seropositive patients face the risk to develop life-threatening T-cell lymphoma/leukemia, or the highly disabling and incurable HTLV1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Over the years, other complications to HTLV-1 have been proposed and debated intensely. One of these, although rare, associations include cerebellar ataxia occurring most often in Japanese patients with manifest HAM/TSP. Here we present a HTLV-1 seropositive patient from the Middle East featuring a slowly progressive cerebellar syndrome with cerebellar atrophy but not evidence of spastic paraparesis. In addition, this patient suffered from autoimmune conditions such as Sjögren’s syndrome and vitiligo which are putatively associated with HTLV-1.
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Affiliation(s)
| | - Christer Lidman
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Tobias Granberg
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease Imperial College London, London, UK
| | - Martin Paucar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
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Thwaites RS, Sanchez Sevilla Uruchurtu A, Siggins MK, Liew F, Russell CD, Moore SC, Fairfield C, Carter E, Abrams S, Short CE, Thaventhiran T, Bergstrom E, Gardener Z, Ascough S, Chiu C, Docherty AB, Hunt D, Crow YJ, Solomon T, Taylor GP, Turtle L, Harrison EM, Dunning J, Semple MG, Baillie JK, Openshaw PJ. Inflammatory profiles across the spectrum of disease reveal a distinct role for GM-CSF in severe COVID-19. Sci Immunol 2021; 6:eabg9873. [PMID: 33692097 PMCID: PMC8128298 DOI: 10.1126/sciimmunol.abg9873] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/05/2021] [Indexed: 12/15/2022]
Abstract
While it is now widely accepted that host inflammatory responses contribute to lung injury, the pathways that drive severity and distinguish coronavirus disease 2019 (COVID-19) from other viral lung diseases remain poorly characterized. We analyzed plasma samples from 471 hospitalized patients recruited through the prospective multicenter ISARIC4C study and 39 outpatients with mild disease, enabling extensive characterization of responses across a full spectrum of COVID-19 severity. Progressive elevation of levels of numerous inflammatory cytokines and chemokines (including IL-6, CXCL10, and GM-CSF) were associated with severity and accompanied by elevated markers of endothelial injury and thrombosis. Principal component and network analyses demonstrated central roles for IL-6 and GM-CSF in COVID-19 pathogenesis. Comparing these profiles to archived samples from patients with fatal influenza, IL-6 was equally elevated in both conditions whereas GM-CSF was prominent only in COVID-19. These findings further identify the key inflammatory, thrombotic, and vascular factors that characterize and distinguish severe and fatal COVID-19.
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Affiliation(s)
- Ryan S Thwaites
- National Heart and Lung Institute, Imperial College London, U.K
| | | | | | - Felicity Liew
- National Heart and Lung Institute, Imperial College London, U.K
| | - Clark D Russell
- University of Edinburgh Centre for Inflammation Research, Edinburgh, U.K
| | - Shona C Moore
- Dept of Clinical Infection, Microbiology and Immunology, University of Liverpool, U.K
| | - Cameron Fairfield
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, U.K
| | - Edwin Carter
- Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, U.K
| | - Simon Abrams
- Dept of Clinical Infection, Microbiology and Immunology, University of Liverpool, U.K
| | - Charlotte-Eve Short
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, U.K
| | | | - Emma Bergstrom
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, U.K
| | - Zoe Gardener
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, U.K
| | - Stephanie Ascough
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, U.K
| | - Christopher Chiu
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, U.K
| | - Annemarie B Docherty
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, U.K
- Intensive Care Unit, Royal Infirmary Edinburgh, Edinburgh, U.K
| | - David Hunt
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, U.K
| | - Yanick J Crow
- Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, U.K
| | - Tom Solomon
- Dept of Clinical Infection, Microbiology and Immunology, University of Liverpool, U.K
| | - Graham P Taylor
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, U.K
| | - Lance Turtle
- Dept of Clinical Infection, Microbiology and Immunology, University of Liverpool, U.K
- Tropical and infectious disease unit, Liverpool University Hospitals NHS Foundation Trust (member of Liverpool Health Partners), U.K
| | - Ewen M Harrison
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, U.K
| | - Jake Dunning
- National Infection Service, Public Health England, London, UK
| | - Malcolm G Semple
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, U.K.
- Respiratory Medicine, Alder Hey Children's Hospital, Liverpool, U.K
| | - J Kenneth Baillie
- Intensive Care Unit, Royal Infirmary Edinburgh, Edinburgh, U.K.
- Roslin Institute, University of Edinburgh, Edinburgh, U.K
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Moshe M, Daunt A, Flower B, Simmons B, Brown JC, Frise R, Penn R, Kugathasan R, Petersen C, Stockmann H, Ashby D, Riley S, Atchison C, Taylor GP, Satkunarajah S, Naar L, Klaber R, Badhan A, Rosadas C, Marchesin F, Fernandez N, Sureda-Vives M, Cheeseman H, O'Hara J, Shattock R, Fontana G, Pallett SJC, Rayment M, Jones R, Moore LSP, Ashrafian H, Cherapanov P, Tedder R, McClure M, Ward H, Darzi A, Elliott P, Cooke GS, Barclay WS. SARS-CoV-2 lateral flow assays for possible use in national covid-19 seroprevalence surveys (React 2): diagnostic accuracy study. BMJ 2021; 372:n423. [PMID: 33653694 PMCID: PMC7921617 DOI: 10.1136/bmj.n423] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To evaluate the performance of new lateral flow immunoassays (LFIAs) suitable for use in a national coronavirus disease 2019 (covid-19) seroprevalence programme (real time assessment of community transmission 2-React 2). DESIGN Diagnostic accuracy study. SETTING Laboratory analyses were performed in the United Kingdom at Imperial College, London and university facilities in London. Research clinics for finger prick sampling were run in two affiliated NHS trusts. PARTICIPANTS Sensitivity analyses were performed on sera stored from 320 previous participants in the React 2 programme with confirmed previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Specificity analyses were performed on 1000 prepandemic serum samples. 100 new participants with confirmed previous SARS-CoV-2 infection attended study clinics for finger prick testing. INTERVENTIONS Laboratory sensitivity and specificity analyses were performed for seven LFIAs on a minimum of 200 serum samples from participants with confirmed SARS-CoV-2 infection and 500 prepandemic serum samples, respectively. Three LFIAs were found to have a laboratory sensitivity superior to the finger prick sensitivity of the LFIA currently used in React 2 seroprevalence studies (84%). These LFIAs were then further evaluated through finger prick testing on participants with confirmed previous SARS-CoV-2 infection: two LFIAs (Surescreen, Panbio) were evaluated in clinics in June-July 2020 and the third LFIA (AbC-19) in September 2020. A spike protein enzyme linked immunoassay and hybrid double antigen binding assay were used as laboratory reference standards. MAIN OUTCOME MEASURES The accuracy of LFIAs in detecting immunoglobulin G (IgG) antibodies to SARS-CoV-2 compared with two reference standards. RESULTS The sensitivity and specificity of seven new LFIAs that were analysed using sera varied from 69% to 100%, and from 98.6% to 100%, respectively (compared with the two reference standards). Sensitivity on finger prick testing was 77% (95% confidence interval 61.4% to 88.2%) for Panbio, 86% (72.7% to 94.8%) for Surescreen, and 69% (53.8% to 81.3%) for AbC-19 compared with the reference standards. Sensitivity for sera from matched clinical samples performed on AbC-19 was significantly higher with serum than finger prick at 92% (80.0% to 97.7%, P=0.01). Antibody titres varied considerably among cohorts. The numbers of positive samples identified by finger prick in the lowest antibody titre quarter varied among LFIAs. CONCLUSIONS One new LFIA was identified with clinical performance suitable for potential inclusion in seroprevalence studies. However, none of the LFIAs tested had clearly superior performance to the LFIA currently used in React 2 seroprevalence surveys, and none showed sufficient sensitivity and specificity to be considered for routine clinical use.
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Affiliation(s)
- Maya Moshe
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Anna Daunt
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Barnaby Flower
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Bryony Simmons
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Jonathan C Brown
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Rebecca Frise
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Rebecca Penn
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Ruthiran Kugathasan
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Claire Petersen
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Helen Stockmann
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Deborah Ashby
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Steven Riley
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Christina Atchison
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Sutha Satkunarajah
- Institute for Global Health Innovation, Imperial College London, London, UK
| | - Lenny Naar
- Institute for Global Health Innovation, Imperial College London, London, UK
| | - Robert Klaber
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
| | - Anjna Badhan
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Federica Marchesin
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Natalia Fernandez
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Macià Sureda-Vives
- Synthetic Biology Group, London Institute of Medical Sciences, Imperial College London, London, UK
| | - Hannah Cheeseman
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Jessica O'Hara
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Robin Shattock
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Gianluca Fontana
- Institute for Global Health Innovation, Imperial College London, London, UK
| | - Scott J C Pallett
- Chelsea and Westminster NHS Foundation Trust, London, UK
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham, UK
| | | | - Rachael Jones
- Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Luke S P Moore
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Peter Cherapanov
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Chromatin Structure and Mobile DNA Laboratory, Francis Crick Institute, London, UK
| | - Richard Tedder
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Myra McClure
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Helen Ward
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
| | - Ara Darzi
- Institute for Global Health Innovation, Imperial College London, London, UK
| | - Paul Elliott
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
- School of Public Health, Imperial College London, St Mary's Hospital, London, UK
- National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Chemical and Radiation Threats and Hazards, Imperial College London, London, UK
| | - Graham S Cooke
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Wendy S Barclay
- Department of Infectious Disease, Imperial College London, School of Medicine, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
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Einsiedel L, Chiong F, Jersmann H, Taylor GP. Correction to: Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection. Retrovirology 2021; 18:5. [PMID: 33618702 PMCID: PMC7901201 DOI: 10.1186/s12977-021-00549-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Lloyd Einsiedel
- Department of Medicine, Alice Springs Hospital, Alice Springs, NT, 0870, Australia.
| | - Fabian Chiong
- Department of Medicine, Alice Springs Hospital, Alice Springs, NT, 0870, Australia
| | - Hubertus Jersmann
- Department of Respiratory Medicine, Faculty of Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Graham P Taylor
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
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