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van de Weg CAM, Thomazella MV, Marmorato MP, Correia CA, Dias JZC, Maestri A, Zanella LGFABE, Cerqueira NB, Félix AC, Moreira CHV, Buccheri R, Costa PR, Kallás EG. Levels of angiopoietin-2 are predictive for mortality in yellow fever virus infected patients. J Infect Dis 2023:jiad389. [PMID: 37711029 DOI: 10.1093/infdis/jiad389] [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: 03/26/2023] [Revised: 07/25/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023] Open
Abstract
In 2018 there was a large yellow fever outbreak in São Paulo, Brazil, with a high fatality rate. Yellow fever virus can cause, among other symptoms, haemorrhage and disseminated intravascular coagulation, indicating a role for endothelial cells in the disease pathogenesis. Here, we conducted a case-control study and measured markers related to endothelial damage in plasma and its association with mortality. We found that angiopoietin-2 is strongly associated with a fatal outcome and could serve as a predictive marker for mortality. This could be used to monitor severe patients and provide care to improve disease outcome.
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Affiliation(s)
- Cornelia A M van de Weg
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Mateus V Thomazella
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Mariana P Marmorato
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Carolina A Correia
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Juliana Z C Dias
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Alvino Maestri
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Luiz G F A B E Zanella
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Natalia B Cerqueira
- Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Alvina C Félix
- Institute of Tropical Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Carlos H V Moreira
- Infectious Diseases Institute "Emílio Ribas", São Paulo, SP, Brazil
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Division of HIV, ID, & Global Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital, USA
| | - Renata Buccheri
- Infectious Diseases Institute "Emílio Ribas", São Paulo, SP, Brazil
| | - Priscilla R Costa
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Esper G Kallás
- Medical Investigation Laboratory 60 (LIM-60), School of Medicine, University of São Paulo, São Paulo, SP, Brazil
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
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Avelino-Silva VI, Thomazella MV, Marmorato MP, Correia CA, Dias JZC, Maestri A, Cerqueira NB, Moreira CHV, Buccheri R, Félix AC, Zanella LGFABE, Costa PR, Kallás EG. Viral Kinetics in Sylvatic Yellow Fever Cases. J Infect Dis 2022; 227:1097-1103. [PMID: 36316804 DOI: 10.1093/infdis/jiac435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background
Yellow fever is a mosquito-borne zoonotic disease caused by yellow fever virus (YFV). Between 2017 and 2019, more than 504 human cases and 176 deaths were confirmed in the outskirts of São Paulo city. Throughout this outbreak, studies suggested a potential association between YFV viremia and mortality.
Methods
Viral ribonucleic acid was measured using reverse-transcription quantitative polymerase chain reaction in plasma samples collected at up to 5 time points, between 3 and 120 days after symptoms onset.
Results
Eighty-four patients with confirmed YFV infection were included. Most were males, median age was 42, and 30 (36%) died. Deceased patients were older than survivors (P = .003) and had a higher viremia across all time points (P = .0006). Mean values of viremia had a positive, statistically significant correlation with peak values of neutrophils, indirect bilirubin, aspartate transaminase, international normalized ratio, and creatinine. Finally, a Cox proportional hazards model adjusted for age and laboratory variables showed that viremia is independently associated with death, with a mean 1.84-fold increase (84%) in the hazard of death (P < .001) for each unit increase in mean log10 viremia.
Conclusions
Our results raise the importance of monitoring YFV viremia and suggest a potential benefit of antiviral drugs or neutralizing monoclonal antibodies early in the course of this infection to improve disease outcomes.
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Affiliation(s)
- Vivian I Avelino-Silva
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 05403-000 , Brazil
| | - Mateus Vailant Thomazella
- Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 1246-903 , Brazil
| | - Mariana Prado Marmorato
- Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 1246-903 , Brazil
| | - Carolina A Correia
- Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 1246-903 , Brazil
| | - Juliana Z C Dias
- Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 1246-903 , Brazil
| | - Alvino Maestri
- Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 1246-903 , Brazil
| | - Natalia B Cerqueira
- Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo , SP, 05403-000 , Brazil
| | - Carlos H V Moreira
- Institute of Infectology “Emilio Ribas” , São Paulo, SP, 01246-900 , Brazil
- Institute of Tropical Medicine, Universidade de São Paulo , São Paulo, SP, 05403-000 , Brazil
| | - Renata Buccheri
- Institute of Infectology “Emilio Ribas” , São Paulo, SP, 01246-900 , Brazil
| | - Alvina C Félix
- Institute of Tropical Medicine, Universidade de São Paulo , São Paulo, SP, 05403-000 , Brazil
| | - Luiz G F A B E Zanella
- Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 1246-903 , Brazil
| | - Priscilla R Costa
- Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 1246-903 , Brazil
| | - Esper G Kallás
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 05403-000 , Brazil
- Medical Investigation Laboratory 60 (LIM-60), Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, 1246-903 , Brazil
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Silveira CGT, Magnani DM, Costa PR, Avelino-Silva VI, Ricciardi MJ, Timenetsky MDCST, Goulart R, Correia CA, Marmorato MP, Ferrari L, Nakagawa ZB, Tomiyama C, Tomiyama H, Kalil J, Palacios R, Precioso AR, Watkins DI, Kallás EG. Plasmablast Expansion Following the Tetravalent, Live-Attenuated Dengue Vaccine Butantan-DV in DENV-Naïve and DENV-Exposed Individuals in a Brazilian Cohort. Front Immunol 2022; 13:908398. [PMID: 35837409 PMCID: PMC9274664 DOI: 10.3389/fimmu.2022.908398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/31/2022] [Indexed: 11/30/2022] Open
Abstract
An effective vaccine against the dengue virus (DENV) should induce a balanced, long-lasting antibody (Ab) response against all four viral serotypes. The burst of plasmablasts in the peripheral blood after vaccination may reflect enriched vaccine-specific Ab secreting cells. Here we characterize the acute plasmablast responses from naïve and DENV-exposed individuals following immunization with the live attenuated tetravalent (LAT) Butantan DENV vaccine (Butantan-DV). The frequency of circulating plasmablasts was determined by flow cytometric analysis of fresh whole blood specimens collected from 40 participants enrolled in the Phase II Butantan-DV clinical trial (NCT01696422) before and after (days 6, 12, 15 and 22) vaccination. We observed a peak in the number of circulating plasmablast at day 15 after vaccination in both the DENV naïve and the DENV-exposed vaccinees. DENV-exposed vaccinees experienced a significantly higher plasmablast expansion. In the DENV-naïve vaccinees, plasmablasts persisted for approximately three weeks longer than among DENV-exposed volunteers. Our findings indicate that the Butantan-DV can induce plasmablast responses in both DENV-naïve and DENV-exposed individuals and demonstrate the influence of pre-existing DENV immunity on Butantan DV-induced B-cell responses.
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Affiliation(s)
- Cássia G. T. Silveira
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Diogo M. Magnani
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Priscilla R. Costa
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Vivian I. Avelino-Silva
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Michael J. Ricciardi
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL, United States
| | | | - Raphaella Goulart
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carolina A. Correia
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Mariana P. Marmorato
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Lilian Ferrari
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Zelinda B. Nakagawa
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Claudia Tomiyama
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Helena Tomiyama
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jorge Kalil
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ricardo Palacios
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Alexander R. Precioso
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
- Pediatrics Department, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - David I. Watkins
- Department of Pathology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Esper G. Kallás
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil
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Narciso TARM, Hoshida MS, Costa PR, Niquirilo A, Biancolin SE, Lin LH, Francisco RPV, Brizot ML. Fetal-Maternal Hemorrhage in First-Trimester Intrauterine Hematoma. Fetal Diagn Ther 2021; 48:227-234. [PMID: 33706316 DOI: 10.1159/000513747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/10/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The objective of this study was to compare the frequency and percentage of fetal hemoglobin (HbF%) by flow cytometry of (1) first-trimester asymptomatic patients with intrauterine hematoma (IUH), (2) first-trimester pregnant patients with vaginal bleeding (VB), and (3) first-trimester asymptomatic pregnant women without hematoma. METHODS Prospective study involving pregnant women in the first trimester of pregnancy. Patients with ultrasound findings of asymptomatic hematoma and with VB were paired with asymptomatic pregnant women of same gestational age without hematoma (control group [CG]). Maternal blood HbF% was evaluated by flow cytometry. The groups were compared in terms of circulating fetal hemoglobin and HbF%. RESULTS Sixty-six patients were selected, 22 with hematoma, 17 with bleeding, and 27 in the CG. Fetal hemoglobin was detected in 15 patients with hematoma (68.2%) and 13 with bleeding (76.5%) and in 20 of the control (74.1%) (p = 0.830). The mean HbF% of each group was 0.054, 0.012, and 0.042 for hematoma, bleeding, and control, respectively, and differences were not significant (p = 0.141). There was a moderate negative correlation between the volume of hematoma and HbF% (rSpearman = -0.527; p = 0.012). CONCLUSIONS The fetal-maternal hemorrhage expressed by Hbf% in first-trimester pregnancies did not seem to differ between patients with and without ultrasound findings of IUH.
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Affiliation(s)
- Thaisa A R M Narciso
- Department of Obstetrics and Gynecology/Faculdade de Medicina FMUSP/Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Mara S Hoshida
- Department of Obstetrics and Gynecology/Faculdade de Medicina FMUSP/Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Priscilla R Costa
- Division of Clinical Immunology and Allergy/Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Andrea Niquirilo
- Division of Clinical Immunology and Allergy/Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sckarlet E Biancolin
- Department of Obstetrics and Gynecology/Faculdade de Medicina FMUSP/Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Lawrence H Lin
- Department of Obstetrics and Gynecology/Faculdade de Medicina FMUSP/Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rossana P V Francisco
- Department of Obstetrics and Gynecology/Faculdade de Medicina FMUSP/Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Maria L Brizot
- Department of Obstetrics and Gynecology/Faculdade de Medicina FMUSP/Universidade de Sao Paulo, Sao Paulo, Brazil,
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Silva GP, Pereira-Manfro WF, Costa PR, Costa DA, Ferreira B, Barreto DM, Frota ACC, Hofer CB, Figueredo CM, Coelho B, Kallas EG, Milagres LG. Association between circulating exhausted CD4+ T cells with poor meningococcal C conjugate vaccine antibody response in HIV-infected children and adolescents. Clinics (Sao Paulo) 2021; 76:e2902. [PMID: 34614112 PMCID: PMC8449930 DOI: 10.6061/clinics/2021/e2902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/15/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate the expression levels of surface markers of activation (CD38 and HLA-DR), inhibition (PD-1, TIGIT and CD57) and co-stimulation (CD28 and CD127) on CD4+ T cells of children/adolescents with vertical HIV infection (HI patients) and HIV-uninfected (HU) controls vaccinated with the meningococcal C conjugate vaccine (MCC). METHODS HI patients (n=12), aged 8-17 years, were immunized with two MCC injections, while HU controls (n=9), aged 5.3-10.7 years, received a single MCC dose (as per national recommendation at the time of this study, a single MCC vaccine dose should be given for healthy children and youth aged 1-18 years). The HI patients were categorized according to the combined antiretroviral therapy (cART) treatment. Blood samples were obtained before vaccination, after priming, and after the administration of a booster dose of vaccine to determine the serum bactericidal antibody (SBA) titers and the expression levels of surface markers on CD4+ T cells by flow cytometry. The levels of serum cytokines, IL-4 and CXCL-13 were also measured using Luminex kits. RESULTS The co-expression of the TIGIT-HLA-DR-CD38 molecules increased in the CD4+ T cells of HI patients/no-cART who also showed a lower frequency of CD127+CD28+ CD4+ T cells than HI patients/cART and HU group subjects. There were significant negative correlations between the frequency of exhausted CD4+ T cells and the SBA response. IL-4 levels were higher in HI patients/cART and positively correlated with SBA titers but negatively associated with the expression of exhaustion markers. Moreover, the CXCL-13 levels were positively correlated with the exhausted CD4+ T cells. CONCLUSION The results of our study suggest that the co-expression of exhaustion markers and/or loss of co-stimulatory molecules influence the SBA response in HI patients.
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Affiliation(s)
- Giselle P. Silva
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Wania F. Pereira-Manfro
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Priscilla R. Costa
- Divisao de Imunologia Clinica e Alergia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Dayane A. Costa
- Divisao de Imunologia Clinica e Alergia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Bianca Ferreira
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Daniela M. Barreto
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Ana Cristina C. Frota
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Cristina B. Hofer
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Carlos M. Figueredo
- Departamento de Periodontia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
- School of Dentistry and Oral Health, Griffith University, QLD, Australia
| | - Barbara Coelho
- Departamento de Periodontia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Esper G. Kallas
- Divisao de Imunologia Clinica e Alergia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Lucimar G. Milagres
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
- Corresponding author. E-mails: /
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Kallas EG, Precioso AR, Palacios R, Thomé B, Braga PE, Vanni T, Campos LMA, Ferrari L, Mondini G, da Graça Salomão M, da Silva A, Espinola HM, do Prado Santos J, Santos CLS, Timenetsky MDCST, Miraglia JL, Gallina NMF, Weiskopf D, Sette A, Goulart R, Salles RT, Maestri A, Sallum AME, Farhat SCL, Sakita NK, Ferreira JCOA, Silveira CGT, Costa PR, Raw I, Whitehead SS, Durbin AP, Kalil J. Safety and immunogenicity of the tetravalent, live-attenuated dengue vaccine Butantan-DV in adults in Brazil: a two-step, double-blind, randomised placebo-controlled phase 2 trial. Lancet Infect Dis 2020; 20:839-850. [PMID: 32220283 DOI: 10.1016/s1473-3099(20)30023-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/17/2019] [Accepted: 01/16/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Butantan Institute has manufactured a lyophilised tetravalent live-attenuated dengue vaccine Butantan-DV, which is analogous to the US National Institutes of Health (NIH) TV003 admixture. We aimed to assess the safety and immunogenicity of Butantan-DV. METHODS We did a two-step, double-blind, randomised placebo-controlled phase 2 trial at two clinical sites in São Paulo, Brazil. We recruited healthy volunteers aged 18-59 years; pregnant women, individuals with a history of neurological, heart, lung, liver or kidney disease, diabetes, cancer, or autoimmune diseases, and individuals with HIV or hepatitis C were excluded. Step A was designed as a small bridge-study between Butantan-DV and TV003 in DENV-naive participants. In step A, we planned to randomly assign 50 dengue virus (DENV)-naive individuals to receive two doses of Butantan-DV, TV003, or placebo, given 6 months apart. In step B, we planned to randomly assign 250 participants (DENV-naive and DENV-exposed) to receive one dose of Butantan-DV or placebo. Participants were randomly assigned, by computer-generated block randomisation (block sizes of five); participants in step A were randomly assigned (2:2:1) to receive Butantan-DV, TV003, or placebo and participants in step B were randomly assigned (4:1) to receive Butantan-DV or placebo. Participants and study staff were unaware of treatment allocation. The primary safety outcome was the frequency of solicited and unsolicited local and systemic adverse reactions within 21 days of the first vaccination, analysed by intention to treat. The primary immunogenicity outcome was seroconversion rates of the DENV-1-4 serotypes measured 91 days after the first vaccination, analysed in the per-protocol population, which included all participants in step A, and all participants included in step B who completed all study visits with serology sample collection. This trial is registered with ClinicalTrials.gov, NCT01696422. FINDINGS Between Nov 5, 2013, and Sept 21, 2015, 300 individuals were enrolled and randomly assigned: 155 (52%) DENV-naive participants and 145 (48%) DENV-exposed participants. Of the 155 DENV-naive participants, 97 (63%) received Butantan-DV, 17 (11%) received TV003, and 41 (27%) received placebo. Of the 145 DENV-exposed participants, 113 (78%) received Butantan-DV, three (2%) received TV003, and 29 (20%) received placebo. Butantan-DV and TV003 were both immunogenic, well-tolerated, and no serious adverse reactions were observed. In step A, rash was the most frequent adverse event (16 [845] of 19 participants in the Butantan-DV group and 13 [76%] of 17 participants in the TV003 group). Viraemia was similar between the Butantan-DV and TV003 groups. Of the 85 DENV-naive participants in the Butantan-DV group who attended all visits for sample collection for seroconversion analysis and thus were included in the per-protocol analysis population, 74 (87%) achieved seroconversion to DENV-1, 78 (92%) to DENV-2, 65 (76%) to DENV-3, and 76 (89%) to DENV-4. Of the 101 DENV-exposed participants in the Butantan-DV group who attended all visits for sample collection for seroconversion analysis, 82 (81%) achieved seroconversion to DENV-1, 79 (78%) to DENV-2, 83 (82%) to DENV-3, and 78 (77%) to DENV-4. INTERPRETATION Butantan-DV and TV003 were safe and induced robust, balanced neutralising antibody responses against the four DENV serotypes. Efficacy evaluation of the Butantan-DV vaccine is ongoing. FUNDING Intramural Research Program US NIH National Institute of Allergy and Infectious Diseases, Brazilian National Bank for Economic and Social Development, Fundação de Amparo à Pesquisa do Estado de São Paulo, and Fundação Butantan.
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Affiliation(s)
- Esper G Kallas
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alexander Roberto Precioso
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil; Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil.
| | - Ricardo Palacios
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Beatriz Thomé
- Preventive Medicine Department, Federal University of São Paulo, São Paulo, Brazil
| | - Patrícia Emília Braga
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Tazio Vanni
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Lúcia M A Campos
- Department of Pediatrics, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Lilian Ferrari
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Gabriella Mondini
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Maria da Graça Salomão
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Anderson da Silva
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Heloisa M Espinola
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Joane do Prado Santos
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | | | | | - João Luiz Miraglia
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Neuza M F Gallina
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Daniela Weiskopf
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, San Diego, CA, USA
| | - Alessandro Sette
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, San Diego, CA, USA
| | - Raphaella Goulart
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rafael Tavares Salles
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alvino Maestri
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Neusa K Sakita
- Department of Pediatrics, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Juliana C O A Ferreira
- Department of Pediatrics, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Cassia G T Silveira
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Priscilla R Costa
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Isaias Raw
- Division of Clinical Trials and Pharmacovigilance, Instituto Butantan, São Paulo, Brazil
| | - Stephen S Whitehead
- Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Anna P Durbin
- Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jorge Kalil
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
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7
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Santoro-Fernandes V, Santos JC, Mariano L, Vanin VR, Costa PR. Uncertainty estimation and statistical comparative methodology for mammography x-ray energy spectra. Biomed Phys Eng Express 2020; 6:035018. [PMID: 33438663 DOI: 10.1088/2057-1976/ab817d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Numerical models are an alternative to measurements of x-ray energy spectra when validated by comparative methods that assess the similarity of experimental and calculated spectra. In this work, we compared x-ray energy spectra using several methodologies and determined the methodology with highest statistical power among them. Experiments and Monte Carlo (MC) simulations were used to generate a set of 65 experimental and simulated x-ray mammography spectra pairs typically used in mammography applications. They were generated using Tungsten and Molybdenum targets and Molybdenum and Rhodium filters. The x-ray beams were transmitted through breast tissue equivalent material (bTEM) plates with different glandularities and thicknesses, and the transmitted beam was detected using solid-state x-ray spectrometry with a Cadmium Telluride (CdTe) diode. The MC simulations used the PENELOPE code. Additional uncertainties, beyond that from counting, were propagated using the MC method. Quantitative comparative methods based on the [Formula: see text] statistics, the first and second half-value layers, the mean energy, the effective energy, and the non-parametric u-test were applied and their specificity (true negative rate) was assessed. The polyenergetic normalized glandular dose (DgNp) to a 6 cm breast of 50/50 glandularity was derived from the spectra. In this work, the [Formula: see text] statistics attained the highest score; therefore, it is the most indicated metric for the x-ray energy spectra comparative evaluations. The contribution of the additional uncertainties was important, being responsible for up to 98% of the spectra total uncertainty and shifting the mean of the evaluated [Formula: see text] to 1.2(1), compatible with its expected value. The use of non-parametric test is discouraged by our results, since it failed to distinguish spectra pairs that resulted in up to 72% discrepant DgNp.
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Kallas EG, D'Elia Zanella LGFAB, Moreira CHV, Buccheri R, Diniz GBF, Castiñeiras ACP, Costa PR, Dias JZC, Marmorato MP, Song ATW, Maestri A, Borges IC, Joelsons D, Cerqueira NB, Santiago E Souza NC, Morales Claro I, Sabino EC, Levi JE, Avelino-Silva VI, Ho YL. Predictors of mortality in patients with yellow fever: an observational cohort study. Lancet Infect Dis 2019; 19:750-758. [PMID: 31104909 DOI: 10.1016/s1473-3099(19)30125-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Yellow fever virus infection results in death in around 30% of symptomatic individuals. The aim of this study was to identify predictors of death measured at hospital admission in a cohort of patients admitted to hospital during the 2018 outbreak of yellow fever in the outskirts of São Paulo city, Brazil. METHODS In this observational cohort study, we enrolled patients with yellow fever virus from two hospitals in São Paolo-the Hospital das Clínicas, University of São Paulo and the Infectious Diseases Institute "Emilio Ribas". Patients older than 18 years admitted to hospital with fever or myalgia, headache, arthralgia, oedema, rash, or conjunctivitis were consecutively screened for inclusion in the present study. Consenting patients were included if they had travelled to geographical areas in which yellow fever virus cases had been previously confirmed. Yellow fever infection was confirmed by real-time PCR in blood collected at admission or tissues at autopsy. We sequenced the complete genomes of yellow fever virus from infected individuals and evaluated demographic, clinical, and laboratory findings at admission and investigated whether any of these measurements correlated with patient outcome (death). FINDINGS Between Jan 11, 2018, and May 10, 2018, 118 patients with suspected yellow fever were admitted to Hospital das Clínicas, and 113 patients with suspected yellow fever were admitted to Infectious Diseases Institute "Emilio Ribas". 95 patients with suspected yellow fever were included in the study, and 136 patients were excluded. Three (3%) of 95 patients with suspected yellow fever who were included in the study were excluded because they received a different diagnosis, and 16 patients with undetectable yellow fever virus RNA were excluded. Therefore, 76 patients with confirmed yellow fever virus infection, based on detectable yellow fever virus RNA in blood (74 patients) or yellow fever virus confirmed only at the autopsy report (two patients), were included in our analysis. 27 (36%) of 76 patients died during the 60 day period after hospital admission. We generated 14 complete yellow fever virus genomes from the first 15 viral load-detectable samples. The genomes belonged to a single monophyletic clade of the South America I genotype, sub-genotype E. Older age, male sex, higher leukocyte and neutrophil counts, higher alanine aminotransferase, aspartate transaminase (AST), bilirubin, and creatinine, prolonged prothrombin time, and higher yellow fever virus RNA plasma viral load were associated with higher mortality. In a multivariate regression model, older age, elevated neutrophil count, increased AST, and higher viral load remained independently associated with death. All 11 (100%) patients with neutrophil counts of 4000 cells per mL or greater and viral loads of 5·1 log10 copies/mL or greater died (95% CI 72-100), compared with only three (11%) of 27 (95% CI 2-29) among patients with neutrophil counts of less than 4000 cells per mL and viral loads of less than 5·1 log10 copies/mL. INTERPRETATION We identified clinical and laboratory predictors of mortality at hospital admission that could aid in the care of patients with yellow fever virus. Identification of these prognostic markers in patients could help clinicians prioritise admission to the intensive care unit, as patients often deteriorate rapidly. Moreover, resource allocation could be improved to prioritise key laboratory examinations that might be more useful in determining whether a patient could have a better outcome. Our findings support the important role of the virus in disease pathogenesis, suggesting that an effective antiviral could alter the clinical course for patients with the most severe forms of yellow fever. FUNDING São Paulo Research Foundation (FAPESP).
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Affiliation(s)
- Esper G Kallas
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - Luiz Gonzaga F A B D'Elia Zanella
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Infectious Diseases Institute "Emilio Ribas", São Paulo, Brazil
| | - Carlos Henrique V Moreira
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Infectious Diseases Institute "Emilio Ribas", São Paulo, Brazil
| | - Renata Buccheri
- Infectious Diseases Institute "Emilio Ribas", São Paulo, Brazil
| | | | | | - Priscilla R Costa
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Juliana Z C Dias
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Mariana P Marmorato
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Alice T W Song
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Alvino Maestri
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Igor C Borges
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Daniel Joelsons
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Natalia B Cerqueira
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Ingra Morales Claro
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ester C Sabino
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - José Eduardo Levi
- Tropical Medicine Institute, University of São Paulo, São Paulo, Brazil; DASA Laboratories, São Paulo, Brazil
| | - Vivian I Avelino-Silva
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Yeh-Li Ho
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Marmorato MP, Pedreño‐Lopez N, Deheinzelin JR, Magnani DM, Bailey VK, Costa PR, Zanella LG, Moreira CH, Buccheri R, Avelino‐Silva VI, Cerqueira NB, Silveira CG, Yeh‐Li H, Watkins DI, Kallás EG. CARACTERIZAÇÃO DA EXPANSÃO DE PLASMOBLASTOS E DO REPERTÓRIO DE ANTICORPOS INDUZIDOS PELA VACINAÇÃO COM 17DD E INFECÇÃO PELO VÍRUS DA FEBRE AMARELA. Braz J Infect Dis 2018. [DOI: 10.1016/j.bjid.2018.10.011] [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: 11/24/2022] Open
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Paquin-Proulx D, Costa PR, Terrassani Silveira CG, Marmorato MP, Cerqueira NB, Sutton MS, O’Connor SL, Carvalho KI, Nixon DF, Kallas EG. Latent Mycobacterium tuberculosis Infection Is Associated With a Higher Frequency of Mucosal-Associated Invariant T and Invariant Natural Killer T Cells. Front Immunol 2018; 9:1394. [PMID: 29971068 PMCID: PMC6018487 DOI: 10.3389/fimmu.2018.01394] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 06/05/2018] [Indexed: 12/11/2022] Open
Abstract
Increasing drug resistance and the lack of an effective vaccine are the main factors contributing to Mycobacterium tuberculosis (Mtb) being a major cause of death globally. Despite intensive research efforts, it is not well understood why some individuals control Mtb infection and some others develop active disease. HIV-1 infection is associated with an increased incidence of active tuberculosis, even in virally suppressed individuals. Mucosal-associated invariant T (MAIT) and invariant natural killer T (iNKT) cells are innate T cells that can recognize Mtb-infected cells. Contradicting results regarding the frequency of MAIT cells in latent Mtb infection have been reported. In this confirmatory study, we investigated the frequency, phenotype, and IFNγ production of MAIT and iNKT cells in subjects with latent or active Mtb infection. We found that the frequency of both cell types was increased in subjects with latent Mtb infection compared with uninfected individuals or subjects with active infection. We found no change in the expression of HLA-DR, PD-1, and CCR6, as well as the production of IFNγ by MAIT and iNKT cells, among subjects with latent Mtb infection or uninfected controls. The proportion of CD4- CD8+ MAIT cells in individuals with latent Mtb infection was, however, increased. HIV-1 infection was associated with a loss of MAIT and iNKT cells, and the residual cells had elevated expression of the exhaustion marker PD-1. Altogether, the results suggest a role for MAIT and iNKT cells in immunity against Mtb and show a deleterious impact of HIV-1 infection on those cells.
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Affiliation(s)
- Dominic Paquin-Proulx
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, DC, United States
| | | | | | | | | | - Matthew S. Sutton
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Shelby L. O’Connor
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Karina I. Carvalho
- Hospital Israelita Albert Einstein, Instituto Israelita de Ensino e Pesquisa, São Paulo, Brazil
| | - Douglas F. Nixon
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, DC, United States
| | - Esper G. Kallas
- School of Medicine, University of São Paulo, São Paulo, Brazil
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Grifoni A, Angelo MA, Lopez B, O'Rourke PH, Sidney J, Cerpas C, Balmaseda A, Silveira CGT, Maestri A, Costa PR, Durbin AP, Diehl SA, Phillips E, Mallal S, De Silva AD, Nchinda G, Nkenfou C, Collins MH, de Silva AM, Lim MQ, Macary PA, Tatullo F, Solomon T, Satchidanandam V, Desai A, Ravi V, Coloma J, Turtle L, Rivino L, Kallas EG, Peters B, Harris E, Sette A, Weiskopf D. Global Assessment of Dengue Virus-Specific CD4 + T Cell Responses in Dengue-Endemic Areas. Front Immunol 2017; 8:1309. [PMID: 29081779 PMCID: PMC5646259 DOI: 10.3389/fimmu.2017.01309] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [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: 09/07/2017] [Accepted: 09/28/2017] [Indexed: 11/18/2022] Open
Abstract
Background Dengue is a major public health problem worldwide. Assessment of adaptive immunity is important to understanding immunopathology and to define correlates of protection against dengue virus (DENV). To enable global assessment of CD4+ T cell responses, we mapped HLA-DRB1-restricted DENV-specific CD4+ T cell epitopes in individuals previously exposed to DENV in the general population of the dengue-endemic region of Managua, Nicaragua. Methods HLA class II epitopes in the population of Managua were identified by an in vitro IFNγ ELISPOT assay. CD4+ T cells purified by magnetic bead negative selection were stimulated with HLA-matched epitope pools in the presence of autologous antigen-presenting cells, followed by pool deconvolution to identify specific epitopes. The epitopes identified in this study were combined with those previously identified in the DENV endemic region of Sri Lanka, to generate a “megapool” (MP) consisting of 180 peptides specifically designed to achieve balanced HLA and DENV serotype coverage. The DENV CD4MP180 was validated by intracellular cytokine staining assays. Results We detected responses directed against a total of 431 epitopes, representing all 4 DENV serotypes, restricted by 15 different HLA-DRB1 alleles. The responses were associated with a similar pattern of protein immunodominance, overall higher magnitude of responses, as compared to what was observed previously in the Sri Lanka region. Based on these epitope mapping studies, we designed a DENV CD4 MP180 with higher and more consistent coverage, which allowed the detection of CD4+ T cell DENV responses ex vivo in various cohorts of DENV exposed donors worldwide, including donors from Nicaragua, Brazil, Singapore, Sri Lanka, and U.S. domestic flavivirus-naïve subjects immunized with Tetravalent Dengue Live-Attenuated Vaccine (TV005). This broad reactivity reflects that the 21 HLA-DRB1 alleles analyzed in this and previous studies account for more than 80% of alleles present with a phenotypic frequency ≥5% worldwide, corresponding to 92% phenotypic coverage of the general population (i.e., 92% of individuals express at least one of these alleles). Conclusion The DENV CD4 MP180 can be utilized to measure ex vivo responses to DENV irrespective of geographical location.
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Affiliation(s)
- Alba Grifoni
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
| | - Michael A Angelo
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
| | - Benjamin Lopez
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
| | - Patrick H O'Rourke
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
| | - John Sidney
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
| | - Cristhiam Cerpas
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Managua, Nicaragua
| | - Angel Balmaseda
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud, Managua, Nicaragua
| | - Cassia G T Silveira
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alvino Maestri
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Priscilla R Costa
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Anna P Durbin
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sean A Diehl
- Vaccine Testing Center, Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, United States
| | - Elizabeth Phillips
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.,Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Simon Mallal
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia.,Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Aruna D De Silva
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States.,Genetech Research Institute, Colombo, Sri Lanka
| | - Godwin Nchinda
- Chantal BIYA International Reference Centre for Research on the Prevention and Management of HIV/AIDS CIRCB, Yaoundé, Cameroon
| | - Celine Nkenfou
- Chantal BIYA International Reference Centre for Research on the Prevention and Management of HIV/AIDS CIRCB, Yaoundé, Cameroon
| | - Matthew H Collins
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Aravinda M de Silva
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Mei Qiu Lim
- Emerging Infectious Disease Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Paul A Macary
- Immunology Programme, Department of Microbiology and Immunology, Life Sciences Institute, National University of Singapore, Singapore, Singapore
| | - Filippo Tatullo
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom
| | - Tom Solomon
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.,National Institute for Health Research, Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
| | - Vijaya Satchidanandam
- Department of Microbiology and Cell Biology, Indian Institute of Science, Bangalore, India
| | - Anita Desai
- Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Vasanthapram Ravi
- Neurovirology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Lance Turtle
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.,National Institute for Health Research, Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
| | - Laura Rivino
- Emerging Infectious Disease Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Esper G Kallas
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Bjoern Peters
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Alessandro Sette
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
| | - Daniela Weiskopf
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology, La Jolla, CA, United States
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Lopez Gonzales AH, Santos JC, Mariano L, Tomal A, Costa PR. Evaluation of mean conversion coefficients from air-kerma to H *(10) using secondary and transmitted x-ray spectra in the diagnostic radiology energy range. J Radiol Prot 2016; 36:842-857. [PMID: 27739403 DOI: 10.1088/0952-4746/36/4/842] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Ambient dose equivalent H *(10) is an operational quantity recommended by the IAEA to establish dose constraints in area monitoring for external radiation. The direct measurement of H *(10) is not common due to the complexity in the calibration procedures of radiation monitors involving the use of expanded and aligned radiation fields. Therefore, conversion coefficients are used to assess H *(10) from the physical quantity air-kerma. Conversion coefficients published by international commissions, ICRU and ICRP, present a correlation with the radiation beam quality. However, Brazilian regulation establishes 1.14 Sv Gy-1 as unique conversion coefficient to convert air-kerma into H *(10), disregarding its beam quality dependence. The present study computed mean conversion coefficients from secondary and transmitted x-ray beams in order to improve the current assessment of H *(10). The weighting of conversion coefficients corresponding to monoenergetic beams with the spectrum energy distribution in terms of air-kerma was used to compute the mean conversion coefficients. In order to represent dedicated chest radiographic facilities, an anthropomorphic phantom was used as scatter object of the primary beam. Secondary x-ray spectra were measured in the diagnostic energy range at scattering angles of 30°, 60°, 90° 120° and 150° degrees. Barite mortar plates were used as attenuator of the secondary beam to produce the corresponding transmitted x-ray spectra. Results show that the mean conversion coefficients are about 43% higher than the recommended value accepted by Brazilian regulation. For secondary radiation measured at 100 kV the mean coefficient should be 1.46 Sv Gy-1, which represent the higher value in the mean coefficient set corresponding to secondary beams. Moreover, for transmitted x-ray beams at 100 kV, the recommended mean conversion coefficient is 1.65 Sv Gy-1 for all barite mortar plate thickness and all scattering angles. An example of application shows the discrepancy in the evaluation of secondary shielding barriers in a controlled area when the shielding goals is evaluated. The conclusion based on these results is that a unique coefficient may not be adequate for deriving the H *(10).
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Santos JC, Mariano L, Tomal A, Costa PR. Evaluation of conversion coefficients relating air-kerma to H*(10) using primary and transmitted x-ray spectra in the diagnostic radiology energy range. J Radiol Prot 2016; 36:117-132. [PMID: 26835613 DOI: 10.1088/0952-4746/36/1/117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
According to the International Commission on Radiation Units and Measurements (ICRU), the relationship between effective dose and incident air-kerma is complex and depends on the attenuation of x-rays in the body. Therefore, it is not practical to use this quantity for shielding design purposes. This correlation is adopted in practical situations by using conversion coefficients calculated using validated mathematical models by the ICRU. The ambient dose equivalent, H*(10), is a quantity adopted by the IAEA for monitoring external exposure. Dose constraint levels are established in terms of H*(10), while the radiation levels in radiometric surveys are calculated by means of the measurements of air-kerma with ion chambers. The resulting measurements are converted into ambient dose equivalents by conversion factors. In the present work, an experimental study of the relationship between the air-kerma and the operational quantity ambient dose equivalent was conducted using different experimental scenarios. This study was done by measuring the primary x-ray spectra and x-ray spectra transmitted through materials used in dedicated chest radiographic facilities, using a CdTe detector. The air-kerma to ambient dose equivalent conversion coefficients were calculated from these measured spectra. The resulting values of the quantity ambient dose equivalent using these conversion coefficients are more realistic than those available in the literature, because they consider the real energy distribution of primary and transmitted x-ray beams. The maximum difference between the obtained conversion coefficients and the constant value recommended in national and international radiation protection standards is 53.4%. The conclusion based on these results is that a constant coefficient may not be adequate for deriving the ambient dose equivalent.
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Affiliation(s)
- J C Santos
- Instituto de Física da Universidade de São Paulo, SP, Brazil
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14
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Weiskopf D, Cerpas C, Angelo MA, Bangs DJ, Sidney J, Paul S, Peters B, Sanches FP, Silvera CGT, Costa PR, Kallas EG, Gresh L, de Silva AD, Balmaseda A, Harris E, Sette A. Human CD8+ T-Cell Responses Against the 4 Dengue Virus Serotypes Are Associated With Distinct Patterns of Protein Targets. J Infect Dis 2015; 212:1743-51. [PMID: 25980035 DOI: 10.1093/infdis/jiv289] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [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: 03/24/2015] [Accepted: 05/06/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND All 4 dengue virus (DENV) serotypes are now simultaneously circulating worldwide and responsible for up to 400 million human infections each year. Previous studies of CD8(+) T-cell responses in HLA-transgenic mice and human vaccinees demonstrated that the hierarchy of immunodominance among structural versus nonstructural proteins differs as a function of the infecting serotype. This led to the hypothesis that there are intrinsic differences in the serotype-specific reactivity of CD8(+) T-cell responses. METHODS We tested this hypothesis by analyzing serotype-specific CD8(+) T-cell reactivity in naturally infected human donors from Sri Lanka and Nicaragua, using ex vivo interferon γ-specific enzyme-linked immunosorbent spot assays. RESULTS Remarkably similar and clear serotype-specific patterns of immunodominance in both cohorts were identified. Pooling of epitopes that accounted for 90% of the interferon γ response in both cohorts resulted in a global epitope pool. Its reactivity was confirmed in naturally infected donors from Brazil, demonstrating its global applicability. CONCLUSIONS This study provides new insight into differential serotype-specific immunogenicity of DENV proteins. It further provides a potentially valuable tool for future investigations of CD8(+) T-cell responses in the typically small sample volumes available from patients with acute fever and children without requiring prior knowledge of either infecting DENV serotype or HLA type.
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Affiliation(s)
- Daniela Weiskopf
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology
| | - Cristhiam Cerpas
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud
| | - Michael A Angelo
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology
| | - Derek J Bangs
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology
| | - John Sidney
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology
| | - Sinu Paul
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology
| | - Bjoern Peters
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology
| | - Françoise P Sanches
- Division of Clinical Immunology and Allergy (LIM-60), School of Medicine, University of São Paulo, Brazil
| | - Cassia G T Silvera
- Division of Clinical Immunology and Allergy (LIM-60), School of Medicine, University of São Paulo, Brazil
| | - Priscilla R Costa
- Division of Clinical Immunology and Allergy (LIM-60), School of Medicine, University of São Paulo, Brazil
| | - Esper G Kallas
- Division of Clinical Immunology and Allergy (LIM-60), School of Medicine, University of São Paulo, Brazil
| | - Lionel Gresh
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Aruna D de Silva
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology Genetech Research Institute, Colombo, Sri Lanka
| | - Angel Balmaseda
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministerio de Salud
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California-Berkeley
| | - Alessandro Sette
- Division of Vaccine Discovery, La Jolla Institute for Allergy and Immunology
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Lopez Gonzales AH, Tomal A, Costa PR. Evaluation of characteristic-to-total spectrum ratio: Comparison between experimental and a semi-empirical model. Appl Radiat Isot 2015; 100:27-31. [PMID: 25600507 DOI: 10.1016/j.apradiso.2015.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 07/30/2014] [Revised: 12/20/2014] [Accepted: 01/08/2015] [Indexed: 11/25/2022]
Abstract
Primary X-ray spectra were measured in the range of 80-150kV in order to validate a computer program based on a semiempirical model. The ratio between the characteristic and total air Kerma was considered to compare computed results and experimental data. Results show that the experimental spectra have higher first HVL and mean energy than the calculated ones. The ratios between the characteristic and total air Kerma for calculated spectra are in good agreement with experimental results for all filtrations used.
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Affiliation(s)
- A H Lopez Gonzales
- Laboratory of Radiation Dosimetry and Medical Physics, Physics Institute of São Paulo University, 66318 São Paulo, SP, Brazil
| | - A Tomal
- Physics Institute "Gleb Wataghin", Universidade Estadual de Campinas, 13083-859 Campinas, SP, Brazil
| | - P R Costa
- Laboratory of Radiation Dosimetry and Medical Physics, Physics Institute of São Paulo University, 66318 São Paulo, SP, Brazil.
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Milagres LG, Costa PR, Silva GP, Carvalho KI, Pereira-Manfro WF, Ferreira B, Barreto DM, Frota ACC, Hofer CB, Kallas EG. Subsets of memory CD4+ T cell and bactericidal antibody response to Neisseria meningitidis serogroup C after immunization of HIV-infected children and adolescents. PLoS One 2014; 9:e115887. [PMID: 25532028 PMCID: PMC4274125 DOI: 10.1371/journal.pone.0115887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 09/08/2014] [Accepted: 11/27/2014] [Indexed: 11/18/2022] Open
Abstract
Meningococcal disease is endemic in Brazil, with periodic outbreaks and case fatality rates reach as high as 18 to 20% of cases. Conjugate vaccines against meningococci are immunogenic in healthy children. However, we have previously shown a poor bactericidal antibody response to a Men C conjugate vaccine in Brazilian HIV-infected children and adolescents after a single vaccine administration. The goal of the present work was to investigate associations between bactericidal antibody response induced by MenC vaccine and the frequency and activation profile (expression of CD38, HLA-DR and CCR5 molecules) of total CD4+ memory T cell sub-populations in HIV-1-infected children and adolescents. Responders to vaccination against MenC had a predominance (about 44%) of CD4+ TINTERMEDIATE subset followed by TTRANSITIONAL memory subset (23 to 26%). Importantly, CD4+ TINT frequency was positively associated with bactericidal antibody response induced by vaccination. The positive correlation persisted despite the observation that the frequency TINT CD38+HLA-DR+ was higher in responders. In contrast, CD4+ TCENTRAL MEMORY (TCM) subset negatively correlated with bactericidal antibodies. In conclusion, these data indicate that less differentiated CD+ T cells, like TCM may be constantly differentiating into intermediate and later differentiated CD4+ T cell subsets. These include CD4 TINT subset which showed a positive association with bactericidal antibodies.
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Affiliation(s)
- Lucimar G. Milagres
- State University of Rio de Janeiro, Department of Microbiology, Immunology and Parasitology, Rio de Janeiro, RJ, Brazil
| | - Priscilla R. Costa
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Giselle P. Silva
- State University of Rio de Janeiro, Department of Microbiology, Immunology and Parasitology, Rio de Janeiro, RJ, Brazil
| | - Karina I. Carvalho
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Wânia F. Pereira-Manfro
- State University of Rio de Janeiro, Department of Microbiology, Immunology and Parasitology, Rio de Janeiro, RJ, Brazil
| | - Bianca Ferreira
- Preventive Medicine Department, School of Medicine – Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Daniella M. Barreto
- Preventive Medicine Department, School of Medicine – Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Ana Cristina C. Frota
- Preventive Medicine Department, School of Medicine – Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Cristina B. Hofer
- Instituto de Puericultura e Pediatria Martagão Gesteira – Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Preventive Medicine Department, School of Medicine – Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Esper G. Kallas
- Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
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Snyder-Cappione JE, Nixon DF, Loo CP, Chapman JM, Meiklejohn DA, Melo FF, Costa PR, Sandberg JK, Rodrigues DS, Kallas EG. Individuals with pulmonary tuberculosis have lower levels of circulating CD1d-restricted NKT cells. J Infect Dis 2007; 195:1361-4. [PMID: 17397008 DOI: 10.1086/513567] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 11/21/2006] [Indexed: 11/03/2022] Open
Abstract
Mycobacterium tuberculosis (MTB) is a leading cause of mortality worldwide from an infectious agent. Natural killer T (NKT) cells recognize mycobacterial antigens and contribute to anti-MTB immunity in mouse models. NKT cells were measured in subjects with pulmonary tuberculosis, MTB-exposed individuals, and healthy controls. NKT cell levels are selectively lower in peripheral blood mononuclear cells from individuals with pulmonary tuberculosis than in both MTB-exposed subjects and healthy control subjects. This apparent loss of NKT cells from the peripheral blood is sustained during the 6 months after the initiation of MTB treatment. These findings indicate that NKT cells may be an important component of antituberculosis immunity.
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18
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Künzel R, Herdade SB, Costa PR, Terini RA, Levenhagen RS. Ambient dose equivalent and effective dose from scattered x-ray spectra in mammography for Mo/Mo, Mo/Rh and W/Rh anode/filter combinations. Phys Med Biol 2006. [PMID: 16585846 DOI: 10.1088/0031‐9155/51/8/008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this study, scattered x-ray distributions were produced by irradiating a tissue equivalent phantom under clinical mammographic conditions by using Mo/Mo, Mo/Rh and W/Rh anode/filter combinations, for 25 and 30 kV tube voltages. Energy spectra of the scattered x-rays have been measured with a Cd(0.9)Zn(0.1)Te (CZT) detector for scattering angles between 30 degrees and 165 degrees . Measurement and correction processes have been evaluated through the comparison between the values of the half-value layer (HVL) and air kerma calculated from the corrected spectra and measured with an ionization chamber in a nonclinical x-ray system with a W/Mo anode/filter combination. The shape of the corrected x-ray spectra measured in the nonclinical system was also compared with those calculated using semi-empirical models published in the literature. Scattered x-ray spectra measured in the clinical x-ray system have been characterized through the calculation of HVL and mean photon energy. Values of the air kerma, ambient dose equivalent and effective dose have been evaluated through the corrected x-ray spectra. Mean conversion coefficients relating the air kerma to the ambient dose equivalent and to the effective dose from the scattered beams for Mo/Mo, Mo/Rh and W/Rh anode/filter combinations were also evaluated. Results show that for the scattered radiation beams the ambient dose equivalent provides an overestimate of the effective dose by a factor of about 5 in the mammography energy range. These results can be used in the control of the dose limits around a clinical unit and in the calculation of more realistic protective shielding barriers in mammography.
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Affiliation(s)
- R Künzel
- Instituto de Física, Universidade de São Paulo, Rua do Matão, Travessa R, 187, Cidade Universitária, CEP 05508-900, São Paulo, Brazil.
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19
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Künzel R, Herdade SB, Costa PR, Terini RA, Levenhagen RS. Ambient dose equivalent and effective dose from scattered x-ray spectra in mammography for Mo/Mo, Mo/Rh and W/Rh anode/filter combinations. Phys Med Biol 2006; 51:2077-91. [PMID: 16585846 DOI: 10.1088/0031-9155/51/8/008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this study, scattered x-ray distributions were produced by irradiating a tissue equivalent phantom under clinical mammographic conditions by using Mo/Mo, Mo/Rh and W/Rh anode/filter combinations, for 25 and 30 kV tube voltages. Energy spectra of the scattered x-rays have been measured with a Cd(0.9)Zn(0.1)Te (CZT) detector for scattering angles between 30 degrees and 165 degrees . Measurement and correction processes have been evaluated through the comparison between the values of the half-value layer (HVL) and air kerma calculated from the corrected spectra and measured with an ionization chamber in a nonclinical x-ray system with a W/Mo anode/filter combination. The shape of the corrected x-ray spectra measured in the nonclinical system was also compared with those calculated using semi-empirical models published in the literature. Scattered x-ray spectra measured in the clinical x-ray system have been characterized through the calculation of HVL and mean photon energy. Values of the air kerma, ambient dose equivalent and effective dose have been evaluated through the corrected x-ray spectra. Mean conversion coefficients relating the air kerma to the ambient dose equivalent and to the effective dose from the scattered beams for Mo/Mo, Mo/Rh and W/Rh anode/filter combinations were also evaluated. Results show that for the scattered radiation beams the ambient dose equivalent provides an overestimate of the effective dose by a factor of about 5 in the mammography energy range. These results can be used in the control of the dose limits around a clinical unit and in the calculation of more realistic protective shielding barriers in mammography.
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Affiliation(s)
- R Künzel
- Instituto de Física, Universidade de São Paulo, Rua do Matão, Travessa R, 187, Cidade Universitária, CEP 05508-900, São Paulo, Brazil.
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20
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Rosa R, Costa PR, Bandarra N, Nunes ML. Changes in tissue biochemical composition and energy reserves associated with sexual maturation in the ommastrephid squids Illex coindetii and Todaropsis eblanae. Biol Bull 2005; 208:100-113. [PMID: 15837959 DOI: 10.2307/3593118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The aim of this study was to investigate the biochemical changes that occur during sexual maturation of the squids Illex coindetii and Todaropsis eblanae. In both species, amino acids and protein content increased in the gonad throughout maturation, but the allocation of these nitrogen compounds from the digestive gland and muscle was not evident. A significant (P < 0.05) increase in the content of lipids and fatty acids was observed in the gonad and digestive gland. It seems that both species take energy for egg production directly from food, rather than from stored products. Analyses for cholesterol revealed a significant (P < 0.05) increase in the gonad, and the lipid content differences between species are potentially related to different feeding ecologies. The glycogen reserves in the gonad increased significantly (P < 0.05), suggesting that glycogen has an important role in the maturation process. It was evident that sexual maturation had a significant effect upon the gonad energy content, but because the energy variation in the digestive gland and muscle was nonsignificant (P > 0.05), there was no evidence that storage reserves are transferred from tissue to tissue.
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Affiliation(s)
- R Rosa
- Departamento de Inovação Tecnológica e Valorização dos Produtos da Pesca, IPIMAR, Avenida de Brasília, 1449-006 Lisboa, Portugal.
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21
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Rosa R, Costa PR, Pereira J, Nunes ML. Biochemical dynamics of spermatogenesis and oogenesis in Eledone cirrhosa and Eledone moschata (Cephalopoda: Octopoda). Comp Biochem Physiol B Biochem Mol Biol 2004; 139:299-310. [PMID: 15465677 DOI: 10.1016/j.cbpc.2004.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [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: 04/30/2004] [Revised: 08/04/2004] [Accepted: 08/04/2004] [Indexed: 11/18/2022]
Abstract
The effect of spermatogenesis and oogenesis on protein, lipid, glycogen, cholesterol and energy contents, total amino acid and fatty acid profiles of Eledone cirrhosa and Eledone moschata tissues (gonad, digestive gland and muscle) was investigated. A significant (p<0.05) increase in the amino acids and protein content of the gonad throughout sexual maturation (namely in oogenesis) was observed, but the allocation of these nitrogen compounds from the digestive gland and muscle was not evident. The major essential amino acids (EAA) in the three tissues were leucine, lysine and arginine. The major nonessential amino acids (NEAA) were glutamic acid, aspartic acid and alanine. A significant increase in lipid and fatty acid contents of gonad and digestive gland was observed. There was also little evidence of accumulated lipid storage reserves being used for egg production. It seems that for egg production Eledone species use energy directly from food, rather than from stored products. Most of saturated fatty acid (SFA) content of the three tissues was presented as 16:0 and 18:0, monounsaturated fatty acid (MUFA) content as 18:1 and 20:1 and polyunsaturated fatty acid (PUFA) content as 20:4n-6, 20:5n-3 and 22:6n-3. Cholesterol and glycogen contents significantly increased in gonad and digestive gland throughout maturation while the muscle revealed no obvious pattern. If Eledone's component sterols are of a dietary origin, a considerable variation in the cholesterol content between species might be expected on the basis of the sterol composition of their prey. Although spermatogenesis and oogenesis had a significant effect (p<0.05) in gonad and digestive gland energy content, the biochemical composition of digestive gland and muscle may not be primarily influenced by sexual maturation, but rather by other biotic factors such as feeding activity, food availability, spawning and brooding.
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Affiliation(s)
- R Rosa
- Departamento de Inovação Tecnológica e Valorização dos Produtos da Pesca, IPIMAR, Avenida de Brasília, 1449-006 Lisboa, Portugal.
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22
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Terini RA, Pereira MAG, Künzel R, Costa PR, Herdade SB. Comprehensive analysis of the spectrometric determination of voltage applied to X-ray tubes in the radiography and mammography energy ranges using a silicon PIN photodiode. Br J Radiol 2004; 77:395-404. [PMID: 15121703 DOI: 10.1259/bjr/32514512] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This work describes the analysis of factors which affect the results of estimation of the electron accelerating potential (kVp) applied to an X-ray tube, through determination of the end point of the energy spectrum of the emitted radiation beam. Measurements have been performed utilizing two spectrometers each with a silicon PIN photodiode: one operating at room temperature, and the other, a high resolution spectrometer, with a Peltier cooler. Both were directly irradiated by different X-ray beams. Both systems work at low voltage and without liquid nitrogen cooling, thus avoiding the drawbacks presented by germanium detectors. Each kVp value was determined by linear regression of the end of the spectrum, so as to give, simultaneously, the best fit to the experimental data and low standard deviation for the kVp value. Detector energy resolution and calibration, counting statistics and high voltage waveform ripple have been investigated in order to establish better experimental conditions and to optimize measurement time. Results of measurements carried out with X-ray tubes connected to single-phase, three-phase or constant potential units, using additional filtration of Cu, Al or Mo (for mammographic beams), are presented. The variations resulted in kVp uncertainties up to 0.1 kV.
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Affiliation(s)
- R A Terini
- Serviço Técnico de Aplicações Médico-Hospitalares, Instituto de Eletrotécnica e Energia, Universidade de São Paulo, Av. Prof. Luciano Gualberto, 1289, Cidade Universitária, CEP. 05508-010, São Paulo, SP, Brazil
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23
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Milan EP, Kallás EG, Costa PR, da Matta DA, Lopes Colombo A. Oral colonization by Candida spp. among AIDS household contacts. Mycoses 2002; 44:273-7. [PMID: 11714061] [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: 02/22/2023]
Abstract
This study was designed to investigate the oral yeast colonization rate of household contacts of AIDS patients. Sixty-four AIDS household contacts were sequentially enrolled along with 103 HIV-negative blood bank donors (control group). Samples were obtained by swabbing the oral mucosa. Yeast isolates were identified by classical methods and antifungal susceptibility testing was performed according to NCCLS microbroth assay. Candida spp. was recovered from the oral cavity of 33% of the AIDS household contacts, in contrast with 14% of the control group (P = 0.003 or P = 0.04 after adjusting for oral prosthesis use). Candida albicans was the most frequently isolated species in both groups. All of the isolates were susceptible to fluconazole, itraconazole and ketoconazole. In conclusion, we were able to demonstrate a higher colonization rate in the AIDS household contacts group compared with the control group. No resistant isolates to antifungal drugs was observed. We suggest that the contact with AIDS patients may play a role as a risk factor for developing oral colonization by Candida spp.
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Affiliation(s)
- E P Milan
- Division of Infectious Diseases, Escola Paulista de Medicina--UNIFESP, São Paulo, Brazil
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24
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Melo PA, Silva NM, Brito FV, Buarque CD, de Souza DV, Rodrigues VP, Poças ES, Noël F, Albuquerque EX, Costa PR. Synthesis and preliminary pharmacological evaluation of coumestans with different patterns of oxygenation. Bioorg Med Chem Lett 2001; 11:283-6. [PMID: 11212092 DOI: 10.1016/s0960-894x(00)00621-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Five coumestans with different patterns of oxygenation in rings A and D were synthesized from resorcinol and aromatic aldehydes, and screened for their antimyotoxic activity. The most potent compound (2b, IC50 = 1 microM) was selected for study of its pharmacological profile.
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25
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Silva MC, Herdade SB, Lammoglia P, Costa PR, Terini RA. Determination of the voltage applied to x-ray tubes from the bremsstrahlung spectrum obtained with a silicon PIN photodiode. Med Phys 2000; 27:2617-23. [PMID: 11128315 DOI: 10.1118/1.1318222] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This work describes a methodology for the obtainment of the electron accelerating potential (kVp) applied to an x-ray tube, through the determination of the end point of the energy spectrum of the radiation emitted by the tube. The measurements have been performed utilizing alternatively two silicon PIN photodiodes, directly irradiated by the x-ray beam. Both were operated at room temperature, with low bias, so avoiding the drawbacks presented by photomultiplier tubes and germanium detectors. The energy calibration of the system was performed with X- and gamma-emitter radioactive sources, which makes the method absolute. Each kVp value was determined by means of a linear regression in the end of the spectrum, to give, simultaneously, a good fit of the straight line to the experimental data and a low standard deviation for the kVp value. Results of the measurements carried out with an x-ray tube connected to a three-phase generator, using additional filtration between 1.5 and 4.0 mm of Cu, are presented. This filtration was used in order to minimize the contribution of low energy photons and to reduce pulse pile-up. Errors determined for the values of kVp are between 0.06 and 0.16 kV, in the potential range from 50 to 100 kV. As an example, the methodology has been applied in the verification of the secondary calibration of a voltage divider, utilized, by its turn, in the tertiary calibration of noninvasive kVp meters. All intrinsic sources of errors involved in the process are discussed and evaluated.
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Affiliation(s)
- M C Silva
- Instituto de Física, Universidade de São Paulo, SP, Brazil.
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26
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Milan EP, Burattini MN, Kallás EG, Fischmann O, Costa PR, Colombo AL. Azole resistance among oral Candida species isolates from AIDS patients under ketoconazole exposure. Diagn Microbiol Infect Dis 1998; 32:211-6. [PMID: 9884838 DOI: 10.1016/s0732-8893(98)00107-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This is a prospective study designed to investigate species distribution and azole susceptibility profile among Candida spp. isolated from the oral cavities of AIDS patients. One hundred thirty-two AIDS patients sequentially admitted at a teaching tertiary care hospital were enrolled in this study. Samples were obtained by swabbing the oral cavities of the patients. Yeast isolates were identified by classical methods and the antifungal susceptibility profile was further determined according to the NCCLS microbroth assay. Among all patients with prescriptions of systemic antifungal drugs, ketoconazole had been elected to treat 56% of patients. We found 82% of oral yeast carriage, 22% of them harboring non-albicans species. Overall rates of susceptibility dose dependent/resistance to azoles was 16% for itraconazole, 13% for ketoconazole, and 10% for fluconazole with a high agreement rate among the susceptibility profiles of all isolates tested against the triazoles.
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Affiliation(s)
- E P Milan
- Division of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
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27
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Lansbury PT, Costa PR, Griffiths JM, Simon EJ, Auger M, Halverson KJ, Kocisko DA, Hendsch ZS, Ashburn TT, Spencer RG. Structural model for the beta-amyloid fibril based on interstrand alignment of an antiparallel-sheet comprising a C-terminal peptide. Nat Struct Biol 1995; 2:990-8. [PMID: 7583673 DOI: 10.1038/nsb1195-990] [Citation(s) in RCA: 359] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Amyloids are a class of noncrystalline, yet ordered, protein aggregates. A new approach was used to provide the initial structural data on an amyloid fibril--comprising a peptide (beta 34-42) from the C-terminus of the beta-amyloid protein--based on measurement of intramolecular 13C-13C distances and 13C chemical shifts by solid-state 13C NMR and individual amide absorption frequencies by isotope-edited infrared spectroscopy. Intermolecular orientation and alignment within the amyloid sheet was determined by fitting models to observed intermolecular 13C-13C couplings. Although the structural model we present is defined to relatively low resolution, it nevertheless shows a pleated antiparallel beta-sheet characterized by a specific intermolecular alignment.
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Affiliation(s)
- P T Lansbury
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge 02139, USA
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28
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Gross JD, Costa PR, Dubacq JP, Warschawski DE, Lirsac PN, Devaux PF, Griffin RG. Multidimensional NMR in lipid systems. Coherence transfer through J couplings under MAS. J Magn Reson B 1995; 106:187-90. [PMID: 7850186 DOI: 10.1006/jmrb.1995.1031] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- J D Gross
- Francis Bitter National Magnet Laboratory, Massachusetts Institute of Technology, Cambridge 02139
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Abstract
Os autores isolaram e estudaram morfologicamente Lagochilascaris minor Leiper 1909, material obtido na cirurgia de um abscesso cervical direito de um menino de cor branca, com cinco anos de idade, procedente da cidade de Colorado, no Município de Vilhena, em Rondonia-Brasil. É sugerida uma chave para o diagnóstico diferencial das espécies do gênero Lagochilascaris.
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Barreiro EJ, Costa PR, de Mello RT, Barros PR. [Use of natural sources in the preparation of biologically active compounds. II: Anti-inflammatory agents]. AN ACAD BRAS CIENC 1981; 53:65-7. [PMID: 7283282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
In order to improve the knowledge on the natural sources of Brazilian florae, a research program is in course for the preparation of different groups of compounds which could have biological activity using abundant Natural Products as starting materials. This paper deals with work and results in the synthesis of anti-inflammatory analogs.
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31
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Barreiro EJ, Costa PR, Gomes LN, Pereira AL. [Use of natural sources in the preparation of biologically active compounds. I: Prostanoids]. AN ACAD BRAS CIENC 1981; 53:61-3. [PMID: 7197135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
In order to improve the knowledge on the natural sources of Brazilian florae, a research program is in course for the preparation of different groups of compounds which could have biological activity, using abundant Natural Products as starting materials. This paper deals with the work and results in the formal synthesis of prostaglandin analogs.
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32
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Costa PR, Torres LB, Rabi JA. [Synthesis of quinolines from safrole]. AN ACAD BRAS CIENC 1980; 52:483-8. [PMID: 7212459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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