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Estrada M, Zhu C, Bzami A, White JA, Lal M. Development of a quantitative ELISA for SARS-CoV-2 vaccine candidate, NDV-HXP-S, with CpG 1018® adjuvant. Hum Vaccin Immunother 2024; 20:2315709. [PMID: 38372198 PMCID: PMC10877971 DOI: 10.1080/21645515.2024.2315709] [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: 11/29/2023] [Accepted: 02/05/2024] [Indexed: 02/20/2024] Open
Abstract
NDV-HXP-S is a Newcastle disease virus (NDV) vectored vaccine candidate which expresses the S-antigen of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This vaccine candidate is under evaluation in human clinical studies with and without cytosine phosphate guanine (CpG) 1018® adjuvant. Existing potency methods for NDV-HXP-S do not allow for quantification of the S-antigen when the adjuvant is present. To support evaluation of NDV-HXP-S with CpG 1018® adjuvant, an inhibition enzyme-linked immunosorbent assay (ELISA) was developed to allow for quantification and stability assessments of the vaccine. A pilot 6-month stability study was conducted on NDV-HXP-S vaccine with and without CpG 1018® adjuvant under refrigerated conditions (2°C to 8°C) and accelerated stability testing conditions (40°C). The vaccine was mixed with and without CpG 1018® adjuvant in saline and maintained S-antigen content at 2°C to 8°C for the entire 6-month period. Additionally, a pilot controlled temperature chain (CTC) stability study was conducted at the completion of the 6-month study and demonstrated the possibility for this vaccine candidate to attain CTC stability labeling.
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Affiliation(s)
- Marcus Estrada
- Medical Devices and Health Technologies, PATH, Seattle, WA, USA
| | - Changcheng Zhu
- Medical Devices and Health Technologies, PATH, Seattle, WA, USA
| | - Anan Bzami
- Medical Devices and Health Technologies, PATH, Seattle, WA, USA
| | | | - Manjari Lal
- Medical Devices and Health Technologies, PATH, Seattle, WA, USA
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Chetia P, Bharadwaj C, Purbey R, Yadav A, Lal M, Rajulu AV, Sadiku ER, Selvam SP, Jarugala J. Influence of silylated nano cellulose reinforcement on the mechanical, water resistance, thermal, morphological and antibacterial properties of soy protein isolate (SPI)-based composite films. Int J Biol Macromol 2023; 242:124861. [PMID: 37192712 DOI: 10.1016/j.ijbiomac.2023.124861] [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: 12/28/2022] [Revised: 04/27/2023] [Accepted: 05/10/2023] [Indexed: 05/18/2023]
Abstract
The aim of this research work is to improve the mechanical and water-resistance properties of soy protein isolate (SPI) biofilm. In this work, 3-aminopropyltriethoxysilane (APTES) coupling agent modified nanocellulose was introduced into the SPI matrix in the presence of citric acid cross-linker. The presence of amino groups in APTES facilitated to form cross-linked structures with soy protein. The incorporation of a citric acid cross-linker made the cross-linking process more productive, and the surface smoothness of the film was confirmed by a Scanning Electron Microscope (FE-SEM). From the study of the mechanical and thermal properties and water resistance of the film, it was confirmed that the results were highly satisfactory for the modified nanocellulose incorporated film compared to the non-modified one. Additionally, coating of citral essential oil onto SPI nanocomposite film displayed antimicrobial properties due to the presence of various phenolic groups in the citral oil. The Tensile Strength and Young's Modulus of silane-modified nanocellulose containing film were enhanced by ~119 % and ~ 112 %, respectively on incorporation of 1 % APTES-modified nanocellulose. Consequently, this work is expected to offer an effective way for silylated nano-cellulose reinforcing soy protein isolate (SPI) based bio nanocomposite films for packaging applications. As an example, we have demonstrated one of the application as wrapping films for packing black grapes.
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Affiliation(s)
- P Chetia
- Academy of Scientific and Innovative Research, Ghaziabad, Uttar Pradesh 201002, India; Polymer and Petroleum Group, Materials Sciences and Technology Division, CSIR North EastInstitute of Science and Technology, Jorhat 785006, Assam, India
| | - C Bharadwaj
- Academy of Scientific and Innovative Research, Ghaziabad, Uttar Pradesh 201002, India; Polymer and Petroleum Group, Materials Sciences and Technology Division, CSIR North EastInstitute of Science and Technology, Jorhat 785006, Assam, India
| | - R Purbey
- Academy of Scientific and Innovative Research, Ghaziabad, Uttar Pradesh 201002, India; Polymer and Petroleum Group, Materials Sciences and Technology Division, CSIR North EastInstitute of Science and Technology, Jorhat 785006, Assam, India
| | - A Yadav
- Biological Sciences and Technology Division, CSIR North East Institute of Science and Technology, Jorhat, 785006, Assam, India
| | - M Lal
- Agro-Technology and Rural Development Division, CSIR North East Institute of Science and Technology, Jorhat 785006, Assam, India
| | - A Varada Rajulu
- Centre for Composite Materials, International Research Centre, Kalasalingam University, Anand Nagar, Krishnankoil, Tamil Nadu 626 126, India
| | - E R Sadiku
- Metallurgical and Materials Engineering (Polymer Division), Tshwane University of Technology, Pretoria, South Africa
| | - S Periyar Selvam
- Department of Food and Process Engineering, School of Bioengineering, SRM Institute of Science and Technology, Kattankulathur, Chennai 603203, Tamil Nadu, India
| | - J Jarugala
- Academy of Scientific and Innovative Research, Ghaziabad, Uttar Pradesh 201002, India; Polymer and Petroleum Group, Materials Sciences and Technology Division, CSIR North EastInstitute of Science and Technology, Jorhat 785006, Assam, India.
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Duc Dang A, Dinh Vu T, Hai Vu H, Thanh Ta V, Thi Van Pham A, Thi Ngoc Dang M, Van Le B, Huu Duong T, Van Nguyen D, Lawpoolsri S, Chinwangso P, McLellan JS, Hsieh CL, Garcia-Sastre A, Palese P, Sun W, Martinez JL, Gonzalez-Dominguez I, Slamanig S, Manuel Carreño J, Tcheou J, Krammer F, Raskin A, Minh Vu H, Cong Tran T, Mai Nguyen H, Mercer LD, Raghunandan R, Lal M, White JA, Hjorth R, Innis BL, Scharf R. Safety and immunogenicity of an egg-based inactivated Newcastle disease virus vaccine expressing SARS-CoV-2 spike: Interim results of a randomized, placebo-controlled, phase 1/2 trial in Vietnam. Vaccine 2022; 40:3621-3632. [PMID: 35577631 PMCID: PMC9106407 DOI: 10.1016/j.vaccine.2022.04.078] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 02/03/2022] [Revised: 04/03/2022] [Accepted: 04/25/2022] [Indexed: 01/13/2023]
Abstract
Production of affordable coronavirus disease 2019 (COVID-19) vaccines in low- and middle-income countries is needed. NDV-HXP-S is an inactivated egg-based Newcastle disease virus (NDV) vaccine expressing the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Wuhan-Hu-1. The spike protein was stabilized and incorporated into NDV virions by removing the polybasic furin cleavage site, introducing the transmembrane domain and cytoplasmic tail of the fusion protein of NDV, and introducing six prolines for stabilization in the prefusion state. Vaccine production and clinical development was initiated in Vietnam, Thailand, and Brazil. Here the interim results from the first stage of the randomized, dose-escalation, observer-blind, placebo-controlled, phase 1/2 trial conducted at the Hanoi Medical University (Vietnam) are presented. Healthy adults aged 18-59 years, non-pregnant, and with self-reported negative history for SARS-CoV-2 infection were eligible. Participants were randomized to receive one of five treatments by intramuscular injection twice, 28 days apart: 1 μg +/- CpG1018 (a toll-like receptor 9 agonist), 3 μg alone, 10 μg alone, or placebo. Participants and personnel assessing outcomes were masked to treatment. The primary outcomes were solicited adverse events (AEs) during 7 days and subject-reported AEs during 28 days after each vaccination. Investigators further reviewed subject-reported AEs. Secondary outcomes were immunogenicity measures (anti-spike immunoglobulin G [IgG] and pseudotyped virus neutralization). This interim analysis assessed safety 56 days after first vaccination (day 57) in treatment-exposed individuals and immunogenicity through 14 days after second vaccination (day 43) per protocol. Between March 15 and April 23, 2021, 224 individuals were screened and 120 were enrolled (25 per group for active vaccination and 20 for placebo). All subjects received two doses. The most common solicited AEs among those receiving active vaccine or placebo were all predominantly mild and included injection site pain or tenderness (<58%), fatigue or malaise (<22%), headache (<21%), and myalgia (<14%). No higher proportion of the solicited AEs were observed for any group of active vaccine. The proportion reporting vaccine-related AEs during the 28 days after either vaccination ranged from 4% to 8% among vaccine groups and was 5% in controls. No vaccine-related serious adverse event occurred. The immune response in the 10 μg formulation group was highest, followed by 1 μg + CpG1018, 3 μg, and 1 μg formulations. Fourteen days after the second vaccination, the geometric mean concentrations (GMC) of 50% neutralizing antibody against the homologous Wuhan-Hu-1 pseudovirus ranged from 56.07 IU/mL (1 μg, 95% CI 37.01, 84.94) to 246.19 IU/mL (10 μg, 95% CI 151.97, 398.82), with 84% to 96% of vaccine groups attaining a ≥ 4-fold increase over baseline. This was compared to a panel of human convalescent sera (N = 29, 72.93 95% CI 33.00-161.14). Live virus neutralization to the B.1.617.2 (Delta) variant of concern was reduced but in line with observations for vaccines currently in use. Since the adjuvant has shown modest benefit, GMC ratio of 2.56 (95% CI, 1.4-4.6) for 1 μg +/- CpG1018, a decision was made not to continue studying it with this vaccine. NDV-HXP-S had an acceptable safety profile and potent immunogenicity. The 3 μg dose was advanced to phase 2 along with a 6 μg dose. The 10 μg dose was not selected for evaluation in phase 2 due to potential impact on manufacturing capacity. ClinicalTrials.gov NCT04830800.
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Affiliation(s)
- Anh Duc Dang
- National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hai Ba Trung District, Hanoi, Viet Nam
| | - Thiem Dinh Vu
- National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hai Ba Trung District, Hanoi, Viet Nam
| | - Ha Hai Vu
- National Institute of Hygiene and Epidemiology, 1 Yersin Street, Hai Ba Trung District, Hanoi, Viet Nam
| | - Van Thanh Ta
- Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, Viet Nam
| | - Anh Thi Van Pham
- Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, Viet Nam
| | - Mai Thi Ngoc Dang
- Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, Viet Nam
| | - Be Van Le
- Institute of Vaccines and Medical Biologicals, 9 Pasteur, Xuong Huan, Nha Trang City, Khanh Hoa, Viet Nam
| | - Thai Huu Duong
- Institute of Vaccines and Medical Biologicals, 9 Pasteur, Xuong Huan, Nha Trang City, Khanh Hoa, Viet Nam
| | - Duoc Van Nguyen
- Institute of Vaccines and Medical Biologicals, 9 Pasteur, Xuong Huan, Nha Trang City, Khanh Hoa, Viet Nam
| | - Saranath Lawpoolsri
- Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Pailinrut Chinwangso
- Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS), Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Jason S McLellan
- College of Natural Sciences, The University of Texas at Austin, 120 Inner Campus Dr Stop G2500, Austin, TX 78712, USA
| | - Ching-Lin Hsieh
- College of Natural Sciences, The University of Texas at Austin, 120 Inner Campus Dr Stop G2500, Austin, TX 78712, USA
| | - Adolfo Garcia-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; Department of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; The Global Health and Emerging Pathogen Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Peter Palese
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Weina Sun
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Jose L Martinez
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Irene Gonzalez-Dominguez
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Stefan Slamanig
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Johnstone Tcheou
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; Department of Pathology, Molecular and Cell Based Medicine Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Ariel Raskin
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Huong Minh Vu
- WHO Vietnam Country Office, 304 Kim Ma Street, Ba Dinh District, Hanoi, Viet Nam
| | - Thang Cong Tran
- PATH Vietnam, 1101, 11th Floor, Hanoi Towers, 49 Hai Ba Trung Street, Hoan Kiem District, Hanoi, Viet Nam
| | - Huong Mai Nguyen
- PATH Vietnam, 1101, 11th Floor, Hanoi Towers, 49 Hai Ba Trung Street, Hoan Kiem District, Hanoi, Viet Nam
| | - Laina D Mercer
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | | | - Manjari Lal
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Jessica A White
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Richard Hjorth
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Bruce L Innis
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA.
| | - Rami Scharf
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA.
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4
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Pitisuttithum P, Luvira V, Lawpoolsri S, Muangnoicharoen S, Kamolratanakul S, Sivakorn C, Narakorn P, Surichan S, Prangpratanporn S, Puksuriwong S, Lamola S, Mercer LD, Raghunandan R, Sun W, Liu Y, Carreño JM, Scharf R, Phumratanaprapin W, Amanat F, Gagnon L, Hsieh CL, Kaweepornpoj R, Khan S, Lal M, McCroskery S, McLellan J, Mena I, Meseck M, Phonrat B, Sabmee Y, Singchareon R, Slamanig S, Suthepakul N, Tcheou J, Thantamnu N, Theerasurakarn S, Tran S, Vilasmongkolchai T, White JA, Bhardwaj N, Garcia-Sastre A, Palese P, Krammer F, Poopipatpol K, Wirachwong P, Hjorth R, Innis BL. Safety and immunogenicity of an inactivated recombinant Newcastle disease virus vaccine expressing SARS-CoV-2 spike: Interim results of a randomised, placebo-controlled, phase 1 trial. EClinicalMedicine 2022; 45:101323. [PMID: 35284808 PMCID: PMC8903824 DOI: 10.1016/j.eclinm.2022.101323] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/24/2022] [Accepted: 02/11/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Production of affordable coronavirus disease 2019 (COVID-19) vaccines in low- and middle-income countries is needed. NDV-HXP-S is an inactivated egg-based recombinant Newcastle disease virus vaccine expressing the spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It's being developed by public sector manufacturers in Thailand, Vietnam, and Brazil; herein are initial results from Thailand. METHODS This phase 1 stage of a randomised, dose-escalation, observer-blind, placebo-controlled, phase 1/2 trial was conducted at the Vaccine Trial Centre, Mahidol University (Bangkok). Healthy males and non-pregnant females, aged 18-59 years and negative for SARS-CoV-2 antibodies, were eligible. Participants were randomised to receive one of six treatments by intramuscular injection twice, 28 days apart: 1 µg, 1 µg+CpG1018 (a toll-like receptor 9 agonist), 3 µg, 3 µg+CpG1018, 10 µg, or placebo. Participants and personnel assessing outcomes were masked to treatment. The primary outcomes were solicited and spontaneously reported adverse events (AEs) during 7 and 28 days after each vaccination, respectively. Secondary outcomes were immunogenicity measures (anti-S IgG and pseudotyped virus neutralisation). An interim analysis assessed safety at day 57 in treatment-exposed individuals and immunogenicity through day 43 per protocol. ClinicalTrials.gov (NCT04764422). FINDINGS Between March 20 and April 23, 2021, 377 individuals were screened and 210 were enroled (35 per group); all received dose one; five missed dose two. The most common solicited AEs among vaccinees, all predominantly mild, were injection site pain (<63%), fatigue (<35%), headache (<32%), and myalgia (<32%). The proportion reporting a vaccine-related AE ranged from 5·7% to 17·1% among vaccine groups and was 2·9% in controls; there was no vaccine-related serious adverse event. The 10 µg formulation's immunogenicity ranked best, followed by 3 µg+CpG1018, 3 µg, 1 µg+CpG1018, and 1 µg formulations. On day 43, the geometric mean concentrations of 50% neutralising antibody ranged from 122·23 international units per mL (IU/mL; 1 µg, 95% confidence interval (CI) 86·40-172·91) to 474·35 IU/mL (10 µg, 95% CI 320·90-701·19), with 93·9% to 100% of vaccine groups attaining a ≥ 4-fold increase over baseline. INTERPRETATION NDV-HXP-S had an acceptable safety profile and potent immunogenicity. The 3 µg and 3 µg+CpG1018 formulations advanced to phase 2. FUNDING National Vaccine Institute (Thailand), National Research Council (Thailand), Bill & Melinda Gates Foundation, National Institutes of Health (USA).
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Affiliation(s)
- Punnee Pitisuttithum
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Viravarn Luvira
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Saranath Lawpoolsri
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Sant Muangnoicharoen
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Supitcha Kamolratanakul
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Chaisith Sivakorn
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Piengthong Narakorn
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Somchaiya Surichan
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Sumalee Prangpratanporn
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Suttida Puksuriwong
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Steven Lamola
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Laina D Mercer
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | | | - Weina Sun
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Yonghong Liu
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Juan Manuel Carreño
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Rami Scharf
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Weerapong Phumratanaprapin
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Fatima Amanat
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Luc Gagnon
- Nexelis, 525 Bd Cartier O, Laval, QC H7V 3S8, Canada
| | - Ching-Lin Hsieh
- College of Natural Sciences, The University of Texas at Austin, 120 Inner Campus Dr Stop G2500, Austin, TX 78712, USA
| | - Ruangchai Kaweepornpoj
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Sarwat Khan
- Nexelis, 525 Bd Cartier O, Laval, QC H7V 3S8, Canada
| | - Manjari Lal
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Stephen McCroskery
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Jason McLellan
- College of Natural Sciences, The University of Texas at Austin, 120 Inner Campus Dr Stop G2500, Austin, TX 78712, USA
| | - Ignacio Mena
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Marcia Meseck
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Benjaluck Phonrat
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Yupa Sabmee
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Ratsamikorn Singchareon
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Stefan Slamanig
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Nava Suthepakul
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Johnstone Tcheou
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Narumon Thantamnu
- Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand
| | - Sompone Theerasurakarn
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Steven Tran
- Nexelis, 525 Bd Cartier O, Laval, QC H7V 3S8, Canada
| | | | - Jessica A White
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Nina Bhardwaj
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Adolfo Garcia-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Peter Palese
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Kittisak Poopipatpol
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Ponthip Wirachwong
- The Government Pharmaceutical Organization, 75/1 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
| | - Richard Hjorth
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Bruce L Innis
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
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5
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Pitisuttithum P, Luvira V, Lawpoolsri S, Muangnoicharoen S, Kamolratanakul S, Sivakorn C, Narakorn P, Surichan S, Prangpratanporn S, Puksuriwong S, Lamola S, Mercer LD, Raghunandan R, Sun W, Liu Y, Carreño JM, Scharf R, Phumratanaprapin W, Amanat F, Gagnon L, Hsieh CL, Kaweepornpoj R, Khan S, Lal M, McCroskery S, McLellan J, Mena I, Meseck M, Phonrat B, Sabmee Y, Singchareon R, Slamanig S, Suthepakul N, Tcheou J, Thantamnu N, Theerasurakarn S, Tran S, Vilasmongkolchai T, White JA, Garcia-Sastre A, Palese P, Krammer F, Poopipatpol K, Wirachwong P, Hjorth R, Innis BL. Safety and Immunogenicity of an Inactivated Recombinant Newcastle Disease Virus Vaccine Expressing SARS-CoV-2 Spike: Interim Results of a Randomised, Placebo-Controlled, Phase 1/2 Trial. medRxiv 2021. [PMID: 34580673 DOI: 10.1101/2021.09.17.21263758] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Production of affordable coronavirus disease 2019 (COVID-19) vaccines in low- and middle-income countries is needed. NDV-HXP-S is an inactivated egg-based Newcastle disease virus vaccine expressing the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It's being developed in Thailand, Vietnam, and Brazil; herein are initial results from Thailand. Methods This phase 1 stage of a randomised, dose-escalation, observer-blind, placebo-controlled, phase 1/2 trial was conducted at the Vaccine Trial Centre, Mahidol University (Bangkok). Healthy adults aged 18-59 years, non-pregnant and negative for SARS-CoV-2 antibodies were eligible. Participants were block randomised to receive one of six treatments by intramuscular injection twice, 28 days apart: 1 µg±CpG1018 (a toll-like receptor 9 agonist), 3 µg±CpG1018, 10 µg, or placebo. Participants and personnel assessing outcomes were masked to treatment. The primary outcomes were solicited and spontaneously reported adverse events (AEs) during 7 and 28 days after each vaccination, respectively. Secondary outcomes were immunogenicity measures (anti-S IgG and pseudotyped virus neutralisation). An interim analysis assessed safety at day 57 in treatment-exposed individuals and immunogenicity through day 43 per protocol. ClinicalTrials.gov ( NCT04764422 ). Findings Between March 20 and April 23, 2021, 377 individuals were screened and 210 were enrolled (35 per group); all received dose one; five missed dose two. The most common solicited AEs among vaccinees, all predominantly mild, were injection site pain (<63%), fatigue (<35%), headache (<32%), and myalgia (<32%). The proportion reporting a vaccine-related AE ranged from 5·7% to 17·1% among vaccine groups and was 2·9% in controls; there was no vaccine-related serious adverse event. The 10 µg formulation's immunogenicity ranked best, followed by 3 µg+CpG1018, 3 µg, 1 µg+CpG1018, and 1 µg formulations. On day 43, the geometric mean concentrations of 50% neutralising antibody ranged from 122·23 IU/mL (1 µg, 95% CI 86·40-172·91) to 474·35 IU/mL (10 µg, 95% CI 320·90-701·19), with 93·9% to 100% of vaccine groups attaining a ≥4-fold increase over baseline. Interpretation NDV-HXP-S had an acceptable safety profile and potent immunogenicity. The 3 µg and 3 µg+CpG1018 formulations advanced to phase 2. Funding National Vaccine Institute (Thailand), National Research Council (Thailand), Bill & Melinda Gates Foundation, National Institutes of Health (USA).
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White JA, Lal M. Technical product attributes in development of an oral enteric vaccine for infants. Vaccine 2020; 37:4800-4804. [PMID: 31358239 DOI: 10.1016/j.vaccine.2019.02.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/12/2019] [Accepted: 02/25/2019] [Indexed: 11/17/2022]
Abstract
Development of an oral enteric vaccine for infants is important for Shigella and enterotoxigenic Escherichia coli (ETEC) vaccine development. At a recent workshop titled "Technical Product Attributes in Development of an Oral Enteric Vaccine for Infants," at the 2nd International Vaccines Against Shigella and ETEC Conference (VASE Conference), the preferred product attributes for development were discussed for these vaccines. The aims of this workshop were to identify gaps and gather opinions from key experts from preclinical, process development, manufacturing, regulatory, and clinical areas to fine-tune and refine key target product attributes for infant oral vaccine development. The workshop used some examples of marketed oral infant vaccines to discuss potential improvements that can be made, such as inclusion of preservatives, multidose vials, and antacid buffer presentation (liquid or lyophilized) in novel oral enteric vaccine development.
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Affiliation(s)
| | - Manjari Lal
- PATH, PO Box 900922, Seattle, WA 98109, USA.
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7
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Lal M. Freeze-dried tablets for oral vaccine delivery: Ease of administration and potential for production in existing facilities. Vaccine 2020; 38:4142-4145. [PMID: 32321686 DOI: 10.1016/j.vaccine.2020.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/17/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Manjari Lal
- PATH, PO Box 900922, Seattle, WA 98109, USA.
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McAdams DH, Lal M, Lai M, Quintanar-Solares M. Feasibility Study for the Rectal Route of Administration for Gentamicin Evaluated in the Neonatal Minipig Model. J Pharm Sci 2019; 109:992-1001. [PMID: 31404543 DOI: 10.1016/j.xphs.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 07/26/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022]
Abstract
Neonatal infections are a major cause of newborn mortality in low- and middle-income countries, particularly in areas without access to inpatient care. To address this, the World Health Organization developed guidelines for delivering simplified antibiotic regimens (oral amoxicillin and intramuscular gentamicin) in outpatient settings to young infants with suspected serious bacterial infection when referral is not feasible. However, there are still limitations to access, as the regimen requires a health care provider trained in giving intramuscular injections to infants. To provide a needle-free, simplified alternate to intramuscular delivery, PATH investigated the feasibility of the rectal administration of gentamicin. Potential formulations were screened by in vitro testing, and 2 liquid enema formulations and a cocoa butter suppository were developed and evaluated in a preclinical study of the rectal uptake of gentamicin in a neonatal minipig model. Sera samples from the control group, dosed by intramuscular injection, resulted in expected sera concentrations of gentamicin, but no gentamicin was detected in the sera of groups rectally dosed with the test formulations. The results of this study did not provide evidence to support the therapeutic feasibility of rectally absorbed gentamicin.
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Affiliation(s)
- David H McAdams
- PATH, Medical Devices and Health Technologies Group, PO Box 900922, Seattle, Washington 98109.
| | - Manjari Lal
- PATH, Medical Devices and Health Technologies Group, PO Box 900922, Seattle, Washington 98109
| | - Manshun Lai
- PATH, Medical Devices and Health Technologies Group, PO Box 900922, Seattle, Washington 98109
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Berrington JE, Clarke P, Embleton ND, Ewer AK, Geethanath R, Gupta S, Lal M, Oddie S, Shafiq A, Vasudevan C, Bührer C. Retinopathy of prematurity screening at ≥30 weeks: urinary NTpro-BNP performance. Acta Paediatr 2018; 107:1722-1725. [PMID: 29617052 DOI: 10.1111/apa.14354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 11/29/2022]
Abstract
AIM Urinary N-terminal B-type natriuretic peptide NTproBNP levels are associated with the development of retinopathy of prematurity (ROP) in infants <30 weeks of gestation. The incidence of ROP in more mature infants who meet other ROP screening criteria is very low. We therefore aimed to test whether urinary NTproBNP predicted ROP development in these infants. METHODS Prospective observational study in 151 UK infants ≥30 + 0 weeks of gestation but also <32 weeks of gestation and/or <1501 g, to test the hypothesis that urinary NTproBNP levels on day of life (DOL) 14 and 28 were able to predict ROP development. RESULTS Urinary NTproBNP concentrations on day 14 and day 28 of life did not differ between infants with and without ROP (medians 144 vs 128 mcg/mL, respectively, p = 0.86 on DOL 14 and medians 117 vs 94 mcg/mL, respectively, p = 0.64 on DOL28). CONCLUSION The association previously shown for infants <30 completed weeks between urinary NTproBNP and the development of ROP was not seen in more mature infants. Urinary NTproBNP does not appear helpful in rationalising direct ophthalmoscopic screening for ROP in more mature infants, and may suggest a difference in pathophysiology of ROP in this population.
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Affiliation(s)
- JE Berrington
- Newcastle Neonatal Service; Newcastle upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
| | - P Clarke
- Norfolk and Norwich University Hospitals NHS Foundation Trust; Norfolk UK
| | - ND Embleton
- Newcastle Neonatal Service; Newcastle upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
- Institute of Health and Society; Newcastle University; Newcastle upon Tyne UK
| | - AK Ewer
- Birmingham Womens Hospital; Birmingham UK
| | | | - S Gupta
- University Hospital of North Tees; Stockton UK
| | - M Lal
- South Tees NHS Foundation Trust; Middlesbrough UK
| | - S Oddie
- Bradford Teaching Hospitals NHS Foundation Trust; Bradford UK
| | - A Shafiq
- Department of Ophthalmology; Newcastle Upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
| | - C Vasudevan
- Bradford Teaching Hospitals NHS Foundation Trust; Bradford UK
| | - C Bührer
- Charité Universitätsmedizin; Berlin Germany
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Derby N, Lal M, Aravantinou M, Kizima L, Barnable P, Rodriguez A, Lai M, Wesenberg A, Ugaonkar S, Levendosky K, Mizenina O, Kleinbeck K, Lifson JD, Peet MM, Lloyd Z, Benson M, Heneine W, O'Keefe BR, Robbiani M, Martinelli E, Grasperge B, Blanchard J, Gettie A, Teleshova N, Fernández-Romero JA, Zydowsky TM. Griffithsin carrageenan fast dissolving inserts prevent SHIV HSV-2 and HPV infections in vivo. Nat Commun 2018; 9:3881. [PMID: 30250170 PMCID: PMC6155161 DOI: 10.1038/s41467-018-06349-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [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] [Received: 04/13/2018] [Accepted: 08/24/2018] [Indexed: 01/04/2023] Open
Abstract
Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) strategies with proven in vivo efficacy rely on antiretroviral drugs, creating the potential for drug resistance and complicated treatment options in individuals who become infected. Moreover, on-demand products are currently missing from the PrEP development portfolio. Griffithsin (GRFT) is a non-antiretroviral HIV entry inhibitor derived from red algae with an excellent safety profile and potent activity in vitro. When combined with carrageenan (CG), GRFT has strong activity against herpes simplex virus-2 (HSV-2) and human papillomavirus (HPV) in vitro and in vivo. Here, we report that GRFT/CG in a freeze-dried fast dissolving insert (FDI) formulation for on-demand use protects rhesus macaques from a high dose vaginal SHIV SF162P3 challenge 4 h after FDI insertion. Furthermore, the GRFT/CG FDI also protects mice vaginally against HSV-2 and HPV pseudovirus. As a safe, potent, broad-spectrum, on-demand non-antiretroviral product, the GRFT/CG FDI warrants clinical development.
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Affiliation(s)
- Nina Derby
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA.
| | - Manjari Lal
- PATH, 2201 Westlake Ave, Suite 200, Seattle, WA, 98121, USA
| | - Meropi Aravantinou
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Larisa Kizima
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Patrick Barnable
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Aixa Rodriguez
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Manshun Lai
- PATH, 2201 Westlake Ave, Suite 200, Seattle, WA, 98121, USA
| | - Asa Wesenberg
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Shweta Ugaonkar
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Keith Levendosky
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Olga Mizenina
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Kyle Kleinbeck
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Jeffrey D Lifson
- AIDS and Cancer Virus Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, 8560 Progress Dr, Frederick, MD, 21701, USA
| | - M Melissa Peet
- MPI Research, 54943 N. Main St, Mattawan, MI, 49071, USA
| | - Zachary Lloyd
- MPI Research, 54943 N. Main St, Mattawan, MI, 49071, USA
| | - Michael Benson
- MPI Research, 54943 N. Main St, Mattawan, MI, 49071, USA
| | - Walid Heneine
- Centers for Disease Control, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Barry R O'Keefe
- Molecular Targets Program, Center for Cancer Research, and Natural Products Branch, Developmental Therapeutics Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Building 560, Room 21-105, Frederick, MD, 21702-1201, USA
| | | | - Elena Martinelli
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - Brooke Grasperge
- Tulane National Primate Research Center, 18703 Three Rivers Rd, Covington, LA, 70433-8915, USA
| | - James Blanchard
- Tulane National Primate Research Center, 18703 Three Rivers Rd, Covington, LA, 70433-8915, USA
| | - Agegnehu Gettie
- Aaron Diamond AIDS Research Center, 455 1st Ave. #7, New York, NY, 10016, USA
| | - Natalia Teleshova
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
| | - José A Fernández-Romero
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
- Science Department, Borough of Manhattan Community College, 199 Chambers St, New York, NY, 10007, USA
| | - Thomas M Zydowsky
- Center for Biomedical Research, Population Council, 1230 York Ave, New York, NY, 10065, USA
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Lal M, Lai M, Ugaonkar S, Wesenberg A, Kizima L, Rodriguez A, Levendosky K, Mizenina O, Fernández-Romero J, Zydowsky T. Development of a Vaginal Fast-Dissolving Insert Combining Griffithsin and Carrageenan for Potential Use Against Sexually Transmitted Infections. J Pharm Sci 2018; 107:2601-2610. [PMID: 29902477 DOI: 10.1016/j.xphs.2018.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 02/12/2018] [Revised: 04/24/2018] [Accepted: 06/05/2018] [Indexed: 10/14/2022]
Abstract
Precoital, on-demand topical microbicides to reduce a woman's risk of sexually transmitted infections have been in development for nearly 3 decades, but no product has been approved due to acceptability issues and poor adherence in clinical trials. We set out to develop a self-administered vaginal fast-dissolving insert (FDI) produced by freeze-drying that would deliver safe and effective amounts of the antiviral agents griffithsin (GRFT) and carrageenan (CG) and would have properties women and their partners find acceptable. We evaluated FDI physical criteria, attributes of the gel produced upon dissolving, and GRFT stability. The lead formulation, FDI-024, was selected from 13 candidates and contains 4 mg of GRFT, 15 mg of CG, and excipients (the cryoprotectant sucrose and bulking agents dextran 40 and mannitol). The FDI exhibits good friability and hardness and is stable for at least 6 months at up to 40°C/75% relative humidity. It disintegrates in less than 60 s in a physiologically relevant volume (∼1 mL) of simulated vaginal fluid, forming a viscous semi-solid gel with favorable mucoadhesive and spreading properties. The formulation retains the antiviral activity of GRFT and CG against HIV type 1 and human papillomavirus, respectively, in cell-based assays.
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Affiliation(s)
- Manjari Lal
- PATH, PO Box 900922, Seattle, Washington 98109.
| | - Manshun Lai
- PATH, PO Box 900922, Seattle, Washington 98109
| | - Shweta Ugaonkar
- Population Council, Center for Biomedical Research, New York, New York 10065
| | - Asa Wesenberg
- Population Council, Center for Biomedical Research, New York, New York 10065
| | - Larisa Kizima
- Population Council, Center for Biomedical Research, New York, New York 10065
| | - Aixa Rodriguez
- Population Council, Center for Biomedical Research, New York, New York 10065
| | - Keith Levendosky
- Population Council, Center for Biomedical Research, New York, New York 10065
| | - Olga Mizenina
- Population Council, Center for Biomedical Research, New York, New York 10065
| | - José Fernández-Romero
- Population Council, Center for Biomedical Research, New York, New York 10065; The City University of New York, Borough of Manhattan Community College, Science Department, New York, New York 10007
| | - Thomas Zydowsky
- Population Council, Center for Biomedical Research, New York, New York 10065
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Vellarikkal SK, Jayarajan R, Verma A, Ravi R, Senthilvel V, Kumar A, Saini L, Gulati S, Lal M, Mathur A, Chhetri MK, Faruq M, Scaria V, Sivasubbu S. A founder mutation MLC1 c.736delA associated with megalencephalic leukoencephalopathy with subcortical cysts-1 in north Indian kindred. Clin Genet 2018; 94:271-273. [PMID: 29667716 DOI: 10.1111/cge.13251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/01/2018] [Accepted: 03/19/2018] [Indexed: 11/28/2022]
Affiliation(s)
- S K Vellarikkal
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India.,Academy of Scientific and Innovative Research (AcSIR), CSIR-IGIB South Campus, New Delhi, India
| | - R Jayarajan
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - A Verma
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - R Ravi
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - V Senthilvel
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - A Kumar
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - L Saini
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - S Gulati
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - M Lal
- Alshifa Multispeciality Hospital, New Delhi, India
| | - A Mathur
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - M K Chhetri
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India
| | - M Faruq
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India.,Academy of Scientific and Innovative Research (AcSIR), CSIR-IGIB South Campus, New Delhi, India
| | - V Scaria
- Academy of Scientific and Innovative Research (AcSIR), CSIR-IGIB South Campus, New Delhi, India.,GN Ramachandran Knowledge Center for Genome Informatics, CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | - S Sivasubbu
- Genomics and Molecular Medicine Unit, CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB), New Delhi, India.,Academy of Scientific and Innovative Research (AcSIR), CSIR-IGIB South Campus, New Delhi, India
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Pittman DW, Brantly AM, Drobonick AL, King HT, Mesta DC, Richards CG, Lal M, Lai M. The Palatability of Lopinavir and Ritonavir Delivered by an Innovative Freeze-Dried Fast-Dissolving Tablet Formulation. AIDS Res Treat 2018; 2018:5908167. [PMID: 29593900 PMCID: PMC5822810 DOI: 10.1155/2018/5908167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 07/17/2017] [Accepted: 12/03/2017] [Indexed: 01/19/2023] Open
Abstract
Negative hedonic sensory qualities of HIV antiretroviral drugs often reduce patient adherence particularly in pediatric populations requiring oral consumption. This study examines the palatability of an innovative delivery mechanism utilizing a freeze-drying-in-blister approach to create fast-dissolving tablets (FDTs) containing a fixed-dose combination of lopinavir and ritonavir (LPV/r). Consumption patterns of solutions during brief-access and long-term testing and baby foodstuff consumption were analyzed to evaluate the orosensory detection and avoidance of placebo FDTs containing no LPV/r (FDT-) and FDTs containing LPV/r (FDT+). Rats showed no change in consumption patterns for the placebo FDT- compared with control solutions. Rats can detect but do not avoid FDT+ at body-weight-adjusted dosages in both brief-access (30-s) and long-term (23 h) consumption tests. There is an aversive response to concentrated doses of FDT+ during brief-access tests that cannot be masked by 25% sucrose. However, the strongest FDT+ concentration was not rejected when mixed with 50 g of applesauce, banana sauce, or rice cereal baby foodstuffs. The averseness of the FDT+ was associated with the presence of LPV/r and not the FDT- formulation itself. The novel FDT formulation appears to be a palatable delivery mechanism for oral antiretroviral pharmaceuticals especially when mixed with baby foodstuffs.
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Affiliation(s)
- David W. Pittman
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Alexandra M. Brantly
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Alexandra L. Drobonick
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Hannah T. King
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Daniel C. Mesta
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Caroline G. Richards
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Manjari Lal
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
| | - Manshun Lai
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, USA
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Abstract
Oral administration of vaccines is simpler and more acceptable than injection via needle and syringe, particularly for infants (Fig. 1) This route is promising for new vaccines in development against enterotoxigenic Escherichia coli (ETEC) and Shigella that cause childhood diarrhea with devastating consequences in low-resource countries. However, vaccine antigens and adjuvants given orally need buffering against the degradative effects of low stomach pH, and the type and volume of antacid buffer require special attention for infants. In addition, container/closure systems must be compatible with vaccine formulations, protect against water and gas transfer, and have minimal impact on the cold chain. Health care workers in demanding low-resource settings need an administration device that is easy to use, yet will accurately measure and safely deliver the correct vaccine dose. Developers must consider manufacturing capabilities, and immunization program managers want affordable vaccines. As new combination enteric vaccine candidates advance into clinical evaluation, features of the final vaccine presentation-liquid or dry format, diluent, buffer, primary and secondary packaging, and administration device-should be taken into account early in product development to achieve the greatest possible impact for the vaccine.
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White JA, Haghighi C, Brunner J, Estrada M, Lal M, Chen D. Preformulation studies with the Escherichia coli double mutant heat-labile toxin adjuvant for use in an oral vaccine. J Immunol Methods 2017; 451:83-89. [PMID: 28939395 PMCID: PMC5703769 DOI: 10.1016/j.jim.2017.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/12/2017] [Accepted: 09/12/2017] [Indexed: 11/25/2022]
Abstract
Double mutant heat-labile toxin (dmLT) is a promising adjuvant for oral vaccine administration. The aims of our study were to develop sensitive methods to detect low concentrations of dmLT and to use the assays in preformulation studies to determine whether dmLT remains stable under conditions encountered by an oral vaccine. We developed a sandwich ELISA specific for intact dmLT and a sensitive SDS-PAGE densitometry method, and tested stability of dmLT in glass and plastic containers, in saliva, at the pH of stomach fluid, and in high-osmolarity buffers. The developed ELISA has a quantification range of 62.5 to 0.9 ng/mL and lower limit of detection of 0.3 ng/mL; the limit of quantification of the SDS-PAGE is 10 μg/mL. This work demonstrates the application of dmLT assays in preformulation studies to development of an oral vaccine containing dmLT. Assays reported here will facilitate the understanding and use of dmLT as an adjuvant.
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16
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Lal M, Lai M, Estrada M, Zhu C. Developing a Flexible Pediatric Dosage Form for Antiretroviral Therapy: A Fast-Dissolving Tablet. J Pharm Sci 2017; 106:2173-2177. [PMID: 28499879 PMCID: PMC5514784 DOI: 10.1016/j.xphs.2017.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 01/10/2017] [Revised: 04/20/2017] [Accepted: 05/01/2017] [Indexed: 11/26/2022]
Abstract
Current presentations of the anti-HIV drugs lopinavir and ritonavir make appropriate dosing for children difficult. We conducted a feasibility study to develop a formulation for these drugs with child-safe excipients in a flexible dosage form for children across the pediatric age spectrum. The freeze-drying in blister approach was used to produce fast-dissolving tablets (FDTs), as these can be dispersed in fluids for easy administration, even to infants, and appropriate portions of the dispersion can be given for different ages/weights. We combined various ratios of polymers, surfactants, and bulking agents to incorporate the 2 highly hydrophobic drugs while maintaining drug stability, rapid disintegration, and good handling properties. The final FDT was robust and disintegrated in 0.5 mL of fluid in 10 s with up to 4 tablets dissolving in 2 mL to achieve varying doses accommodated in a common teaspoon. Drug recovery after dissolution in small volumes of liquid or fluid foods was 90%-105%. The final candidate FDT was stable at 40°C, 75% relative humidity for up to 3 months. FDTs are a promising flexible dosage form for antiretroviral treatment for pediatric patients, especially in low-resource settings.
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Affiliation(s)
- Manjari Lal
- PATH, PO Box 900922, Seattle, Washington 98121.
| | - Manshun Lai
- PATH, PO Box 900922, Seattle, Washington 98121
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Iyengar PK, Srinivasan M, Sikka SK, Shyam A, Chitra V, Kulkarni LV, Rout RK, Krishnan MS, Malhotra SK, Gaonkar DG, Sadhukhan HK, Nagvenkar VB, Nayar MG, Mitra SK, Raghunathan P, Degwekar SB, Radhakrishnan TP, Sundaresan R, Arunachalam J, Raju VS, Kalyanaraman R, Gangadharan S, Venkateswaran G, Moorthy PN, Venkateswarlu KS, Yuvaraju B, Kishore K, Guha SN, Panajkar MS, Rao KA, Raj P, Suryanarayana P, Sathyamoorthy A, Datta T, Bose H, Prabhu LH, Sankaranarayanan S, Shetiya RS, Veeraraghavan N, Murthy TS, Sen BK, Joshi PV, Sharma KGB, Joseph TB, Iyengar TS, Shrikhande VK, Mittal KC, Misra SC, Lal M, Rao PS. Bhabha Atomic Research Centre Studies in Cold Fusion. ACTA ACUST UNITED AC 2017. [DOI: 10.13182/fst90-a29233] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- P. K. Iyengar
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - M. Srinivasan
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - S. K. Sikka
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - A. Shyam
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - V. Chitra
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - L. V. Kulkarni
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - R. K. Rout
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - M. S. Krishnan
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - S. K. Malhotra
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - D. G. Gaonkar
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - H. K. Sadhukhan
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - V. B. Nagvenkar
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - M. G. Nayar
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - S. K. Mitra
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - P. Raghunathan
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - S. B. Degwekar
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | | | - R. Sundaresan
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - J. Arunachalam
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - V. S. Raju
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - R. Kalyanaraman
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - S. Gangadharan
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | | | - P. N. Moorthy
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | | | - B. Yuvaraju
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - K. Kishore
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - S. N. Guha
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - M. S. Panajkar
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - K. A. Rao
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - P. Raj
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | | | | | - T. Datta
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - H. Bose
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - L. H. Prabhu
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | | | - R. S. Shetiya
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | | | - T. S. Murthy
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - B. K. Sen
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - P. V. Joshi
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - K. G. B. Sharma
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - T. B. Joseph
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - T. S. Iyengar
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | | | - K. C. Mittal
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - S. C. Misra
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - M. Lal
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
| | - P. S. Rao
- Bhabha Atomic Research Centre, Trombay, Bombay 400085, India
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Abstract
Introduction: We would like to analyze the role of cemented hemiarthroplasty in elderly osteoporotic unstable intertrochanteric fractures through trochanteric fracture window. Materials and Methods: The study was conducted from July 2011 to July 2014. From a total of 265 consecutive patients with intertrochanteric fractures of 42 patients were selected according to inclusion criteria and results were analyzed prospectively. All patients were operated at tertiary care institute. Patients which matched the inclusion criteria were selected. 42 patients entered the study and all completed the study. Primary cemented hemiarthroplasty was done in all patients. Modified Harris Hip Score was used to assess all the patients. Results: 42 patients were included in the study with an average age of 80.7 years. Only AO/OTA type 31-A2.2 and 31-A2.3 were included, average HHS at final follow up of three years was 86.2. No revision or reoperation was done. Conclusion: In a selected cohort of patients primary prosthetic replacement in elderly osteoporotic unstable intertrochanteric fractures is good option and the surgical technique allowed us to perform it more easily.
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Affiliation(s)
- A Thakur
- Department of Orthopaedics, Indira Gandhi Medical College, Shimla, India
| | - M Lal
- Department of Orthopaedics, Indira Gandhi Medical College, Shimla, India
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Abstract
Thermoresponsive gels have unique physicochemical properties that may enable more effective mucosal delivery of active compounds. The thermoresponsive gel (TRG) formulation developed by our group for sublingual delivery maintains fluid-like liquid properties at 2 °C-8 °C and forms a gel at the physiological temperature (~37 °C) within a few seconds. Here, we describe the preparation of a thermoresponsive gel vaccine formulation. Our preclinical studies with various antigens suggest that the mucoadhesive, adjuvanted TRG formulation enabled increased contact of the vaccine antigen with the mucosa, resulting in increased mucosal response(s) with a potential for antigen dose reduction.
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Affiliation(s)
- Manjari Lal
- PATH, 900922, Westlake Ave, Suite 200, Seattle, WA, 98109, USA.
| | - Jessica White
- PATH, 900922, Westlake Ave, Suite 200, Seattle, WA, 98109, USA
| | - Changcheng Zhu
- PATH, 900922, Westlake Ave, Suite 200, Seattle, WA, 98109, USA
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Lal M, Jarrahian C, Zhu C, Hosken NA, McClurkan CL, Koelle DM, Saxon E, Roehrig A, Zehrung D, Chen D. Stability of live attenuated rotavirus vaccine with selected preservatives and primary containers. Vaccine 2016; 34:2483-9. [PMID: 27085171 DOI: 10.1016/j.vaccine.2016.03.093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 12/21/2015] [Revised: 03/22/2016] [Accepted: 03/29/2016] [Indexed: 10/22/2022]
Abstract
Rotavirus infection, which can be prevented by vaccination, is responsible for a high burden of acute gastroenteritis disease in children, especially in low-income countries. An appropriate formulation, packaging, and delivery device for oral rotavirus vaccine has the potential to reduce the manufacturing cost of the vaccine and the logistical impact associated with introduction of a new vaccine, simplify the vaccination procedure, and ensure that the vaccine is safely and accurately delivered to children. Single-dose prefilled presentations can be easy to use; however, they are typically more expensive, can be a bottleneck during production, and occupy a greater volume per dose vis-à-vis supply chain storage and medical waste disposal, which is a challenge in low-resource settings. Multi-dose presentations used thus far have other issues, including increased wastage of vaccine and the need for separate delivery devices. In this study, the goals were to evaluate both the technical feasibility of using preservatives to develop a liquid multi-dose formulation and the primary packaging alternatives for orally delivered, liquid rotavirus vaccines. The feasibility evaluation included evaluation of commonly used preservatives for compatibility with rotavirus vaccines and stability testing of rotavirus vaccine in various primary containers, including Lameplast's plastic tubes, BD's oral dispenser version of Uniject™ (Uniject DP), rommelag's blow-fill-seal containers, and MEDInstill's multi-dose vial and pouch. These presentations were compared to a standard glass vial. The results showed that none of the preservatives tested were compatible with a live attenuated rotavirus vaccine because they had a detrimental effect on the viability of the virus. In the presence of preservatives, vaccine virus titers declined to undetectable levels within 1 month. The vaccine formulation without preservatives maintained a stability profile over 12 months in all primary containers that was similar to its profile in standard glass vials. This study demonstrates that there are multiple options for the primary container for rotavirus vaccines intended for oral delivery. Selection of an optimal primary container should take into consideration additional factors, including stability as well as cold chain volume, usability, cost, and manufacturing feasibility.
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Affiliation(s)
| | | | | | - Nancy A Hosken
- PATH, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - David M Koelle
- Department of Medicine, University of Washington, Seattle, WA, USA; Department of Laboratory Medicine, University of Washington, Seattle, WA, USA; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Benaroya Research Institute, Seattle, WA, USA
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Bhau BS, Borah B, Ahmed R, Phukon P, Gogoi B, Sarmah DK, Lal M, Wann SB. Influence of root-knot nematode infestation on antioxidant enzymes, chlorophyll content and growth in Pogostemon cablin (Blanco) Benth. Indian J Exp Biol 2016; 54:254-261. [PMID: 27295922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Plants adapt themselves to overcome adverse environmental conditions, and this involves a plethora of concurrent cellular activities. Physiological experiments or metabolic profiling can quantify this response. Among several diseases of Pogostemon cablin (Blanco) Benth. (Patchouli), root-knot nematode infection caused by Meloidogyne incognita (Kofoid and White) Chitwood causes severe damage to the plant and hence, the oil production. In the present study, we identified M. incognita morphologically and at molecular level using sequenced characterized amplified region marker (SCAR). M. incognita was artificially inoculated at different levels of second stage juveniles (J₂) to examine the effect on Patchouli plant growth parameters. Peroxidase and polyphenol oxidase enzyme activity and changes in the total phenol and chlorophyll contents in M. incognita was also evaluated in response to infection. The results have demonstrated that nematode infestation leads to increased peroxidase activities in the leaves of the patchouli plants and thereby, increase in phenolic content as a means of defence against nematode infestation. Chlorophyll content was also found decreased but no changes in polyphenol oxidase enzyme activity.
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Chandrasekaran L, Lal M, Van De Verg LL, Venkatesan MM. A study of different buffers to maximize viability of an oral Shigella vaccine. Vaccine 2015; 33:6156-60. [PMID: 26428454 DOI: 10.1016/j.vaccine.2015.09.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 04/22/2015] [Revised: 08/13/2015] [Accepted: 09/19/2015] [Indexed: 11/15/2022]
Abstract
Live, whole cell killed and subunit vaccines are being developed for diarrheal diseases caused by V. cholerae, Shigella species, ETEC, and Campylobacter. Some of these vaccines can be administered orally since this route best mimics natural infection. Live vaccines administered orally have to be protected from the harsh acidic gastric environment. Milk and bicarbonate solutions have been administered to neutralize the stomach acid. For many Shigella vaccine trials, 100-120 ml of a bicarbonate solution is ingested followed by the live vaccine candidate, which is delivered in 30 ml of bicarbonate, water or saline. It is not clear if maximum bacterial viability is achieved under these conditions. Also, volumes of neutralizing buffer that are optimal for adults may be unsuitable for children and infants. To address these questions, we performed studies to determine the viability and stability of a Shigella sonnei vaccine candidate, WRSS1, in a mixture of different volumes of five different buffer solutions added to hydrochloric acid to simulate gastric acidity. Among the buffers tested, bicarbonate solution, rotavirus buffer and CeraVacx were better at neutralizing acid and maintaining the viability of WRSS1. Also, a much smaller volume of the neutralizing buffer was sufficient to counteract stomach acid while maintaining bacterial viability.
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Affiliation(s)
- Lakshmi Chandrasekaran
- Bacterial Diseases Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Manjari Lal
- PATH, Enteric Vaccines Initiative, Seattle, WA, USA
| | | | - Malabi M Venkatesan
- Bacterial Diseases Branch, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.
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23
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Bhushan R, Lal M. Enantioseparation of amino alcohols by reversed-phase high-performance liquid chromatography using cyanuric chloride-based chiral derivatizing reagents having amino acids and their amides as chiral auxiliaries. ACTA CHROMATOGR 2014. [DOI: 10.1556/achrom.26.2014.3.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Zhu C, Shoji Y, McCray S, Burke M, Hartman CE, Chichester JA, Breit J, Yusibov V, Chen D, Lal M. Stabilization of HAC1 Influenza Vaccine by Spray Drying: Formulation Development and Process Scale-Up. Pharm Res 2014; 31:3006-18. [DOI: 10.1007/s11095-014-1394-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 04/15/2014] [Indexed: 11/29/2022]
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26
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Lal M, Zhu C, McClurkan C, Koelle DM, Miller P, Afonso C, Donadeu M, Dungu B, Chen D. Development of a low-dose fast-dissolving tablet formulation of Newcastle disease vaccine for low-cost backyard poultry immunisation. Vet Rec 2014; 174:504. [PMID: 24591479 DOI: 10.1136/vr.101926] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The immunisation of backyard poultry is critical for maintaining healthy flocks to provide nutrition and income for low-resource farmers worldwide. A vaccine presentation for flocks of less than 50 birds could make it more affordable and accessible, increasing uptake and impact. Fast-dissolving tablets (FDT) of Newcastle disease virus (NDV) vaccine were produced by freeze drying the LaSota NDV strain combined with excipients into tablets containing a small number of doses and packaged in polymer blister sheets. The NDV-FDT vaccine maintained virus stability for more than six months at 4°C, based on plaque assay and egg infectivity dose data. Stability was further confirmed in a challenge study, where the tablet vaccine elicited a strong immune response and provided 100 per cent protection to vaccinated chickens infected with a virulent strain of NDV. The vaccine tablet can be diluted in water (no needle or syringe required) and administered either in drinking water or with a dropper via an intraocular and/or intransal route. Results indicate that FDTs containing a small number of doses are a feasible presentation for backyard poultry farmers. The compact packaging of the FDTs will also provide cost savings in storing and distributing the vaccine in the cold chain.
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Affiliation(s)
- M Lal
- Department of Vaccine and Pharmaceutical Technologies, PATH, Seattle, WA, USA
| | - C Zhu
- Department of Vaccine and Pharmaceutical Technologies, PATH, Seattle, WA, USA
| | - C McClurkan
- Division of Allergy and Infectious Diseases, Department of Medicine,Division of Virology, Department of Laboratory Medicine, Department of Global Health, University of Washington, Seattle, WA, USA Vaccine and Infectious Disease Division, The Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - D M Koelle
- Division of Allergy and Infectious Diseases, Department of Medicine,Division of Virology, Department of Laboratory Medicine, Department of Global Health, University of Washington, Seattle, WA, USA Vaccine and Infectious Disease Division, The Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - P Miller
- Southeast Poultry Research Lab, USDA ARS, Athens, GA, USA
| | - C Afonso
- Southeast Poultry Research Lab, USDA ARS, Athens, GA, USA
| | - M Donadeu
- Global Alliance for Livestock Veterinary Medicines, Edinburgh, Scotland, UK
| | - B Dungu
- Global Alliance for Livestock Veterinary Medicines, Edinburgh, Scotland, UK
| | - D Chen
- Department of Vaccine and Pharmaceutical Technologies, PATH, Seattle, WA, USA
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White JA, Blum JS, Hosken NA, Marshak JO, Duncan L, Zhu C, Norton EB, Clements JD, Koelle DM, Chen D, Weldon WC, Steven Oberste M, Lal M. Serum and mucosal antibody responses to inactivated polio vaccine after sublingual immunization using a thermoresponsive gel delivery system. Hum Vaccin Immunother 2014; 10:3611-21. [PMID: 25483682 PMCID: PMC4514067 DOI: 10.4161/hv.32253] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/23/2014] [Accepted: 08/04/2014] [Indexed: 01/27/2023] Open
Abstract
Administering vaccines directly to mucosal surfaces can induce both serum and mucosal immune responses. Mucosal responses may prevent establishment of initial infection at the port of entry and subsequent dissemination to other sites. The sublingual route is attractive for mucosal vaccination, but both a safe, potent adjuvant and a novel formulation are needed to achieve an adequate immune response. We report the use of a thermoresponsive gel (TRG) combined with a double mutant of a bacterial heat-labile toxin (dmLT) for sublingual immunization with a trivalent inactivated poliovirus vaccine (IPV) in mice. This TRG delivery system, which changes from aqueous solution to viscous gel upon contact with the mucosa at body temperature, helps to retain the formulation at the site of delivery and has functional adjuvant activity from the inclusion of dmLT. IPV was administered to mice either sublingually in the TRG delivery system or intramuscularly in phosphate-buffered saline. We measured poliovirus type-specific serum neutralizing antibodies as well as polio-specific serum Ig and IgA antibodies in serum, saliva, and fecal samples using enzyme-linked immunosorbent assays. Mice receiving sublingual vaccination via the TRG delivery system produced both mucosal and serum antibodies, including IgA. Intramuscularly immunized animals produced only serum neutralizing and binding Ig but no detectable IgA. This study provides proof of concept for sublingual immunization using the TRG delivery system, comprising a thermoresponsive gel and dmLT adjuvant.
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Key Words
- CT, cholera toxin
- DPBS, Dulbecco's phosphate-buffered saline
- DU, D-antigen units
- ELISA, enzyme-linked immunosorbent assay
- IM, intramuscular
- IPV, inactivated poliovirus vaccine
- IgA, immunoglobulin A
- IgG, immunoglobulin G
- OPV, oral poliovirus vaccine
- PBS, phosphate-buffered saline
- RT, room temperature
- SL, sublingual
- SSI, Staten Serum Institute
- TMB, tetramethylbenzidine
- TRG, thermoresponsive gel
- adjuvants
- dmLT
- dmLT, double mutant heat-labile toxin
- mucosal immune response
- poliovirus
- sublingual immunization
- thermoresponsive gel
- vaccine delivery
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Affiliation(s)
| | | | - Nancy A Hosken
- Department of Medicine; University of Washington; Seattle, WA USA
| | - Joshua O Marshak
- Department of Medicine; University of Washington; Seattle, WA USA
| | | | | | - Elizabeth B Norton
- Department of Microbiology and Immunology; Tulane University School of Medicine; New Orleans, LA USA
| | - John D Clements
- Department of Microbiology and Immunology; Tulane University School of Medicine; New Orleans, LA USA
| | - David M Koelle
- Department of Medicine; University of Washington; Seattle, WA USA
- Department of Laboratory Medicine; University of Washington; Seattle, WA USA
- Vaccine and Infectious Diseases Division; Fred Hutchinson Cancer Research Institute; Seattle, WA USA
- Department of Global Health; University of Washington; Seattle, WA USA
| | | | - William C Weldon
- Division of Viral Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
| | - M Steven Oberste
- Division of Viral Diseases; Centers for Disease Control and Prevention; Atlanta, GA USA
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Lal M, Raheja S, Kale S, Das N, Gogia AR, Bhowmik KT. An experience with 156 patients attending a newly organized pain and palliative care clinic in a tertiary hospital. Indian J Cancer 2013; 49:293-7. [PMID: 23238147 DOI: 10.4103/0019-509x.104491] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT Pain and palliative care clinic (PCC). AIMS The primary object of this study was to enumerate the demographic characteristics of patients attending a newly organized PCC. The secondary purpose was to detect symptom prevalence and frequency of different cancers in these patients. SETTINGS AND DESIGN Prospective cross-sectional descriptive study. MATERIALS AND METHODS A prospective cross-sectional descriptive study was done on patients referred to the PCC of a tertiary hospital in North India. Comprehensive details of all patients were recorded systematically on the first visit on a proforma specially prepared for the newly established palliative care clinic. STATISTICAL ANALYSIS USED The descriptive statistics of palliative care data was presented in terms of frequencies and percentages (%) for categorical variables. RESULTS The data collected at our PCC showed that out of 156 patients, 87 were males and 69 were females. Patients of all ages varying from 6 to 85 years were seen. Most patients (82.1%) lived with their families, and 28 (17.1%) patients lived alone and had no financial support. The most common primary diagnoses were head and neck cancers (38.5%), carcinoma cervix (15.4%), breast cancer (10.3%), colorectal cancer (6.4%), and lung cancer (4.5%). Frequency of seven most common symptoms was pain (100%), insomnia (64.1%), loss of appetite (34.6%), nausea (32.7%), vomiting (32.1%), constipation (31.4%) and sore mouth (28.8%). CONCLUSIONS Population-based studies determine the actual magnitude of sufferers and suffering and show that palliative care services should be included as an essential component in a tertiary care hospital. The objective should be to reach out to the patient and help in improving the patent's quality of life in every way possible.
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Affiliation(s)
- M Lal
- Department of Radiotherapy, Safdarjung Hospital and VMMC, New Delhi, India
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Lal M, Priddy S, Bourgeois L, Walker R, Pebley W, Brown J, Desai J, Darsley MJ, Kristensen D, Chen D. Development of a fast-dissolving tablet formulation of a live attenuated enterotoxigenic E. coli vaccine candidate. Vaccine 2013; 31:4759-64. [DOI: 10.1016/j.vaccine.2013.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/28/2013] [Accepted: 08/05/2013] [Indexed: 12/29/2022]
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Lal M, Pattison HM, Allan TF, Callender R. Does post-caesarean dyspareunia reflect sexual malfunction, pelvic floor and perineal dysfunction? J OBSTET GYNAECOL 2012; 31:617-30. [PMID: 21973137 DOI: 10.3109/01443615.2011.594915] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim was to define post-caesarean dyspareunia as a sexual and pelvic-perineal symptom. Post-caesarean (80 elective, 104 emergency) and 100 vaginally delivered primiparae had domiciliary interviews at 10 months postpartum. A total of 50 (28% and 27%) post-caesarean and 46 (46%) vaginally delivered, reported dyspareunia. Severely impaired general sexual health occurred in 82 (24% elective, 25% emergency, 35% vaginally delivered) as category 3 (dyspareunia with sexual symptoms) and 27 (10% elective, 7% emergency, 12% vaginally delivered) as category 4 (reduced frequency < 6). The risk of dyspareunia (RR 1.14, CI 0.73, 1.77) or impaired general sexual health (RR 0.93, CI 0.32, 2.74) was similar among those with or without perineal trauma. Both caesarean and perineal scars were associated with sexual malfunction. Primiparae with new incontinence had a lower risk of dyspareunia than impaired general sexual health. Awareness of the associations of post-caesarean dyspareunia and impaired general sexual health with incontinence would facilitate appropriate obstetric decision-making. Further research is indicated.
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Affiliation(s)
- M Lal
- Women's and Children's Directorate, Dudley Group of Hospitals NHS Foundation Trust, Dudley, UK.
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Rizvi SAH, Naqvi SAA, Zafar MN, Hussain Z, Hashmi A, Hussain M, Akhtar SF, Ahmed E, Aziz T, Sultan G, Sultan S, Mehdi SH, Lal M, Ali B, Mubarak M, Faiq SM. A renal transplantation model for developing countries. Am J Transplant 2011; 11:2302-7. [PMID: 21883911 DOI: 10.1111/j.1600-6143.2011.03712.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The estimated incidence of end-stage renal disease (ESRD) in Pakistan is 100 per million population. Paucity and high costs of renal replacement therapy allows only 10% to get dialysis and 4-5% transplants. Our center, a government organization, started a dialysis and transplant program in 1980s where all services were provided free of charge to all patients. It was based on the concept of community government partnership funded by both partners. The guiding principles were equity, transparency, accountability and development of all facilities under one roof. This partnership has sustained itself for 30 years with an annual budget of $25 million in 2009. Daily 600 patients are dialyzed and weekly 10-12 receive transplants. One- and 5-year graft survival of 3000 transplants is 92% and 85%, respectively. The institute became a focus of transplantation in Pakistan and played a vital role in the campaign against transplant tourism and in promulgation of transplant law of 2007, and also helped to increase altruistic transplants in the country. This model emphasizes that in developing countries specialized centers in government sector are necessary for transplantation to progress and community support can make it available to the common man.
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Affiliation(s)
- S A H Rizvi
- Department of Urology, Sindh Institute of Urology and Transplantation, Civil Hospital, Karachi, Pakistan.
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Abstract
OBJECTIVE To study the relationship of adolescent development and eating disorder related quality of life in Indian females. METHOD 461 female school students (aged 12-17 yrs) were recruited from middle to high socio-economic status (SES), English speaking schools in Delhi, India. Adolescent development was measured by Tanner stage and months since menarche. Subjects completed the Quality of Life for Eating Disorders questionnaire (QOL ED), which included six subscores. Correlation and partial correlation coefficient analysis to control for Body Mass Index (BMI) were performed. RESULTS After controlling for BMI, all adolescent development measures were correlated with the psychological feelings (PSY) subscore. This subscore contained items relating to confusion, social unease, sadness, difficulty coping, desiring perfection and loss of control. Tanner breast stage was correlated with the eating behaviour (EB) subscore. DISCUSSION During adolescent development, Indian girls became more aware of their psychological feelings and emotions. Only those reporting breast development were using behaviours to control their body, weight and shape. These behaviours are not associated with the presence of disordered eating thoughts, such as preoccupation with food, eating, body weight or shape.
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Affiliation(s)
- M Lal
- Department of Obstetrics and Gynaecology, University of Sydney, Royal North Shore Hospital, NSW 2065, Australia.
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Abstract
ABSTRACTMeasurements of the equilibrium electrical conductivity of Ca-doped BaTiO3indicate a highly acceptor-doped behavior when y > 1 in the general formula (Ba1−xCaxO)yTiO2. It has been suggested that when there is an excess of alkaline earth oxides, some Ca++occupies Ti-sites, where it acts as a doubly charged acceptor, CaTi''. This possibility has been checked with a recently developed technique for determining the crystallographic site occupancy of impurity atoms. Known as ALCHEMI (Atom Location Using Channeling-Enhanced Microanalysis), the technique relies on the dependence of the characteristic X-ray emission on the incident electron beam direction. A significant channeling effect was observed for slightly positive and negative excitations of the [100] reflection. The results indicate that for the composition (Ba0,85Ca0.15O)1.02TiO2.00, a substantial fraction of the total calcium (> 20%) occupies Ti sites.
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Lal M, Joshi M, Kumar DN, Friend CS, Winiarz J, Asefa T, Kim K, Prasad PN. Inorganic- Organic Hybrid Materials For Photonics. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-519-217] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractMolecular materials comprised of inorganic:organic composites are of considerable interest in photonics, optoelectronics and biophotonics. We report broad band lasing and tunable filters in sol-gel processed poly (p-phenylene vinylene) PPV: Silica composites. Optical power limiting in near IR wavelength region is also reported in dye doped PPV: silica multiphasic nanocomposites. For making hybrid inorganic: organic composites the reverse micelle mediated synthesis technique has been exploited to synthesize dye encapsulated metal oxide particles, thiocresol capped CdS clusters, Cul and AgI nanoparticles. These particles were dispersed in polymeric matrix for applications in photoconductivity and photorefractive measurements.
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Chen D, Kapre S, Goel A, Suresh K, Beri S, Hickling J, Jensen J, Lal M, Preaud J, LaForce M, Kristensen D. Thermostable formulations of a hepatitis B vaccine and a meningitis A polysaccharide conjugate vaccine produced by a spray drying method. Vaccine 2010; 28:5093-9. [DOI: 10.1016/j.vaccine.2010.04.112] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 04/28/2010] [Accepted: 04/30/2010] [Indexed: 11/26/2022]
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Kashyap S, Lal M. S-31 Alkaptonuric Ochronosis – A Review of 8 Cases. J Biomech 2010. [DOI: 10.1016/s0021-9290(10)70084-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lal M. I181 Violence against women: The role of the obstetrician/gynaecologist in prevention and care. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60181-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Braun LJ, Jezek J, Peterson S, Tyagi A, Perkins S, Sylvester D, Guy M, Lal M, Priddy S, Plzak H, Kristensen D, Chen D. Characterization of a thermostable hepatitis B vaccine formulation. Vaccine 2009; 27:4609-14. [DOI: 10.1016/j.vaccine.2009.05.069] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2009] [Revised: 05/19/2009] [Accepted: 05/26/2009] [Indexed: 10/20/2022]
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Lal M, Kaur H. A microbiological study of bottled mineral water marketed in Ludhiana. Indian J Public Health 2006; 50:31-2. [PMID: 17193757] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
The microbiological quality of bottled mineral water marketed in Ludhiana was examined, Twenty three brands were analyzed for presumptive coliform count by multiple tube tests, and E. coli count was confirmed by Eijkman test. Bacterial and fungal loads were tested by membrane filtration test. Out of 23 only one sample (4.4%) showed the presumptive coliform count to be 460 most probable number (MPN)l 1 00ml,and 1 was found to be positive when tested by Eijkman test for Ecoli. In the membrane filtration test three samples (13%) showed more than two types of bacteria. Different types of bacteria isolated included Bacillus sp (19/23). Pseudomonas spp (13123), Ecoli, Klebsiella sp and S.albus one each Fungi was isolated from five of twenty three. (22%) samples. Only one brand of mineral water was unfit for human consumption. The rest of the samples were contaminated with non pathogenic flora.
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Affiliation(s)
- M Lal
- Dept. of Microbiology, CMC & Hospital, Ludhiana.
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Lal M. Invasiveness - An indicator of differentiation of virulent and non virulent isolates of Yersinia enterocolitica. Indian J Med Microbiol 2005; 23:69-70. [PMID: 15928432 DOI: 10.4103/0255-0857.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Asuzu MC, Ram BP, Salusalu M, Lal M, Tuqa S. Participatory operational research of the dynamics of the primary health care programme in Fiji. Pac Health Dialog 2004; 11:31-37. [PMID: 18181439] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
To review the history of primary health care (PFIC) in Fiji, to find out the present PHC policy situation at all the management levels as well as the dynamics of community mobilization and PHC service extension. Findings are to be used to propose the strengthening of the implementation of PHC in the country as the case may be. This is a mail questionnaire study of managers at all three levels of the health services for the historical study and those at the district health system for the PHC implementation. Fiji has had a very active primary health care programme. Community mobilization and health service extension was initially very active and health status indices improved greatly. However, this momentum has dropped due to reduction in following the initial directives for this purpose as at the early part of the programme. It is recommended that the programme of community health service extension be restored as a matter of a national written policy. The medical officers in charge of PHC should be trained in community medicine as before, in order to regain the lost momentum.
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Affiliation(s)
- M C Asuzu
- Department of Preventive and Social Medicine, University College Hospital, Ibadan Nigeria.
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Lal M, Kaur H, Gupta LK. Differentiation between Virulent and Avirulent Y.enterocolitica Isolates using Congo Red Magnesium Oxalate Agar. Indian J Med Microbiol 2003. [DOI: 10.1016/s0255-0857(21)03081-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lal M, Kaur H, Gupta LK. Anticryptococcal activity of garlic extract - a preliminary report. Indian J Med Microbiol 2003; 21:214. [PMID: 17643027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Lal M, Kaur H, Gupta LK. Y. enterocolitica gastroenteritis - a prospective study. Indian J Med Microbiol 2003; 21:186-8. [PMID: 17643016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Two thousand faecal samples were collected from diarrhoeal patients of all age groups and processed by using MacConkey agar and Yersinia selective agar [Cefsulodin-Irgasan-Novobiocin (CIN) media]. One hundred and seventy faecal samples from non-diarrhoeal (healthy controls) were also processed. Samples were subjected to cold enrichment before processing. Three hundred and seventy-four (18.7%) faecal samples were positive for bacterial pathogens, of which 41 (2.05%) had Y. enterocolitica infection. Y. enterocolitica was more common in patients above 16 years of age 23/41 (56%). Higher rates of isolation were recorded during winter months. Of the typable isolates 21.9% belonged to 0:3 serotype followed by 01, 2a, 3 (17%) serotype. Twelve (29.2%) isolates were untypable. 51.2% isolates of Y. enterocolitica belonged to biotype IV whereas 24.4%, 19.5%, 4.9% belonged to type I, II and III respectively. Majority of the isolates were found sensitive to chloramphenicol, gentamicin, amikacin, ciprofloxacin, ampicillin, netromycin, cefoperazone, tobramycin and pefloxacin. All isolates were resistant to ofloxacin.
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Affiliation(s)
- M Lal
- Department of Microbiology, Christian Medical College, Ludhiana -141 008, Punjab, India
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Kaur H, Lal M. Cryptosporodium infection in patients of diarrhoea in Ludhiana. Trop Gastroenterol 2002; 23:206. [PMID: 12833715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Dhanjal TS, Lal M, Haynes R, Lip G. A comparison of cardiovascular risk factors among Indo-Asian and caucasian patients admitted with acute myocardial infarction in Kuala Lumpur, Malaysia and Birmingham, England. Int J Clin Pract 2001; 55:665-8. [PMID: 11777289] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Indo-Asians in the UK are at an increased risk of coronary artery disease (CAD); this may be a reflection of their cardiovascular risk factor profile as well as of a more sedentary lifestyle. We hypothesised that Indo-Asians in Malaysia and the UK may exhibit a similar cardiovascular risk factor and physical activity profile, which would be more adverse compared with caucasians. We studied 70 consecutive Indo-Asian patients admitted to hospitals in Kuala Lumpur, Malaysia (n=42; 35 males; mean age 60.6 years, SD 11.8); and Birmingham, England (n=28; 20 males; mean age 60.8 years, SD 12.9). Both groups of Indo-Asian patients were compared with 20 caucasian patients (13 males; mean age 62.7 years, SD 9.4) admitted with myocardial infarction from Birmingham. There was a higher prevalence of diabetes among Indo-Asians in both countries than among caucasians (p=0.0225). By contrast, caucasians had a higher prevalence of hypercholesterolaemia (p=0.0113), peripheral vascular disease (p=0.0008), regular alcohol consumption (p<0.0001) and family history of CAD (p=0.0041). There were no significant differences in mean age, body mass index or blood pressures. There was a significantly lower leisure activity score (p=0.001) and total physical activity score (p=0.003) among Indo-Asians in both countries than among caucasians. This survey has demonstrated differences in cardiovascular risk factors among Indo-Asian and caucasian patients. The high prevalence of diabetes, as well as the lower physical activity and sedentary lifestyles among Indo-Asians, in both Malaysia and the UK, may in part contribute to the high incidence of CAD in this ethnic group.
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Affiliation(s)
- T S Dhanjal
- University Department of Medicine, City Hospital, Birmingham, UK
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Aizman O, Uhlén P, Lal M, Brismar H, Aperia A. Ouabain, a steroid hormone that signals with slow calcium oscillations. Proc Natl Acad Sci U S A 2001; 98:13420-4. [PMID: 11687608 PMCID: PMC60886 DOI: 10.1073/pnas.221315298] [Citation(s) in RCA: 222] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2001] [Indexed: 12/20/2022] Open
Abstract
The plant-derived steroid, digoxin, a specific inhibitor of Na,K-ATPase, has been used for centuries in the treatment of heart disease. Recent studies demonstrate the presence of a digoxin analog, ouabain, in mammalian tissue, but its biological role has not been elucidated. Here, we show in renal epithelial cells that ouabain, in doses causing only partial Na,K-ATPase inhibition, acts as a biological inducer of regular, low-frequency intracellular calcium ([Ca(2+)](i)) oscillations that elicit activation of the transcription factor, NF-kappa B. Partial inhibition of Na,K-ATPase using low extracellular K(+) and depolarization of cells did not have these effects. Incubation of cells in Ca(2+)-free media, inhibition of voltage-gated calcium channels, inositol triphosphate receptor antagonism, and redistribution of actin to a thick layer adjacent to the plasma membrane abolished [Ca(2+)](i) oscillations, indicating that they were caused by a concerted action of inositol triphosphate receptors and capacitative calcium entry via plasma membrane channels. Blockade of ouabain-induced [Ca(2+)](i) oscillations prevented activation of NF-kappa B. The results demonstrate a new mechanism for steroid signaling via plasma membrane receptors and underline a novel role for the steroid hormone, ouabain, as a physiological inducer of [Ca(2+)](i) oscillations involved in transcriptional regulation in mammalian cells.
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Affiliation(s)
- O Aizman
- Department of Woman and Child Health, Karolinska Institutet, Astrid Lindgren Children's Hospital, Q2:09, S-171 76 Stockholm, Sweden
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Sircar AR, Kumar A, Lal M. Clinical evaluation of sibutramine in obese type 2 diabetic patients refractory to dietary management. J Assoc Physicians India 2001; 49:885-8. [PMID: 11837755] [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] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
MATERIAL AND METHODS An open, non-comparative study was carried out to assess the efficacy and toleration profile of sibutramine, a new antiobesity drug, in promoting weight loss in obese type 2 diabetes mellitus subject who failed to reduce weight after strict dietary control. Twenty seven patients completed the study. Sibutramine was started as a single morning dose of 10 mg and was subsequently increased to 15 mg daily if weight loss was not satisfactory. The total duration of the study was twelve weeks with followup at every four weeks. Effect of drug was monitored in terms of weight reduction, changes in body mass index, waist circumference, hip circumference, waist/hip ratio and other metabolic parameters. A fixed dietary prescription and concomitant therapy with drugs, if required and not likely to interfere with the trial therapy, was permitted but was not changed during the study period. RESULTS At the end of 12 week, mean weight reduction in study subjects was 4.16 kg (p < 0.001), the corresponding BMI decreased by 1.6 (p < 0.0001) and hip circumference by 3.68 (p < 0.001). However, there was no significant change in fasting blood glucose and Hb(A1c) values. CONCLUSION The study indicates sibutramine to be an effective and well tolerated agent leading to significant reduction in parameter of obesity in obese type 2 diabetic subjects.
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Affiliation(s)
- A R Sircar
- Department of Medicine, KG's Medical College, Lucknow
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