A dual-antigen self-amplifying RNA SARS-CoV-2 vaccine induces potent humoral and cellular immune responses and protects against SARS-CoV-2 variants through T cell-mediated immunity

Self-amplifying RNA vaccines may induce equivalent or more potent immune responses at lower doses compared to non-replicating mRNA vaccines via amplified antigen expression. In this paper, we demonstrate that 1 μg of an LNP-formulated dual-antigen self-amplifying RNA vaccine (ZIP1642), encoding both the S-RBD and N antigen, elicits considerably higher neutralizing antibody titers against Wuhan-like Beta B.1.351 and Delta B.1.617.2 SARS-CoV-2 variants compared to those of convalescent patients. In addition, ZIP1642 vaccination in mice expanded both S- and N-specific CD3+CD4+ and CD3+CD8+ T cells and caused a Th1 shifted cytokine response. We demonstrate that the induction of such dual antigen-targeted cell-mediated immune response may provide better protection against variants displaying highly mutated Spike proteins, as infectious viral loads of both Wuhan-like and Beta variants were decreased after challenge of ZIP1642 vaccinated hamsters. Supported by these results, we encourage redirecting focus toward the induction of multiple antigen-targeted cell-mediated immunity in addition to neutralizing antibody responses to bypass waning antibody responses and attenuate infectious breakthrough and disease severity of future SARS-CoV-2 variants.

Invasive rhino-orbital-cerebral aspergillosis in an immunocompetent patient

INTRODUCTION

Rhino-orbital-aspergillosis (ROA) is a rare but serious disease in immunocompetent patients. Diagnosis is often delayed due to the absence of specific clinical symptoms. We describe the case of a patient who presented initially with ROA which spread progressively to the right ethmoid-sphenoid sinuses and then to the brain.

OBSERVATION

A 61-year-old patient with a history of well-controlled diabetes presented with a sudden severe decrease in right visual acuity. Cerebral MRI showed the presence of an infiltrate in the right orbital apex extending to the homolateral cavernous sinus without any cerebral involvement. A diagnosis of right orbital myositis was made and corticosteroid therapy was started. His symptoms worsened progressively leading to quasi-blindness. A new MRI showed the development of right sphenoid-ethmoid osteolytic lesions. A fungal aetiology was suspected and tests for fungal biomarkers found a β-(1-3)-D-glucan level of 99pg/ml but negative galactomannan. An ethmoid biopsy was performed for histological and mycological investigations, including the detection of Aspergillus DNA by qPCR. qPCR was positive and culture resulted in the isolation of multi-sensitive Aspergillus fumigatus. Treatment was initiated with voriconazole. Due to persistence of blindness and the appearance of a lesion extending to the right frontal lobe, surgical excision was performed followed by antifungal treatment for a total duration of 1year. The patient is currently stable, but has persistence of blindness in the right eye.

CONCLUSION

Invasive ROA is a rare but serious disease in immunocompetent patients which should be evoked in the differential diagnosis of a tumour or vasculitis. Early diagnosis is essential for optimal management.

Immunogenicity, safety and reactogenicity of the pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in 2-17-year-old children with asplenia or splenic dysfunction: A phase 3 study

BACKGROUND

Immunization with pneumococcal vaccines is an important prophylactic strategy for children with asplenia or splenic dysfunction, who are at high risk of bacterial infections (including S. pneumoniae). This study aimed to assess immunogenicity and safety of pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, GSK) in this at-risk population.

METHODS

This phase III, multi-centre, open-label, controlled study, in which at-risk children with asplenia or splenic dysfunction were enrolled (age strata: 2-4, 5-10 and 11-17years), was conducted in Poland and the Russian Federation. For the 2-4years at-risk group, healthy age-matched children were enrolled as control. Unprimed children (not previously vaccinated with any pneumococcal vaccine) received 2 PHiD-CV doses (≥2months apart) and pneumococcal vaccine-primed children received 1 dose. Immune responses were assessed pre-vaccination and one month post-each dose. Solicited and unsolicited adverse events (AEs) were recorded for 4 and 31days post-vaccination, respectively, and serious AEs (SAEs) throughout the study.

RESULTS

Of 52 vaccinated children (18 at-risk primed, 28 at-risk unprimed and 6 control unprimed), 45 (18, 23 and 4, respectively) were included in the according-to-protocol cohort for immunogenicity. Post-vaccination (post-dose 1 in primed and post-dose 2 in unprimed children), for each vaccine pneumococcal serotype and vaccine-related serotype 6A all at-risk children had antibody concentrations ≥0.2µg/mL, and for vaccine-related serotype 19A at least 94.4%. Increases in antibody geometric mean concentrations were observed. For most serotypes, all at-risk children had post-vaccination opsonophagocytic activity (OPA) titers ≥8 and increases in OPA geometric mean titers were observed. No safety concerns were raised. One non-fatal SAE (respiratory tract infection, considered not vaccine-related) was reported by one at-risk unprimed child.

CONCLUSION

PHiD-CV was immunogenic and well tolerated in 2-17-year-old children with asplenia or splenic dysfunction. Clinical Trial Registry: www.clinicaltrials.gov, NCT01746108.

The DSM5/RDoC debate on the future of mental health research: implication for studies on human stress and presentation of the signature bank

In 2008, the National Institute of Mental Health (NIMH) announced that in the next few decades, it will be essential to study the various biological, psychological and social "signatures" of mental disorders. Along with this new "signature" approach to mental health disorders, modifications of DSM were introduced. One major modification consisted of incorporating a dimensional approach to mental disorders, which involved analyzing, using a transnosological approach, various factors that are commonly observed across different types of mental disorders. Although this new methodology led to interesting discussions of the DSM5 working groups, it has not been incorporated in the last version of the DSM5. Consequently, the NIMH launched the "Research Domain Criteria" (RDoC) framework in order to provide new ways of classifying mental illnesses based on dimensions of observable behavioral and neurobiological measures. The NIMH emphasizes that it is important to consider the benefits of dimensional measures from the perspective of psychopathology and environmental influences, and it is also important to build these dimensions on neurobiological data. The goal of this paper is to present the perspectives of DSM5 and RDoC to the science of mental health disorders and the impact of this debate on the future of human stress research. The second goal is to present the "Signature Bank" developed by the Institut Universitaire en Santé Mentale de Montréal (IUSMM) that has been developed in line with a dimensional and transnosological approach to mental illness.

Inter-individual distances during open-field tests in Japanese quail (Coturnix japonica) selected for high or low levels of social reinstatement behaviour

Inter-individual distances (IIDs), during open-field tests, were measured in single sex pairs of quail of lines divergently selected for high (HSR) or low (LSR) levels of social reinstatement (SR) behaviour. Tests were carried out when the chicks were 1-, 3- and 6-weeks of age. IIDs were established within 1 min and remained stable thereafter. In HSR and mixed line pairs, but not LSR line pairs, IIDs increased with age. IIDs were shorter in HSR line pairs than in LSR or mixed line pairs at 1- and 3-weeks of age but not at 6-weeks of age when IIDs were similar in all pair-types. At 1- and 3-weeks of age, IIDs in mixed line pairs were intermediate to those in HSR and LSR line pairs. The sex of the pair-members did not influence IIDs. Previous studies have shown that selection for SR behaviour, in quail chicks, has effects that persist into later life and influence characters not present in the birds' behavioural repertoire at the time of testing for the purposes of selection. Such behaviour patterns include aggression, sexual behaviour and socio-sexual proximity behaviour. All of these behaviour patterns are expressed at higher levels in HSR line birds than LSR line birds. Differences in IIDs between HSR and LSR line birds may, therefore, be due to an interaction between environmental and genetic effects. In young HSR chicks, social reinstatement is the primary motivation and IIDs are short. However, as the HSR line chicks' age, IIDs reflect an interaction between social attraction and aggression related avoidance behaviour that tends to increase IIDs. In LSR line chicks aggression and social motivation are low at all ages and IIDs tend to remain stable.

Place preferences of Japanese quail given a permanent choice between a social or a non-social but enriched situation

Japanese quail from two lines selected for high (HSR) or low (LSR) levels of social reinstatement behaviour were permanently placed from 2 days to 6 weeks of age in a situation where one tested animal had the choice between being in social contact with a stimulus animal in a bare compartment of the cage or out of visual contact with the stimulus animal in a relatively rich environment containing food, water and wood shavings. The young (1 or 2 weeks of age) quails spent most of their time (over 80%) in the social compartment, about 10% feeding and drinking, and about 10% performing other activities in the non-social compartment. Hardly any differences appeared between the two lines when 1 or 2 weeks old, but at 4 weeks of age the LSR quails started to decrease the time spent in the social compartment and this phenomenon only appeared at 6 weeks of age and to a lesser extent in the HSR quails. At 4 and 6 weeks the differences between lines were significant. The lack of difference between the two lines in young quails can be explained by the very high social motivation expressed even by LSR quails in the conditions of the study. When they are older line differences are expressed. This change coincides with the time when the natural coveys start to disperse and also with the beginning of sexual development. These results confirm the hypothesis of François et al. (François, N., Mills, A.D., Faure, J.M., 1997. Inter-individual distances in Japanese quail (Coturnix japonica) selected for high or low levels of sociability. Behav. Process. (in press)) that line differences in social motivation persist into adult or near adult life and can still be demonstrated, provided the circumstances are such that aggression does not prevent close social contact.

Drag enhancement with polymers

Drag on a cylinder can be enhanced in the presence of polymers. This enhancement is directly related to the interaction of the polymers with the flow around the obstacle. The presence of the polymers modifies the flow in the vicinity of the cylinder giving rise to a band of higher shear, large molecular elongations and large velocity fluctuations. The measured drag on the cylinder is directly related to the modification of the flow field by the presence of the polymers.

Effect of short-term exposure to two hydrophilic-coated and one gel pre-lubricated urinary catheters on sperm vitality, motility and kinematics in vitro

AIM

This study aimed to determine the in vitro effect of a short-term exposure to two hydrophilic-coated and one gel pre-lubricated urinary catheters on human sperm quality.

METHODS

Semen samples of various qualities were coincubated with each catheter for 5 min at 37 degrees C. The percentages of live and motile sperm with their kinematic characteristics were blindly assessed in control and treated samples at the end of the coincubation and 10 and 55 min later.

RESULTS

The three catheters had no effect on sperm vitality. Similarly, the lubricated catheter and one hydrophilic-coated catheter negligibly modulated sperm motility. In contrast, the other hydrophilic-coated catheter tested had a significant negative effect on sperm movement.

CONCLUSION

Further studies are warranted, the issue being especially relevant to the collection of spermatozoa in spinal cord diseased patients catheterizing themselves several times a day. In this population, compounds releasing from the catheter and accumulating in the urethra could be an additional factor contributing to the poor sperm quality.

Multilocus sequence typing reveals intrafamilial transmission and microevolutions of Candida albicans isolates from the human digestive tract

Candida albicans is a human commensal that is also responsible for superficial and systemic infections. Little is known about the carriage of C. albicans in the digestive tract and the genome dynamics that occur during commensalisms of this diploid species. The aim of this study was to evaluate the prevalence, diversity, and genetic relationships among C. albicans isolates recovered during natural colonization of the digestive tract of humans, with emphasis on Crohn's disease patients who produce anti-yeast antibodies and may have altered Candida sp. carriage. Candida sp. isolates were recovered from 234 subjects within 25 families with multiple cases of Crohn's disease and 10 control families, sampled at the oral and fecal sites. Prevalences of Candida sp. and C. albicans carriage were 53.4% and 46.5%, respectively, indicating frequent commensal carriage. No differences in prevalence of carriage could be observed between Crohn's disease patients and healthy subjects. Multilocus sequence typing (MLST) of C. albicans isolates revealed frequent colonization of a subject or several members of the same family by genetically indistinguishable or genetically close isolates. These latter isolates differed by loss-of-heterozygosity events at one or several of the MLST loci. These loss-of-heterozygosity events could be due to either chromosome loss followed by duplication or large mitotic recombination events between complementary chromosomes. This study was the first to jointly assess commensal carriage of C. albicans, intrafamilial transmission, and microevolution. The high frequency of each of these events suggests that the digestive tract provides an important and natural niche for microevolutions of diploid C. albicans through the loss of heterozygosity.

[Mechanisms and treatment of psoriasis]

Psoriasis is a common dermatosis that affects 3-5% of the European population. Current treatments offer considerable clinical benefits, but their use is limited due to tolerance problems. Recent years have seen the development of new treatments, used separately or in combination to improve the chronic lesions caused by this disease. T cells play an important role in the pathogenesis of psoriasis. Various techniques target the T cells and the immunological mechanisms involved in their activation. In 2005, treatment of psoriasis is directed essentially towards immunological pathways.

[Management of reproduction disorders in spinal cord injured adolescents]

Adolescence is a period of research of sexual identity. How does a teenager build himself when a paraplegic or quadriplegic? How can the team of nursing staff help him? First we shall study the erection and the sexual relations and secondly we shall study the procreation issue. It is necessary to have early concrete information really suitable for a neurologic definition of a spinal cord injury and to conserve sperm before having complications of urinary infections. We inform 24 paraplegic or tetraplegic teenagers at the CMPA in Neufmoutiers and the CECOS at the Cochin Hospital in Paris.

Synthesis and antifungal activity of a ferrocene-fluconazole analogue

A novel ferrocene fluconazole analogue was synthesized and its antifungal properties investigated against yeast strains of medical importance, including those intrinsically resistant to fluconazole. In vitro tests revealed a slight increase in fungal growth and a reversal of the effect of fluconazole at minimal inhibitory concentrations.

[Genital sexual and procreation disorders in patients with spinal cord injuries]

The first part of this report discusses techniques contributing to improved sexual relations in couples where either partner is paraplegic. The advantages and disadvantages of these techniques are described, in particular for intracavernous injections of vasoactive products. The second part considers procreative assistance for couples where the male is paraplegic, using mechanical, chemical and more recently surgical techniques. Surgery involves puncture of the ductus deferens. Significant experimental progress in medically assisted precreation is contributing to improved results. The importance of the psychological and emotional context must not be forgotten, as well as prevention of complications such as urological infections.

[Post-traumatic hemobilia caused by arteriobiliary fistula. A case report and review of the literature]

One new case of post-traumatic hematobilia due to an arteriobilary fistula is reported. This etiology is relatively rare, and its diagnosis is sometimes difficult if the three signs: pain, bleeding and jaundice are not observed. The most effective paraclinical examination still is selective arteriogrpahy, which makes the diagnosis possible, accurately locates the fistula and sometimes allows hyperselective embolization, as it did in this case. The use of embolization for the treatment of post-traumatic hematobilia due to an arteriobiliary fistula reduces operative mortality for this disease, which still has a poor prognosis.

Total parenteral nutrition (TPN): the team concept

The septic and metabolic complications observed in patients receiving TPN have led to the development of teams involving people from various fields. The application of this concept and the design of a new infusion system have led to the elimination of most complications. In 15 months (January 1979 - March 1980), 68 patients were given TPN for a total duration of 1,424 days. Seventy-two catheters were inserted in the superior vena cava for a total duration of 1,617 days. These procedures do not seem to have induced any mechanical or septic complication in these patients.

Expression of genetic markers of erythrocyte immunoglobulin G autoantibodies in autoimmune hemolytic anemia

The Gm allotype constitution of the autoantibody molecules and the serum Gm phenotypes were determined in 19 patients with autiommune hemolytic anemia of IgG type. The results showed that the known heterogeneity of the antierythrocyte autoantibodies in this disease concerns not only the immunoglobulin class and the isotypic subclass, but also the genetic markers of these molecules. Evidence was obtained that the anomalous production of antierythrocyte autoantibodies is polyclonal, that thse autoantibodies belong mainly to the IgG1 isotypic subclass, and that they have a preference for the Gm(1) allotype. In addition, certain of the findings point to a preferential expression of the Gm(1,21) haplotype.

[Experimental study of electro-ejaculation in the baboon (author's transl)]

With the aim of applying the technique of electro-ejaculation to paraplegics, the authors perfected an apparatus which permits stimulation with an intra-rectal electrode. Out of 27 electro-ejaculations carried out on 9 monkeys, there were 5 failures and 22 successes (but 3 of these only contained coagulum). The results improved at the same time as the technique. Although the motility and the number of spermatozoa were rather reduced in comparison with normal ejaculation, the semen obtained appeared to be utilizable. Observation of the animal, rectoscopy as well as the histological investigations carried out in 3 of the animals which were sacrificed showed no complication or lesion. The apparatus and technique which subsequently proved to be applicable in the paraplegic male should enable the improvement of his possibilities of procreation.