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Deng ZD, Argyelan M, Miller J, Jones TR, Upston J, McClintock SM, Abbott CC. On assumptions and key issues in electric field modeling for ECT. Mol Psychiatry 2024:10.1038/s41380-024-02567-9. [PMID: 38671213 DOI: 10.1038/s41380-024-02567-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024]
Affiliation(s)
- Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Miklos Argyelan
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Center for Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, NY, USA
| | - Jeremy Miller
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Thomas R Jones
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Joel Upston
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Shawn M McClintock
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
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Abbott CC, Miller J, Farrar D, Argyelan M, Lloyd M, Squillaci T, Kimbrell B, Ryman S, Jones TR, Upston J, Quinn DK, Peterchev AV, Erhardt E, Datta A, McClintock SM, Deng ZD. Amplitude-determined seizure-threshold, electric field modeling, and electroconvulsive therapy antidepressant and cognitive outcomes. Neuropsychopharmacology 2024; 49:640-648. [PMID: 38212442 PMCID: PMC10876627 DOI: 10.1038/s41386-023-01780-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/06/2023] [Accepted: 11/26/2023] [Indexed: 01/13/2024]
Abstract
Electroconvulsive therapy (ECT) pulse amplitude, which dictates the induced electric field (E-field) magnitude in the brain, is presently fixed at 800 or 900 milliamperes (mA) without clinical or scientific rationale. We have previously demonstrated that increased E-field strength improves ECT's antidepressant effect but worsens cognitive outcomes. Amplitude-determined seizure titration may reduce the E-field variability relative to fixed amplitude ECT. In this investigation, we assessed the relationships among amplitude-determined seizure-threshold (STa), E-field magnitude, and clinical outcomes in older adults (age range 50 to 80 years) with depression. Subjects received brain imaging, depression assessment, and neuropsychological assessment pre-, mid-, and post-ECT. STa was determined during the first treatment with a Soterix Medical 4×1 High Definition ECT Multi-channel Stimulation Interface (Investigation Device Exemption: G200123). Subsequent treatments were completed with right unilateral electrode placement (RUL) and 800 mA. We calculated Ebrain defined as the 90th percentile of E-field magnitude in the whole brain for RUL electrode placement. Twenty-nine subjects were included in the final analyses. Ebrain per unit electrode current, Ebrain/I, was associated with STa. STa was associated with antidepressant outcomes at the mid-ECT assessment and bitemporal electrode placement switch. Ebrain/I was associated with changes in category fluency with a large effect size. The relationship between STa and Ebrain/I extends work from preclinical models and provides a validation step for ECT E-field modeling. ECT with individualized amplitude based on E-field modeling or STa has the potential to enhance neuroscience-based ECT parameter selection and improve clinical outcomes.
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Affiliation(s)
| | - Jeremy Miller
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Danielle Farrar
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Miklos Argyelan
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Megan Lloyd
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Taylor Squillaci
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Brian Kimbrell
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Sephira Ryman
- Mind Research Network, Albuquerque, NM, USA
- Department of Neurology, Albuquerque, NM, USA
| | - Thomas R Jones
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Joel Upston
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Davin K Quinn
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Angel V Peterchev
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
- Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA
- Department of Neurosurgery, Duke University School of Medicine, Durham, NC, USA
| | - Erik Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA
| | | | - Shawn M McClintock
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Zhi-De Deng
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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Quinn DK, Upston J, Jones TR, Gibson BC, Olmstead TA, Yang J, Price AM, Bowers-Wu DH, Durham E, Hazlewood S, Farrar DC, Miller J, Lloyd MO, Garcia CA, Ojeda CJ, Hager BW, Vakhtin AA, Abbott CC. Electric field distribution predicts efficacy of accelerated intermittent theta burst stimulation for late-life depression. Front Psychiatry 2023; 14:1215093. [PMID: 37593449 PMCID: PMC10427506 DOI: 10.3389/fpsyt.2023.1215093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/13/2023] [Indexed: 08/19/2023] Open
Abstract
Introduction Repetitive transcranial magnetic stimulation (rTMS) is a promising intervention for late-life depression (LLD) but may have lower rates of response and remission owing to age-related brain changes. In particular, rTMS induced electric field strength may be attenuated by cortical atrophy in the prefrontal cortex. To identify clinical characteristics and treatment parameters associated with response, we undertook a pilot study of accelerated fMRI-guided intermittent theta burst stimulation (iTBS) to the right dorsolateral prefrontal cortex in 25 adults aged 50 or greater diagnosed with LLD and qualifying to receive clinical rTMS. Methods Participants underwent baseline behavioral assessment, cognitive testing, and structural and functional MRI to generate individualized targets and perform electric field modeling. Forty-five sessions of iTBS were delivered over 9 days (1800 pulses per session, 50-min inter-session interval). Assessments and testing were repeated after 15 sessions (Visit 2) and 45 sessions (Visit 3). Primary outcome measure was the change in depressive symptoms on the Inventory of Depressive Symptomatology-30-Clinician (IDS-C-30) from Visit 1 to Visit 3. Results Overall there was a significant improvement in IDS score with the treatment (Visit 1: 38.6; Visit 2: 31.0; Visit 3: 21.3; mean improvement 45.5%) with 13/25 (52%) achieving response and 5/25 (20%) achieving remission (IDS-C-30 < 12). Electric field strength and antidepressant effect were positively correlated in a subregion of the ventrolateral prefrontal cortex (VLPFC) (Brodmann area 47) and negatively correlated in the posterior dorsolateral prefrontal cortex (DLPFC). Conclusion Response and remission rates were lower than in recently published trials of accelerated fMRI-guided iTBS to the left DLPFC. These results suggest that sufficient electric field strength in VLPFC may be a contributor to effective rTMS, and that modeling to optimize electric field strength in this area may improve response and remission rates. Further studies are needed to clarify the relationship of induced electric field strength with antidepressant effects of rTMS for LLD.
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Affiliation(s)
- Davin K. Quinn
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Joel Upston
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Thomas R. Jones
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Benjamin C. Gibson
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Tessa A. Olmstead
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Justine Yang
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | | | - Dorothy H. Bowers-Wu
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Erick Durham
- Department of Psychiatry, Texas Tech University, El Paso, TX, United States
| | - Shawn Hazlewood
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Danielle C. Farrar
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Jeremy Miller
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Megan O. Lloyd
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Crystal A. Garcia
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Cesar J. Ojeda
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Brant W. Hager
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | | | - Christopher C. Abbott
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
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De Oliveira DMP, Keller B, Hayes AJ, Ong CLY, Harbison-Price N, El-Deeb IM, Li G, Keller N, Bohlmann L, Brouwer S, Turner AG, Cork AJ, Jones TR, Paterson DL, McEwan AG, Davies MR, McDevitt CA, von Itzstein M, Walker MJ. Neurodegenerative Disease Treatment Drug PBT2 Breaks Intrinsic Polymyxin Resistance in Gram-Positive Bacteria. Antibiotics (Basel) 2022; 11:antibiotics11040449. [PMID: 35453201 PMCID: PMC9027797 DOI: 10.3390/antibiotics11040449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/03/2022] Open
Abstract
Gram-positive bacteria do not produce lipopolysaccharide as a cell wall component. As such, the polymyxin class of antibiotics, which exert bactericidal activity against Gram-negative pathogens, are ineffective against Gram-positive bacteria. The safe-for-human-use hydroxyquinoline analog ionophore PBT2 has been previously shown to break polymyxin resistance in Gram-negative bacteria, independent of the lipopolysaccharide modification pathways that confer polymyxin resistance. Here, in combination with zinc, PBT2 was shown to break intrinsic polymyxin resistance in Streptococcus pyogenes (Group A Streptococcus; GAS), Staphylococcus aureus (including methicillin-resistant S. aureus), and vancomycin-resistant Enterococcus faecium. Using the globally disseminated M1T1 GAS strain 5448 as a proof of principle model, colistin in the presence of PBT2 + zinc was shown to be bactericidal in activity. Any resistance that did arise imposed a substantial fitness cost. PBT2 + zinc dysregulated GAS metal ion homeostasis, notably decreasing the cellular manganese content. Using a murine model of wound infection, PBT2 in combination with zinc and colistin proved an efficacious treatment against streptococcal skin infection. These findings provide a foundation from which to investigate the utility of PBT2 and next-generation polymyxin antibiotics for the treatment of Gram-positive bacterial infections.
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Affiliation(s)
- David M. P. De Oliveira
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Bernhard Keller
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Andrew J. Hayes
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC 3000, Australia; (A.J.H.); (M.R.D.); (C.A.M.)
| | - Cheryl-Lynn Y. Ong
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Nichaela Harbison-Price
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Ibrahim M. El-Deeb
- Institute for Glycomics, Griffith University, Gold Coast, QLD 4222, Australia; (I.M.E.-D.); (M.v.I.)
| | - Gen Li
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Nadia Keller
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Lisa Bohlmann
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Stephan Brouwer
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Andrew G. Turner
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Amanda J. Cork
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Thomas R. Jones
- School of Earth and Environmental Sciences, The University of Queensland, Brisbane, QLD 4072, Australia;
| | - David L. Paterson
- Australian Infectious Diseases Research Centre, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD 4006, Australia;
| | - Alastair G. McEwan
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
| | - Mark R. Davies
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC 3000, Australia; (A.J.H.); (M.R.D.); (C.A.M.)
| | - Christopher A. McDevitt
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC 3000, Australia; (A.J.H.); (M.R.D.); (C.A.M.)
| | - Mark von Itzstein
- Institute for Glycomics, Griffith University, Gold Coast, QLD 4222, Australia; (I.M.E.-D.); (M.v.I.)
| | - Mark J. Walker
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD 4072, Australia; (D.M.P.D.O.); (B.K.); (C.-L.Y.O.); (N.H.-P.); (G.L.); (N.K.); (L.B.); (S.B.); (A.G.T.); (A.J.C.); (A.G.M.)
- Correspondence: ; Tel.: +61-7-33461623
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Deng ZD, Argyelan M, Miller J, Quinn DK, Lloyd M, Jones TR, Upston J, Erhardt E, McClintock SM, Abbott CC. Electroconvulsive therapy, electric field, neuroplasticity, and clinical outcomes. Mol Psychiatry 2022; 27:1676-1682. [PMID: 34853404 PMCID: PMC9095458 DOI: 10.1038/s41380-021-01380-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 01/08/2023]
Abstract
Electroconvulsive therapy (ECT) remains the gold-standard treatment for patients with depressive episodes, but the underlying mechanisms for antidepressant response and procedure-induced cognitive side effects have yet to be elucidated. Such mechanisms may be complex and involve certain ECT parameters and brain regions. Regarding parameters, the electrode placement (right unilateral or bitemporal) determines the geometric shape of the electric field (E-field), and amplitude determines the E-field magnitude in select brain regions (e.g., hippocampus). Here, we aim to determine the relationships between hippocampal E-field strength, hippocampal neuroplasticity, and antidepressant and cognitive outcomes. We used hippocampal E-fields and volumes generated from a randomized clinical trial that compared right unilateral electrode placement with different pulse amplitudes (600, 700, and 800 mA). Hippocampal E-field strength was variable but increased with each amplitude arm. We demonstrated a linear relationship between right hippocampal E-field and right hippocampal neuroplasticity. Right hippocampal neuroplasticity mediated right hippocampal E-field and antidepressant outcomes. In contrast, right hippocampal E-field was directly related to cognitive outcomes as measured by phonemic fluency. We used receiver operating characteristic curves to determine that the maximal right hippocampal E-field associated with cognitive safety was 112.5 V/m. Right hippocampal E-field strength was related to the whole-brain ratio of E-field strength per unit of stimulation current, but this whole-brain ratio was unrelated to antidepressant or cognitive outcomes. We discuss the implications of optimal hippocampal E-field dosing to maximize antidepressant outcomes and cognitive safety with individualized amplitudes.
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Affiliation(s)
- Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Miklos Argyelan
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY, USA
- Center for Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry, Hempstead, NY, USA
| | - Jeremy Miller
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Davin K Quinn
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Megan Lloyd
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Thomas R Jones
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Joel Upston
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Erik Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA
| | - Shawn M McClintock
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
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Quinn DK, Story-Remer J, Brandt E, Fratzke V, Rieger R, Wilson JK, Gill D, Mertens N, Hunter M, Upston J, Jones TR, Richardson JD, Myers O, Arciniegas DB, Campbell R, Clark VP, Yeo RA, Shuttleworth CW, Mayer AR. Transcranial direct current stimulation modulates working memory and prefrontal-insula connectivity after mild-moderate traumatic brain injury. Front Hum Neurosci 2022; 16:1026639. [PMID: 36310843 PMCID: PMC9608772 DOI: 10.3389/fnhum.2022.1026639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Persistent posttraumatic symptoms (PPS) may manifest after a mild-moderate traumatic brain injury (mmTBI) even when standard brain imaging appears normal. Transcranial direct current stimulation (tDCS) represents a promising treatment that may ameliorate pathophysiological processes contributing to PPS. Objective/Hypothesis: We hypothesized that in a mmTBI population, active tDCS combined with training would result in greater improvement in executive functions and post-TBI cognitive symptoms and increased resting state connectivity of the stimulated region, i.e., left dorsolateral prefrontal cortex (DLPFC) compared to control tDCS. Methods: Thirty-four subjects with mmTBI underwent baseline assessments of demographics, symptoms, and cognitive function as well as resting state functional magnetic resonance imaging (rsfMRI) in a subset of patients (n = 24). Primary outcome measures included NIH EXAMINER composite scores, and the Neurobehavioral Symptom Inventory (NSI). All participants received 10 daily sessions of 30 min of executive function training coupled with active or control tDCS (2 mA, anode F3, cathode right deltoid). Imaging and assessments were re-obtained after the final training session, and assessments were repeated after 1 month. Mixed-models linear regression and repeated measures analyses of variance were calculated for main effects and interactions. Results: Both active and control groups demonstrated improvements in executive function (EXAMINER composite: p < 0.001) and posttraumatic symptoms (NSI cognitive: p = 0.01) from baseline to 1 month. Active anodal tDCS was associated with greater improvements in working memory reaction time compared to control (p = 0.007). Reaction time improvement correlated significantly with the degree of connectivity change between the right DLPFC and the left anterior insula (p = 0.02). Conclusion: Anodal tDCS improved reaction time on an online working memory task in a mmTBI population, and decreased connectivity between executive network and salience network nodes. These findings generate important hypotheses for the mechanism of recovery from PPS after mild-moderate TBI.
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Affiliation(s)
- Davin K Quinn
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Jacqueline Story-Remer
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States
| | - Emma Brandt
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States
| | - Violet Fratzke
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States
| | - Rebecca Rieger
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - John Kevin Wilson
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States
| | - Darbi Gill
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States
| | - Nickolas Mertens
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States.,Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Michael Hunter
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States
| | - Joel Upston
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Thomas R Jones
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Jessica D Richardson
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Orrin Myers
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, United States
| | - David B Arciniegas
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Richard Campbell
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States.,Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States
| | - Vincent P Clark
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States.,Mind Research Network, Albuquerque, NM, United States
| | - Ronald A Yeo
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States.,Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - C William Shuttleworth
- Center for Brain Recovery and Repair, University of New Mexico, Albuquerque, NM, United States.,Department of Neurosciences, University of New Mexico, Albuquerque, NM, United States
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Hossack BR, Lemos-Espinal JA, Sigafus BH, Muths E, Carreón Arroyo G, Toyos Martinez D, Hurtado Félix D, Padilla GM, Goldberg CS, Jones TR, Sredl MJ, Chambert T, Rorabaugh JC. Distribution of tiger salamanders in northern Sonora, Mexico: comparison of sampling methods and possible implications for an endangered subspecies. AMPHIBIA-REPTILIA 2021. [DOI: 10.1163/15685381-bja10072] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Many aquatic species in the arid USA-Mexico borderlands region are imperiled, but limited information on distributions and threats often hinders management. To provide information on the distribution of the Western Tiger Salamander (Ambystoma mavortium), including the USA-federally endangered Sonoran Tiger Salamander (Ambystoma mavortium stebbinsi), we used traditional (seines, dip-nets) and modern (environmental DNA [eDNA]) methods to sample 91 waterbodies in northern Sonora, Mexico, during 2015-2018. The endemic Sonoran Tiger Salamander is threatened by introgressive hybridization and potential replacement by another sub-species of the Western Tiger Salamander, the non-native Barred Tiger Salamander (A. m. mavortium). Based on occupancy models that accounted for imperfect detection, eDNA sampling provided a similar detection probability (0.82 [95% CI: 0.56-0.94]) as seining (0.83 [0.46-0.96]) and much higher detection than dip-netting (0.09 [0.02-0.23]). Volume of water filtered had little effect on detection, possibly because turbid sites had greater densities of salamanders. Salamanders were estimated to occur at 51 sites in 3 river drainages in Sonora. These results indicate tiger salamanders are much more widespread in northern Sonora than previously documented, perhaps aided by changes in land and water management practices. However, because the two subspecies of salamanders cannot be reliably distinguished based on morphology or eDNA methods that are based on mitochondrial DNA, we are uncertain if we detected only native genotypes or if we documented recent invasion of the area by the non-native sub-species. Thus, there is an urgent need for methods to reliably distinguish the subspecies so managers can identify appropriate interventions.
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Affiliation(s)
- Blake R. Hossack
- U.S. Geological Survey, Northern Rocky Mountain Science Center, Wildlife Biology Program, University of Montana, Missoula, MT 59812, USA
| | | | - Brent H. Sigafus
- U.S. Geological Survey, Southwest Biological Science Center, Tucson, AZ 85719, USA
| | - Erin Muths
- U.S. Geological Survey, Fort Collins Science Center, Fort Collins, CO 80526, USA
| | | | | | | | | | - Caren S. Goldberg
- School of the Environment, Washington State University, Pullman, WA 99164, USA
| | - Thomas R. Jones
- Arizona Game and Fish Department, 5000 W Carefree Hwy, Phoenix, AZ 85086, USA
| | - Michael J. Sredl
- Retired; Arizona Game and Fish Department, 5000 W Carefree Hwy, Phoenix, AZ 85086, USA
| | - Thierry Chambert
- CEFE, CNRS, Paul Valéry University Montpellier, Montpellier, France
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Abbott CC, Quinn D, Miller J, Ye E, Iqbal S, Lloyd M, Jones TR, Upston J, De Deng Z, Erhardt E, McClintock SM. Electroconvulsive Therapy Pulse Amplitude and Clinical Outcomes. Am J Geriatr Psychiatry 2021; 29:166-178. [PMID: 32651051 PMCID: PMC7744398 DOI: 10.1016/j.jagp.2020.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Electroconvulsive therapy (ECT) pulse amplitude, which determines the induced electric field magnitude in the brain, is currently set at 800-900 milliamperes (mA) on modern ECT devices without any clinical or scientific rationale. The present study assessed differences in depression and cognitive outcomes for three different pulse amplitudes during an acute ECT series. We hypothesized that the lower amplitudes would maintain the antidepressant efficacy of the standard treatment and reduce the risk of neurocognitive impairment. METHODS This double-blind investigation randomized subjects to three treatment arms: 600, 700, and 800 mA (active comparator). Clinical, cognitive, and imaging assessments were conducted pre-, mid- and post-ECT. Subjects had a diagnosis of major depressive disorder, age range between 50 and 80 years, and met clinical indication for ECT. RESULTS The 700 and 800 mA arms had improvement in depression outcomes relative to the 600 mA arm. The amplitude groups showed no differences in the primary cognitive outcome variable, the Hopkins Verbal Learning Test-Revised (HVLT-R) retention raw score. However, secondary cognitive outcomes such as the Delis Kaplan Executive Function System Letter and Category Fluency measures demonstrated cognitive impairment in the 800 mA arm. DISCUSSION The results demonstrated a dissociation of depression (higher amplitudes better) and cognitive (lower amplitudes better) related outcomes. Future work is warranted to elucidate the relationship between amplitude, electric field, neuroplasticity, and clinical outcomes.
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Affiliation(s)
- Christopher C Abbott
- Department of Psychiatry (CCA, DQ, JM, EY, SI, ML, TRJ, JU), University of New Mexico, Albuquerque, NM.
| | - Davin Quinn
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Jeremy Miller
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Enstin Ye
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Sulaiman Iqbal
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Megan Lloyd
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Thomas R Jones
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Joel Upston
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Zhi De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD,Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Erik Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM
| | - Shawn M McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX,Division of Brain Stimulation and Neurophysiology, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
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Quinn DK, Jones TR, Upston J, Huff M, Ryman SG, Vakhtin AA, Abbott CC. Right prefrontal intermittent theta-burst stimulation for major depressive disorder: A case series. Brain Stimul 2020; 14:97-99. [PMID: 33242610 DOI: 10.1016/j.brs.2020.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022] Open
Affiliation(s)
- Davin K Quinn
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA.
| | - Thomas R Jones
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA
| | - Joel Upston
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA
| | - Michael Huff
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA
| | - Sephira G Ryman
- Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA
| | - Andrei A Vakhtin
- Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA
| | - Christopher C Abbott
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA
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Beeslaar J, Absalon J, Anderson AS, Eiden JJ, Balmer P, Harris SL, Jones TR, O'Neill RE, Pregaldien JL, Radley D, Maansson R, Ginis J, Srivastava A, Perez JL. MenB-FHbp Vaccine Protects Against Diverse Meningococcal Strains in Adolescents and Young Adults: Post Hoc Analysis of Two Phase 3 Studies. Infect Dis Ther 2020; 9:641-656. [PMID: 32700260 PMCID: PMC7452968 DOI: 10.1007/s40121-020-00319-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Two phase 3 studies in adolescents and young adults demonstrated that MenB-FHbp, a meningococcal serogroup B (MenB) vaccine, elicits protective immune responses after 2 or 3 doses based on serum bactericidal antibody assays using human complement (hSBA) against 4 primary and 10 additional diverse, vaccine-heterologous MenB test strains. Lower limits of quantitation (LLOQs; titers 1:8 or 1:16; titers ≥ 1:4 correlate with protection) were used to evaluate responses to individual strains and all 4 primary strains combined (composite response). A post hoc analysis evaluated percentages of subjects with protective responses to as many as 8 strains combined (4 primary plus additional strains). Methods Immune responses were measured using hSBAs against 4 primary strains in adolescents (n = 1509, MenB-FHbp; n = 898, hepatitis A virus vaccine/saline) and young adults (n = 2480, MenB-FHbp; n = 824, saline) receiving MenB-FHbp or control at 0, 2, and 6 months. Ten additional strains were evaluated in subsets of subjects from approximately 1800 MenB-FHbp recipients across both studies. Percentages of subjects with hSBA titers ≥ LLOQ for different numbers of primary strains or primary plus additional strains combined (7 or 8 strains total per subset) were determined before vaccination, 1 month post-dose 2, and 1 month post-dose 3. Results Across the panel of primary plus additional strains, at 1 month post-dose 3, titers ≥ LLOQ were elicited in 93.7–95.7% of adolescents and 91.7–95.0% of young adults for ≥ 5 test strains combined and in 70.5–85.8% of adolescents and 67.5–81.4% of young adults for ≥ 7 strains combined. Among adolescents, 99.8%, 99.0%, 92.8%, and 82.7% had titers ≥ LLOQ against at least 1, 2, 3, and all 4 primary strains, respectively; corresponding percentages for young adults were 99.7%, 97.7%, 94.0%, and 84.5%. Conclusions Results support the ability of MenB-FHbp to provide broad coverage against MenB strains expressing diverse FHbp variants. Trial Registration ClinicalTrials.gov identifiers NCT01830855, NCT01352845. Electronic supplementary material The online version of this article (10.1007/s40121-020-00319-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Johannes Beeslaar
- Vaccine Clinical Research and Development, Pfizer Ltd UK, Hurley, UK.
| | - Judith Absalon
- Vaccine Clinical Research and Development, Pfizer Inc, Pearl River, NY, USA
| | | | - Joseph J Eiden
- Vaccine Clinical Research and Development, Pfizer Inc, Pearl River, NY, USA
| | - Paul Balmer
- Vaccine Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Shannon L Harris
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | - Thomas R Jones
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | - Robert E O'Neill
- Vaccine Research and Development, Pfizer Inc, Pearl River, NY, USA
| | | | - David Radley
- Vaccine Clinical Research and Development, Pfizer Inc, Pearl River, NY, USA
| | - Roger Maansson
- Vaccine Clinical Research and Development, Pfizer Inc, Collegeville, PA, USA
| | - John Ginis
- Vaccine Research and Development, Pfizer Inc, Collegeville, PA, USA
| | - Amit Srivastava
- Vaccine Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - John L Perez
- Vaccine Clinical Research and Development, Pfizer Inc, Collegeville, PA, USA
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Zhou Q, Jones TR, Moghadas H, Daneshmand M. Microfabrication of monolithic wafer-level miniaturized millimeter-wave air-filled half-mode waveguide filter based on the inward curving split ring resonator array. Nanotechnology 2020; 31:195202. [PMID: 32081838 DOI: 10.1088/1361-6528/ab7048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this paper, we propose a miniaturized monolithic bandpass filter utilizing an air-filled half-mode waveguide and an inward curving split ring resonator array in the millimeter-wave band. The waveguide blocks the wave below cutoff frequency and the uniplanar array forms a rejection band above the transmission band. The microfabrication process of the filter adopts photoimageable technology and the combination of films with different thicknesses to build a 3D structure. The measured prototype has a center frequency at 65.5 GHz with a 3 dB fractional bandwidth of 30.7%. The minimum insertion loss is 2.1 dB. The proposed component offers excellent performance including a wide transmission band, a low pass-band insertion loss, an excellent isolation in the stop-band, and a steep roll-off at the upper cutoff frequency. Besides, due to the scalability of the waveguide and periodic array, this filter can be adapted for other frequency ranges.
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Affiliation(s)
- Qihui Zhou
- College of Electronic Science and Technology, National University of Defense Technology, Changsha, People's Republic of China. Department of Electrical and Computer Engineering, University of Alberta, Edmonton, Canada
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Harris SL, Tan C, Perez J, Radley D, Jansen KU, Anderson AS, Jones TR. Selection of diverse strains to assess broad coverage of the bivalent FHbp meningococcal B vaccine. NPJ Vaccines 2020; 5:8. [PMID: 32025339 PMCID: PMC6989502 DOI: 10.1038/s41541-019-0154-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 11/20/2019] [Indexed: 01/14/2023] Open
Abstract
MenB-FHbp is a recombinant meningococcal serogroup B (MenB) vaccine composed of 2 factor H binding proteins (FHbps). Meningococcal vaccines targeting polysaccharide serogroup A, C, Y, and W capsules were licensed upon confirmation of bactericidal antibody induction after initial efficacy studies with serogroup A and C vaccines. Unlike meningococcal polysaccharide vaccines, wherein single strains demonstrated bactericidal antibodies per serogroup for each vaccine, MenB-FHbp required a more robust approach to demonstrate that bactericidal antibody induction could kill strains with diverse FHbp sequences. Serum bactericidal assays using human complement were developed for 14 MenB strains, representing breadth of meningococcal FHbp diversity of ~80% of circulating MenB strains. This work represents an innovative approach to license a non-toxin protein vaccine with 2 antigens representing a single virulence factor by an immune correlate, and uniquely demonstrates that such a vaccine provides coverage across bacterial strains by inducing broadly protective antibodies. Neisseria meningitidis is an important cause of invasive meningococcal disease, effective vaccines exist for some serogroups but immunogenicity to the MenB group is poor. Thomas R. Jones and colleagues examine serum bactericidal responses from volunteers challenged with MenB-FHbp – a recombinant MenB vaccine containing two Factor H (FH)-binding proteins. Serum bactericidal responses are tested against 14 MenB clinical isolates selected in an unbiased manner to cover the vast breadth of FHbp antigen and epidemiological diversity. This work demonstrates the broad efficacy of the MenB-FHbp vaccine using a serum bactericidal activity as a surrogate of protection.
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Affiliation(s)
| | - Cuiwen Tan
- Pfizer Vaccine Research and Development, Pearl River, NY USA
| | - John Perez
- 2Pfizer Vaccine Research and Development, Collegeville, PA USA
| | - David Radley
- 2Pfizer Vaccine Research and Development, Collegeville, PA USA
| | | | | | - Thomas R Jones
- Pfizer Vaccine Research and Development, Pearl River, NY USA
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Jones TR, Hernandez-Aldave S, Kaspar RB, Letterio MP, Yan Y, Bertoncello P. Tris(2,4,6-trimethoxyphenyl)polysulfone-methylene quaternary phosphonium chloride (TPQPCl) ionomer chemically modified electrodes: An electroanalytical study towards sensing applications. Electrochim Acta 2019. [DOI: 10.1016/j.electacta.2019.04.089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Vesikari T, Østergaard L, Beeslaar J, Absalon J, Eiden JJ, Jansen KU, Jones TR, Harris SL, Maansson R, Munson S, O'Neill RE, York LJ, Perez JL. Persistence and 4-year boosting of the bactericidal response elicited by two- and three-dose schedules of MenB-FHbp: A phase 3 extension study in adolescents. Vaccine 2019; 37:1710-1719. [PMID: 30770221 DOI: 10.1016/j.vaccine.2018.11.073] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/25/2018] [Accepted: 11/26/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND The period of heightened risk of invasive meningococcal disease in adolescence extends for >10 years. This study aimed to evaluate persistence of the immune response to the serogroup B meningococcal (MenB) vaccine MenB-FHbp (Trumenba®, Bivalent rLP2086) under two- and three-dose primary vaccination schedules, both of which are approved in the United States and the European Union, and to assess safety and immunogenicity of a booster dose. METHODS This was an open-label extension study of a phase 2 randomized MenB-FHbp study (primary study). This interim analysis includes data through 1 month after booster vaccination. In the primary study, adolescents 11-18 years of age were randomized using an interactive voice or web-based response system to receive 120 μg MenB-FHbp under 0-, 1-, 6-month; 0-, 2-, 6-month; 0-, 6-month; 0-, 2-month; or 0-, 4-month schedules (termed study groups for the current analysis). For the primary study, participants were blinded to their vaccine study group allocation, but investigators and the study sponsor were unblinded. Immune responses in subjects from the primary study were evaluated through 48 months after primary vaccination (persistence stage; 17 sites in Czech Republic, Denmark, Germany, and Sweden). Safety and immunogenicity of a booster dose given at 48 months after primary vaccination (booster stage; 14 sites in Czech Republic, Denmark, and Sweden) were also assessed. Immune responses were evaluated in serum bactericidal assays with human complement (hSBAs) using four MenB test strains representative of disease-causing MenB strains in the United States and Europe and expressing factor H binding proteins (FHbps) heterologous to the vaccine antigens. The primary immunogenicity endpoints were the proportions of subjects with hSBA titers greater than or equal to the assays' lower limit of quantitation (LLOQ; 1:8 or 1:16 depending on strain) at 12, 18, 24, 36, and 48 months after primary vaccination (persistence stage) and 1 and 48 months after the primary vaccination series and 1 month after receipt of the booster dose (booster stage). Safety evaluations during the booster stage included local reactions and systemic events by severity, antipyretic use, adverse events (AEs), immediate AEs, serious AEs (SAEs), medically attended AEs (MAEs), newly diagnosed chronic medical conditions (NDCMCs), and missed days of school and work because of AEs. The modified intent-to-treat (mITT) population was used for immunogenicity evaluations in the persistence stage. The booster stage immunogenicity evaluations used the evaluable immunogenicity population; analyses were also performed in the mITT population. For the persistence stage, safety evaluations included subjects with at least one blood draw, whereas for the booster stage, they included subjects who received the booster dose and had available safety data. This trial is registered at ClinicalTrials.gov number NCT01543087. FINDINGS A total of 465 subjects were enrolled in the persistence stage, and 271 subjects were enrolled in the booster stage. Sera for the extension phase of this interim analysis were collected from September 7, 2012 to December 7, 2015. One month after primary vaccination, 73.8-100.0% of subjects depending on study group responded with hSBA titers ≥LLOQ. Response rates declined during the 12 months after last primary vaccination and then remained stable through 48 months, with 18.0-61.3% of subjects depending on study group having hSBA titers ≥LLOQ at this time point. One month after receipt of the booster dose, 91.9-100.0% of subjects depending on study group had hSBA titers ≥LLOQ against the four primary strains individually and 91.8-98.2% had hSBA titers ≥LLOQ against all four strains combined (composite response). Geometric mean titers were higher after booster vaccination than at 1 month after primary vaccination. Immune responses were generally similar across study groups, regardless of whether a two- or three-dose primary series was received. None of the AEs (2.2-6.9% of subjects depending on study group) or NDCMCs (1.8-5.0%) that were reported during the persistence stage were considered related to the investigational product. Local reactions and systemic events were reported by 84.4-93.8% and 68.8-76.6% of subjects depending on study group, respectively, in the booster stage; these were generally similar across study groups, transient, and less frequent than after any primary vaccination. Additionally, there was no general progressive worsening in severity of reactogenicity events (ie, potentiation; ≤3 subjects per group), and reactogenicity events did not lead to any study withdrawals. No NDCMCs or immediate AEs were reported during the booster stage. AEs were reported by 3.7-12.5% of subjects depending on study group during the booster stage. The two possibly related AEs included a mild worsening of psoriasis and a severe influenza-like illness that resolved in 10 days. INTERPRETATION Immune responses declined after the primary vaccination series; however, a substantially greater number of subjects retained protective responses at 48 months after primary vaccination compared with subjects having protective responses before vaccination. Persistence trends were similar across all 5 study groups regardless of whether a two- or three-dose primary schedule was received. Furthermore, a booster dose given 48 months after primary vaccination was safe, well-tolerated, and elicited robust immune responses indicative of immunologic memory; these responses were similar between two- and three-dose primary schedule study groups. Use of a booster dose may help further extend protection against MenB disease in adolescents. FUNDING Pfizer Inc.
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Affiliation(s)
- Timo Vesikari
- Vaccine Research Center, University of Tampere Medical School, Biokatu 10, 33520 Tampere, Finland
| | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital, Skejby, Palle Juul-Jensens Blvd 99, 8200 Aarhus N, Denmark
| | - Johannes Beeslaar
- Pfizer UK Vaccine Research and Development, Horizon Building, Honey Lane, Hurley SL6 6RJ, UK.
| | - Judith Absalon
- Pfizer Vaccine Research and Development, 401 North Middletown Road, Pearl River, NY 10965, USA
| | - Joseph J Eiden
- Pfizer Vaccine Research and Development, 401 North Middletown Road, Pearl River, NY 10965, USA
| | - Kathrin U Jansen
- Pfizer Vaccine Research and Development, 401 North Middletown Road, Pearl River, NY 10965, USA
| | - Thomas R Jones
- Pfizer Vaccine Research and Development, 401 North Middletown Road, Pearl River, NY 10965, USA
| | - Shannon L Harris
- Pfizer Vaccine Research and Development, 401 North Middletown Road, Pearl River, NY 10965, USA
| | - Roger Maansson
- Pfizer Vaccine Research and Development, 500 Arcola Road, Collegeville, PA 19426, USA
| | - Samantha Munson
- Pfizer Vaccine Research and Development, 500 Arcola Road, Collegeville, PA 19426, USA
| | - Robert E O'Neill
- Pfizer Vaccine Research and Development, 401 North Middletown Road, Pearl River, NY 10965, USA
| | - Laura J York
- Pfizer Vaccine Medical Development, Scientific & Clinical Affairs, 500 Arcola Road, Collegeville, PA 19426, USA
| | - John L Perez
- Pfizer Vaccine Research and Development, 500 Arcola Road, Collegeville, PA 19426, USA
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Schmoele-Thoma B, van Cleeff M, Greenberg RN, Gurtman A, Jones TR, Sundaraiyer V, Gruber WC, Scott DA. Persistence of antibodies 1 year after sequential administration of the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine in adults. Hum Vaccin Immunother 2019; 15:575-583. [PMID: 30648932 PMCID: PMC6605716 DOI: 10.1080/21645515.2018.1538618] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Vaccination with the 13-valent pneumococcal conjugate vaccine (PCV13) followed ≥ 1 year by the 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for immunocompetent adults ≥ 65 years of age in the United States. This study assessed antipneumococcal opsonophagocytic activity (OPA) geometric mean titers (GMTs) to PCV13 in PPSV23-naive and PPSV23-preimmunized adults 1 year after a second vaccine dose. Two parent studies were conducted previously: (1) PPSV23 vaccine–naive subjects (60–64 years of age at enrollment) received PCV13 followed by PCV13 or PPSV23 1 year later or PPSV23 followed by PCV13 1 year later; and (2) subjects (≥ 70 years of age at enrollment) vaccinated with PPSV23 ≥ 5 years before study entry received PCV13 or PPSV23 followed by PCV13 1 year later. Overall, 962 subjects (PPSV23-naive, n = 519; PPSV23-preimmunized, n = 443) who received both vaccinations in the parent studies were enrolled. Numerically higher OPA GMTs persisted for at least 1 year after administration of PCV13 as the initial vaccine (PCV13/PPSV23 or PCV13/PCV13) compared with those who received PPSV23 either 1 or 5 years prior (PPSV23/PCV13). This impairment in antibody responses to subsequent PCV13 vaccination produced by initial PPSV23 vaccination persisted for at least 1 year. OPA GMTs were numerically higher for most serotypes 1 year after 2 doses of PCV13 compared with 1 year after the first PCV13 dose. These data suggest PCV13 should be given first if both vaccines are to be administered, higher immune responses were achieved when PCV13 was given first and persisted at least 1 year (ClinicalTrials.gov Identifier: NCT01025336).
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Affiliation(s)
- Beate Schmoele-Thoma
- a Pfizer Vaccine Clinical Research and Development , Pfizer Pharma GmbH , Berlin , Germany
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Harris SL, Tan C, Andrew L, Hao L, Liberator PA, Absalon J, Anderson AS, Jones TR. The bivalent factor H binding protein meningococcal serogroup B vaccine elicits bactericidal antibodies against representative non-serogroup B meningococci. Vaccine 2018; 36:6867-6874. [DOI: 10.1016/j.vaccine.2018.05.081] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 11/26/2022]
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Perez JL, Absalon J, Beeslaar J, Balmer P, Jansen KU, Jones TR, Harris S, York LJ, Jiang Q, Radley D, Anderson AS, Crowther G, Eiden JJ. From research to licensure and beyond: clinical development of MenB-FHbp, a broadly protective meningococcal B vaccine. Expert Rev Vaccines 2018; 17:461-477. [DOI: 10.1080/14760584.2018.1483726] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- John L. Perez
- Pfizer Vaccines Research and Development, Collegeville, PA, USA
| | - Judith Absalon
- Pfizer Vaccines Research and Development, Pearl River, NY, USA
| | | | - Paul Balmer
- Pfizer Vaccines Research and Development, Collegeville, PA, USA
| | | | - Thomas R. Jones
- Pfizer Vaccines Research and Development, Pearl River, NY, USA
| | - Shannon Harris
- Pfizer Vaccines Research and Development, Pearl River, NY, USA
| | - Laura J. York
- Pfizer Vaccines Medical Development, Scientific & Clinical Affairs, Collegeville, PA, USA
| | - Qin Jiang
- Pfizer Vaccines Research and Development, Collegeville, PA, USA
| | - David Radley
- Pfizer Vaccines Research and Development, Collegeville, PA, USA
| | | | | | - Joseph J. Eiden
- Pfizer Vaccines Research and Development, Pearl River, NY, USA
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Ostergaard L, Vesikari T, Absalon J, Beeslaar J, Ward BJ, Senders S, Eiden JJ, Jansen KU, Anderson AS, York LJ, Jones TR, Harris SL, O'Neill R, Radley D, Maansson R, Prégaldien JL, Ginis J, Staerke NB, Perez JL. A Bivalent Meningococcal B Vaccine in Adolescents and Young Adults. N Engl J Med 2017; 377:2349-2362. [PMID: 29236639 DOI: 10.1056/nejmoa1614474] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND MenB-FHbp is a licensed meningococcal B vaccine targeting factor H-binding protein. Two phase 3 studies assessed the safety of the vaccine and its immunogenicity against diverse strains of group B meningococcus. METHODS We randomly assigned 3596 adolescents (10 to 18 years of age) to receive MenB-FHbp or hepatitis A virus vaccine and saline and assigned 3304 young adults (18 to 25 years of age) to receive MenB-FHbp or saline at baseline, 2 months, and 6 months. Immunogenicity was assessed in serum bactericidal assays that included human complement (hSBAs). We used 14 meningococcal B test strains that expressed vaccine-heterologous factor H-binding proteins representative of meningococcal B epidemiologic diversity; an hSBA titer of at least 1:4 is the accepted correlate of protection. The five primary end points were the proportion of participants who had an increase in their hSBA titer for each of 4 primary strains by a factor of 4 or more and the proportion of those who had an hSBA titer at least as high as the lower limit of quantitation (1:8 or 1:16) for all 4 strains combined after dose 3. We also assessed the hSBA responses to the primary strains after dose 2; hSBA responses to the 10 additional strains after doses 2 and 3 were assessed in a subgroup of participants only. Safety was assessed in participants who received at least one dose. RESULTS In the modified intention-to-treat population, the percentage of adolescents who had an increase in the hSBA titer by a factor of 4 or more against each primary strain ranged from 56.0 to 85.3% after dose 2 and from 78.8 to 90.2% after dose 3; the percentages of young adults ranged from 54.6 to 85.6% and 78.9 to 89.7%, after doses 2 and 3, respectively. Composite responses after doses 2 and 3 in adolescents were 53.7% and 82.7%, respectively, and those in young adults were 63.3% and 84.5%, respectively. Responses to the 4 primary strains were predictive of responses to the 10 additional strains. Most of those who received MenB-FHbp reported mild or moderate pain at the vaccination site. CONCLUSIONS MenB-FHbp elicited bactericidal responses against diverse meningococcal B strains after doses 2 and 3 and was associated with more reactions at the injection site than the hepatitis A virus vaccine and saline. (Funded by Pfizer; ClinicalTrials.gov numbers, NCT01830855 and NCT01352845 ).
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Affiliation(s)
- Lars Ostergaard
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Timo Vesikari
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Judith Absalon
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Johannes Beeslaar
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Brian J Ward
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Shelly Senders
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Joseph J Eiden
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Kathrin U Jansen
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Annaliesa S Anderson
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Laura J York
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Thomas R Jones
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Shannon L Harris
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Robert O'Neill
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - David Radley
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Roger Maansson
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Jean-Louis Prégaldien
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - John Ginis
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - Nina B Staerke
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
| | - John L Perez
- From Aarhus University Hospital, Aarhus, Denmark (L.O., N.B.S.); Vaccine Research Center, University of Tampere Medical School, Tampere, Finland (T.V.); Pfizer Vaccine Clinical Research and Development (J.A., J.J.E.) and Pfizer Vaccine Research and Development (K.U.J., A.S.A., T.R.J., S.L.H., R.O.), Pearl River, NY; Pfizer Vaccine Clinical Research and Development, Hurley, United Kingdom (J.B.); Research Institute of the McGill University Health Center, Montreal (B.J.W.); Senders Pediatrics, South Euclid, OH (S.S.); Pfizer Vaccine Medical Development, Scientific and Clinical Affairs (L.J.Y.) and Pfizer Vaccine Clinical Research and Development (D.R., R.M., J.G., J.L.P.), Collegeville, PA; and Pfizer Vaccine Clinical Research and Development, Brussels (J.-L.P.)
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Taha MK, Hawkins JC, Liberator P, Deghmane AE, Andrew L, Hao L, Jones TR, McNeil LK, O’Neill RE, Perez JL, Jansen KU, Anderson AS. Bactericidal activity of sera from adolescents vaccinated with bivalent rLP2086 against meningococcal serogroup B outbreak strains from France. Vaccine 2017; 35:1530-1537. [DOI: 10.1016/j.vaccine.2017.01.066] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/26/2017] [Accepted: 01/27/2017] [Indexed: 12/11/2022]
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Donald RGK, Hawkins JC, Hao L, Liberator P, Jones TR, Harris SL, Perez JL, Eiden JJ, Jansen KU, Anderson AS. Meningococcal serogroup B vaccines: Estimating breadth of coverage. Hum Vaccin Immunother 2016; 13:255-265. [PMID: 27960595 PMCID: PMC5328210 DOI: 10.1080/21645515.2017.1264750] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Neisseria meningitidis serogroup B (MenB) is an important cause of invasive meningococcal disease. The development of safe and effective vaccines with activity across the diversity of MenB strains has been challenging. While capsular polysaccharide conjugate vaccines have been highly successful in the prevention of disease due to meningococcal serogroups A, C, W, and Y, this approach has not been possible for MenB owing to the poor immunogenicity of the MenB capsular polysaccharide. Vaccines based on outer membrane vesicles have been successful in the prevention of invasive MenB disease caused by the single epidemic strain from which they were derived, but they do not confer broad protection against diverse MenB strains. Thus, alternative approaches to vaccine development have been pursued to identify vaccine antigens that can provide broad protection against the epidemiologic and antigenic diversity of invasive MenB strains. Human factor H binding protein (fHBP) was found to be such an antigen, as it is expressed on nearly all invasive disease strains of MenB and can induce bactericidal responses against diverse MenB strains. A bivalent vaccine (Trumenba®, MenB-FHbp, bivalent rLP2086) composed of equal amounts of 2 fHBP variants from each of the 2 immunologically diverse subfamilies of fHBP (subfamilies A and B) was the first MenB vaccine licensed in the United States under an accelerated approval pathway for prevention of invasive MenB disease. Due to the relatively low incidence of meningococcal disease, demonstration of vaccine efficacy for the purposes of licensure of bivalent rLP2086 was based on vaccine-elicited bactericidal activity as a surrogate marker of efficacy, as measured in vitro by the serum bactericidal assay using human complement. Because bacterial surface proteins such as fHBP are antigenically variable, an important component for evaluation and licensure of bivalent rLP2086 included stringent criteria for assessment of breadth of coverage across antigenically diverse and epidemiologically important MenB strains. This review describes the rigorous approach used to assess broad coverage of bivalent rLP2086. Alternative nonfunctional assays proposed for assessing vaccine coverage are also discussed.
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Affiliation(s)
| | | | - Li Hao
- a Pfizer Vaccine Research and Development , Pearl River , NY , USA
| | - Paul Liberator
- a Pfizer Vaccine Research and Development , Pearl River , NY , USA
| | - Thomas R Jones
- a Pfizer Vaccine Research and Development , Pearl River , NY , USA
| | - Shannon L Harris
- a Pfizer Vaccine Research and Development , Pearl River , NY , USA
| | - John L Perez
- b Pfizer Vaccine Research and Development , Collegeville , PA , USA
| | - Joseph J Eiden
- a Pfizer Vaccine Research and Development , Pearl River , NY , USA
| | - Kathrin U Jansen
- a Pfizer Vaccine Research and Development , Pearl River , NY , USA
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Vesikari T, Senders S, Absalon J, Eiden JJ, Jansen KU, Beeslaar JF, York LJ, Jones TR, Maansson R, Harris SL, O'Neill RE, Ginis J, Anderson AS, Perez JL. Immunogenicity of MenB-FHbp (Bivalent rLP2086), a Meningococcal Serogroup B Vaccine, in US Adolescents: Results From a Phase 3 Trial. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Timo Vesikari
- Vaccine Research Center, University of Tampere, Tampere, Finland
| | | | | | | | | | | | - Laura J. York
- Pfizer Medical Development and Scientific Affairs, Collegeville, Pennsylvania
| | | | | | | | | | - John Ginis
- Pfizer Vaccine Research, Collegeville, Pennsylvania
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Vesikari T, Wysocki J, Beeslaar J, Eiden J, Jiang Q, Jansen KU, Jones TR, Harris SL, O'Neill RE, York LJ, Perez JL. Immunogenicity, Safety, and Tolerability of Bivalent rLP2086 Meningococcal Group B Vaccine Administered Concomitantly With Diphtheria, Tetanus, and Acellular Pertussis and Inactivated Poliomyelitis Vaccines to Healthy Adolescents. J Pediatric Infect Dis Soc 2016; 5:180-7. [PMID: 26803328 PMCID: PMC5407129 DOI: 10.1093/jpids/piv064] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 01/20/2015] [Accepted: 09/01/2015] [Indexed: 11/13/2022]
Abstract
KEY POINTS Concomitant administration of bivalent rLP2086 (Trumenba [Pfizer, Inc] and diphtheria, tetanus, and acellular pertussis and inactivated poliovirus vaccine (DTaP/IPV) was immunologically noninferior to DTaP/IPV and saline and was safe and well tolerated. Bivalent rLP2086 elicited robust and broad bactericidal antibody responses to diverse Neisseria meningitidis serogroup B strains expressing antigens heterologous to vaccine antigens after 2 and 3 vaccinations. BACKGROUND Bivalent rLP2086, a Neisseria meningitidis serogroup B (MnB) vaccine (Trumenba [Pfizer, Inc]) recently approved in the United States to prevent invasive MnB disease in individuals aged 10-25 years, contains recombinant subfamily A and B factor H binding proteins (fHBPs). This study evaluated the coadministration of Repevax (diphtheria, tetanus, and acellular pertussis and inactivated poliovirus vaccine [DTaP/IPV]) (Sanofi Pasteur MSD, Ltd) and bivalent rLP2086. METHODS Healthy adolescents aged ≥11 to <19 years received bivalent rLP2086 + DTaP/IPV or saline + DTaP/IPV at month 0 and bivalent rLP2086 or saline at months 2 and 6. The primary end point was the proportion of participants in whom prespecified levels of antibodies to DTaP/IPV were achieved 1 month after DTaP/IPV administration. Immune responses to bivalent rLP2086 were measured with serum bactericidal assays using human complement (hSBAs) against 4 MnB test strains expressing fHBP subfamily A or B proteins different from the vaccine antigens. RESULTS Participants were randomly assigned to receive bivalent rLP2086 + DTaP/IPV (n = 373) or saline + DTaP/IPV (n = 376). Immune responses to DTaP/IPV in participants who received bivalent rLP2086 + DTaP/IPV were noninferior to those in participants who received saline + DTaP/IPV.The proportions of bivalent rLP2086 + DTaP/IPV recipients with prespecified seroprotective hSBA titers to the 4 MnB test strains were 55.5%-97.3% after vaccination 2 and 81.5%-100% after vaccination 3. The administration of bivalent rLP2086 was well tolerated and resulted in few serious adverse events. CONCLUSIONS Immune responses to DTaP/IPV administered with bivalent rLP2086 to adolescents were noninferior to DTaP/IPV administered alone. Bivalent rLP2086 was well tolerated and elicited substantial and broad bactericidal responses to diverse MnB strains in a high proportion of recipients after 2 vaccinations, and these responses were further enhanced after 3 vaccinations.ClinicalTrials.gov identifier NCT01323270.
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Affiliation(s)
- Timo Vesikari
- Vaccine Research Centre, University of Tampere Medical School, Finland
| | - Jacek Wysocki
- Department of Preventive Medicine, Poznan University of Medical Sciences, Poland
| | | | - Joseph Eiden
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | - Qin Jiang
- Medical Development and Scientific Affairs
| | | | - Thomas R. Jones
- Vaccine Research and Development, Pfizer, Pearl River, New York
| | | | | | | | - John L. Perez
- Vaccine Research, Pfizer, Collegeville, Pennsylvania
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Vesikari T, Østergaard L, Diez-Domingo J, Wysocki J, Flodmark CE, Beeslaar J, Eiden J, Jiang Q, Jansen KU, Jones TR, Harris SL, O'Neill RE, York LJ, Crowther G, Perez JL. Meningococcal Serogroup B Bivalent rLP2086 Vaccine Elicits Broad and Robust Serum Bactericidal Responses in Healthy Adolescents. J Pediatric Infect Dis Soc 2016; 5:152-60. [PMID: 26407272 PMCID: PMC5407127 DOI: 10.1093/jpids/piv039] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/09/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Neisseria meningitidis serogroup B (MnB) is a leading cause of invasive meningococcal disease in adolescents and young adults. A recombinant factor H binding protein (fHBP) vaccine (Trumenba(®); bivalent rLP2086) was recently approved in the United States in individuals aged 10-25 years. Immunogenicity and safety of 2- or 3-dose schedules of bivalent rLP2086 were assessed in adolescents. METHODS Healthy adolescents (11 to <19 years) were randomized to 1 of 5 bivalent rLP2086 dosing regimens (0,1,6-month; 0,2,6-month; 0,2-month; 0,4-month; 0,6-month). Immunogenicity was assessed by serum bactericidal antibody assay using human complement (hSBA). Safety assessments included local and systemic reactions and adverse events. RESULTS Bivalent rLP2086 was immunogenic when administered as 2 or 3 doses; the most robust hSBA responses occurred with 3 doses. The proportion of subjects with hSBA titers ≥1:8 after 3 doses ranged from 91.7% to 95.0%, 98.9% to 99.4%, 88.4% to 89.0%, and 86.1% to 88.5% for MnB test strains expressing vaccine--heterologous fHBP variants A22, A56, B24, and B44, respectively. After 2 doses, responses ranged from 90.8% to 93.5%, 98.4% to 100%, 69.1% to 81.1%, and 70.1% to 77.5%. Geometric mean titers (GMTs) were highest among subjects receiving 3 doses and similar between the 2- and 3-dose regimens. After 2 doses, GMTs trended numerically higher among subjects with longer intervals between the first and second dose (6 months vs 2 and 4 months). Bivalent rLP2086 was well tolerated. CONCLUSIONS Bivalent rLP2086 was immunogenic and well tolerated when administered in 2 or 3 doses. Three doses yielded the most robust hSBA response rates against MnB strains expressing vaccine-heterologous subfamily B fHBPs.
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Affiliation(s)
| | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital, Denmark
| | - Javier Diez-Domingo
- Área de Investigación en Vacunas, FISABIO-Public Health, Universidad Católica de Valencia, Spain
| | - Jacek Wysocki
- Department of Preventive Medicine, Poznań University of Medical Sciences, Poland
| | - Carl-Erik Flodmark
- Vaccine Unit, Department of Pediatrics, Skåne University Hospital, Malmo, Sweden
| | | | | | - Qin Jiang
- Pfizer Global Vaccines, Collegeville, Pennsylvania
| | | | | | | | | | - Laura J. York
- Pfizer Medical and Scientific Affairs, Collegeville, Pennsylvania
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Muse D, Christensen S, Bhuyan P, Absalon J, Eiden J, Jones TR, York LJ, Jansen KU, O'Neill RE, Harris SL, Perez JL. Immunogenicity and Safety of Bivalent rLP2086, a Meningococcal Serogroup B Vaccine, Coadministered With Tdap and MCV4 in US Adolescents. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv131.98] [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: 11/13/2022] Open
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Sui J, Pearlson GD, Du Y, Yu Q, Jones TR, Chen J, Jiang T, Bustillo J, Calhoun VD. In search of multimodal neuroimaging biomarkers of cognitive deficits in schizophrenia. Biol Psychiatry 2015; 78:794-804. [PMID: 25847180 PMCID: PMC4547923 DOI: 10.1016/j.biopsych.2015.02.017] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 12/12/2014] [Accepted: 02/02/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND The cognitive deficits of schizophrenia are largely resistant to current treatments and thus are a lifelong illness burden. The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) provides a reliable and valid assessment of cognition across major cognitive domains; however, the multimodal brain alterations specifically associated with MCCB in schizophrenia have not been examined. METHODS The interrelationships between MCCB and the abnormalities seen in three types of neuroimaging-derived maps-fractional amplitude of low-frequency fluctuations (fALFF) from resting-state functional magnetic resonance imaging (MRI), gray matter (GM) density from structural MRI, and fractional anisotropy from diffusion MRI-were investigated by using multiset canonical correlation analysis in data from 47 schizophrenia patients treated with antipsychotic medications and 50 age-matched healthy control subjects. RESULTS One multimodal component (canonical variant 8) was identified as both group differentiating and significantly correlated with the MCCB composite. It demonstrated 1) increased cognitive performance associated with higher fALFF (intensity of regional spontaneous brain activity) and higher GM volumes in thalamus, striatum, hippocampus, and the mid-occipital region, with co-occurring fractional anisotropy changes in superior longitudinal fascicules, anterior thalamic radiation, and forceps major; 2) higher fALFF but lower GM volume in dorsolateral prefrontal cortex related to worse cognition in schizophrenia; and 3) distinct domains of MCCB might exhibit dissociable multimodal signatures, e.g., increased fALFF in inferior parietal lobule particularly correlated with decreased social cognition. Medication dose did not relate to these findings in schizophrenia. CONCLUSIONS Our results suggest linked functional and structural deficits in distributed cortico-striato-thalamic circuits may be closely related to MCCB-measured cognitive impairments in schizophrenia.
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Affiliation(s)
- Jing Sui
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, New Mexico; Brainnetome Center and National Laboratory of Pattern Recognition (JS, TJ), Institute of Automation, Chinese Academy of Sciences, Beijing, China.
| | - Godfrey D. Pearlson
- Olin Neuropsychiatry Research Center, Hartford, CT, USA, 06106,Dept. of Psychiatry, Yale University, New Haven, CT, USA, 06519,Dept. of Neurobiology, Yale University, New Haven, CT, USA, 06519
| | - Yuhui Du
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA, 87106,School of Information and Communication Engineering, North University of China, Taiyuan, China, 030051
| | - Qingbao Yu
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA, 87106
| | - Thomas R. Jones
- Dept. of Psychiatry and Neuroscience, University of New Mexico, Albuquerque, NM, USA, 87131
| | - Jiayu Chen
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA, 87106
| | - Tianzi Jiang
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China, 100190
| | - Juan Bustillo
- Dept. of Psychiatry and Neuroscience, University of New Mexico, Albuquerque, NM, USA, 87131
| | - Vince D. Calhoun
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA, 87106,Dept. of Psychiatry, Yale University, New Haven, CT, USA, 06519,Dept. of Psychiatry and Neuroscience, University of New Mexico, Albuquerque, NM, USA, 87131,Dept. of Electronic and Computer Engineering, University of New Mexico, Albuquerque, NM, USA, 87131
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Williams NJ, Sherlock C, Jones TR, Clough HE, Telfer SE, Begon M, French N, Hart CA, Bennett M. The prevalence of antimicrobial-resistant Escherichia coli in sympatric wild rodents varies by season and host. J Appl Microbiol 2015; 110:962-70. [PMID: 21255210 DOI: 10.1111/j.1365-2672.2011.04952.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To investigate the prevalence and temporal patterns of antimicrobial resistance in wild rodents with no apparent exposure to antimicrobials. METHODS AND RESULTS Two sympatric populations of bank voles and wood mice were trapped and individually monitored over a 2- year period for faecal carriage of antimicrobial-resistant Escherichia coli. High prevalences of ampicillin-, chloramphenicol-, tetracycline- and trimethoprim-resistant E. coli were observed. A markedly higher prevalence of antimicrobial-resistant E. coli was found in wood mice than in bank voles, with the prevalence in both increasing over time. Superimposed on this trend was a seasonal cycle with a peak prevalence of resistant E. coli in mice in early- to mid-summer and in voles in late summer and early autumn. CONCLUSIONS These sympatric rodent species had no obvious contact with antimicrobials, and the difference in resistance profiles between rodent species and seasons suggests that factors present in their environment are unlikely to be drivers of such resistance. SIGNIFICANCE AND IMPACT OF THE STUDY These findings suggest that rodents may represent a reservoir of antimicrobial-resistant bacteria, transmissible to livestock and man. Furthermore, such findings have implications for human and veterinary medicine regarding antimicrobial usage and subsequent selection of antimicrobial-resistant organisms.
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Affiliation(s)
- N J Williams
- National Centre for Zoonosis Research, Institute of Infection and Global Health, University of Liverpool, Cheshire, UK Department of Mathematics and Statistics, Lancaster University, Lancaster, UK Institute of Integrative Biology, University of Liverpool, Liverpool, UK Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Palmerston North, New Zealand School of Host Immunity and Infection, University of Liverpool, Liverpool, UK
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Bhuyan P, Eiden J, Jones TR, York LJ, Ginis J, Jansen KU, Perez JL. 1081Immunogenicity of Human Papilloma Vaccine Coadministered with an Investigational Bivalent rLP2086 Vaccine Against Meningococcal Serogroup B in Healthy Adolescents. Open Forum Infect Dis 2014. [DOI: 10.1093/ofid/ofu052.789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Prakash Bhuyan
- Pfizer Vaccine Research, Collegeville, PA
- Pfizer Vaccine Research, Collegeville, PA
| | - Joseph Eiden
- Pfizer Vaccine Research, Pearl River, NY
- Pfizer Vaccine Research, Collegeville, PA
| | - Thomas R. Jones
- Pfizer Vaccine Research, Pearl River, NY
- Pfizer Vaccine Research, Collegeville, PA
| | - Laura J. York
- Pfizer Vaccine Research, Collegeville, PA
- Pfizer Vaccine Research, Collegeville, PA
| | - John Ginis
- Pfizer Vaccine Research, Collegeville, PA
- Pfizer Vaccine Research, Collegeville, PA
| | - Kathrin U. Jansen
- Pfizer Vaccine Research, Pearl River, NY
- Pfizer Vaccine Research, Collegeville, PA
| | - John L. Perez
- Pfizer Vaccine Research, Collegeville, PA
- Pfizer Vaccine Research, Collegeville, PA
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Zlotnick GW, Jones TR, Liberator P, Hao L, Harris S, McNeil LK, Zhu D, Perez J, Eiden J, Jansen KU, Anderson AS. The discovery and development of a novel vaccine to protect against Neisseria meningitidis Serogroup B Disease. Hum Vaccin Immunother 2014; 11:5-13. [PMID: 25483509 DOI: 10.4161/hv.34293] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Vaccines have had a major impact on the reduction of many diseases globally. Vaccines targeted against invasive meningococcal disease (IMD) due to serogroups A, C, W, and Y are used to prevent these diseases. Until recently no vaccine had been identified that could confer broad protection against Neisseria meningitidis serogroup B (MnB). MnB causes IMD in the very young, adolescents and young adults and thus represents a significant unmet medical need. In this brief review, we describe the discovery and development of a vaccine that has the potential for broad protection against this devastating disease.
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Singh S, Bray MA, Jones TR, Carpenter AE. Pipeline for illumination correction of images for high-throughput microscopy. J Microsc 2014; 256:231-6. [PMID: 25228240 PMCID: PMC4359755 DOI: 10.1111/jmi.12178] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 08/12/2014] [Indexed: 12/24/2022]
Abstract
The presence of systematic noise in images in high-throughput microscopy experiments can significantly impact the accuracy of downstream results. Among the most common sources of systematic noise is non-homogeneous illumination across the image field. This often adds an unacceptable level of noise, obscures true quantitative differences and precludes biological experiments that rely on accurate fluorescence intensity measurements. In this paper, we seek to quantify the improvement in the quality of high-content screen readouts due to software-based illumination correction. We present a straightforward illumination correction pipeline that has been used by our group across many experiments. We test the pipeline on real-world high-throughput image sets and evaluate the performance of the pipeline at two levels: (a) Z′-factor to evaluate the effect of the image correction on a univariate readout, representative of a typical high-content screen, and (b) classification accuracy on phenotypic signatures derived from the images, representative of an experiment involving more complex data mining. We find that applying the proposed post-hoc correction method improves performance in both experiments, even when illumination correction has already been applied using software associated with the instrument. To facilitate the ready application and future development of illumination correction methods, we have made our complete test data sets as well as open-source image analysis pipelines publicly available. This software-based solution has the potential to improve outcomes for a wide-variety of image-based HTS experiments.
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Affiliation(s)
- S Singh
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, U.S.A
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MacIntyre CR, Ridda I, Gao Z, Moa AM, McIntyre PB, Sullivan JS, Jones TR, Hayen A, Lindley RI. A randomized clinical trial of the immunogenicity of 7-valent pneumococcal conjugate vaccine compared to 23-valent polysaccharide vaccine in frail, hospitalized elderly. PLoS One 2014; 9:e94578. [PMID: 24760002 PMCID: PMC3997415 DOI: 10.1371/journal.pone.0094578] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 03/17/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Elderly people do not mount strong immune responses to vaccines. We compared 23-valent capsular polysaccharide (23vPPV) alone versus 7-valent conjugate (PCV7) vaccine followed by 23vPPV 6 months later in hospitalized elderly. METHODS Participants were randomized to receive 23vPPV or PCV7-23vPPV. Antibodies against serotypes 3, 4, 6A, 6B, 9V, 14, 18C, 19A, 19F, 23F were measured by enzyme-linked immunosorbent (ELISA) and opsonophagocytic (OPA) assays at baseline, 6 months and 12 months. RESULTS Of 312 recruited, between 40% and 72% of subjects had undetectable OPA titres at baseline. After one dose, PCV7 recipients had significantly higher responses to serotypes 9V (both assays) and 23F (OPA only), and 23vPPV recipients had significantly higher responses to serotype 3 (ELISA), 19F and 19A (OPA only). In subjects with undetectable OPA titres at baseline, a proportionately greater rise in OPA titre (P<0.01) was seen for all serotypes after both vaccines. The GMT ratio of OPA was significantly higher at 12 months in the PCV7-23vPPV group for serotypes 6A, 9V, 18C and 23F. OPA titre levels for these serotypes increased moderately after 6 months, whereas immunity waned in the 23vPPV only arm. CONCLUSION We did not show overwhelming benefit of one vaccine over the other. Low baseline immunity does not preclude a robust immune response, reiterating the importance of vaccinating the frail elderly. A schedule of PCV7-23vPPV prevents waning of antibody, suggesting that both vaccines could be useful in the elderly. Follow up studies are needed to determine persistence of immunity. TRIAL REGISTRATION The Australian Clinical Trials Registry ACTRN12607000387426.
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Affiliation(s)
- C. Raina MacIntyre
- School of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia
- National Centre for Immunization Research and Surveillance (NCIRS), Westmead, Australia
| | - Iman Ridda
- School of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia
| | - Zhanhai Gao
- School of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia
| | - Aye M. Moa
- School of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia
| | - Peter B. McIntyre
- National Centre for Immunization Research and Surveillance (NCIRS), Westmead, Australia
| | - John S. Sullivan
- Central Clinical School, The University of Sydney, Sydney, Australia
| | - Thomas R. Jones
- Pfizer Vaccine Research, Pfizer, Pearl River, New York, United States of America
| | - Andrew Hayen
- School of Public Health and Community Medicine, UNSW Australia, The University of New South Wales, Sydney, Australia
| | - Richard I. Lindley
- Westmead Clinical School, Westmead Hospital, and the George Institute for Global Health, The University of Sydney, Sydney, Australia
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Jackson LA, Gurtman A, Rice K, Pauksens K, Greenberg RN, Jones TR, Scott DA, Emini EA, Gruber WC, Schmoele-Thoma B. Immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine in adults 70 years of age and older previously vaccinated with 23-valent pneumococcal polysaccharide vaccine. Vaccine 2013; 31:3585-93. [PMID: 23688527 DOI: 10.1016/j.vaccine.2013.05.010] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 04/11/2013] [Accepted: 05/01/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND The currently recommended single dose of the 23-valent pneumococcal free polysaccharide vaccine (PPSV23) for adults 65 years of age and older does not provide extended protection into older age. This reflects a significant unmet medical need for alternative strategies to protect older adults against pneumococcal infection, which may be met by the 13-valent polysaccharide conjugate vaccine (PCV13). METHODS We performed a randomized, modified double-blind trial in 936 adults aged 70 years and older who had previously received PPSV23 at least 5 years before study entry and were now vaccinated with PCV13 or PPSV23. At 1 year after enrollment, all subjects received a follow-on dose of PCV13. Anti-pneumococcal opsonophagocytic activity (OPA) titers were measured before and at 1 month after each vaccination. RESULTS Following the enrollment vaccination, OPA titers were significantly greater in the PCV13 group compared to the PPSV23 group for 10 of the 12 serotypes common to both vaccines and to serotype 6A which is unique to PCV13. Responses were noninferior for the other 2 common serotypes. Responses to PCV13 given at 1 year were generally lower in the group that received PPSV23 at enrollment. CONCLUSION In adults aged 70 years and older previously vaccinated with PPSV23, PCV13 was significantly more immunogenic than PPSV23 for most of the common serotypes and for serotype 6A. The OPA responses after a follow-on dose of PCV13 one year later indicate that a prior dose of PPSV23, but not PCV13, diminishes the response to the subsequent administration of PCV13.
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Affiliation(s)
- Lisa A Jackson
- The Group Health Research Institute, Group Health, Seattle, WA, USA.
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Marshall HS, Richmond PC, Nissen MD, Wouters A, Baber J, Jiang Q, Anderson AS, Jones TR, Harris SL, Jansen KU, Perez JL. A phase 2 open-label safety and immunogenicity study of a meningococcal B bivalent rLP2086 vaccine in healthy adults. Vaccine 2013; 31:1569-75. [PMID: 23352429 DOI: 10.1016/j.vaccine.2013.01.021] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 01/08/2013] [Accepted: 01/14/2013] [Indexed: 01/26/2023]
Abstract
BACKGROUND Neisseria meningitidis serogroup B (MnB) is a leading cause of bacterial meningitis and septicemia in adolescents and young adults. No currently licensed and available vaccine has been shown to provide broad protection against endemic MnB disease. A bivalent rLP2086 vaccine based on two factor H-binding proteins (fHBPs) has been developed to provide broad protection against MnB disease-causing strains. METHODS This study assessed the safety and immunogenicity of the final formulation of a bivalent rLP2086 vaccine in 60 healthy adults (18-40 years of age) receiving 120 μg doses at 0, 1, and 6 months. Safety was assessed by collecting solicited reactogenicity data and participant-reporting of adverse events. Immunogenicity was evaluated by human serum bactericidal assay (hSBA) against 5 MnB strains expressing distinct fHBP variants and fHBP-specific immunoglobulin G titre. RESULTS After each immunisation, local reactions such as pain at the injection site and erythema were generally mild or moderate. The most common vaccine-related adverse event was upper respiratory tract infection, which was reported by two participants. Seroprotection (hSBA titres ≥ 1:4) was achieved in 94.3% of participants against a MnB strain expressing the vaccine-homologous fHBP variant A05 and 70.0%-94.7% against MnB strains expressing the heterologous fHBP variants B02, A22, B44, and B24. Seroconversion rates (≥ 4-fold rise in hSBA titres) ranged from 70.0% to 94.7% across the five MnB test strains following the 3-dose vaccination regimen. Immunogenicity responses tended to increase upon subsequent vaccine doses. CONCLUSIONS Bivalent rLP2086 is a promising vaccine candidate for broad protection against MnB disease-causing strains.
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Affiliation(s)
- Helen S Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital and School of Paediatrics and Reproductive Health, University of Adelaide, North Adelaide, South Australia 5006, Australia.
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Anderson AS, Hao L, Jiang Q, Harris SL, Jones TR, Perez JL, York L, Eiden J, Jansen KU. Potential impact of the bivalent rLP2806 vaccine on Neisseria meningitidis carriage and invasive serogroup B disease. Hum Vaccin Immunother 2012; 9:471-9. [PMID: 23249817 PMCID: PMC3891702 DOI: 10.4161/hv.23222] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [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] [Indexed: 01/21/2023] Open
Abstract
Asymptomatic throat carriage of Neisseria meningitidis is common in healthy individuals. In unusual cases, the bacteria become invasive, resulting in life-threatening disease. Effective meningococcal serogroup B (MnB) vaccines should provide broad protection against disease-causing strains and may confer indirect protection by impacting carriage and subsequent transmission. Factor H binding proteins (fHBPs), components of MnB vaccines in development, are classified into two immunologically distinct subfamilies (A and B). fHBP variants of MnB strains carried by adolescents are similar to those detected in infants with MnB disease. A vaccine containing subfamily A and B fHBP variants elicited bactericidal antibody responses (titers ≥ 1:4) against MnB strains expressing fHBP variants common to carriage strains and strains that cause disease in adolescents and infants in 75–100% of adolescent study subjects. This suggests that the bivalent fHBP vaccine has the potential to provide protection against invasive MnB strains and interrupt meningococcal carriage, which may also reduce infant MnB disease.
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Richmond PC, Marshall HS, Nissen MD, Jiang Q, Jansen KU, Garcés-Sánchez M, Martinón-Torres F, Beeslaar J, Szenborn L, Wysocki J, Eiden J, Harris SL, Jones TR, Perez JL. Safety, immunogenicity, and tolerability of meningococcal serogroup B bivalent recombinant lipoprotein 2086 vaccine in healthy adolescents: a randomised, single-blind, placebo-controlled, phase 2 trial. The Lancet Infectious Diseases 2012; 12:597-607. [DOI: 10.1016/s1473-3099(12)70087-7] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hensley FR, Jones TR, Maxwell MS, Adams LJ, Nedella NS. Demography, Terrestrial Behavior, and Growth of Sonora Mud Turtles (Kinosternon sonoriense) in an Extreme Habitat. Herpetological Monographs 2010. [DOI: 10.1655/10-042.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jiang HQ, Hoiseth SK, Harris SL, McNeil LK, Zhu D, Tan C, Scott AA, Alexander K, Mason K, Miller L, DaSilva I, Mack M, Zhao XJ, Pride MW, Andrew L, Murphy E, Hagen M, French R, Arora A, Jones TR, Jansen KU, Zlotnick GW, Anderson AS. Broad vaccine coverage predicted for a bivalent recombinant factor H binding protein based vaccine to prevent serogroup B meningococcal disease. Vaccine 2010; 28:6086-93. [PMID: 20619376 DOI: 10.1016/j.vaccine.2010.06.083] [Citation(s) in RCA: 163] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Revised: 06/18/2010] [Accepted: 06/25/2010] [Indexed: 10/19/2022]
Abstract
Factor H binding proteins (fHBP), are bacterial surface proteins currently undergoing human clinical trials as candidate serogroup B Neisseria meningitidis (MnB) vaccines. fHBP protein sequences segregate into two distinct subfamilies, designated A and B. Here, we report the specificity and vaccine potential of mono- or bivalent fHBP-containing vaccines. A bivalent fHBP vaccine composed of a member of each subfamily elicited substantially broader bactericidal activity against MnB strains expressing heterologous fHBP than did either of the monovalent vaccines. Bivalent rabbit immune sera tested in serum bactericidal antibody assays (SBAs) against a diverse panel of MnB clinical isolates killed 87 of the 100 isolates. Bivalent human immune sera killed 36 of 45 MnB isolates tested in SBAs. Factors such as fHBP protein variant, PorA subtype, or MLST were not predictive of whether the MnB strain could be killed by rabbit or human immune sera. Instead, the best predictor for killing in the SBA was the level of in vitro surface expression of fHBP. The bivalent fHBP vaccine candidate induced immune sera that killed MnB isolates representing the major MLST complexes, prevalent PorA subtypes, and fHBP variants that span the breadth of the fHBP phylogenetic tree. Importantly, epidemiologically prevalent fHBP variants from both subfamilies were killed.
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Affiliation(s)
- Han-Qing Jiang
- Pfizer Vaccine Research, 401N. Middletown Rd., Pearl River, NY 10965, USA
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Cannada LK, Jones TR, Guerrero-Bejarano M, Viehe T, Levy M, Farrell ED, Ostrum RF. Retrograde intramedullary nailing of femoral diaphyseal fractures caused by low-velocity gunshots. Orthopedics 2009; 32:162. [PMID: 19309067 DOI: 10.3928/01477447-20090301-05] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to evaluate the results of retrograde intramedullary nailing of femoral diaphyseal fractures caused by low-velocity gunshots. Seventy-three patients (68 men and 5 women) with 74 femoral diaphyseal fractures caused by gunshots were treated with reamed, retrograde, statically locked intramedullary nailing. The main outcome measures were fracture union, the need for additional operations, shortening, angular deformity, postoperative knee range of motion, and complication rate. Twenty-nine patients sustained additional injuries. During initial treatment, 18 patients underwent further orthopedic and nonorthopedic elective procedures. Three patients had fasciotomies for compartment syndrome. At follow-up, 3 patients had shortening >10 mm (range, 12-18 mm) and 1 had angulation >10 degrees (13 degrees recurvatum). Four patients underwent surgeries after discharge. Complications included 1 case of heterotopic bone formation, 1 hypertrophic nonunion that went on to union after dynamization, 2 postoperative positive blood cultures, and 1 wound dehiscence. There were no cases of septic arthritis. Our data indicate that there is a low incidence of shortening, angular deformity, complication, and infection rates following treatment of femoral gunshot diaphyseal fractures with a retrograde nail. This study demonstrates that this is an acceptable alternative for the treatment of these injuries.
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Affiliation(s)
- Lisa K Cannada
- Department of Orthopedic Surgery, St Louis University, St Louis, Missouri 63110, USA
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McNeil LK, Murphy E, Zhao XJ, Guttmann S, Harris SL, Scott AA, Tan C, Mack M, DaSilva I, Alexander K, Mason K, Jiang HQ, Zhu D, Mininni TL, Zlotnick GW, Hoiseth SK, Jones TR, Pride MW, Jansen KU, Anderson AS. Detection of LP2086 on the cell surface of Neisseria meningitidis and its accessibility in the presence of serogroup B capsular polysaccharide. Vaccine 2009; 27:3417-21. [PMID: 19200847 DOI: 10.1016/j.vaccine.2009.01.075] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The outer membrane protein LP2086, a human factor H binding protein, is undergoing clinical trials as a vaccine against invasive serogroup B meningococcal (MnB) disease. As LP2086 is a surface protein, expression of capsular polysaccharide could potentially limit accessibility of anti-LP2086 antibodies to LP2086 expressed on the surface of bacteria. To determine whether variability in expression levels of the serogroup B capsule (Cap B) might interfere with accessibility of anti-LP2086 antibody binding to LP2086, we evaluated the ability of anti-Cap B and anti-LP2086 antibodies to bind to the surface of 1263 invasive clinical MnB strains by flow cytometry. One of the anti-LP2086 monoclonal antibodies used recognizes virtually all LP2086 sequence variants. Our results show no correlation between the amount of Cap B expressed and the binding of anti-LP2086 antibodies. Furthermore, the susceptibility of MnB bacteria to lysis by anti-LP2086 immune sera was independent of the level of Cap B expressed. The data presented in this paper demonstrates that Cap B does not interfere with the binding of antibodies to LP2086 expressed on the outer membrane of MnB clinical isolates.
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Affiliation(s)
- Lisa K McNeil
- Wyeth Research, 401 N. Middletown Rd., Pearl River, NY 10965, United States
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Kean LS, Adams AB, Strobert E, Hendrix R, Gangappa S, Jones TR, Shirasugi N, Rigby MR, Hamby K, Jiang J, Bello H, Anderson D, Cardona K, Durham MM, Pearson TC, Larsen CP. Induction of chimerism in rhesus macaques through stem cell transplant and costimulation blockade-based immunosuppression. Am J Transplant 2007; 7:320-35. [PMID: 17241112 DOI: 10.1111/j.1600-6143.2006.01622.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [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] [Indexed: 01/25/2023]
Abstract
A strategy for producing high-level hematopoietic chimerism after non-myeloablative conditioning has been established in the rhesus macaque. This strategy relies on hematopoietic stem cell transplantation after induction with a non-myeloablative dose of busulfan and blockade of the IL2-receptor in the setting of mTOR inhibition with sirolimus and combined CD28/CD154 costimulation blockade. Hematopoietic stem cells derived from bone marrow and leukopheresis products both were found to be successful in inducing high-level chimerism. Mean peripheral blood peak donor chimerism was 81% with a median chimerism duration of 145 days. Additional immune modulation strategies, such as pre-transplant CD8 depletion, donor-specific transfusion, recipient thymectomy or peritransplant deoxyspergualin treatment did not improve the level or durability of chimerism. Recipient immunologic assessment suggested that chimerism occurred amidst donor-specific down-regulation of alloreactive T cells, and the reappearance of vigorous T-mediated alloreactivity accompanied rejection of the transplants. Furthermore, viral reactivation constituted a significant transplant-related toxicity and may have negatively impacted the ability to achieve indefinite survival of transplanted stem cells. Nevertheless, this chimerism-induction regimen induced amongst the longest-lived stem cell chimerism reported to date for non-human primates and thus represents a platform upon which to evaluate emerging tolerance-induction strategies.
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Affiliation(s)
- L S Kean
- The Emory Transplant Center, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
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Hu BT, Yu X, Jones TR, Kirch C, Harris S, Hildreth SW, Madore DV, Quataert SA. Approach to validating an opsonophagocytic assay for Streptococcus pneumoniae. Clin Diagn Lab Immunol 2005; 12:287-95. [PMID: 15699424 PMCID: PMC549308 DOI: 10.1128/cdli.12.2.287-295.2005] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Streptococcus pneumoniae (pneumococcus) polysaccharide serotype-specific antibodies that have opsonophagocytic activity are considered a primary mechanism of host defense against pneumococcal disease. In vitro opsonophagocytic assays (OPAs) with antibody and complement to mediate opsonophagocytic killing of bacteria have been designed and developed as an adjunct to the standardized serum immunoglobulin G antipneumococcal capsular polysaccharide enzyme immunoassay to assess the effectiveness of pneumococcal vaccines. OPA presents challenges for assay standardization and assay precision due to the multiple biologically active and labile components involved in the assay, including human polymorphonuclear leukocytes or cultured effector cells, bacteria, and complement. Control of these biologically labile components is critical for consistent assay performance. An approach to validating the performance of the assay in accordance with International Conference for Harmonization guidelines, including its specificity, intermediate precision, accuracy, linearity, and robustness, is presented. Furthermore, we established parameters for universal reagents and standardization of the use of these reagents to ensure the interlaboratory reproducibility and validation of new methodologies.
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Affiliation(s)
- Branda T Hu
- Applied Immunology & Microbiology, Wyeth Vaccines Research, 401 N. Middletown Rd., 180/152A, Pearl River, NY 10965, USA.
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Sikkema DJ, Ziembiec NA, Jones TR, Hildreth SW, Madore DV, Quataert SA. Assignment of weight-based immunoglobulin G1 (IgG1) and IgG2 units in antipneumococcal reference serum lot 89-S(F) for pneumococcal polysaccharide serotypes 1, 4, 5, 7F, 9V, and 18C. Clin Diagn Lab Immunol 2005; 12:218-23. [PMID: 15643011 PMCID: PMC540223 DOI: 10.1128/cdli.12.1.218-223.2005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Weight-based assignments for immunoglobulin G1 (IgG1) and IgG2 subclass antibodies to Streptococcus pneumoniae capsular polysaccharides (PnPs) in antipneumococcal standard reference serum lot 89-S (lot 89-S), also known as lot 89-SF, have been determined for serotypes 1, 4, 5, 7F, 9V, and 18C. This extends the usefulness of lot 89-S beyond the IgG1 and IgG2 subclass assignments for serotypes 3, 6B, 14, 19F, and 23F made previously (A. Soininen, H. Kayhty, I. Seppala, and T. Wuorimaa, Clin. Diagn. Lab. Immunol. 5:561-566, 1998) to cover 11 major serotypes associated with the highest percentage of pneumococcal disease worldwide. A method of equivalence of absorbances in enzyme immunosorbent assays was used to determine the IgG1 and IgG2 antibody concentrations for the additional serotypes in lot 89-S, based on the subclass values previously assigned for PnPs serotypes 6B, 14, and 23F. This cross-standardization method assures consistency with previous antibody assignments in that reference serum. The newly assigned subclass values for serotype 9V, and previously assigned values for serotype 14, were used to quantitate PnPs antibodies in sera from adult and pediatric subjects immunized with a pneumococcal conjugate vaccine. There was a predominance of IgG1 anti-PnPs antibodies in pediatric sera and IgG2 anti-PnPs antibodies in the adult sera. The IgG1 and IgG2 subclass assignments for the 11 PnPs serotypes in antipneumococcal standard reference serum lot 89-S are useful for quantitating and characterizing immune responses to pneumococcal infection and vaccination regimens.
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Affiliation(s)
- Daniel J Sikkema
- Wyeth Vaccines Research, 401 N. Middletown Rd., 180/149B, Pearl River, NY 10965, USA.
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Khan N, Bruton R, Taylor GS, Cobbold M, Jones TR, Rickinson AB, Moss PAH. Identification of cytomegalovirus-specific cytotoxic T lymphocytes in vitro is greatly enhanced by the use of recombinant virus lacking the US2 to US11 region or modified vaccinia virus Ankara expressing individual viral genes. J Virol 2005; 79:2869-79. [PMID: 15709006 PMCID: PMC548448 DOI: 10.1128/jvi.79.5.2869-2879.2005] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [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] [Indexed: 11/20/2022] Open
Abstract
Cytomegalovirus (CMV) elicits a potent T-cell response in humans that appears to protect the host from virus-associated disease. Despite facing strong host defense mechanisms, CMV remains as a lifelong infection that may reactivate and cause life-threatening disease in immunocompromised individuals. This persistence is probably assisted by expression of immune subversion proteins of the virus encoded by genes belonging to the US gene family. These proteins modulate major histocompatibility complex expression in infected cells and bias in vitro experiments toward the detection of only certain specificities. We have combined the use of recombinant CMV, lacking the US2 to US11 region genes, and cytoplasmic gamma interferon staining to define a more accurate assessment of CMV-specific responses in vivo. Recombinant CMV stimulation reveals a CD8 response much larger than that of parental virus in all donors tested. In some cases, this represented up to 10-fold increases in the number of cells detected. Responses were directed mainly against pp65, IE-1, and pp50 in the majority of donors. In addition, previously unreported IE-2-specific T-cell responses could be detected in a minority of cases. Furthermore, we observed a less marked increase in the response to mutant CMV by CD4 T cells in some donors. This suggests that a much broader T-cell response to CMV exists in vivo than is revealed by restimulation with wild-type virus and adds to the evidence that the efficacy of immune evasion strategies may not be as absolute as previously believed.
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Affiliation(s)
- Naeem Khan
- CR UK Institute for Cancer Studies, Vincent Dr., Edgbaston, University of Birmingham, Birmingham B15 2TA, United Kingdom
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Adams AB, Shirasugi N, Jones TR, Durham MM, Strobert EA, Cowan S, Rees P, Hendrix R, Price K, Kenyon NS, Hagerty D, Townsend R, Hollenbaugh D, Pearson TC, Larsen CP. Development of a Chimeric Anti-CD40 Monoclonal Antibody That Synergizes with LEA29Y to Prolong Islet Allograft Survival. J Immunol 2004; 174:542-50. [PMID: 15611281 DOI: 10.4049/jimmunol.174.1.542] [Citation(s) in RCA: 161] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In recent years, reagents have been developed that specifically target signals critical for effective T cell activation and function. Manipulation of the CD28/CD80/86 and CD40/CD154 pathways has exhibited extraordinary efficacy, particularly when the pathways are blocked simultaneously. Despite the reported efficacy of anti-CD154 in rodents and higher models, its future clinical use is uncertain due to reported thromboembolic events in clinical trials. To circumvent this potential complication, we developed and evaluated a chimeric Ab targeting CD40 (Chi220, BMS-224819) as an alternative to CD154. Although Chi220 blocks CD154 binding, it also possesses partial agonist properties and weak stimulatory potential. The anti-CD40 was tested alone and in combination with a rationally designed, high affinity variant of CTLA4-Ig, LEA29Y (belatacept), in a nonhuman primate model of islet transplantation. Although either agent alone only modestly prolonged islet survival (Chi220 alone: 14, 16, and 84 days; LEA29Y alone: 58 and 60 days), their combination (LEA29Y and Chi220) dramatically facilitated long term survival (237, 237, 220, >185, and 172 days). We found that the effects of Chi220 treatment were not mediated solely through deletion of CD20-bearing cells and that the combined therapy did not significantly impair established antiviral immunity.
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Affiliation(s)
- Andrew B Adams
- Department of Surgery, Emory Transplant Center, Emory University School of Medicine, Woodruff Memorial Research Building, 101 Woodruff Circle, Atlanta, GA 30322, USA
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45
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Sedegah M, Charoenvit Y, Aguiar J, Sacci J, Hedstrom R, Kumar S, Belmonte A, Lanar DE, Jones TR, Abot E, Druilhe P, Corradin G, Epstein JE, Richie TL, Carucci DJ, Hoffman SL. Effect on antibody and T-cell responses of mixing five GMP-produced DNA plasmids and administration with plasmid expressing GM-CSF. Genes Immun 2004; 5:553-61. [PMID: 15318164 DOI: 10.1038/sj.gene.6364125] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [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: 11/09/2022]
Abstract
One potential benefit of DNA vaccines is the capacity to elicit antibody and T-cell responses against multiple antigens at the same time by mixing plasmids expressing different proteins. A possible negative effect of such mixing is interference among plasmids regarding immunogenicity. In preparation for a clinical trial, we assessed the immunogenicity of GMP-produced plasmids encoding five Plasmodium falciparum proteins, PfCSP, PfSSP2, PfEXP1, PfLSA1, and PfLSA3, given as a mixture, or alone. The mixture induced higher levels of antibodies against whole parasites than did the individual plasmids, but was associated with a decrease in antibodies to individual P. falciparum proteins. T-cell responses were in general decreased by administration of the mixture. Immune responses to individual plasmids and mixtures were generally higher in inbred mice than in outbreds. In inbred BALB/c and C57BL/6 mice, coadministration of a plasmid expressing murine granulocyte-macrophage colony-stimulating factor (mGM-CSF), increased antibody and T-cell responses, but in outbred CD-1 mice, coadministration of mGM-CSF was associated with a decrease in antibody responses. Such variability in data from studies in different strains of mice underscores the importance of genetic background on immune response and carefully considering the goals of any preclinical studies of vaccine mixtures planned for human trials.
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Affiliation(s)
- M Sedegah
- 1Malaria Program, Naval Medical Research Center, Silver Spring, MD, USA
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Bloom JD, Dushin RG, Curran KJ, Donahue F, Norton EB, Terefenko E, Jones TR, Ross AA, Feld B, Lang SA, DiGrandi MJ. Thiourea inhibitors of herpes viruses. Part 2: N-Benzyl-N′-arylthiourea inhibitors of CMV. Bioorg Med Chem Lett 2004; 14:3401-6. [PMID: 15177441 DOI: 10.1016/j.bmcl.2004.04.093] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [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: 01/29/2004] [Accepted: 04/27/2004] [Indexed: 11/20/2022]
Abstract
A series of highly potent thiourea inhibitors of cytomegalovirus (CMV) with improved stability properties was prepared and evaluated. Compound 29 inhibited the virus in cultured HFF cells with IC50 of 0.2 nM.
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Affiliation(s)
- Jonathan D Bloom
- Chemical and Screening Sciences and Infectious Disease Research, Wyeth Research, 401 N. Middletown Rd, Pearl River, NY 10965, USA.
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Netterwald JR, Jones TR, Britt WJ, Yang SJ, McCrone IP, Zhu H. Postattachment events associated with viral entry are necessary for induction of interferon-stimulated genes by human cytomegalovirus. J Virol 2004; 78:6688-91. [PMID: 15163760 PMCID: PMC416537 DOI: 10.1128/jvi.78.12.6688-6691.2004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Utilizing a human cytomegalovirus-specific fusion inhibitor and an antiglycoprotein H antibody, we studied the role of virion fusion in interferon-stimulated gene (ISG) induction. Our results indicate that ISG induction does not occur when virion-mediated, post-high-affinity attachment events are inhibited by either reagent. Thus, virion-mediated postattachment events, such as fusion, are required for ISG induction.
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Affiliation(s)
- James R Netterwald
- Department of Microbiology and Molecular Genetics, UMDNJ-New Jersey Medical School, 225 Warren Streeet, Newark, NJ 07101-1709, USA
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van Troostenburg AR, Lee D, Jones TR, Dyck-Jones JA, Silverman MH, Lam GN, Warrington SJ. Safety, tolerability and pharmacokinetics of subcutaneous Å6, an 8-amino acid peptide with anti-angiogenic properties, in healthy men. Int J Clin Pharmacol Ther 2004; 42:253-9. [PMID: 15176647 DOI: 10.5414/cpp42253] [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: 11/18/2022] Open
Abstract
AIMS To assess the safety, tolerability and pharmacokinetics of subcutaneous A6, an 8-amino acid peptide with anti-angiogenic properties, in healthy men. METHODS Double-blind, placebo-controlled, parallel-group, dose-rising, phase I study of single and repeated doses. In the single dose phase, successive groups of 5 subjects received A6 15, 35, 75, 150, 300 mg, or placebo, as subcutaneous injections in the upper thigh. In the repeat dose phase, 2 groups of 6 subjects received repeat doses of A6 35 mg and 75 mg, or placebo, and 1 group of 5 subjects received 150 mg, or placebo, 12-hourly for 6 days (11 doses in total). In each group, 4 subjects received active treatment, the remainder placebo. Pharmacokinetics of A6 were assessed up to 24 h after single doses, for 12 h after the first of the repeated doses, and up to 24 h after the last of the repeated doses. MATERIALS A6 for subcutaneous injection in phosphate buffer, pH 5.6-6.0. Phosphate-buffered saline was used as placebo. RESULTS All dose regimens of A6 were safe and well-tolerated, both systemically and locally. Time to peak plasma concentration was similar (0.5-2.1 h) in all dosage groups. Cmax and AUC(0-inf) were linearly proportional to dose. Mean Cmax ranged from 454-10,333 ng/ml and mean AUC(0-inf) from 1,690-43,371 ng x h/ml after the 15 and 300 mg single doses, respectively. Terminal t(1/2) was 1.4-1.8 h, and there was no evidence of unexpected drug accumulation. Urinary excretion of unchanged A6 was 94.6% (SD 20.7) after the 300 mg single dose (0-24 h collection), and 78.4% (SD 13.0) after the 150 mg repeated dose (0-12 h collection). A6 did not trigger production of anti-A6 IgG antibodies within 14 days of the first dose. CONCLUSION Single doses of A6 up to 300 mg, and repeated doses up to 150 mg, were well-tolerated and safe in healthy young men. A6 was rapidly absorbed; it was eliminated, mainly unchanged, in urine. Plasma concentrations were dose-proportional. A6 did not trigger an early immunogenic response.
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Jones TR, Lee SW, Johann SV, Razinkov V, Visalli RJ, Feld B, Bloom JD, O'Connell J. Specific inhibition of human cytomegalovirus glycoprotein B-mediated fusion by a novel thiourea small molecule. J Virol 2004; 78:1289-300. [PMID: 14722284 PMCID: PMC321382 DOI: 10.1128/jvi.78.3.1289-1300.2004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [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: 11/20/2022] Open
Abstract
A novel small molecule inhibitor of human cytomegalovirus (HCMV) was identified as the result of screening a chemical library by using a whole-virus infected-cell assay. Synthetic chemistry efforts yielded the analog designated CFI02, a compound whose potency had been increased about 100-fold over an initial inhibitor. The inhibitory concentration of CFI02 in various assays is in the low nanomolar range. CFI02 is a selective and potent inhibitor of HCMV; it has no activity against other CMVs, alphaherpesviruses, or unrelated viruses. Mechanism-of-action studies indicate that CFI02 acts very early in the replication cycle, inhibiting virion envelope fusion with the cell plasma membrane. Mutants resistant to CFI02 have mutations in the abundant virion envelope glycoprotein B that are sufficient to confer resistance. Taken together, the data suggest that CFI02 inhibits glycoprotein B-mediated HCMV virion fusion. Furthermore, CFI02 inhibits the cell-cell spread of HCMV. This is the first study of a potent and selective small molecule inhibitor of CMV fusion and cell-cell spread.
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Affiliation(s)
- Thomas R Jones
- Infectious Disease Section, Wyeth Research, Pearl River, New York 10965, USA.
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Abstract
The human cytomegalovirus (HCMV) virion is comprised of a linear double-stranded DNA genome, proteinaceous capsid and tegument, and a lipid envelope containing virus-encoded glycoproteins. Of these components, the tegument is the least well defined in terms of both protein content and function. Several of the major tegument proteins are phosphoproteins (pp), including pp150, pp71, pp65, and pp28. pp28, encoded by the UL99 open reading frame (ORF), traffics to vacuole-like cytoplasmic structures and was shown recently to be essential for envelopment. To elucidate the UL99 amino acid sequences necessary for its trafficking and function in the HCMV replication cycle, two types of viral mutants were analyzed. Using a series of recombinant viruses expressing various UL99-green fluorescent protein fusions, we demonstrate that myristoylation at glycine 2 and an acidic cluster (AC; amino acids 44 to 57) are required for the punctate perinuclear and cytoplasmic (vacuole-like) localization observed for wild-type pp28. A second approach involving the generation of several UL99 deletion mutants indicated that at least the C-terminal two-thirds of this ORF is nonessential for viral growth. Furthermore, the data suggest that an N-terminal region of UL99 containing the AC is required for viral growth. Regarding virion incorporation or UL99-encoded proteins, we provide evidence that suggests that a hypophosphorylated form of pp28 is incorporated, myristoylation is required, and sequences within the first 57 amino acids are sufficient.
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Affiliation(s)
- Thomas R Jones
- Infectious Disease Section, Wyeth Research, Pearl River, New York 10965, USA.
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